Welcome to Ultimate EnerGI™ Blog

Many die every year from accidental or intentional ingestion of toxic substances. Most cases of poisoning, however, are innocent and often occur in small children. Since infants are so prone to put unfamiliar substances in their mouth, careful surveillance by parents is necessary to prevent these incidents. The home should be inspected to be sure that cleaning fluids, medicines, insect poisons, and solvents are carefully secured beyond the reach of children. Never put toxic substances into soft drink bottles or other containers that are normally used for food. Particularly harmful preparations should be kept in a locked cabinet. As children are able, they should be instructed carefully concerning the danger of many household chemicals.

When accidental ingestion of a poisonous substance occurs, usually the first procedure is to induce vomiting. The sooner this is done after the ingestion of the poison, the better the results will be. Many substances are absorbed rapidly. If syrup of Ipecac is not available, give some lukewarm water or other liquid to dilute the poison. Then prepare at once to visit an emergency room.

Sticking the finger in the throat to induce gagging may be helpful when pills have been ingested, but should never be used in the case of swallowed lye, strong acids, gasoline, kerosene, or other hydrocarbons. Aspiration may result, producing a serious pneumonia. The caustic properties of lye make further corrosive burning of the esophagus a possibility. Even perforation may result if vomiting is instituted.

The most helpful remedy for poisoning is the early administration of activated charcoal. Every home should have a box of powdered charcoal on hand, as well as the “activated” capsules. Charcoal has phenomenal powers to adsorb poisonous chemicals. The usual dose of charcoal is thirty to sixty grams (2 to 4 tablespoons of the powder). It is mixed with water to make a “slurry.” One must drink this water suspension as quickly as possible. The charcoal, administered early, can adsorb most drugs. Because of its insolubility, it is not absorbed into the bloodstream.

Many poisonous plant substances and mushrooms may be ingested. Botanical field guides are helpful to identify these substances. Some of the more common ones will be mentioned here. Every adult, especially every parent, should know how to identify the most common plants around their locality, and particularly be able to recognize the toxic species. Mushrooms are a most interesting class of plants. Some of them are nutritious and quite tasty, while others may be deadly when swallowed. The Amanita species are among the most toxic substances known to affect man. The recognition of this extremely poisonous mushroom should be thoroughly understood, so that no accidents will occur. Consult a field guide or first aid manual for any questions in identifying such toxic plants. The poison control center can be reached by telephone from most cities. Check your phone directory for the number.

Many suicides take place each year through the ingestion of harmful drugs. Overdoses of sedatives or tranquilizers are common. Most cases can be salvaged by early recognition and gastric lavage. All emergency rooms should be equipped with materials to wash out (lavage) an individual’ s stomach. However, the early induction of vomiting may make this unpleasant procedure unnecessary. Activated charcoal is usually administered to adsorb the drug and prevent its effect on the system. REMEMBER to take suicide notes, hints, and actual attempts very seriously!

Often the best response is a willingness to listen and sincerely attempt to understand the plight of the distressed individual. Tragic deaths or deliberate overdoses could be prevented by the exercise of love and mutual understanding when disturbances arise in the family. As in many other aspects of emergency medicine, your loving attention may reduce the toll that accidents are now taking in our turbulent society.

Share This

Proper handling of injuries from animal or human bites requires experience and judgment. As a general rule, all bites that break the skin should be considered infected wounds. For this reason they should all be protected against tetanus with the appropriate tetanus toxoid booster inoculation. If previous vaccination has not been completed within the recommended period of time (usually 10 years), human tetanus antitoxin is also administered.

As soon as possible after an injury occurs, the wound should be washed thoroughly with water using the best available antiseptic soap. Careful irrigation and cleansing of the bite will remove most of the foreign substances that would otherwise produce complications or infection. When the laceration is severe or hemorrhage is present, ligatures to close the wound may be necessary. Smaller bites are best treated with the open technique, permitting them to heal by second intention. Human bites are among the most likely to become infected, because of the abundant flora of germs resident in the mouth. The lysozyme content of a dog’s saliva makes it less likely to contain virulent bacteria. But all animals, including cats, horses, dogs, and wild pets are likely to cause damage if they bite. Obviously, many of these injuries can be prevented by appropriate care in handling animals.

The bite of an animal infected with rabies virus is particularly serious. The animal usually exhibits strange behavior, and may be unsteady, foaming at the mouth, salivating, and unusually vicious. Rabies or hydrophobia, as it is sometimes called, is a viral infection of the central nervous system. Untreated, all known cases result in death. Proper rabies control requires vaccination of all pets, such as dogs and cats, with careful avoidance of untamed animals. Never pet or attempt to fondle any strange animal!

If an animal suspected of having rabies has bitten someone, the animal should be quarantined with the local health department or humane society. Within two weeks it usually becomes apparent whether rabies is present or not. If the bite is extensive or near the face, immediate inoculation of the patient with antirabies vaccine is begun. This therapy involves a series of daily injections for about two weeks. Although painful, they may be life saving. Most emergency rooms and health departments have information as to how the antirabies vaccine can be procured and administered. It is imperative to follow through with a full course of adequate protection to save the lives of such unfortunate victims.

Share This

Two common cold injuries are frostbite and hypothermia. Taking precautions during winter weather can help you avoid them. First, never push yourself to exhaustion when exercising or working in cold weather. When you are worn out, you’re more likely to fall or suffer injury. Take hourly breaks during long treks, skiing expeditions, or work that takes you outdoors for several hours.

Second, drink plenty of water when exercising in the cold, just as you would in warm weather. You can become dehydrated if you neglect to replace fluids, especially when sweating. This reduced blood flow to the skin, which could lead to cold injury.

Remember the wind chill factor when exercising outdoors on a cold windy day. Windchill means that a calm, subfreezing weather can do less damage to skin than a warmer, windy day. When exercising outside, head into the wind first, when you are fresh and dry. If you exercise awhile and become sweaty, the dampness will magnify the windchill factor. Rain, even a cool drizzle, causes greater heat loss when you skin stays wet. Snow, even though it has a special charm and beauty, can making walking or running hazardous. During a snowstorm your ability to see is limited. Driving visibility is reduced. Wear reflective clothing when walking.

Read the rest of this entry »

Share This

Many thermal injuries can damage the skin. Burns include injuries caused by scalding, fire, radiation, caustic chemicals, and electricity. Although each type of burn requires individualized treatment, some generalizations are appropriate. Classification of burns is important to determine their severity, as well as to gauge the response to treatment. Traditionally, the extent is described by degrees. A first-degree burn involves the superficial layers of the skin only, and manifests itself in reddening. The most common type is sunburn. Prolonged use of heating pads or split-second exposure to a fire may also produce this self-limited, but occasionally painful type of burn.

Second degree or “partial thickness” burns also involve the skin surface or epidermis. This burn, however, transfers sufficient heat to the skin to produce blistering. These deeper types are more painful. Second degree burns of babies or small children are especially likely to become infected. If extensive, they may result in dehydration or shock.

The deepest burn, called third degree or “full thickness” involves both layers of skin, epidermis, and dermis. These may extend into the subcutaneous fat and muscle, destroying both blood vessels and nerves that supply the skin. Small full thickness burns may be produced by electricity, although more commonly they are caused by fire or chemicals. Remember that a deep partial thickness burn may become badly infected, with extension of the burn to involve all the skin layers. In contrast to first and second-degree burns that heal rapidly, the deeper full thickness variety is very slow to heal. The skin forms granulation tissue, with gradual progression to skin renewal, or grafting may be necessary.

Immediate first aid in the case of burns requires the application of cold. Often a potential third degree burn can be converted to a second degree or a second degree to a first-degree burn by the immediate use of ice or other application of cold to counteract the thermal injury. This should be prolonged for thirty to sixty minutes, unless the burn is extensive enough to necessitate immediate emergency medical care.

A second way to classify burns is according to the extent of skin involvement. The “rule of nines” has commonly been used to approximate the burn area. The accompanying diagram helps illustrate how these burned areas can be calculated. Because of the ever-present danger of contracture or scarring, burns involving the face or hands are especially serious.

Unless superficial, most burns can be treated like abrasions, with appropriate cleansing and protection against infection. Sterile dressings can be used to relieve pain and prevent the entrance of germs. Small burns are more amenable to the “open technique” than are extensive injuries. In this approach, the burn is cleansed and left open to the air to dry. Rapid formation of a crust seals off the burn, functioning like a scab to prevent infection while healing occurs beneath.

Read the rest of this entry »

Share This

You may wonder why I would seem so bold to even suggest fracture treatment in a home-like setting. The reasons are twofold. First, many are completely unable to afford the expenses of emergency room care or the services of an orthopedist today. Second, many fractures occur in a remote rural setting in countries where medical services are not available. Therefore, it is advisable to know some of the basic principles of diagnosis and management, not only to alleviate acute suffering, but also to prevent residual deformity as the fractured bone heals.

Fractures of the bones may be classified in several ways. The greenstick fracture is one in which only a portion of the bone is broken, leaving the major segment intact. This is more typically seen in children, since their bones are soft and still growing. Perfect diagnosis can only be obtained with x-ray. The closed fracture, formerly called simple fracture, is one in which the skin is not broken, and the bone is fractured in only one place. No other fragments are seen, and displacement is usually slight. A comminuted fracture, on the other hand, is one in which multiple fragments of the bone are present. It is usually caused by a more severe, shattering type of injury. Open (compound) fractures are those in which a sharp fragment of bone actually penetrates the skin, allowing contamination and a high risk of severe infection. Osteomyelitis of the bone is a common sequel of these extensive injuries.

Read the rest of this entry »

Share This