Tag Archives: health

Straight, No Chaser: Trauma Quick Tips and The Week In Review

Medical Treatment, Health Prevention, , , , , , , , , , , ,

cch trauma
This week in Straight, No Chaser, we reviewed multiple topics related to Trauma, the #1 cause of death between ages 1-44.  Here’s the Week In Review and featured Quick Tips.
1)   Over the weekend, we started with discussions of Amputations of Permanent Teeth and Fingers.

  1. Remember, you lose 1% viability per minute for a dislodged tooth.  Get help quick!  https://jeffreysterlingmd.com/2013/07/27/straight-no-chaser-saturday-quick-tips-the-tooth-of-the-matter-is/
  2. The transport of displaced fingers and teeth is vital to successful reimplantation.  Never place them directly on ice!  https://jeffreysterlingmd.com/2013/07/28/sunday-quick-tips-give-me-the-finger/

2)   On Monday, we talked about Motor Vehicle Crashes.
https://jeffreysterlingmd.com/2013/07/29/straight-no-chaser-human-shark-week-part-1-motor-vehicle-trauma/
https://jeffreysterlingmd.com/2013/07/29/trauma-quick-tips-how-to-survive-that-motor-vehicle-crash-mvc/

  1. Avoiding distracted driving is the most important factor in preventing crashes.
  2. Wearing your seat beat is the most important factor in surviving crashes.
  3. The middle back seat (while wearing a seat belt) is the safest place in the car.

3)   On Tuesday, we reviewed Traumatic Brain Injuries/Concussions.
https://jeffreysterlingmd.com/2013/07/30/straight-no-chaser-heads-up-traumatic-brain-injuries-concussions-part-i/
https://jeffreysterlingmd.com/2013/07/30/straight-no-chaser-heads-up-traumatic-brain-injuries-concussion-part-ii/
https://jeffreysterlingmd.com/2013/07/30/straight-no-chaser-concussions-post-script-a-neurologists-thoughts/

  1. Dr. Flippen, a neurologist from UCLA, reminded us that most patients will recover but never as fast as they wish.
  2. After a head injury, expect not to be released back to sporting activity for at least two weeks.

4)   On Wednesday, we reviewed Mass Disasters and talked about the importance of an Emergency Kit.
https://jeffreysterlingmd.com/2013/07/31/straight-no-chaser-when-disaster-strikes/

  1. Remember to have access to 1 gallon per day per person, half for drinking and half for cooking/hygiene.

5)   On Wednesday, we also discussed Dog, Cat and Shark Bites.
https://jeffreysterlingmd.com/2013/07/31/straight-no-chaser-who-let-the-dogs-out-animal-bites/

  1. Cat scratches are also a major infection risk and should be evaluated.
  2. Who’d have thought sharks were nibbling you out of curiosity instead of biting you out of hunger?

6)   On Thursday, we reviewed Penetrating Trauma (Gunshot and Stab Wounds).  https://jeffreysterlingmd.com/2013/08/01/straight-no-chaser-gunshot-and-stab-wounds/

  1. Remember the ‘Golden Hour’ of Trauma and get seen as soon as possible after being stabbed or shot, just as soon as you ensure your safety.
  2. It is very important to avoid worsening possible spinal injuries by excessive movement.

7)   On Friday, we reviewed Residential Fires and its associated trauma.

  1. In Part I, we emphasized the importance of installing smoke and carbon monoxide detectors, having an escape plan and not sticking around to fight the fire.   https://jeffreysterlingmd.com/2013/08/02/straight-no-chaser-the-roof-is-on-fire-the-trauma-of-residential-fires/
  2. In Part II, we discussed treatment of possible injuries that may occur.  https://jeffreysterlingmd.com/2013/08/02/straight-no-chaser-your-questions-on-treatment-of-fire-related-injuries/
  3. Remember if any head or neck injuries exist, try your best not to move.
  4. Remember that if you’re feeling like you have the flu after being exposed to a fire, it could be carbon monoxide poisoning!

8)   On Saturday, we reviewed Snakebites.
https://jeffreysterlingmd.com/2013/08/03/straight-no-chaser-stop-the-life-you-save-may-be-your-own-snake-bites/

  1. We debunked the myth about sucking venom out of snakebite wounds.  Don’t do it!

9)   Saturday, we also reviewed Elderly Falls.
https://jeffreysterlingmd.com/2013/08/03/straight-no-chaser-ive-fallen-and-cant-get-up-quick-tips-on-elderly-falls/

  1. We identified head injuries/bleeds, lacerations and hip fractures as injuries to guard against.
  2. We discussed the importance of home improvements, diet, exercise and checking for osteoporosis and vision checking for maintainance of health.

Quick Tips on Elderly Falls

Health Prevention, , , , , , , , , , , ,

Introduction

This post is about elderly falls

elderly falls
Are all of you DIYers (do it yourself) ready for a weekend project to help a loved one? Here you go. First, let’s start with some not so fun facts.

  • Every year, one of every three adults older than 65 has a fall.
  • Falls are the #1 cause of injury death in senior citizens.
  • Falls are the #1 cause of nonfatal injuries and trauma hospitalizations.
  • Typical injuries include lacerations, hip fractures and head injuries (including intracranial bleeds). These injuries occur in approximately 20-30% of falls.

Quick Tips

elderly falls prevention

How can older adults prevent falls and the complications of falls? Here are six Quick Tips I hope you’ll share with your loved ones.

  • Start by doing some home improvements to accommodate the shortcomings of your elderly relatives. Consider railings and grab bars – near the bed, on the stairways, shower, tub and toilet. Improve lighting. Clear out and widen walking paths. Consider using a walker.
  • Exercise regularly. It keeps the brain sharp and the leg muscles strong. Inactivity promotes bad outcomes when activity is attempted. Have their doctors arrange for home health care and physical therapy if indicated.
  • Have your loved one and your family review medications with their physician. You need to know which medications and drug interactions can promote loss of balance, dizziness, drowsiness, and/or mental status changes, all of which can lead to falls.
  • Keep those eyes checked. This should be happening at least once a year. Be diligent in changing prescriptions as needed. Could you imagine being a little confused and not being able to see? What would you expect to happen?
  • Pay attention to diet. Nutritional needs are even greater in those with health issues, which is always the case in the elderly. Supplement Vitamin D and calcium for bone strength.
  • Of course, get screened and, if needed, treated for osteoporosis.

The key is to pay attention. You don’t have to let your loved ones wither into oblivion. Simple quick fixes and some love and attention can go a long way to preventing falls and the injuries that accompany them. My mother fell and suffered a massive intracranial bleed with herniation 2 years ago. I’m pleased to note that she’s made a full recovery, and these tips I’ve offered you make a world of difference. Good luck.

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Ask your SMA expert consultant any questions you may have on this topic. Also, take the #72HoursChallenge, and join the community. Additionally, as a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Another free benefit to our readers is introductory pricing with multiple orders and bundles!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK. Likewise, please share our page with your friends on WordPress! Also like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

Copyright ©2013- 2019 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Stop, The Life You Save May Be Your Own – Snake Bites

Medical Treatment, , , , , , , , , , , , ,

snakes-on-a-plane
So you’ve been snake bitten.  What will you do next?
First things first.  Stay calm.  Call 911.  Realize that most snake bites are non-venomous (A really quick tip regarding the likelihood of a venomous snake: most have triangular heads.).  Here’s 10 additional steps to take while waiting for your help to arrive.
5 Things To Do

  1. Protect yourself.  Get out of the snake’s striking distance.  It should be trying to get away from you as well.
  2. Lie down.  Keep the wound below the level of the heart.
  3. Be still.  Activity simply facilitates spreading of any venom present.
  4. Cover the wound with a loose, clean dressing.  Immobilize the extremity if possible.
  5. Remove all restrictive clothing and jewelry from the area, because the area will swell.

5 Things Not to Do

  1. Try to suck out venom.
  2. Try to cut out the area bitten.
  3. Apply any constrictive dressings.
  4. Apply any cold or ice packs to the wound site.
  5. Run to help.

If you’re lucky enough to have a snake bite kit, you’ll simply follow those instructions, which are a modified version of the instructions I’ve just given.
You will need to be seen by a health care provider for consideration of the following:

  • Anti-venom may be needed.
  • Tetanus immunization may be needed.
  • Appropriate wound cleaning will be needed.
  • Antibiotics for skin infection may be needed.

Let me know if you have any questions.

Straight, No Chaser: The Roof Is On Fire – The Trauma of Residential Fires

Trauma, Health Prevention, , , , , , , , , , , , ,

Image
As Trauma Week winds down on Straight, No Chaser, we work our way back home, which sadly is the site of most traumatic injuries.  In fact, about 85% of all U.S. fire deaths occur in homes.
The good news is the number of residential fire-related deaths and associated injuries is going down, but that won’t help you if you aren’t aware of how to prevent them and get to safety and cared for in the event a fire occurs in your home.  Let’s address this right off the bat.  You’re most likely to die or be injured from a fire if you’re in one of the following groups, according to the Center for Disease Control (but of course, the fire doesn’t check who’s being burnt):

  • Poor
  • Rural
  • African-American
  • Native American
  • Ages less than 4 or over 65

In the U.S. (2010 data), someone dies every 169 minutes and is injured every 30 minutes, amounting to over 2,500 deaths and over 13,000 injuries (and that’s not including firefighters).  Interestingly, victims aren’t burning to death as much as they are dying from inhalation injuries from smoke and gases (estimated to be the cause of death in between 50-80% of cases).  Speaking of smoke, although cooking is the #1 cause of fires, smoking is the leading cause of fire-related deaths.  Alcohol consumption is a contributing factor in 40% of residential fire deaths.  Most fires occur in the winter.
So What To Do?

  • Install a smoke alarm.  They work.  Over one-third of residential fire deaths occur in homes without alarms.
  • Plan your escape in advance.  Have an exit strategy based on where a fire might break out in your home.
  • Don’t fight the fire.  Nearly ½ of fire related injuries occur from efforts to fight the fire.  Get out of the house.  Of course if you have easy access to an extinguisher, use at your discretion.

Tips on How You’ll Be Treated
Fire-related injuries commonly involve burns and bony injuries (bruises, sprains, fractures), which will be addressed as needed.  However, the most important fire-related injuries involve the airway.  These injuries may be due to the heat’s effects on the airway (burns, swelling and inflammation) and/or the effects of carbon monoxide and/or cyanide (inability to oxygenate).  One important fact for families to realize is the presence of any soot/burns anywhere near or in the mouth or nose needs to be evaluated.  Such signs and symptoms are powerful predictors of potential airways damage and imminent failure.

Straight, No Chaser: Violent Crimes – Gunshot and Stab Wounds

Medical Treatment, Skin/Dermatology, Trauma, Health Prevention, , , , , , , , , ,

Penetrating trauma (PT) is of such magnitude in this country that it is nearly impossible to do it justice in short form. This is primarily a medical blog, and as such I’ll defer addressing the politics of it all. The fact remains that gunshot and stab wounds take an astounding toll on human life in the U.S, with over 16,000 homicides annually (approximately 45 deaths every day). The ramifications of these wounds encompass much more than medical considerations, but I’ll devote this space to discussing basics of penetrating trauma.
What Happens
By design, intentional stab and gunshot wound aim to kill. Just as I noted in discussing the blunt trauma seen in motor vehicle crashes, any area of the body can be shot or stabbed. Unintentional injuries are also a source of common emergency room presentations. Major ERs and Trauma Centers are known within the industry as the ‘knife and gun clubs’.
Penetrating injuries to virtually all areas (brain, neck, chest, back, abdomen, groin, extremities) can be fatal. Gunshots wounds have several ways of injuring you, including the direct damage to tissue, indirect damage from the shock waves and direct damage from fragments (of the bullet or bone).

  • PT that reaches blood vessels can cause fatal bleeding. In the abdomen, the liver is the most commonly injured organ because of its large size and can bleed enough to cause shock and death.
  • PT that reaches the spinal cord can cause paralysis and death.
  • PT to the brain can cause all manners of dysfunction, including loss of speech, motion, sensation, bodily functions, paralysis and death.
  • PT to the chest can cause puncture, rupture and/or loss of lung and heart function, leading to a pretty rapid death.

Be reminded that although both gunshot wounds and stab wounds involve penetration and may puncture your internal organs, gunshots are more prone to deeper penetration with higher energy and may create exit wounds, causing damage throughout its course.
What You Can Do
Here are the things you must consider after becoming a victim of penetrating trauma.

  • Get to safety. Perpetrators of penetrating trauma meant to hurt you and often mean for you to be dead. They may be looking to finish the job. I’ve been involved in many scenarios where individuals came to the ER to do just that.
  • Once you’re safe, immediately call 911 regardless of how you feel. You may be in shock and your body will fight feverishly to normalize how you feel – right up until you crash. In other words, you can’t trust how you feel. Another vital consideration about getting medical attention rapidly is what we call ‘The Golden Hour’. The opportunity to address many of the truly life threatening considerations in penetrating trauma is best done within the first 60 minutes of the injury.
  • Once you’re safe, apply pressure (clean towels) to any bleeding sites. Cover yourself with blankets as needed to preserve heat.
  • Avoid movement. Gunshot wounds are associated with spinal cord injuries, so movement could be dangerous.

What You Should Expect
Treatment of penetrating trauma is very dramatic and necessarily regimented due to the early lack of knowledge of the depth and location of injuries. As such, assessment and treatment protocols generally are in place for the region of the body penetrated. The first consideration is always ensuring that the patient’s Airway is intact, Breathing is still ongoing, and Circulation (blood flow) is sufficient (The ‘ABCs’ of Trauma management). After that, use of x-rays, CT scans and other radiologic modalities to identify the location and extent of injuries will be employed based on the stability of the patient. Sometimes immediate surgical intervention is needed.
This is another situation where prevention is the best course of action. Avoiding injuries when possible should go without saying but often does not. Gun safety for gun owners is crucial to avoid unintentional injuries. Attention to detail is very important when handling guns and knives. Unintentional injuries tend to occur when handlers of these weapons get too comfortable. Unfortunately, once penetrating trauma has occurred, it seems like a game of chance. For every person who is told “If that bullet was one more inch to the right, you’d be paralyzed (or dead)”, another family has to be told to make arrangements. Unfortunately, my father was the victim of a random fatal gunshot wound when I was six years old, so I know that story all too well.
If you remember anything from this blog post, remember time is of the essence. Get your loved one to us inside of ‘The Golden Hour’ to give the best chance of a good outcome.

Straight, No Chaser: Concussions Post-Script – A Neurologist's Thoughts

Medical Treatment, Neurology, Health Prevention, , , , , , ,

I’d like to welcome and thank my good friend and noted UCLA Neurologist, Dr. Charles Flippen, II to Straight, No Chaser as a contributor to this topic.
His words:
“Everyone should understand the need for both physical and cognitive rest following concussion to allow full recovery (no symptoms, no meds). That may include postponing tests and/or reduced academic workload with graduated “return to play”. Regarding post-concussion syndrome, most patients will recover, never as fast as they would wish. It will usually be stepwise with headache as usually among the last symptoms to resolve.”

Straight, No Chaser: The Drama of Motor Vehicle Trauma

Trauma, Health Prevention, , , , , , ,

crash01
‘Tis not my task to preach but to inform.   Maybe you think you’ve heard it all before, but let me lay it all out for you so you can truly be an informed consumer.  Forewarned is forearmed.  There’s a reason you hear so much about drinking or texting and driving, wearing seat belts/helmets and speeding.  We have to kick off Human Shark Week with the biggest and baddest predator in the Trauma World: motor vehicle crashes.
Motor vehicle collisons are the single leading cause of death among those between ages 5-34 in the US.  More than 2.3 million adult drivers and passengers were treated in ERs as the result of being injured in motor vehicle crashes in 2009.   Let’s lay this out simply and review the risks, the consequences and preventative efforts you should be taking.
Risky Behavior: Danger is enhanced by various distractions and inadequate protection.  The mistake people make is not understanding that much of the danger is outside of your control – other drivers.  If you’re impaired or distracted, you can’t respond effectively.  I’ve seen it all.

  1. Drinking while driving – Stop it with the “I can handle my liquor” nonsense.  Someone dies every hour from drinking while driving.  It’s not just drunk driving, it’s impaired driving.  Your senses are altered and ability to respond diminished at any level of alcohol consumption and is incrementally more so with more consumption.
  2. Texting while driving
  3. Eating while driving
  4. Reading while driving
  5. Doing your hair/shaving/makeup while driving
  6. Kissing and other sexual activities while driving
  7. Motorcycle driving/riding without a helmet
  8. Letting your children drive without a license and/or formal training: it’s all too true.  Teens are most at risk for accidents and being impaired/distracted/drunk while driving.
  9. Letting your children ride in the front of the car
  10. Not wearing seat belts (the biggest mistake of them all)

Injuries:
I’ve seen nearly every conceivable injury from motor vehicle collisions.  It doesn’t take as much effort as you’d think to have a very bad life after a crash.  Consider the following possible going head to toe (and yes, the list is abbreviated)…

  • Traumatic Brain Injury, including intracranial bleeds, strokes, seizures, concussions, herniation and death…
  • Neck Injury, including fractures, strains, pinched nerves, temporary and permanent loss of motion/sensation in your extremities…
  • Chest wall bruising, heart and lung bruising, collapsed lungs, stab wounds to the heart and lungs, ruptured heart vessels…
  • Abdominal injuries, including contusions to and rupture of the liver, spleen, pancreas, diaphragm and intestines…
  • Genital, urinary and pelvic injuries, including the kidneys and multiple fractures…
  • Nervous, psychologic and musculoskeletal system injuries, including contusions, life-threatening fractures and dislocations, paralysis, facial disfigurement and other scarring, post-traumatic stress syndrome and long term pain syndromes.

Prevention:

  1. Seat belt use reduces serious injuries and deaths in crashes by 50%.  Air bags provide added protection but are not a substitute for seat belts in a crash.
  2. Wear a seat belt every time, every trip.
  3. Seat all kids under 12 in the back seat.
  4. Seat backseat passengers in the middle (it’s the safest spot in the car)
  5. Regarding any function on a smartphone, if you can’t be hands free, it can wait.  If you must use your hands, pull over.
  6. Remember designated drivers?  Yes, that’s still a thing.
  7. If you’re on a motorcycle, wear a helmet, every time, every trip.
  8. Protect your teen.  No license, no vehicle.  Consider driving school.

Impaired and distracted driving will cause you harm; it’s not an ‘if it’ll happen’ situation, it’s ‘when it happens’. Please consider the points I’ve mentioned and the lives of passengers/other drivers when deciding how you handle your vehicle.  Good luck.

Straight, No Chaser: Why is Life so Traumatic? (aka Human Shark Week!)

Trauma, Health Prevention, , , , , , ,

Introduction

shark_week

If there were a human equivalent to shark week, it would be TRAUMA WEEK!  That’s right.  Trauma has all the drama, excitement and tragedy as shark bites and often makes about as much sense as exposing yourself to a shark.

Trauma is the #1 cause of death between ages 1 and 44.  In fact, according to the Centers for Disease Control and Prevention, trauma accounts for more deaths during the majority of life than all other causes combined, checking in at just over 50%.  Traumatic causes of injury are so common and avoidable that it’s worth looking at the top entities separately.  This week we will do just, informing you of where the danger lies and offer simple tips to keep you alive.

So buckle up (literally).  We’ll get into motor vehicle collisions, brain injuries, domestic abuse, suicides and homicides, drownings and other home/recreational injuries.  Trauma. Unfortunately, it’s for everyone.

Follow us!

Ask your SMA expert consultant any questions you may have on this topic. Also, take the #72HoursChallenge, and join the community. Additionally, as a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Another free benefit to our readers is introductory pricing with multiple orders and bundles!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK. Likewise, please share our page with your friends on WordPress! Also like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

Copyright ©2013- 2019 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Saturday Quick Tips – The Tooth of the Matter is…

Head/Eyes/Ears/Nose/Throat, Medical Treatment, Dental, Health Prevention, , , , , , ,

MissingTooth_jpg
What would you do if your tooth fell out or got knocked out? Here’s today’s Quick Tips.
1) Most importantly, be quick about it. You have a loss of survival of about 1% per minute. Get to your closest Emergency Room.
2) Take the tooth and gently rinse it off. Don’t scrub it!
3) Transport it in either milk or your saliva. Don’t let it get dried out. This is not to say that you should keep the tooth in your mouth. We don’t want you to choke!
Final point about your kids’ teeth.
Avulsed primary teeth in the kids (ages 6 months to 5 years) aren’t replaced into their sockets if they fell out.

Straight, No Chaser: Beat the Heat (and Not Just in Miami)

Environmental, Medical Treatment, Neurology, Health Prevention, , , , , , ,

When a loved one dies, families often ask “Is there something I could have done?” Usually I give you information. Today I want to give you information and power to act if needed. There are several varieties of heat related illness, and you would do well to be aware of them, because you can make a difference if someone’s suffering in the heat.
For starters, I really want you to become mindful of Heat Stress, which is the earliest complex of problems arising from excessive heat exposure. Heat stress is that strain and discomfort you get (usually during outdoor exertional activity) that reminds you that you’d be better off inside. You may notice such symptoms as cramping, a prickly-type rash, swelling and a sensation that you want to lose consciousness. If you must remain outdoors due to work, or choose to (playing sports or enjoying the sun), hydration means everything. It really is true that in some instances if you’re not actively urinating, you’re not drinking enough fluid.
Ok, so you’ve ignored both me and your body, and you’re still outdoors, not rehydrating enough. Heat exhaustion may occur next, and it’s defined by ongoing body salt and fluid losses. Now you’re feeling faint, thirsty, anxious, weak, dizzy, you want to vomit and may have a headache, and your body temperature starts to climb. I see a lot of these patients, usually because once you get wobbly, your employers or co-workers are getting concerned, which is good, because at this point, you are actually in danger.
Or maybe you didn’t come to see me when you had the chance, and you’ve collapsed outdoors, to be found and brought in. This is Heat Stroke, and is defined by changes in your mental status, increases in your temperature and disruption of your bodily functions, including a loss of ability to sweat and a loss of your kidney and liver’s abilities to detoxify your body the way they normally do.
Well, in case you’re feeling good about yourself because you’re too smart to exert yourself outdoors, all I’ve been describing is ‘Exertional’ Heat Stroke. The more deadly form of heat related illness is ‘Classic’ Heat Stroke. This is the type that captures the headlines every year in places like Chicago, New Orleans, Miami and Houston. Classic Heat Stroke is seen in those with underlying disease, bad habits or the elderly. I’m talking about the obese, alcoholics, meth and/or cocaine users, folks with thyroid or heart disease or on certain medications like diuretics or beta-blockers. These folks can get the same symptoms simply by not being able to escape the heat. They may actually just be sitting around in a less than optimally air-conditioned home.
So that’s what you’re up against. And yes, many people die from this. By the way, you’re not protected from the heat related illness just because you’re in shape. Let’s end with some 2 tips (one for prevention and the other for assessment and treatment) to help you Beat the Heat.
1) Take caution during the following conditions

  1. 95 degrees is high risk, regardless of the humidity
  2. 85 degrees and 60% or above humidity
  3. 75 degrees and 90% or above humidity

Here, you want to remove yourself from that environment. You need to keep plenty of fluids around. You need to visit an environment where there’s adequate air conditioning. Dress very lightly.
2) If symptoms of heat related illness short of mental status changes occur, think “Check, Call, Care, Cool”

  1. Check – look for those signs and symptoms I mentioned earlier
  2. Call – call 911 immediately. Better to have it and not need it than need it and not have it.
  3. Care – Lie in a cool place, elevate the legs, place cool, wet towels on the body (especially in the armpits and groin), and drink cool fluids. If mental status changes occur, or if the heart or lungs appear to give out, cool by any means necessary while waiting for the ambulance. This could include ice bath, ice packs, fans or cold water, but don’t drown someone trying to put them in a tub of water if you can’t handle them. Don’t forget to remove those layers of clothing.

Please be mindful that it is hotter in July, and unfortunately lives are lost every year to the heat. If you can’t avoid the exposure, at least have a plan for managing the heat and acting on any mishaps. The life you save may be your own.

Straight, No Chaser: Understanding Asthma – Toothpicks and Snot (Part 2 of 2)

Medical Treatment, Respiratory/Lungs, Health Prevention, , , , , ,

As we move into discussing asthma treatment, remember that asthmatics die at an alarming rate.  I mentioned yesterday (and it bears repeating) that death rates have increased over 50% in the last few decades.  If you’re an asthmatic, avoid taking care of yourself at your own peril.  Your next asthma attack could be your last.
The other thing to remember is that asthma is a reversible disease – until it’s not.  At some point (beginning somewhere around age 35 or so), the ongoing inflammation and damage to the lungs will create some irreversible changes, and then the situation’s completely different, possibly predisposing asthmatics to other conditions such as chronic bronchitis, COPD (chronic obstructive pulmonary disease) and lung cancer.  This simply reiterates the importance of identifying and removing those triggers.
Given that, let’s talk about asthma control as treatment.  Consider the following quick tips you might use to help you reduce or virtually eliminate asthma attacks:

  • Avoid cigarette smoke (including second hand smoke) like the plague!
  • Avoid long haired animals, especially cats.
  • Avoid shaggy carpets, window treatments or other household fixtures that retain dust.
  • If you’re spraying any kind of aerosol, if it’s allergy season, if you’re handling trash, or if you react to cold weather, wear a mask while you’re doing it.  It’s better to not look cool for a few moments than to have to look at an emergency room for a few hours or a hospital room for a few days.
  • Be careful to avoid colds and the flu.  Get that flu shot yearly.

If and when all of this fails, and you’re actually in the midst of an asthma attack, treatment options primarily center around two types of medications.

  • Short (and quick) acting bronchodilators (e.g. albuterol, ventolin, proventil, xopenex, alupent, maxair) functionally serve as props (‘toothpicks’, no not real ones, and don’t try to use toothpicks at home) to keep the airways open against the onslaught of mucous buildup inside the lungs combined with other inflammatory changes trying to clog the airways.  These medications do not treat the underlying condition.  They only buy you time and attempt to keep the airways open for…
  • Steroids (e.g. prednisone, prelone, orapred, solumedrol, decadron – none of which are the muscle building kind) are the mainstay of acute asthma treatment, as they combat the inflammatory reaction and other changes that cause the asthma attack.  One can functionally think of steroids as a dump truck moving in to scoop the snot out of the airways.  The only issue with the steroids is they take 2-4 hours to start working, so you have to both get them on board as early as possible while continuing to use the bronchodilators to stem the tide until the steroids kick in.

If you are not successful in avoiding those triggers over the long term, you may need to be placed on ‘controller’ medications at home, which include lower doses of long-acting bronchodilators and steroids.
So in summary, the best treatment of asthma is management of its causes.  Avoid the triggers, thus reducing your acute attacks.  Become educated about signs of an attack.  When needed, get help sooner rather than later.  And always keep an inhaler on you.  It could be the difference between life and death.
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