Sunday, 31 January 2016

Emergency Response - chemical leaks


The other day in the news I saw an article about an emerging concern in Canada.  It seems that there is a genuine fear of sabotage of oil pipelines, particularly in the westof that country.  With that in mind, it struck me that it would be helpful both to non-hazmat emergency responders (for example, ambulance officers) and to general readers to post about responding to a chemical emergency.

Knowing the risk


The first thing to remember is that chemicals are not magical.  Most substances are not dangerous provided proper instructions for their use and storage are followed.

If you live or work in an area where significant chemical use occurs, or in a transport corridor to such an area, it may be prudent to note the “UN Numbers” which you regularly see.  The chemicals denoted by these numbers can be looked up in this publication and guidance as to responding printed off.


Image from here

If you spot a risk


Reporting


If you come upon the scene of an accidental chemical release, or are the first emergency responder on scene, contact the relevant emergency management agency for your jurisdiction.  In Australia, this would mean calling “000” and asking for the fire brigade.  If possible (and if it can be done safely), you should also advise –

  • The UN Number of the escaping chemical.
  • Whether the chemical being spilled is at risk of entering a stormwater drain or watercourse or otherwise escaping the scene.
  • Whether the wind is blowing and in what direction (many iPhones contain a compass application). 

Keeping yourself safe


If possible, put on protective glasses or goggles when near the chemicals.  Protect your mouth and nose with a wet cloth or a mask.  Avoid contact with contaminated water.  Do not consume food or drink which may have been contaminated.

If the substance is thought to be flammable, obviously do not use anything with a naked flame or spark (or an incandescent wire).

If you are in a motor vehicle, close the windows and turn off the air conditioning or heating


Image from here

Keeping others safe


If there are bystanders or people living or working nearby, advise them to stay indoors.  Doors and windows should be closed and air conditioning switched off pending advice from the authorities.

Afterwards


After the initial chemical release is controlled, ensure that checks for the welfare of people in the area (particularly children, the handicapped and the elderly) take place.  Emergency crews should be advised of any symptoms of which they should be aware, and provided with any necessary instructions as to decontaminating or disposing of clothing and equipment.

Acknowledgment


The information in this post has been drawn from the website of the International Civil Defence Organization.


Tuesday, 26 January 2016

Books for Blood

One of the less-expected consequences of Winter Storm Jonas has been a constriction of the blood supply for medical care in many of the affected American states.  In New York, the storm saw over 1,400 donations cancelled.  In the Carolinas, the number came to 2,300.  The total cancelled donations in the 20 affected states was 9,500.


Image from here


The need for a steady blood supply to ensure high quality medical care scarcely needs labouring.  Levi Stone says plainly that
Every two seconds someone in the U.S. needs blood; Approximately 41,000 blood donations are needed every day; ... The blood used in an emergency is already on the shelves before the event occurs; ... A single car accident victim can require as many as 100 pints of blood.
In the hope of contributing something useful, I'm re-running a book giveaway I ran previously.  I have one copy of each of the following books to give away -

If you're a true-crime buff, this is certainly a book I can recommend!
Image from here


  The World's Most Infamous Murders
 Image from here.

The World's Greatest Crimes of Passion
Image from here.


To claim one of these books, you need to make a blood donation within one of the states most directly affected by Jonas.  I understand these to be North Carolina, Kentucky, Virginia, West Virginia, Washington DC, Delaware, Maryland, Ohio, Pennsylvania, New York, New Jersey, Massachusetts, Connecticut and Rhode Island.  Then leave a comment below confirming that you have, so I can contact you to find out where to send your book.  The giveaway is open until 24 February 2016 or until all three books are claimed (whichever comes first).


Hoping this small incentive will encourage people to pitch in.

Monday, 25 January 2016

Cain and the Cavemen

Cain must have been a worried man.  In a short span of time he'd failed to please God and he'd offed his brother.  God had pronounced sentence against him, condemning him to be a wanderer on the face of the earth.  Cain complained that "I shall be a fugitive and a vagabond in the earth; and it shall come to pass, that every one that findeth me shall slay me".  God must have accepted the justice of the complaint, because he said that
whosoever slayeth Cain, vengeance shall be taken on him sevenfold. And the Lord set a mark upon Cain, lest any finding him should kill him (Genesis 4:14-15).
Cain, clearly, was worried about people aside from his parents Adam and Eve, and from somewhere he'd managed to acquire a wife and a sufficient labour force to build a city (Genesis 4:17).


Image from here


The reason this is sticking in my mind is because of the story in the news recently that certain common food allergies may be down to the sharing of DNA between Homo Sapiens (arising about 40,000 years ago) and Neanderthals (arising about 125,000 years ago).  The idea that modern humans simply absorbed the older Neanderthal population has been around for a long time (1).  It's now accepted that Neanderthals and Homo Sapiens existed simultaneously, and that the latter were far more numerous than former (2).  One population being absorbed into the other is nothing if not plausible.



Image from here


Is it too much to suggest that Cain's story should be read as an allegory of the encounter and ultimate union between these two forms of humanity?  I can't imagine a way in which this might be proven: The last identifiable Neanderthal population seems to have died out about 26,000 years ago; the earliest known writing dates from 8,600 years ago (3), and the earliest form of the Book of Genesis seems to have been written down around 3000 years ago.


Perhaps, though, proof is not what's needed.  Even the possibility that the one reflects the other is a suggestion that its author well understood what it means to be part of a rootless, guilt-stained humanity making its way in the world.  One would have to hope that in our day leaders will follow the example of the mercy shown to Cain, and show compassion even for spillers of human blood.
---------------------------------
(1) Kenneth F. Weaver, 'The Search for our Ancestors' (1985) 168 National Geographic 560 at 617.
(2) Marc Mennessier, 'Homo sapiens et Neandertal ont coexisté', Le Figaro, 30 October 2012; idem, 'Neandertal aurait été submergé par le nombre', Le Figaro, 28 July 2011.
(3) Marc Mennessier, 'Les néandertaliens espagnols prennent un coup de vieux', Le Figaro, 7 February 2013; Paul Rincon, '"Earliest writing" found in China', BBC News, 17 April 2003.

Sunday, 24 January 2016

Anissa Hammadi, 'Revisiting Camus' Algiers', El-Watan, 8 November 2013.

I've always been immensely grateful to the high school French teacher who required us to read Albert Camus' novel The Outsider.  Probably no other book, and no other author, influenced my sixteen-year-old brain quite so much.  It's in tribute to that long-ago teacher that I've translated this article revisiting the city Camus immortalised.

Anissa Hammadi, 'Revisiting Camus' Algiers', El-Watan, 8 November 2013.

On the centenary of the birth of Albert Camus, the Algerian daily newspaper El-Watan returns to the places he wrote about.  What has become of the city that the French writer described and cherished?

"People swim in the harbor and then go rest on the buoys.  when you pass a buoy where a pretty girl is sitting, you shout to your friends 'I tell you it's a seagull'"*.  When they weren't swimming, the young people amused themselves taking "long canoe trips paddling around the red and black freighters"*.  Today, the port of Algiers has only commercial activity, and the boats and the rowing club are gone.

What's more, the ports are completely off limits to the public.  Writer and journalist Brahim Hadj Slimane explains that -
What Camus described existed up until the 1970s.  It's not like that anymore, and not just in Algiers.  The young people who swam there were the children of the ordinary suburbs, as was Albert Camus in Belcourt, which was a working-class suburb at that time ... The ports were closed to the public for security reasons, and so, as in Algiers, they lost their conviviality.

El-Kettani beach, Algiers.
Image from here

Next to the port, the beach of Bab El-Oued has also radically changed.  Camus wrote that
The dance hall at Padovani Beach is open every day.  And, in this immense rectangular box, open to the sea all along one side, the poor youngsters of the district come to dance until evening*.
More than sixty-six years later, Padovani Beach - now El-Kettani - has calmed down.  The frenzied dancers have given way to families.

It's an era whose passing is mourned by architect and sociologist Lesbet Djaffar: "One could eat and dance, and students could fill their hearts with joy".  As well as dancing, one could swim: "I dove into the current", explained Camus, speaking of "the swimming baths at the port", now the pool at Rua.  Today on the beach, some boats rest on the sand bars, but nobody uses them.  The few swimmers have masks and snorkels, while the women gossip on the stones at the waters edge.

"The French-Algerians would dance at the Padovani pools, a sort of club by the beach.  It was an entirely French establishment.  The girls sunbathing, the young men swimming - these were not Algerians", declares Camus specialist Christiane Achour, professor of French Literature at the University of Cergy Pontoise (Val-d'Oise).  His vision of Algiers was of a Frenchman in Algeria.
There is a noontime silence on the government square.  In the shade of the trees that grow along each side, Arabs sell penny glasses of iced lemonade, perfumed with orange blossom.  Their cry of 'cool, cool' echoes across the empty square*.
Less exotic and charming that in the vision of the author, Government Square - now Martyr Square - is a worksite for the expansion of a railway station.  The "noonday silence" and the "deserted square" are gone.

Place des Martyrs, Algiers.
Image from here

Besides, being just down from the Casbah, the square was always much better frequented than Camus would have us believe.  Stalls of arts and crafts and many kiosks were set up there.  "It was very busy there in the evenings during Ramadan, because the bakers were there all night", recalled Christiane Achour.  "That still happens, but today it's also the depot for busses going to the outer suburbs, and almost as busy as a railway station.".

Albert Camus lived on the Rue de Lyon in Belcourt, a road better known today as 'Mohamed Belouizdad'.  At Number 124 is the flat where he spent his childhood.  "I don't know for a fact that he lived here, but I suppose he did.  Many French people come here to take photographs", says a young man at the foot of the block of flats.  Belcourt is still a working class suburb, but its cinemas - mentioned many times by Camus - have nearly all vanished.

Rue Mohamed Belouizdad, Belcourt, Algiers.
Image from here

"The cinemas of the district poured a flood of theatregoers into the street", said Camus in The Wrong Side and the Right Side.  His street had no less than five cinemas.  "I recall that there was a cinema on the corner just near his home", remembers Lesbet Djaffar. "At that time, not many Algerians went to the cinema, because most of the films were French.  They preferred American films, which had more action".  Algiers boasted about sixty cinemas in total at that time; now there are only about ten, including two called "Algeria" and "Cinematheque".

The trams and streetcars are among the most iconic parts of Camus' writing on Algiers.  "Sometimes a large tram would rattle swiftly past", he wrote in the story Between Yes and No (1937).  The city had a large network of trams, split up into three large lines.  Before independence, in December 1959, it was closed permanently.  For Lesbet Djaffar, the tramways were a critical part of the atmosphere of the town.  In 2011 the trams returned, but have not captured the city's imagination in the same way.

Today's Algerians do not wholly recognise themselves in the Algiers depicted by Camus, and perhaps they never did.  But certain sensations are undeniably common to them in all ages:
Algiers and a few other privileged coastal towns open into the sky like a mouth or a wound.  What one can fall in love with in Algiers is what everybody lives with: the sea, visible from every corner, a certain heaviness of the sunlight...*
* These quotations have been taken from the volume Albert Camus, Lyrical and Critical Essays, translated by Ellen Conroy Kennedy and edited by Philip Thody (Vintage Books, New York, 1970).

Saturday, 23 January 2016

Office of Civil Defence, Fallout Protection (US Govt Printing Office, n.p., 1961)

Hi everyone,

This is another post asking what we can learn from emergency preparedness as it was practiced in the past.  Today I'm looking at Fallout Protection, prepared in 1961 by the Office of Civil Defence.

Image from here

About

This text is historically interesting for two reasons.  First, it has a rather grimmer and more purposeful style than Surivival Under Atomic Attack, published a decade earlier.  Secondly, governments seem to have had greater faith in people to accept bad news then than they do now: it's difficult to imagine any western government stating bluntly (as this book does at pp.5-6) -
There is no panacea for protection from nuclear attack.  In a major attack upon our country, millions of people would be killed.  There appears to be no practical program that would avoid large-scale loss of life.
The next thing to say is that (viewed from today's perspective) the illustrations in this book are unintentionally rather funny.  Apparently proper clothing for preparing a fallout shelter is a frilly baking apron (p.20), a cardigan (p.24) or skinny jeans (p.23).  And when taking shelter from a nuclear holocaust, remember to wear a necktie or a v-neck sweater (pp.21-22).
 
Sartorial factors may be the least of your worries though: the shelter designs show a family of three crammed into an area measuring rought 4' x 4' x 10' for up to two weeks.  I suggest that after 24 hours tops, most people will be willing to take their chances in the post-apocalyptic wasteland with Big Brain and Friends.
 
Image from here
 
Once one cuts through the comedy, however, there is genuinely good advice for any sort of disaster, nuclear or otherwise.

 

Water

 
This guide notes that humans can live on one quart of water (just under a litre) a day, although it will be more comfortable to allow a gallon (just under 4 litres) a day in warm conditions.  It states that even though water may develop a poor smell or taste, it will still be usable in an emergency.
 
If water contamination is likely (for example, in a flood scenario), a safe water supply can be preserved by closing your house off from the mains.  Water stored in pipes, toilet cisterns and a hot water service will in general be safe to drink.  The book recommends assuming that one will need to purify water from public sources unless advised that it is safe to drink.  Cloudy or unclear water should be strained through a paper towel or multiple thicknesses of clean cloth, or allowed to settle in a deep container before being siphoned off.  After that, it can be freed of germs by being boiled for a few minutes or chemically treated
 

Food

 
This guide recommends keeping a two week supply of food.  This seems a prudent measure in any circumstance where one may be isolated as a result of flooding, fire or snowstorm, and is somewhat more realistic than the American Civil Defence Association's recommendation of a year's supply (I would add as an aside that keeping a year's supply of food in a survival situation looks suspiciously like hoarding and or preparing to profiteer, which raises some moral issues).  Ten-thousand calories should be allowed for each adult over two weeks, assuming that they will be fairly inactive. 
 
It is recommended that one selects foods which are familiar, which will make them a morale-booster when one is otherwise stressed (conceivably they would also be more acceptable to children who are upset by the loss of their routine).  Foods that do not require cooking or refrigeration are recommended.  The guide suggests -
  • Tinned meats, fish and poultry
  • Tinned beans, peas and fruits
  • cereals
  • Peanut butter.
  • Biscuits
  • Tinned or powdered milk
Eating the oldest items first is recommended.  Tinned foods should be discarded if there are bubbles in the juices.
 
The book also says (and I emphatically do not agree!) that bread is still edible when mouldy, that sour milk remains drinkable, and that tinned and packaged animal foods can be eaten by humans without harm.

Friday, 22 January 2016

National Security Resources Board, Survival Under Atomic Attack (Department of Civil Defence, Boston, 1951)

Disaster preparedness has been around pretty well since God said to Noah
The end of all flesh is come before me; for the earth is filled with violence through them; and, behold, I will destroy them with the earth. Make thee an ark of gopher wood; rooms shalt thou make in the ark, and shalt pitch it within and without with pitch.
It seemed to me that it might be interesting to look over what past generations have thought about responding to calamities (actual or potential) and see whether they recommended anything of value for us today.

Image from here
The first text I'm using for this is Survival Under Atomic Attack, prepared by America's National Security Resources Board in the early 1950s.  For myself, I don't view nuclear devastation as a particularly serious risk these days, notwithstanding North Korean sabre rattling.  However, we can derive some useful advice from this book.  When it comes to dealing with situations where a major explosion may occur (for example, certain types of truck accident), it advises that -
Even if you have only a second's warning, there is one important thing you can do to lessen your chances of injury by blast: Fall flat on your face.
More than half of all woundsare the result of being bodily tossed about or being struck by falling and flying objects.  If you lie down flat, you are least likely to e thrown about.  If you have time to pick a good spot, there is less chance of your being struck by flying glass and other things.
If you are inside a building, the best place to flatten out is close against the cellar wall.  If you haven't time to get down there [or don't have one at all!], lie down along an inside wall, or duck under a bed or table.  But don't pick a spot right opposite the windows or you are almost sure to be pelted with shattered glass.
If caught out-of-doors, either drop down alongside the base of a good substantial building  - avoid flimsy, wooden ones likely to be blown over on top of you - or else jump in any handy ditch or gutter.
The book also has some useful points to make where fire and explosion control is concerned.  It recommends 'fire-proof' housekeeping and not letting garbage or detritus build up around your home.  If a major shockwave is expected (whether from an explosion, seismic activity or any other cause), it would be priudent for you to know how to turn off the gas and electrical supply to your house.

What real or imagined disasters from the past do you feel may have something useful to tell us today?

Thursday, 21 January 2016

First aid brushup: Wound management - Crush injury

These injuries are potentially very serious: where a major muscle mass has been compressed for an hour or more, significant toxins will build up.  When the pressure is released, these toxins can enter the bloodstream and cause severe illness or death.





Image from here

Identification

Be particularly alert for restriction of blood flow to a major muscle mass for an hour or more.  The casualty may complain of numbness or tingling at the crush site.  They may also show signs of shock, and there may be swelling, bruising or rigidity.

Management

An ambulance should be called and resuscitation performed if required.




If there is reason to suspect the casualty has been crushed for an hour or more, do not remove the object without a medical team present as this may release the toxins.  In other cases, remove the crushing force without delay if this is physically possible.  Bleeding should be controlled and the casualty kept warm.

Acknowledgement

As with other posts in this series, the information supplied is from Kym Eden's Fun with First Aid (2013).

Wednesday, 20 January 2016

First aid brushup: Wound management - Embedded objects

Identification

It is to be hoped that the object will be visible to the eye.




Image from here

Management

First and foremost: Do not remove the object.  Doing so has the potential to cause severe bleeding. 


Medical assistance will be required (an ambulance may be best).




First aid should consist of applying firm pressure around the wound (not on the object), ideally with a clean pad.  Padding should be placed around the object to support it, and then bandage the padding in place to keep the object stable.  If the injury is to a limb, elevate it (if possible) to reduce swelling.

Acknowledgement

As with other posts in this series, the information supplied is from Kym Eden's Fun with First Aid (2013).

Tuesday, 19 January 2016

First aid brushup: Wound management - Eye injuries


Identification

Eye injuries are particularly uncomfortable and the casualty is likely to report one which has occurred.  A penetrating eye injury will also be accompanied by bleeding inside or from the eye, and the casualty may complaint that their vision is distorted or that they are sensitive to light.






Image from here

Management

If a foreign object is visible in the eye and is small, a damp tissue may be able to remove it.  Alternatively, it may be possible to wash it out with a steady stream of clean water, saline solution or the casualty's own tears (have them tilt their head towards the injured side).  If the object cannot be seen (or if seen, cannot be readily removed) cover the eye and take the casualty to a doctor.






You should not attempt to remove foreign objects from the eye if they are over the pupil.  Rubbing the eye (by the casualty or by a first aider trying to remove the object) is likely to cause further damage.






Where a penetrating eye injury has occurred, call an ambulance.  While waiting, have the casualty lie down with their head slightly raised on a pillow.  Padding should be placed around the object to support it, and then bandage the padding in place to keep the object stable.  Do not attempt to remove or touch the object.  The uninjured eye should also be covered, as this will discourage movement of the eyes and reduce the risk of further injury.

Acknowledgement

As with other posts in this series, the information supplied is from Kym Eden's Fun with First Aid (2013).

Monday, 18 January 2016

First aid brushup: Wound management - Mouth injuries (non-dental)

Identification

Injuries to the tongue, cheeks or lips may be readily reported by the casualty.

Management

Where a cheek has been injured, have the casualty sit up with their head leaning forward and towards the injured side to allow blood to drain.  Pressure should be applied to the wound with a clean pad.  Rinsing the mouth out is not recommended as this will interfere with clotting.  It may be wise to loosen restrictive clothing around the neck.






Where the tongue has been bitten, water should be used to wash the area clean.  The tongue can be pressed against the roof of the mouth to apply pressure to stop the bleeding, and applying ice will help reduce swelling.  Similarly, where a lip has been injured, water should also be used to wash the area clean and ice given to reduce the swelling.






In all cases, injuries to the mouth should be monitored for infection and injuries that seem significant should be referred to a doctor.

Acknowledgement

As with other posts in this series, the information supplied is from Kym Eden's Fun with First Aid (2013).

Sunday, 17 January 2016

First aid brushup: Wound management - Dental injury

It may be possible to replant a tooth which has been knocked out.

Identification

This should be reasonably obvious.




Image from here

Management

The injury to the mouth can be managed by having the casualty sit up with their head leaning forward and towards the injured side so that any blood can drain.  Pressure should be applied to the bleeding socket with clean gauze pad for about 10 minutes (biting may be an effective way to do this). 




Rinsing the mouth out is not recommended as this will interfere with clotting.




The tooth should only be handled by the enamel (not by the roots).  Any dirt should be gently cleaned off it with water or with the casualty's saliva.  However, do not store the tooth in water.  You can attempt to reimplant the tooth provided the casualty is not drowsy, young, unconscious or distressed.  Alternatively, a dentist should be consulted as soon as possible; in the meantime the tooth should be stored in a glass of milk, or wrapped in cling wrap or foil.

Acknowledgement

As with other posts in this series, the information supplied is from Kym Eden's Fun with First Aid (2013).

Saturday, 16 January 2016

First aid brushup: Wound management - Bleeding from the nose

Identification

Blood noses are unlikely to be a serious problem, but may be upsetting to young children.

Management

Encourage the patient to sit up and lean their head forward slightly.  If possible, they should pinch the soft part of the nose for about 10 minutes, and breathe through their mouth.  Blowing the nose is not recommended.






The casualty's collar and/or tie should be loosened and cool wet towels (or an icepack wrapped in a towel) should be placed around the neck or on the forehead.






If the nose bleeds for longer than 15-20 minutes, medical review may be wise.

Acknowledgement

As with other posts in this series, the information supplied is from Kym Eden's Fun with First Aid (2013).

Friday, 15 January 2016

First aid brushup: Wound management - Bleeding from the ear

Identification

Bleeding from the ear can result from different causes.  A burst eardrum may have been caused by trauma, an explosion, or a foreign body being pushed into the ear.  In this case, the casualty may have difficulty standing and complain of deafness and sharp pain or earache.




Image from here




If the casualty has sustained a blow to the head, the ear may bleed watery blood.  This is serious and suggests a possible skull fracture.

Management

Conscious casualty

Encourage the patient to sit with their head leaning toward the injured side so the blood drains.  If the injury is minor, apply gentle pressure with a clean sterile pad.




If the injury may be serious, place the casualty in the recovery position with a clean pad under the ear.  Allow it to drain freely.  An ambulance should be called.

Unconscious casualty

Perform resuscitation if necessary and send for an ambulance.  After breathing is restored, put the casualty in the recovery position with the injured ear downward and allow the ear to drain into a clean pad.  Do not plug the ear

Acknowledgement

As with other posts in this series, the information supplied is from Kym Eden's Fun with First Aid (2013).

Thursday, 14 January 2016

First aid brushup: Wound management - Scalp and Head Wounds

Be aware in cases of scalp and head wounds that there may be more serious underlying injuries, including concussion, skull fractures and spinal injuries.

Identification

Blood vessels run close to the surface on the head, so any wound will bleed profusely.




Image from here

Management

Encourage the casualty to lie down with the head and shoulders slightly supported.  Cover the wound with a clean (ideally sterile) pad and apply firm pressure (but be aware of the risk of a skull fracture).  Secure the pad in place with a bandage.






Because of the risk of head injury, medical assessment would be prudent.

Acknowledgement

As with other posts in this series, the information supplied is from Kym Eden's Fun with First Aid (2013).

Home or Rome?

I've written previously about whether certain churches will tend to thrive better in certain environments.  Something which I'm noticing more and more is how some believers are professing a type of "Biblical Christianity" which focusses almost exclusively on the individual believer, their conscience, and a bible.  In effect, a church limited almost to the family and the home.


The most committed of this school of thought seem to be the King James Only movement, who state that -
the KJV is a divine work of the Holy Spirit. The term "Authorized" has traditionally been applied to the King James Version alone, for this is the one Book which the Holy Spirit has blessed and used for so long. The fact that it bears no copyright allows printing ministries throughout the world to print millions of copies each year for the mission field. I know the King James Bible is the word of God because it has no copyright...
The Holy Spirit doesn't bear witness to the modern translations, but He DOES bear witness to the King James. I've always believed the KJV to be God's word, even before I was saved. No one ever told me to believe this, but the Holy Spirit just bore witness to the King James--not the others. After being saved, I spent several years of my Christian life not being aware of the big debate going on these days between King James Bible believers and New Age Version believers. The whole time I believed only ONE BOOK to be God's word, and even then I was suspicious of the new versions, although no one had told me to be. When I discovered that over eighty percent of the "Christian" schools in our nation do not believe the KJV to be the word of God, I was shocked.
From the conversations I've had with this school of thought, there doesn't seem to be a need for any sacrament except, perhaps, baptism.



King James I
Image from here


Over the last few days I saw three news stories which cast this into an interesting light.  One was Pope Francis' participation in a video with a Moslem, a Jew and a Buddhist.  The reaction from a particular strand of believers was (let us say) robust () -


Maybe the pope needs to go back to Sunday school. Even my 5yr old knows the only way to God is through His son Jesus Christ. allah was the pagan god of the Moon and that is why islam's symbol is a crescent moon. (by JM McRann)
I have never trusted this pope. I smelled a fish by the time I heard him and watched him the 2nd. time. He is evil just as obama. They both want on world order and Islam's ways. (by Brenda Kay Atherton-Lingle)
Pope = Cult leader dedicated to extracting as much money from his followers as possible. (By Duane Hallman)


When I thought about it a bit more, I realised that the Catholic church may be the only denomination which retains enough religious authority for people to become upset when it takes part in an event like this.  What tipped me off was a report of the difficult travails of the Anglican church.  Struggles over sexual morality have meant that denomination has deferred its global summit for some years.  Now that a synod is to be held, there is a fear the church may go into open schism.  Meanwhile, actual Anglican parish churches face closure for lack of worshippers.


Is this an indication of the long term future of Christianity: one or two large, strongly-structured churches, and a great many unaffiliated worshippers carrying out their devotions in their home with a Bible?  The choice for believers may come down to home or Rome


Image from here

Wednesday, 13 January 2016

First aid brushup: Wound management - Amputation

Some accidents may be severe enough to sever or partially sever all or part of a limb.

Identification

An injury of this severity will be hard to miss.


Image from here

Management

Send for an ambulance.  In the meantime, firm pressure with a clean pad should be applied to the wound.  The pad should be secured in place with a tape or bandage




The severed body part should placed in a sealed, airtight plastic bag or container or wrapped in clingwrap.  This 'package' should then be placed in another layer of plastic, and then the whole placed in a container of water.  If possible, add crushed ice to the water to chill the body part.  Mark the container with the casualty's name, date and time and ensure it is handed to the attending paramedics.




Critically, do not let the body part come into direct contact with the ice or water, do not wash it, and do not place it in a fridge or freezer.

Acknowledgement

As with other posts in this series, the information supplied is from Kym Eden's Fun with First Aid (2013).

A new law in Texas

My eye was caught by a story out of Texas earlier today.  A recently passed statute is reported to have guaranteed "that no laws from ‘foreign courts’ will be adopted by Texas civil court judges".


I've been a little concerned by attempts to exclude international and foreign law from domestic courts ever since I read the column now-Presidential candidate Ted Cruz penned for Human Events -
One doesn’t have to be a constitutional scholar to object to foreign laws and foreign courts — laws that are not enacted by our democratic government and judges who are not selected as our Constitution provides — ruling on Americans’ rights and the powers of American government.
While there is some superficial appeal to insisting on the sovereignty of domestic law, there are two strong arguments to the contrary.  One is practical.  Despite the warnings over a decade ago about the International Criminal Court, it seems to be making a worthwhile mark on the world's troublemakers.  Hazel Smith of the International Institute of Korean Studies has explained the recent North Korean nuclear test by saying that
The North Koreans are not led by diplomatic strategy anymore. They are led by a view that the military is what allows the regime to survive ... You have a group of [ruling] families who don't want to see their power go, who don't want to end up in [the International Criminal Court in] The Hague.

Image from here


More fundamentally, there's a philosophical objection which should have meaning to right-wingers like me: there is nothing conservative about blocking international law.  William Blackstone, described by one arch-conservative group as "foundational to American law" considered such law to be a system of rules deducible by natural reason, stemming from the principles of natural justice, and enjoying "universal consent among the civilised inhabitants of the world".  It's hard to imagine a better endorsement.


There are many reforms to the law that conservatives should support.  This isn't one of them.

Tuesday, 12 January 2016

First aid brushup: Wound management - Shock

Shock is the loss of blood volume or pressure to organs in the body which causes them to cease normal function.  Ultimately this condition can result in death.




Image from here

Identification

If possible, find out whether there is a history of any of the following -
  • Multiple fractures or trauma (including brain or spinal injuries)
  • Severe bleeding
  • Severe fluid loss (for example, from dehydration, burns or diarrhoea)
  • Severe infection
  • Allergic reaction

Stages of Shock

Initially the casualty may have pale, cold and clammy skin and their breathing and heart rate increase.


As the condition continues, parts of their boddy (especially the lips) may take on a grey-blue colour and they may appear weak, dizzy and restless.  They may complain of nausea and marked thirst and sweating.




When the supply of blood and oxygen to the brain decreases, you may identify enlarged pupils, drowsiness and yawning, confusion and a drift into unconsciousness.

Management

Conscious casualty

Send for an ambulance.  While waiting, encourage the casualty to lie down on a blanket (or at any rate, on something which will insulate them from cold ground).  If possible, raise their legs to improve blood supply to vital organs, and loosen clothing around the neck, chest and waist to assist breathing.  Do not allow them to eat or drink while waiting for the ambulance, but moisten their lips to help control thirst.

Unconscious casualty

Request an ambulance, and provide CPR and defibrillation if necessary.  When breathing resumes, move the casualty into the recovery position, and then manage any other injuries.  Closely monitor their condition.

Acknowledgement

As with other posts in this series, the information supplied is from Kym Eden's Fun with First Aid (2013).

Monday, 11 January 2016

First Aid brushup - Particular Hazards: Dirty Bombs


There has been a lot of attention lately on the North Korean nuclear weapons test.  First aiders might find useful a brushup concerning a more 'down to earth' atomic hazard: the risk posed by a "dirty bomb".

The risk

A "dirty bomb" (sometimes called a 'radiological dispersal device') combines conventional explosives with radioactive material (for example, certain types of medical and industrial waste).  This combination is unnerving but should not be exaggerated: a dirty bomb is not a nuclear device.  A nuclear weapon, like that tested by North Korea, splits atoms to cause a catastrophic explosion and widespread radioactive contamination.  A dirty bomb is simply a conventional device with contaminants added.

Identification. 

An explosion is proverbially hard to miss, but radioactive material is unlikely to be obvious unless (for example) the debris contain material with a hazardous goods label.



Image from here


Ideally emergency responders will be equipped to detect radiation in the area of an explosion and will be able to relay suitable warnings.  It is probably not worthwhile obtaining one’s own Geiger counter or similar advice: the United States' Nuclear Regulatory Commission warns thatmany of the Geiger counters available commercially are uncalibrated and worthless”.




The Centres for Disease Control advise that radiation injuries may be indicated by the skin becoming red and swollen and the casualty complaining of nausea, vomiting and diarrhoea.  However, they caution that the low radiation levels expected from a dirty bomb situation are unlikely to cause symptoms.

Management

Blast Injuries

Where people have been injured in the explosion itself may require first aid for blast trauma.

Radiation Exposure

Casualties who have not suffered blast injuries but who may have been exposed to radioactive material should be encouraged to avoid any obvious clouds of smoke or dust, and to breathe through tissues or cloth to avoid inhaling radioactive particles.  They should not touch detritus in the area of the explosion which may be contaminated.  For the avoidance of doubt, unpackaged food or water in the area of the explosion may have become contaminated and should not be eaten.  However, food in sealed containers should be safe as long as the outside of the container is washed before it is opened.

Shelter

Casualties should be encouraged to take shelter inside a building of which the doors and windows can be closed, and to avoid public transport.  Once inside the building they should move to an inner room if possible, and limit exposure to radioactive particles which may be outside by closing the doors and windows and shutting off ventilation, heating or air conditioning which draws air in from outside.

Decontamination

It would be prudent for casualties (once indoors) to take off any clothing which may have become contaminated and to put it in a sealed plastic bag along with the cloth or similar item through which they were breathing (the clothing can be examined by an expert to estimate the casualty’s degree of exposure to radiation).  As soon as possible they should wash thoroughly to remove radioactive particles from the skin and hair.

Medication

Anti-radiation medications (for example, potassium iodide) may not be helpful and medical guidance should be sought.

Acknowledgement

This post was prepared using information from the websites of the United States' Nuclear Regulatory Commission, the Centres for Disease Control and the Nuclear Energy Institute.

First aid brushup: Wound management - Bruising

Identification

The skin will be discoloured and may be swollen because of the rupturing of internal blood vessels at the injury site.




Image from here

Management

Use firm pressure to apply a cold pack to the injured area.  An ice pack or a bag of frozen vegetables will be ideal.  If possible, raise or support the injured body part into a comfortable position.

Acknowledgement

As with other posts in this series, the information supplied is from Kym Eden's Fun with First Aid (2013).

Sunday, 10 January 2016

First aid brushup: Wound management - Internal Bleeding

Identification

Internal bleeding is not easy to identify, but can be suspected where the casualty has sustained a fracture, or may have suffered a ruptured internal organ, or has a history of a stomach ulcer.  Look for blood emanating from a body opening (by coughing or vomiting, trickling from the ear or nose, or passing with urine or excrement).


A casualty may show signs of shock, like cold and clammy skin, becoming pale, complaining of thist or acting in an anxious and restless manner.  Their pulse may become weak or rapid and their breathing shallower.

Management

Management options are limited.  An ambulance should be sent for immediately and the casualty kept as comfortable as possible.  If possible, raise their legs to improve blood supply to vital organs, and loosen clothing around the neck, chest and waist to assist breathing.  Do not allow them to eat or drink while waiting for the ambulance, but moisten their lips to help control thirst.

Acknowledgement

As with other posts in this series, the information supplied is from Kym Eden's Fun with First Aid (2013).

Saturday, 9 January 2016

First aid brushup: Wound management - External Bleeding

Identification

External bleeding will follow from a wound to the flesh.  The four types of wounds are -
  • Abrasians and grazes: The rubbing- or scraping-away of the skin surface.  Only small capillaries are damages and so bleeding should be fairly slight.
  • Lacerations: The tearing of the skin by a sharp object (for example, barbed wire).  The edges of the wound will be jagged and uneven.  Lacerations can be very deep and cause severe bleeding.
  • Incisions: Clean cuts through the flesh caused by a sharp object (for example, glass or a blade).  These wounds are often deep and will bleed profusely.
  • Puncture wounds: Piercing of the flesh by a pointed object (for example, a spike or a bullet).  The wound may close around the penetration and bleeding may not be severe, although infe ction may be carried deep into the wound.

Types of bleeds

In general, the brighter and more free-flowing the blood is, the more urgent will be the need to control the bleeding.  The following points are worth noting
  • Blood which is a bright red colour and moves in spurts indicates bleeding from an artery.  These injuries cause high blood loss.
  • Blood which is dark red and flows freely indicates bleeding from a vein.  The loss of blood can be significant.
  • Blood which is bright red but oozes comes from injured capillaries.  The blood loss will tend to be slight.

Image from here

Management

In all cases, check the wound and confirm that there is no foreign object.

Minor bleeding

Clean the wound with warm soapy water or a solution of antiseptic, then apply a clean (ideally non-adherent) dressing.

Significant bleeding

Direct pressure should be applied to the wound, ideally with a clean pad.  Secure the pad in place with a bandage which is tight enough to hold it in place but not so tight it restricts circulation.  If casualty bleeds through the pad, remove the bandage and place a second pad on top of the first (replace the second pad as necessary).  Do not remove the first pad unless significant bleeding continues: if this occurs you may need to remove the pad to identify the injury site more precisely so to apply pressure to it.


If the bleeding is from a limb, elevate it above the level of the heart so as to reduce the blood flow.  Remember to reassure the casualty and keep them calm so as to keep their heart rate down.

Extreme Circumstances

Life-threatening bleeding can be controlled by an arterial torniquet.  However, this may well cause catastrophic damage to a limb.  A torniquet can be applied by wrapping a bandage of at least 2 inches / 5 centimetres directly above the knee or elbow.  Apply it tightly enough to stop circulation of blood to the limb.




This should only be used as a last resort when all other methods of controlling the bleeding have failed.  Eden suggests traumatic amputation or shark attack as examples of injuries which may require a tourniquet.

Acknowledgement

As with other posts in this series, the information supplied is from Kym Eden's Fun with First Aid (2013).

Friday, 8 January 2016

A time (not?) to judge

Hi everyone,






The other day the ABC's "AM" program covered the harsh treatment meted out to captured members of the Waffen-SS by France in the aftermath of the Second World War.  My gut said this was an inappropriate story.  I fumed on Facebook:
Pretty disgusted that the ABC ran this story. For pity's sake, the Waffen-SS was not the German army: it was the military wing of the Nazi Party. Anyone who served in it should have had no protection under the laws of war. They certainly cannot be heard to complain that they were harshly treated
My good friend Māra offered a different view, pointing out that -
Not all SS was evil. In the Baltic States young men were forced to join them. Some of them did it by choice in order to fight Russians who had occupied our countries. My father was one of them and for this Russians sent him to Siberia when they won the war and the world superpowers sacrificed the Baltics to Stalin to protect their own interests.



Image from here




The exchange left me thinking how hard it is to judge other people's actions fairly.  The Third Reich worked little but evil, but clearly there are pleas in mitigation to be made for many who served it.  If that's so, then it's even harder to be confident that one can or should condemn those who served causes where there was genuine justice on both sides (as was done by the people who recently defaced Confederate graves in North Carolina).






All this being so, ought we judge, condemn or disappprove people today whose actions appear worthy of condemnation, like the Oregon militiamen or, indeed, ISIS?  Or is this just a cowardly retreat into deliberate indecision?

Thursday, 7 January 2016

Of blankets

The other day I got an email from the Red Cross.  One passage in it has stuck with me, so I'm sharing it here:
In the most war-torn areas, like Syria, Afghanistan or Yemen, we are working relentlessly to help those most affected by conflict, distributing food, household essentials, providing health care and restoring family links.
As winter settles in, with only 50 Swiss francs we could distribute over 300 blankets.
Help us be a sure sign of hope for all the victims of conflict.
Google tells me that at the moment 50 Swiss francs translates to about A$70.00 / US$49.00.  I well appreciate that most of us are a bit strapped at this time of the year.  But if you're able, and have some spare funds at hand, you could do worse than to make a donation to that cause.


Image from here

Wednesday, 6 January 2016

First aid brushup: Snake bite


Hi everyone,

My good friend Alix suggested a first aid brushup covering snakebite.  It's mid-summer here, so I'm more than happy to oblige.

 
The most important thing to know is that the snake venom travels in the bloodstream, but usually does not enter it directly.  The bite is more likely simply to pierce the skin.  Venom then slowly seeps through the body's tissues and from there goes into the bloodstream.  If the casualty remains as still as possible, the venom will move far less quickly.

Identification

The victim of a snakebite may not know they have been bitten.  The bite itself may leave no visible fang mark(s), or only leave a scratch.

The casualty may complain of a headache, blurred vision, confusion or feeling faint or weak.  They may appear drowsy or restless.  The casualty may be noted to have trouble breathing, speaking or swallowing, or to be salivating or perspiring more than usual.  They may also complain of abdominal pain, nausea or vomiting.  Where a limb has been bitten, the glands in the groin or armpit may become swollen or tender.  There may also be weakness or paralysis in the limbs.

Response

For all types of snakebite

The casualty should be made to lie down and keep still.  Monitor them closely.  If necessary treat for anaphylaxis or administer resuscitation.  Send for an ambulance.

Do not wash the wound: a swab of the area will often enable treaters to select the right antivenom.  You should not cut the bite and try to suck out the venom.

Bite on a Limb

Apply "pressure immobilization" by placing a pad over the bite, and then wrapping a broad pressure bandage over the pad and around the limb.  Ideally, use an elasticised bandage.  If all else fails, use strips of cloth 3-4 inches (7-10cm) wide.

Once the pad is bandaged in place, wrap the entire limb in a second bandage from the fingers or toes to the shoulder or groin.  Any clothing should be covered by the bandage: removing it will tend to move the venom.  The bandage should be too tight to slide a finger between it and the skin or clothing, but not so tight as to restrict circulation.  On that note, do not apply a tourniquet.

Image from here

The bitten limb should be immobilised by binding it against a splint with broad or triangular bandages.  Alternatively, a bitten leg can be bandaged against the unbitten leg, and an arm can be placed in a sling or bound against the body.

You should not remove the bandage or splints once applied.  Do not elevate the limb as this will tend to speed up movement of the venom.

Bites not on a limb

If the casualty has been bitten on the abdomen, apply firm direct pressure over the bite to the extent that you can do so without restricting breathing or chest movement.  If the bite is to the neck or head, do not apply firm pressure.

Bitten while alone

If you have been bitten while on your own, call an ambulance and apply pressure immobilisation.  Keep still until help arrives.  If you must move, do so as gently or slowly as possible while keeping pressure over the bite.

Acknowledgement

As with other posts in this series, the information supplied is from Kym Eden's Fun with First Aid (2013).

Dry day with run

Hi everyone,

It's been another pretty good day here in my world.  The rain had cleared through when I woke up this morning, although the air was still comfortingly damp.  Hopefully the plants were able to draw something of value from the air alone.

I was planning on a run after work, so I put my sports bag in the car when I left.  It struck me that the boot of my car is starting to look rather crowded, between my SES kit bag, the first aid bag, and a sports bag.  This will need planning when I next go shopping!


The day itself was quiet.  Enough work to keep me sporadically occupied, but also enough spare time to write a post on first aid for snakebites (this will go up later).

After work I did indeed go out for that run - a 10km loop around Pykes Road.  I could have gone further but time was a bit tight.  The setting sun lit up the cemetery in a beautiful way.  I snatched a photo as I ran past.


Not much more to note about the day.  Suspect the rain has cleared through now, but maybe we'll be lucky.

More tomorrow.  Hope your days are beginning well.

Tuesday, 5 January 2016

First aid brushup: Burn Injuries (Part 2 of 2)

This is part two of another first aid review post.  I've previously discussed treatment of common burns.  This part deals with burn injuries for which particular measures are needed.  As usual, I have drawn heavily on Kym Eden's Fun with First Aid.

Welder's Flash

A particular type of first degree burn can affect people exposed to ultraviolet light.  It is known as "welder's flash" or "arc eye" because it commonly affects welders.


Image from here

Identification

The casualty's eyes will be red and watering, and they will complain of pain and a sensation like sand in their eyes.  They may be very sensitive to light.

Treatment

Cool wet packs should be applied to the casualty's eyes.  It may be wise to have them remove any contact lenses.  Medical review is recommended.

Airway burns

Be alert to these if the injury occurred in a confined space or it is otherwise thought the casualty may have inhaled hot air or gases.  Where the airways have been badly affected, they can swell and restrict breathing.  Medical assistance is highly recommended.

Identification

The casualty's voice may be hoarse and it may be difficult for them to breathe or speak.  Their face or toungue may be swollen, There may also be singeing of the hair or nasal hair, and black carbon deposits in the nose and mouth.

Treatment

Send for an ambulance.  The casualty will find it easiest to breath if they sit up and lean forward.  They can be given cool water to sip, and the neck area should be cooled with compresses.  Tight restrictive clothing around the neck, chest and waist should be loosened.  If the patient becomes unconscious, move them into the recovery position and monitor their breathing.  If necessary commence resuscitation.

Electrical burns

Identification

These injuries may not be obvious as much of the damage will be internal.  There may be an entry and exit wound.  See whether the surroundings indicate an electrical incident has taken place.


Image from here

Treatment

Firstly, watch for danger.  If you consider that there is a credible risk of live electricity, stand back until you are confident the risk has been removed.  This may be as simple as turning off a switch or may require disconnection by the power company (a piece of advice I have received is to assume that a power line is live until you have seen an electrician pick it up with an ungloved hand!).


Remove any burned clothing which is not adhering to the casualty's wounds, and flood the entry and exit wounds with cool water.  Cover any burns with dry, sterile, non-adherent dressings.

Chemical and similar burns

If it appears the casualty has sustained a chemical burn, try to identify the substance involved so to advise medical staff.

Identification

The skin may be blistered, swollen and discoloured.  The casualty may also complain of severe stinging pain, and there may be chemical containers in the area.  Chemical burns can also cause poisoning, and so the casualty may be complaining of blurred vision, a headache and nausea.


Image from here

Treatment

Removing or reducing exposure is key.  To the extent possible, avoid contact with the chamical yourself.  Remove the patient from the area and if possible take off contaminated clothing.  Flood the burned tissue with cool running water for 20-30 minutes.  Burns should be covered with a dry, sterile, non-adherent dressing and an ambulance sent for.

Chemical injuries to eyes

If the burn is to one or both of the eyes, have the patient sit with the affected eye facing downwards.  Gently flood the eye with cool running water for 20-30 minutes, if necessary prizing the injured eye open.  If necessary the casualty should remove any contact lenses.  A sterile pad or non-adherent dressing should be applied to the injured eye.

Phosphorus burns

If the burn has been caused by phosphorus, keep the injured body part wet or submerged in water continuously (phosphorus will ignite when exposed to air).  Use forceps or a similar device to pick off phosphorus particles, and cover minor burns with a wet compress.  Medical assistance should be sought.

Molten substance burns

Burns caused by molten substances (for example, metal or bitumen) are generally treated as for third degree burns.  The injured area should be flooded with cool running water for 30 minutes (or until the substance has cooled), and after that cold compresses should also be applied. 


Clothing or jewellery should be removed if it may affect circulation when swelling sets in.  However, it is best not to remove the molten substance (save where it blocks an airway or encircles a limb such that circulation may be affected) because this may cause more skin damage.  The injury should be covered with a dry, sterile, non-adherent dressing and the injured limb elevated.  An ambulance should be called.

Cold burns

Identification

Where a casualty has suffered a cold burn, their skin will become hard and will be cold to the touch.  It will appear waxy and pale.  The casualty may complain of numbness, 'pins and needles' or other altered sensation.  When the burn begins to recover it will become red, hot, blistered and painful.


Image from here

Treatment

If physically possible, the casualty should be encouraged to warm the injury with their own body (for example, putting a hand under their arm).  If the face, nose or ears are affected, cover them with a towel or something similar to help them warm.  Consider using lukewarm water to return heat to the injury.  Elevate the limb to reduce pain and swelling, and gently apply a soft clean dressing.

Reasons to hope.

While I drafted this post, I looked over the news of the rising Mississippi River.  The people of Missouri seem to have fared well, with only a small degree of damage and inconvenience.  In Louisiana the authorities are watching the river with concern.  In Alabama heavy rainfall has caused very significant loss and damage.  This excess of water has the power to visit more death and destruction on more people in more parts of the United States than ISIS could ever dream.


What's deeply encouraging is the willingness of people to help.  In one of the classier moves of recent time, American Airlines donated $100,000.00 to the Red Cross to support tornado relief in Texas.  That company has also encouraged donations from its customers - the webpage, if you're interested, is here:


American Airlines logo
Image from here


Pope Francis' call for an end to indifference may be falling on a world where many have already reached the same conclusion.  This is a remarkable basis for hope.  There may be risks to the public wellbeing from any number of quarters (Electromagnetic pulse, anyone?  Or earthquakes?).  Even so, there are more reasons than ever to think that people will respond in the finest of ways.



Some rain at last

Hi everyone,

I'm going to try and post this from a tablet.  Not sure how it'll go: I've never liked the keyboard.

Today started off well with a downpour of rain in the early morning that lasted until about midday.  I was lying in bed desperately willing the pager not to go off, and it stayed blessedly silent.  When I got home from work, I found there'd been about 39mm of rain, and the dog and I were both pleasantly surprised by how much healthier the dams suddenly looked.



The day at work was dead quiet again.  The most exciting bit of it was going to the post office and opp shop at lunch.  I spent about an hour looking for other jobs without success. I really hope that something works out soon.

Hope all your days are starting out well!