Winter advice from St John Ambulance

St John Ambulance volunteers in Hampshire are ready and prepared to offer vital support to patients and emergency services during the winter period.

Crews on standby

The leading first aid charity has 1,000 volunteers across the county who give first aid care to the public each year.  It is bracing itself for more injuries as the big freeze sets in.

St John Ambulance volunteer crews are on standby to support NHS Ambulance Service Trusts, ready if needed with SJA 4x4 vehicles to reach patients in rural areas or to get to places conventional ambulances can’t reach.

Pat Morris, Commander of St John in Hampshire, said: ‘St John Ambulance is a vital part of the nation’s emergency response system, supporting communities and the statutory services in times of crisis.

‘Last winter, our volunteers crewed 4x4 vehicles to help patients who couldn’t be reached in traditional ambulances. They clocked up 3,000 shifts helping deliver babies, treat broken limbs and set up rest centres for those unable to reach their homes in the heavy snow.

‘In winter, especially during the snowy and icy conditions that we are experiencing at the moment, we can expect an increase in the number of sprains and fractures we are treating because more people are slipping and falling in the cold weather and damaging their wrists, ankles or collarbones.’

She added: ‘Elderly and vulnerable people are particularly prone to illness at this time as the cold can exacerbate respiratory problems like asthma.

‘Our volunteers are ready to help around the country but we’re also encouraging everyone to follow our first aid advice, and be community spirited and to check on elderly or vulnerable friends and neighbours.’

St John Ambulance winter first aid advice:

How to differentiate between a sprain and a fracture

Sometimes it can be hard to tell the difference between a strain/sprain and a fracture, they all can be painful, tender and swollen. If you are unable to bear weight on the limb, if there is any obvious deformity or have any doubts about the seriousness of the injury then always seek medical advice.

Fractures need to go to hospital, but beforehand, you should make sure the injured person is kept still and the break supported with your hands or by being bandaged (in a sling if an upper limb break, or bandaged to the uninjured leg, if a lower limb break).

In the case of a sprain it can be treated using the RICE procedure (Rest, Ice, make Comfortable and Elevation). The injured part should be rested and supported and, if a recent injury, an ice pack should be applied to reduce swelling, make sure that the ice does not come into direct contact with the skin. Apply a comfortable support to the injured part with soft padding held in place with a support bandage, finally support the limb ion a raised position to help minimise bruising.      

What to worry about if you hit your head

Most head injuries are minor and involve a headache which improves with rest and painkillers. In some cases the headache can worsen, there may be nausea, confusion, strange behaviour – immediately or within 48h. If this happens they should go to hospital as it may be something more serious such as a bleed on or within the brain. If diagnosed early and caught early most head injuries are very treatable. This is why learning what to look for on a first aid course is so important

How to spot signs of hypothermia and frostbite

Hypothermia and frostbite are rare but as some areas of the country are experiencing temperatures of -17C it’s useful to know the symptoms.

Hypothermia develops when the body temperature falls below 35°C (95°F). The effects vary depending on the speed of the onset and the level to which the body temperature falls. Moderate hypothermia can usually be completely reversed.

Symptoms include:

• Shivering and pale, cold, dry skin.
• Disorientation, apathy or irrational behaviour; occasionally belligerence.
• Impaired consciousness or lethargy.
• Slow and shallow breathing.
• Slow and weakening pulse.
• In extreme cases the heart may stop.

Treatment

If someone has been brought in from outside, immediately replace wet clothing with warm, dry garments.

They can be rewarmed by bathing if they are fit, young and able to climb into a bath unaided. The water should be warm but not too hot – about 40°C (104°F).

Put the casualty in a bed and ensure that they are well covered. Give them warm drinks or high energy foods such as chocolate to help rewarm them.

With frostbite the tissues of the extremities – usually the toes and the fingers – freeze due to low temperatures. In severe cases, it can lead to a permanent loss of sensation and, eventually, tissue death (gangrene) as the blood vessels become irreversibly damaged.

Frostbite usually occurs in freezing or windy and cold conditions. People who cannot move around are particularly susceptible. In many cases frostbite is accompanied by hypothermia and this should be treated accordingly.

Symptoms include

• Pins and needles’ to begin with.
• Pallor followed by numbness.
• Hardening and stiffening of the skin.

A colour change to the skin of the affected area: first white, then mottled and blue. On recovery, the skin may be red, hot, painful and blistered. Where gangrene occurs, the tissue may become black due to the loss of blood supply.

If possible move them into the warmth before you thaw the affected part. Gently remove rings, gloves and any other constrictions such as boots. Warm the affected part with your hands on your lap, or under the casualty’s armpits. Rubbing the affected areas must be avoided as this can damage the skin and other tissues.

Place the affected part in warm water at around 40°C (104°F). Dry carefully, and apply a light dressing of fluffed-up, dry gauze bandage.

Support and raise the affected limb to reduce swelling. An adult may take two paracetamol tablets for intense pain. Take or send them to hospital.

Warning

Do not:

• put the affected part near direct heat
• attempt to thaw the affected part if there is a danger of it refreezing
• allow the casualty to smoke.      

If someone has become hypothermic over a longer period of time, owing to being in a cold house for instance, then it is important to warm them slowly. The elderly and very young are particularly vulnerable. Cover the person with layers of blankets and warm the room to about 25°C (77°F). If the casualty is conscious, give a warm drink such as soup or chocolate. Call for emergency assistance and keep an eye on them until the ambulance arrives.

How to avoid exacerbating respiratory problems due to the cold

At this time of year, especially with the weather conditions the way they are, some people that suffer from respiratory conditions, such as asthma and bronchitis, will suffer more than most. It is important to follow the guidance given to you by your GP. If you have to venture out then make sure you have any medication you might need, such as inhalers, with you. If you notice your condition getting worse, then consult your GP as there may be other underlying conditions like a chest infection for example.