24 May 2009

LIGHTNING INJURIES
Reproduced here is an interesting comprehensive article on Lightning Injuries in our Sunday Star News on 24 May 2009.
Be prepared for First Aid calls because of lightning injuries at the approach of rainstorms and during rainstorms when you are on Ambulance duties in the sports stadiums and open fields and golf courses etc.
According to Star news, there are about 24,000 deaths caused by lightning worldwide per year. About 10 times as many are injured by lightning - that's 240,000 people are struck by lightning per year according to Ron Holle a US meteorologist and researcher who has spent years educating the American public on lightning dangers.
Be prepared to administer Cardiopulmonary resuscitation in the event of cardiac arrest.
Cardiopulmonary arrest is the most common and immediate cause of death from a lightning strike. Apart from immediate effects of lightnining injuires to the victim, there are also delayed long term effects of lightning strikes which may be unrecognised such as memory disturbances, mental and personality changes.
Remember also that rescuer safety and situation safety are also utmost priorities BEFORE approaching any casualty injured by lightning strikes.

22 April 2009

39TH STATE FIRST AID AND HOME NURSING COMPETITION SJAM MELAKA As intended, the 39th State First Aid & Home Nursing Competition held on 19 April 2009 at the grounds of SMK Padang Temu Melaka received strong full participation of 20 teams from School Divisions and Open Divisions this year vying for the championship in order to represent SJAM Melaka at the coming 51st National First Aid & Home Nursing Competition to be held on 30th and 31st May 2009 at Pulapol Kuala Lumpur.
And perhaps also the desire to win the National championship and carry the honour to represent SJA Malaysia in this year Biannual Singapore-Malaysia First Aid & Home Nursing competiton.

YB Chua Kheng Hwa, Ahli Undangan Negeri Kawasan Bemban Melaka officiated the Closing of our competition as well as graciously presented the prizes to all the winners on behalf of YB Hjh Norpipah binte Abdol, Ahli Exco Kerajaan Negeri Melaka, Pengerusi Jawatankuasa Negeri Hal Ehwal Wanita, Pembangunan Keluarga dan Kesihatan who was unable to attend because of officialGovernment duties.

CONGRATULATIONS to all the teams who participated and put up a exciting presentation of their first aid and nursing skills and to the winners of the various sections of the competition and to Kawasan Satu for being the Overall champion of our 39th State First Aid & Home Nursing competition for this year 2009. Dr Haji Mohammad Fadhly bin Yahaya our State Surgeon as Organising Competition Chairman at the Closing Ceremony summed up the competition in his post mortem report on the performance of the various teams and improvements necessary to better their skills. It is our hope that all our members bear in mind all the points emphazised by our State Surgeon and act on them.

KEPUTUSAN PERTANDINGAN PERTOLONGAN CEMAS & PERAWATAN NEGERI TAHUN 2009

JOHAN PASUKAN BAHAGIAN PERAWATAN KADET
Sekolah Menengah Munshi Abdullah (B) Kawasan Satu

JOHAN PASUKAN BAHAGIAN PERAWATAN DEWASA
Cawangan Bacang Kawasan Satu

JOHAN PASUKAN BAHAGIAN AMBULANS KADET
Sekolah Menengah Gajah Berang Kawasan Satu

JOHAN PASUKAN BAHAGIAN AMBULANS DEWASA
Cawangan Bacang Kawasan Satu

JOHAN KESELURUHAN PERTANDINGAN
Kawasan Satu

1 April 2009

PERTANDINGAN PERTOLONGAN CEMAS DAN PERAWATAN PERINGKAT NEGERI MELAKA akan di jalankan pada 19 April 2009 Ahad di SMK Padang Temu Melaka.
Tetamu Kehormat YB Hjh Norpipah bte Abdol Ahli Exco Kerajaan Negeri Melaka, Pengerusi Jawatankuasa Negeri Hal Ehwal Wanita, Pembangunan Keluarga dan Kesihatan telah bersetuju akan datang untuk merasmikan Majlis Penutupan dan Penyampaian Hadiah kepada pemenang-pemenang Pertandingan.

Tahun ini Pertandingan akan di buka untuk menerima bilangan maxima dua puluh buah pasukan untuk bertanding dalam 4 kategori ia itu Ambulans Dewasa, Perawatan Dewasa, Ambulans Kadet dan Perawatan Kadet. Tempat-tempat kosong yang di kosongi Kawasan yang tidak bermampu menghantar pasukan-pasukan nya akan di penuhi oleh pasukan-pasukan daripada lain Kawasan.
Selain untuk memperhebatkan Pertandingan kami, cara ini membolehkan lebih Pasukan-Pasukan menikmati kemanfaatan Pertandingan, dan meluaskan semangat pertandingan. Semua pasukan mendapat peluang yang sama dalam semua ujian-ujian setiap bahagian untuk meraihkan kejohanan.
Yang biasanya, kedudukan Kejohanan akan berdasarkan atas kedudukan ranking daripada pungutan markah setiap ujian.

NASIHAT.... MENGIKUT PERATURAN-PERATURAN PERTANDINGAN !
Peserta-Peserta (dan Ketua Pegawai Pasukan dan Kawasan) di nasihatkan mengikut Peraturan-Peraturan Pertolongan Cemas dan Perawatan Peringkat Kebangsaan St. John Ambulans Malaysia supaya tidak berlaku pasukan nya tidak di benar bertanding oleh sebab kegagalan mengikut peraturan-peraturan seperti-
(a) Semua peserta mesti mempunyai Sijil Pertolongan Cemas dan Sijil Perawatan.
(b) Peserta Ambulans Dewasa dan Perawatan Dewasa - umur pada tarikh pertandingan hendaklah 16 tahun ke atas
(c) Peserta Ambulans Kadet dan Perawatan Kadet - masih seorang kadet dan belum pernah mengambil bahagian dalam kategori Dewasa.
(d) Pasukan yang telah mengambil bahagian dalam pertandingan pada tahun lepas dibenarkan mengambil bahagian dalam kategori yang sama dengan syarat Ketua Pasukan dan seorang ahli lain yang bukan peserta simpanannya diganti dengan ahli-ahli BARU.
(e) Seorang peserta hanya dibenarkan mewakili Negeri tidak lebih daripada dua (2) tahun berturut-turut dalam satu-satu kategori.
************************Selamat bertanding kepada semua pasukan pada hari itu !*************************************

If you are a passionate movie lover, you would be saddened by the sudden tragic passing away of Natasha Richardson, a film star, Tony-winning stage actress and a member of the famed Redgrave acting family on 18 March 2009 due to initially apparently mild head injury. She was 45. Richardson died after suffering injuries in a fall on a ski slope at a Quebec resort about 80 miles northwest of Montreal, Canada.
According to a statement from Mont Tremblant Ski Resort, Richardson fell during a lesson on a beginners' trail.
"She did not show any visible sign of injury, but the ski patrol followed strict procedures and brought her back to the bottom of the slope and insisted she should see a doctor," the statement said.

Richardson, accompanied by her instructor, returned to her hotel, but about an hour after the fall was "not feeling good," the statement said. An ambulance was called, and Richardson was taken to a local hospital before being transferred to Hopital du Sacre-Coeur in Montreal. From there she was transferred to Lenox Hill Hospital in New York City.

'Minor' head injuries can turn serious rapidly, experts say
By Danielle Dellorto
CNN Medical Producer
March 18, 2009
(CNN) -- A blow to the head that at first seems minor and does not result in immediate pain or other symptoms can in fact turn out to be a life-threatening brain injury, experts tell CNN.
Immediate treatment is essential after a brain injury because damage caused by swelling is often irreversible.
It's very common for someone who's had a fall or been in a car accident to appear perfectly lucid just after the impact but then to suddenly, rapidly deteriorate, Dr. Carmelo Graffagnino, director of Duke University Medical Center's Neurosciences Critical Care Unit, told CNN.
Actress Natasha Richardson was talking and joking after she fell Monday during a beginner ski lesson, according to officials at the Canadian resort where she was staying. But soon after she returned to her room she complained of head pain and was taken to a nearby hospital, then to a larger medical center in Montreal. She was flown by private jet Tuesday to a New York hospital. She died Wednesday, according to a family statement.
"A patient can appear so deceivingly normal at first," said Graffagnino, director of Duke University Medical Center's Neurosciences Critical Care Unit. "But they actually have a brain bleed and as the pressure builds up, they'll experience classic symptoms of a traumatic brain injury."
Such injuries are known as epidural hemorrhage. Blood gets trapped between the skull and the hard layer of skin between the bone and brain, known as the dura mater. As the blood flows from the ruptured artery, the fluid builds and punctures the dura.
Patients are often unaware they've fractured their skull. In these cases, the fracture generally occurs just above the ear, in the temporal bone. "There is an artery that runs above the skull and can get torn and begin to bleed above the lining of the brain." Graffagnino says.
"At that point all the pressure is pushed on the brain, causing it to swell but there is often no room for it to move inside the skull cavity. And as the pressure continues, it reduces blood flow to the brain and a patient would begin to feel the symptoms."
The condition is commonly referred to as "Talk and Die" syndrome among neuroscience physicians and surgeons, because the patient can decline so rapidly.
Graffagnino says the initial fall or injury doesn't have to be hard at all. The delay in symptoms can range from five minutes to three hours after the accident.
If an individual isn't medically evaluated after a car accident, sports injury, or just a slip in the driveway, recognizing the signs brain injury early is critical. Nausea, severe headache, glossy eyes, sudden sleepiness, are all common symptoms. Getting to a hospital within the first few hours is critical to prevent permanent brain damage, experts say. An emergency room team can quickly determine the severity of your injury. An emergency craniotomy -- opening of the skull -- surgery is often needed to stop the bleeding and control brain swelling.
Immediate treatment is essential after a brain injury because the initial damage caused by swelling often is irreversible.
"One of the things we teach to trauma teams, is if a group of people are in a car crash and someone dies, we have to assume everyone else has serious injuries--even if they look good, and say they feel totally fine," Graffagnino said.
Certain medications can increase a person's risk for hemorrhages, especially for the elderly. Doctors say even a small bump on the head can be dangerous for patients taking blood thinners, among other prescription drugs.
"Talk and Die" syndrome" also can result from a subdural bleed, which develops between the brain and the dura. These bleeds can "squish the brain," Graffagnino said, and cause injury at a slower rate. A person can often feel normal for several days before feeling any symptoms.
"You don't have to see external injury to have injury to the brain," said Dr Philip Stieg, chair of neurosurgery at NYP/Weill Cornell. To evaluate a person's response after a minor trauma, Stieg recommends checking the size of their pupils and asking questions such as the patient's name and what year it is. In the hours following, Stieg recommends monitoring the person's cognitive skills and to "bring them in to get a CAT scan" if there is a change in behavior.
The brain also can be bruised after an accident, leaving patients with no symptoms or signs of a bleed at first glance. But the nerves surrounding the bruise can begin to stretch, causing what is known as an axonal injury. "The brain is like Jell-O. Imagine if you dropped a bowl of Jell-O on the floor and it looks intact at first but when you examine it really close, you can see it has teeny tiny cracks all in it," Graffagnino said. "Well the brain can have these tiny cracks that don't show up on initial CAT scan but will develop into problems down the line."
Once surgeons stop a brain bleed, the next step is to monitor brain activity and check for permanent damage. A patient typically spends up to a month in a neuro-ICU. Patients who survive often spend the next several years in physical and cognitive therapy to regain function, according to experts.
"The most important thing to do to lower your risk is to wear a helmet when you can, and don't brush off an injury because you feel 'fine' at first," Graffagnino said. "The thing that's going to save a life is for friends and relatives to recognize the first glimmer of a symptom. The quicker we can stop the bleed, the better."

Could a Helmet Have Saved Natasha Richardson?
Jeffrey Kluger Time Story Wednesday, Mar. 18, 2009
It appears that Natasha Richardson was the victim of an unfortunate collision of biology and physics - a collision that is becoming scarily common in the worlds of athletics and organized sports. The human body is a sturdy one, but only up to a point, able to withstand collisions of about 15 m.p.h., which is about as fast as an average person can run. The skull is designed to be especially rugged - the permanent home and helmet for the brain - but even it can't take a much more serious hit. The problem is that over the centuries, we've developed all manner of ways to exceed a mere 15 m.p.h. creep.
One of the most common collision-related head injuries is a concussion, which occurs when the head moves at high speed and stops suddenly as it strikes a hard object. The brain, which is snug but not completely stationary inside the head, may continue moving, colliding with the inside of the skull. This leads to swelling or bruising or - much worse - bleeding. A brain-bleed is immediately life-threatening, but swelling is less so and may not even be evident for a little while, which is what appears to have happened in Richardson's case.
"In organized sports," says Jasper Shealy, a professor emeritus at the Rochester Institute of Technology and a sports-injury expert who has published more than 100 papers on the subject, "the practice had been for players with a head injury to sit on the bench for a little while and, once they felt better, to go back in."
That's a mistake - and not only because it takes more than a few minutes to know how serious the injury is. An initial concussion, neurologists are now learning, can make a second concussion more likely, and the second injury, in turn, increases the risk of subsequent ones over the years. That's precisely the reason some NFL players become known as more concussion-prone than others. Worse, the danger is cumulative: later concussions may become not just more likely, but also more serious. "A sequence of mild events - even just two or more - can equal one big hit," Shealy says. That may have been what happened in Richardson's case, though no one has said publicly if she had any other head injuries in her past.
The fact that Richardson was not wearing a helmet may or may not have made a difference in the gravity of her injury. If skiers are moving slowly - say 10 m.p.h. or slower - and they fall on soft snow, they're probably not going to be hurt severely, whether they're wearing a helmet or not. If they're moving faster than 15 or 20 m.p.h. and strike ice, hard-packed snow or another solid object with the head, they're likely to suffer severe injury, and again the presence of a helmet may not make much difference. It's in the middle area - at speeds that are neither very slow nor very fast - that a helmet can play the biggest role. The trick, of course, is that you never know when you're going to be in that gray zone, since even slow beginner skiers can lose control and speed up, and high-speed skiers have to slow down eventually.
Physics makes things trickier still, causing different parts of the body to move at different speeds. Your skis or snowboard may be sliding along at a slow 10 m.p.h., but if you catch a tip or edge on something stationary, the rest of you plunges forward and accelerates. "The body acts as an inverted pendulum, so the upper body moves much faster than the lower body," says Shealy.
Once you do fall and hit, the brain can do much more than just bump the inside of the skull. "You can have stretching of cortical connections or stretching of blood vessels, and that can lead to bleeding," Shealy says. "You can also have linear or rotational acceleration [of the brain]. There's a lot that can go wrong in there."
Even some experts acknowledge that helmets are no panacea, and not only because they become less effective at higher speeds. Skiers argue that they reduce peripheral vision and also provide a false sense of security that encourages speeding. Those claims may well have some truth, but seat belts too may create a false sense of security, yet few people argue the wisdom of wearing them. Helmets may not provide the same level of protection as a seat belt, but in some cases, even inconsistent protection may make all the difference.

Review of a Conscious casualty with any Head Injury by the First Aider
1. Take a full proper history of the accident
2. Look for symptoms of headache, giddiness, blurring of vision, nausea and vomiting
3. Look for symptoms of altered consciousness temporary or otherwise
4. Look for symptoms of disorientation or loss of memory or speech defects
5. Look for sensorimotor changes in the limbs
6. Changes in vital signs - pulse, blood pressure, breathing, oxygenation and circulation
7. A complete general examination of the casualty
8. Examination of the head for external signs of injury and bleeding. Do not forget to check pupils, nose, and ears.
9. Strongly advise him/her to go to the nearest hospital for further check-up

1 March 2009

Examination of an unconscious patient -
Do not forget to examine the pupils ! Quite useful information can be obtained from a quick examination of the pupils of the eyes of an unconscious patient. For example if both pupils are very small (constricted or "miotic"), it may be a case of :-
- insecticide poisoning (? suicidal) or
- narcotic overdosage (? morphine addiction).
Always have a working torchlight at hand when attending to an unconscious patient.
You can read further about unequal sizes of pupils.
Bet you know about the significance of "fixed dilated" pupils ! Ask your Medical Officer or Nursing Officer if you do not know the answer.

Number of road deaths shot up by 11.6 % this CNY period
Kuala Lumpur : Road deaths increased by 11.6% during the 19th Ops Sikap conducted for the Chinese New Year period from Jan 19 to Feb 2, compared with the same period last year.
The target set earlier by the Internal Security and Public Order director Datuk Hussin Ismail was to reduce the death toll by 5%.
A total of 212 deaths was recorded this year, against 190 last year, during the same period.
The average daily death toll recorded in the 15-day operation was 14.1, compared with 12.6 in 2008.
However, fewer accidents were recorded this year at 14,618 compared with 14,991 last year during the 16th Ops Sikap.
Motorcyclists and pillion riders accounted for 72% of fatal accidents with 152 deaths, an increase of 43.4% from last year.
Followed by car drivers and passengers (29 deaths), pedestrians (14), lorry drivers and attendants (5), cyclists (4), jeep users (three), van users (2) and (1) each involving a bus, taxi, and other vehicles.
There was no fatal bus accident during the operation, but traffic summonses shot up to 142,362.

Personal comments : The above report is a cause of concern to all of us. What about minor accidents that go unreported and settled privately ?
Though our task is to institute first aid for accident victims to help to save lives, the promotion of accident prevention is an equally vital task for us.
Accident prevention is a mutual responsibility. The relevant authorities such as the police and road transport department as well as the drivers and other road users also must play their part.
Driving slowly at all times would help to reduce occurrences of accidents, fatal and nonfatal injuries wouldn't it ?
And the practice of defensive driving always by drivers too ?
Hoping to see the reduction of road accidents and injuries all the year round.

Bulletin 19 Januari 2009

St. John Ambulans Malaysia Negeri Melaka melancarkan Perkhidmatan Ambulans Kecemasan 24-Jam Lebuh Raya Utara-Selatan dan Jalan Raya untuk musim Tahun Baru Cina dengan kerjasama Jabatan Polis Negeri, Jabatan Pengangkutan Jalan Negeri dan Majlis Bandaraya Melaka Bersejarah.

YAB Datuk Seri Hj Mohd Ali bin Mohd Rustam, Ketua Menteri Melaka merangkap Presiden SJAM Melaka hari ini 18 Januari 2008 Ahad di Hang Tuah Walk, Jalan Hang Tuah Melaka merasmikan Pelancaran Perkhidmatan Ambulans Kecemasan 24-Jam St. John Ambulans Malaysia Melaka Lebuh Raya dan Jalan Raya untuk musim Tahun Baru Cina.

Dalam ucapan rasmi YAB, selain menegaskan pada keselamatan jalan raya dan kawalan kemalangan jalan raya, YAB menyentuhkan pada rancangan-rancangan untuk pembangunan dan perkembangan St. John Ambulans Melaka demi membaiki perkhidmatan organisasi kami untuk masyarakat.

YAB Ketua Menteri Melaka juga mengambil kesempatan mengucapkan Selamat Tahun Baru Cina kepada semua ahli-ahli dan masyarakat Tiong Hua !

Terima kasih YAB Ketua Menteri merangkap Presiden SJAM Melaka atas sokongan, bantuan dan kepimpinan YAB !

Bulletin 5 January 2009

A Happy New Year 2009 !

Salam hormat daripada SJAM Melaka. Selamat melayari laman web kami.
Greetings from SJAM State of Melaka.! Welcome to our website.
Thank you for your interest in our fine worldwide organisation
which observes the historical motto of
" Pro Utilitate Hominum - For the Service of Mankind".

Early Year News snippets for 2009

State 24-hours Emergency Ambulance Highway duty for Chinese New Year
18 January 2009 Sunday - Launching by SJAM State of Melaka
24 - 25 January 2009 - Ambulance duty
31 January - 1 February 2009 Ambulance duty

State Kawad Kaki Competition for Pasukan-Pasukan St. John Sekolah Menengah
8 March 2009 Sunday

State First Aid and Nursing Competition
19 April 2009 Sunday .

National First Aid and Nursing Competition
May 2009 - in a Northern State of Malaysia ?

National Conference 2009
in Kota Kinabalu in the later part of 2009.

Article 5 January 2009

QUALITY MANAGEMENT

This is our THEME for attention for YEAR 2009 proposed and accepted at our State Meeting on
4 January 2009.
(Remember...last year's Theme was
DISCIPLINE BY EXAMPLE)

The 3 Q's of Quality Management
xx1. Quality Awarenes
2. Quality Control
xx3. Quality Assurance

Application towards
1. Adminstration
2. Training
3. Certification
4. Services
5. Development
6. Others

Processes involved
1. Objectives
2. Methods and Planning
3. Resources
4. Implementation
5. Testing/Investigation
6. Results
7. Analysis
8. Conclusions
9. Recommendations

Values
1. Compliance
2. Suitability
3. Correctness
4. Knowledge
5. Competency
6. Efficiency
7. Confidence
8. Reliability

Other important points discussed
1. Validation and Verification
2. Regular audit
3. Peer reviews
4. Manpower factors such as personnel integrity,
knowledge, organisational culture, motivation, team
spirit and quality relationship
5. Needs and expectations of our customers/our members
versus the capability of Providers

Leaders think and talk about the solutions.Followers think and talk about the problems.
- Brian Tracy

He who has never learned to obey cannot be a good commander.
-Aristotle

You will never be a leader unless you first learn to follow and be led.
-Tiorio