Prevention is better than… surgery!

December 14, 2021

Most injuries are preventable if safety protocols are adhered to. It’s the advice you’ve heard repeatedly, but one which surprisingly few believe they should adhere to.

Dr. Thea Van Den Heever, Head of Emergency Medicine at Busamed’s Bram Fisher International Airport Hospital says covering swimming pool with a safety net, stopping at regular intervals to stretch and refresh, staying out of the sun between 10AM and 3PM and moderating alcohol intake are common sense practices to employ. “These measures will not only prevent injury, but in truth, they might prevent fatalities.” She says over the holiday period, emergency units will most assuredly receive emergencies related to one or more of the above related injuries.

Fatigue

Dr. Van Den Heever says stretching helps combat driving fatigue. “If you still feel tired rather sleep over in a hotel or guesthouse and drive again after you’re well rested.” She says keeping a following distance between vehicles of at least 2 – 4 seconds gives your brain time to formulate a life-saving response should the driver in front suddenly brake or swerve. Gaps between cars are not an invitation to gap in. Dr. Van Den Heever reiterates that if you cannot see clearly what oncoming traffic looks like, do not overtake. She adds that poor eyesight and not wearing spectacles when you are legally required to is very risky.

If there is a motor vehicle accident, the golden hour is of utmost importance. The Golden Hour of Trauma refers to the time it takes to reach definitive treatment from the time of injury. “The importance here is to prevent hypothermia and hypovolemia with haemorrhage control to prevent further coagulation abnormalities and organ damage. This will result in a better outcome for the patient not just in the short term but in the long term, too.” She says once the golden hour has passed organ failure occurs which might be irreversible and, in some instances may lead to death.

How to save a life

Dr. Van Den Heever says if Advanced Life Support is more than an hour away, the Golden hour can still be salvaged by means of your intervention.

“One must be very careful when moving an injured patient as this might cause more harm to the patient resulting in paralysis. If one has to move a patient due to a hazardous environment (burning building, burning car or live electrical wiring), then be certain not to endanger yourself. Once you are safely with the patient follow Advanced Trauma Life Support guidelines by conducting a primary survey i.e. A,B,C,D,E

1. Airway

The Trauma Salute – introduce yourself and ask the patient his or her name and depending on the answer, this will determine if the airway is blocked or not

2. Breathing

Is the chest moving up and down? Are there visible signs of breath? If no, you might need to start CPR

3. Circulation

Does the patient have normal skin colour? Are they sweating? Do they have a detectable pulse? If the patient is bleeding, you will need to elevate their legs and attempt to stop bleeding by applying pressure on the wound.

4. Disability

You will check for responsiveness in their pupils, pain responses, voice responses and determine a level of
alertness. You might need to place the patient in the recovery position.

5. Environment/Exposure

You might need a space blanket or sun cover to prevent hypothermia and dehydration.

Dr. Van Den Heever says once the patient is moved to a safe area then a secondary survey can be performed, which entails a head-to-toe examination where injuries can be dealt with in an orderly fashion. “If one were to move a patient and one suspects a head or spine injury, the patient must be fully immobilised on a spinal board with headblocks. A wooden plank or door with make shift headblocks such as a blanket or towels on each side of the head, can also be used.” She says the head must be kept in a neutral position and the patient’s airway must remain patent (open) and the safest technique for this is the jaw thrust manoeuvre.

Common Injuries

“The most common injuries can be as simple by applying a pressure bandage on an area that is bleeding. Do not remove impaled objects, but do make sure these objects are secured when moving the patient. By removing the object impaled into the patient, you risk a bleed-out. Rather transport the patient to the hospital where the object can be removed safely.”

Dr. Van Den Heever says a lack of hydration could lead to heat stroke and recommends water be carried on outdoor trips. “Do not play sports on an uneven surface. This tends to cause falls which could lead to injury.”
Safety belts and helmets should be worn at all times as to prevent unnecessary head injuries when doing maintenance work around the house or office. Head injuries are commonly associated with maintenance work, especially if work is undertaken as a considerable height about the ground.

Dr. Thea Van Den Heever, Head of Emergency Medicine

Busamed’s Emergency Units are located in these areas. Call these numbers should the need arise.

Busamed Bram Fischer Private Hospital – Tel: +27 51 412 4269
Busamed Harrismith Private Hospital – Tel: +27 58 304 3064
Busamed Hillcrest Private Hospital – Tel: +27 31 768 8911
Busamed Gateway Private Hospital – Tel: +27 31 492 1234
Busamed Modderfontein Private Hospital – Tel: +27 11 458 2084
Busamed Paardevlei Private Hospital – Tel: +27 21 842 6642/3