Five medical holiday emergencies and how to deal with them

Accidents happen, no matter how many preventative steps we take. Medical emergencies on holiday can be quite traumatic. One way to make sure an emergency doesn’t cause too much panic and stress is to know what to do. We’ve looked at five emergency situations and found the best advice on how to deal with them.

Note: Don’t injure yourself trying to assist a victim. Move your family, friends and bystanders to a safe area away from any danger and assist the victim only when it is safe to do so.

Emergency: DrowningUnfortunately drowning is a reality for too many South Africans, especially in the summer months. Deon Woodley of Watersmart, Lifesaving South Africa’s water safety project, says you should swim in lifeguard patrolled areas, and use safety gear such as lifejackets if you are taking part in water sports. And stay away from the water if you have been drinking alcohol.

If you are in difficulty in the water:

1. Attract attention: Wave one arm above your head, shout for help or blow a whistle (if you have one) to attract the attention of fellow water users.
2. Remain calm: Float on your back, gently tread water and move your hands and arms gently from side to side in the water. No thrashing about!
3. Hold on: Always try to hold on to any form of floatation device such as a body board or pool noodle. Never abandon available floatation in order to swim to safety.
4. Breathe: Breath slowly making full inhalations and exhalations. This helps to keep you buoyant.
5. Keep your eyes open.

If you are caught in a current: Deon says ocean currents lose their strength in deep water, which is where you can escape. You can also escape a current by swimming diagonally across it.

If you are caught in a wavezone where the waves are breaking, usually close to the beach: Calmly submerge under the approaching waves. Deon says you can resurface when the wave has passed, but there is a good chance you will need to go under another wave within a few seconds of the first.

How to help someone in difficulty:

1. Get them to dry land: Call the lifeguards or emergency services for help. Only assist someone if it is safe to do so, you are capable and have told friends, family or the emergency services that you will be entering the water to assist. Don’t put yourself in any danger. Take some form of floatation device with you - this will assist you and the victim.
2. Check breathing: Place the victim on their side (the recovery position - see illustration below) following a rescue if they are semi-conscious or unconscious. Keep their airways open and commence CPR if they are not breathing.
3. Call for medical assistance: If the victim shows any sign of breathing difficulty, vomiting or coughing they may have fluid in the lungs and will need a medical evaluation. Secondary drowning complications can be experienced 24 - 48 hours after an incident and can be serious.
   
   

Emergency: BurnsBurns are painful and many require medical attention. According to Life Healthcare there are four kinds of burns, each may require different medical attention.

Superficial burns
The outer layer of the skin is burnt. The skin will be red and painful. Sunburn is usually regarded as a superficial burn.

1. Clean the burn and remove any clothing around the burn area. If the clothes are sticking to the skin visit an emergency room.
2. Wash the burn with cool water and plain soap.
3. Cool the burn – using cool water not ice.
4. Apply a burn dressing such as Burnshield or cooling gel.

Superficial partial-thickness burns where the burn goes through the top two layers of the skin
The skin will be extremely red, shiny and blisters will form. If touched the skin will change colour but return to normal when the pressure is removed. The burn is painful.

1. Cover the blisters with a sterile non-stick dressing and apply an aloe vera gel or cream, or antibiotic cream. Don’t break the blisters.
2. Change the dressing once a day.
3. Take over the counter pain relief such as Ibuprofen.
4. Keep the burn area above the heart to reduce swelling.

Deep partial thickness burn where the burn goes through the top two layers of skin
There is blistering and the burn hurts if you apply pressure but doesn’t turn white. You need to go to hospital immediately if you have a deep partial thickness burn.

Full thickness burn
This burn requires immediate medical attention. Because the burn is so deep there is nerve damage and the victim may not feel pain, but the skin appears white, grey or black.

Chemical and electrical burns
Both of these should be considered medical emergencies. In the case of chemical burns, you can douse the area in water, no other liquid, and remove clothing around the burn area.

Seek medical attention:

• If a child younger than five is burnt
• If the burn covers a large area – larger than 7cm – or is in a sensitive place such as the hands, feet, face, genitals or joints (knee or shoulder)
• The burn victim has a fever with a temperature of 38 C or higher
• There are signs of infection

Emergency: Bluebottle stingBeware of these pretty blue sea creatures on the beach – their tentacles sting and a close encounter is not pleasant. Bluebottles are easy to spot on land but well camouflaged in the sea. Linda Buys, author of the South African First Aid Manual has some tips on what to do when the bluebottles get too close.

1. Leave the water if you are stung.
2. Remove the tentacles. The easiest way to do this is with a plastic card or blunt knife, but you can also use your hands.
3. Submerge the sting area in hot water. This will help remove the tentacles and ease the pain. If you are not near hot water rinse in seawater until you are ready to leave the beach.

Emergency: SnakebiteSouth Africa is home to over 150 species of snakes. Only 11% are poisonous but being bitten by a poisonous snake can be fatal. The good news is that snakebites are not common, but when you’re exploring your holiday destination you may encounter one so it’s good to know what to do if you are bitten. The African Snakebite Institute has some advice.

1. Take a photo of the snake if you can and note any symptoms such as pain, swelling, dizziness and bleeding as this will assist in identifying the type of venom.
2. Get the victim to a hospital as soon as possible.
3. Keep the victim calm and still.
4. Remove rings and tight clothing around the bite area.
5. Apply a pressure bandage to the affected area if the bite is from a Cape Cobra or Black or Green Mamba - and do this while you are travelling to hospital. Time is of the essence if one of these bite so it really is important to get to medical assistance quickly.
6. Apply CPR if the victim is struggling to breathe.

Emergency: Car accidentWe don’t need any reminding of how dangerous our roads can be. Many accidents are bumps and scratches – but what do you do if you’re in a serious accident and people are injured? Arrive Alive has some tips.

1. Make sure you are safe – park your car on the side of the road, don’t walk in front of oncoming traffic and keep clear of hazards such as fire and chemical spills. If you have latex gloves put them on.
2. Call the emergency services and let the accident victims know you have called for help.
3. Do not move the injured unless there is a threat to their life – such as a fire.
4. Check that the injured’s airways are open, and they are breathing. Apply CPR if they are not.
5. Apply pressure with a clean towel or clothing such as a t-shirt if a wound is bleeding and keep applying this pressure until the emergency services arrive.