Cardio-Pulmonary Resuscitation (CPR) - Part 1: Introduction

Cardio-Pulmonary Resuscitation (CPR) - Part 1: Introduction

CARDIO-PULMONARY RESUSCITATION (CPR)

Cardio-Pulmonary Resuscitation (CPR) is a lifesaving technique useful in many emergencies, including a heart attack or near drowning, in which someone's breathing or heartbeat has stopped.

WHY SHOULD EVERYONE LEARN CPR?

Acute heart disease causing unexpected heart arrest is the most frequent single killer in our society. In addition, breathing and heart arrest are the immediate causes of dearth in a large number of accidents.

Substantial proportion of these deaths could be prevented if:

• Cardio-Pulmonary Resuscitation (CPR) is started immediately by a trained bystander in order to preserve vital functions
• Emergency medical treatment becomes quickly available in order to restore spontaneous heartbeat and breathing

Although qualified medical personnel may be on the spot relatively early, their efforts are too often in vain as nobody has been providing basic life support during the very first and most crucial minutes.

So that a trained bystander is available to perform CPR when arrest occurs, as many as possible of the teachable population should be motivated and trained to perform the relatively simple techniques of CPR.

WHY SHOULD YOU LEARN CPR?

Perhaps some one you love is suffering from heart disease. Maybe the nature of your job requires that you prepared to handle medical emergencies. Or you may believe, as many people do, that knowing the skills of CPR simply makes you a more useful member of  your community.

Whatever your reasons, it is important to remember that CPR can help to save lives. Your hard work and study can make a difference.

LEGAL CONSIDERATIONS IN USA

Recognition is given for successful completion of a CPR course, which includes passing written and performance examinations based on criteria established by the the American Heart Association. It does not imply licensure or warrant future performance.

There was no instance known which a layperson that has performed CPR has been sued successfully. There are 'Good Samaritan' Laws in many states that specifically protect professionals and laypersons performing CPR 'in good faith'. Under most Good Samaritan Laws, laypersons are protected if they performed CPR even if there have no formal training.

All the citizens who are able to learn and perform CPR, if such performance would not pose a medical or psycho-emotional danger to themselves, should learn to perform CPR well enough to sustain the life of the victim until professional emergency medical treatment becomes available.

As a rescuer acting a good faith, you should remember that one CPR is begun, you may stop only when:

• The victim recovers (regains breathing or movement)
• Another trained individual takes over
• You are too exhausted to continue

COMMON CAUSES OF SUDDEN DEATH

• Cardiac Arrest
• Electric Shock
• Drowning
• Drug Overdose / Drug Abuse
• Suffocation
• Severe Allergic Reaction
• Trauma
• Stroke

Unique Therapies in Traditional Chinese Medicine

Unique Therapies in Traditional Chinese Medicine

ACUPUNCTURE AND MOXIBUSTION THERAPY

• Acupuncture and moxibustion therapy has a history of thousands of years. The acupuncture and moxibustion therapy involves the use of jabbing with needles and the placement of burning crushed dry moxa. In acupuncture therapy, specially made needles are used to jab into certain acupuncture points of the body of a patient, curing diseases by twirling or lifting the needles.
• As for moxibustion, dry moxa is crushed and then lit up to fume and scorch certain acupuncture points on the skin, curing diseases by the stimulation of heat.
• The acupuncture and moxibustion originated sometime around the New Stone Age and began to be widely used during the Spring and Autumn Period
• The rationale for acupuncture and moxibustion therapy is: Main and collateral channels as a network of passages for the circulation of energy and blood are all over the human body and its function are to connect the external and internal, the upper and lower part of human body. 
• To jab or scorch certain acupuncture points on the surface of the human body can stimulate the human body through the meridians, then adjust the internal function inside the human body, improve its ability to prevent diseases or cure diseases
• The acupuncture and moxibustion therapy spread to Japan and Korea as early as in the Han and Tang Dynasties and to Arabia and Europe in sequence in the Song and Yuan Dynasties and is still thought of highly up to now

A bronze human with marked acupuncture points

Acupuncture and moxibustion

MASSAGE

• In massage therapy, an aspects of traditional Chinese medicine, a massager uses his hands and other limb parts to push, press, nip and knead the acupuncture points or the surface of the human body for the purpose of disease prevention, healing, health improvement and cosmetology. It belongs to the external therapy of traditional Chinese medicine.
• Chinese medical massage has a long history. It reached its climax and was spread to Korea, Japan and India during the Sui and Tang Dynasties. 
• As a kind of natural therapy, Chinese medical massage has the strong points of less trauma and fewer side effects. As people are attaching much importance to natural therapy with no medicine, trauma or side effects, the Chinese massage therapy techniques are recognized and accepted in more and more countries.

SCRAPING TREATMENT

• Scraping treatment was long popular among people in ancient China. People used copper coins and twine dipped in water or sesame oil to scrape the chest or backs of a patient, alleviating internal inflammation by making local hyperemia on the skin.
• Today, scraping treatment has developed from the previous superficial, simple empirical treatment into one of natural therapies guided by a systematic Chinese medical theory. The tools used in scraping treatment are usually special plates made of buffalo horns or jade and the therapy is applicable to eliminating fatigue, losing weight, cosmetology and keeping fit.

CUPPING THERAPY

• In cupping therapy, cups made of bamboo, pottery or glass are heated and attached to the skin by means of a heat vacuum, causing hyperemia and thus cure the diseases.
• In ancient times, cupping therapy was used for the surgical treatment of inflammation with pyogenesis and was later extended to tuberculosis, rheumatism, rheum, insomnia and others.
• This therapy is simple and effective, hence being passed down from generation to generation, and is still popular today, even rousing interest among some foreigners

Four Great Inventions

Four Great Inventions

Ancient China was a country of inventions and discoveries. Among its abundant brilliant scientific and technological achievements, the 'Four Great Inventions' had made enormous contributions to the development of civilizations of the whole

1. PAPER MAKING 

• Before paper making technology was invented, people carved or wrote Chinese characters on tortoise shells, animals bones, bamboo slices, wooden plates and silk
• Tortoise shells, animals bones and wooden plates are too heavy to use while silk fabrics are too expensive, so none was very practical.
• Around the early period of the Western Han Dynasty (260 BC - 25 AD), people made paper from hemp and ramie, which was rough and not suitable for writing.
• During Eastern Han Dynasty (25 - 220 AD), Cai Lun improved the technique after years of experimentation. 
• He used various plant fibers such as bark, hemp, rags and torn fishing nets as raw materials to produce high quality paper. 
• People call the paper that he invented as Cai Hou's paper because Cai Lun was bestowed the tittle of Longting Hou (Longting Marquis)
• Cai Hou's paper was cheap, easily available and suitable for writing on.
• Its emergence marked the beginning of paper replacing jian and bo ( one type of writing instrument before the invention of Cai Hou's paper). 
• Jian is bamboo slices used to write on and bo is a general term of silk products.
• China's paper making technology spread to the Korean Peninsula, Vietnam and Japan in the late Sui (581 - 618 AD) and early Tang (618 - 907 AD) Dynasties, later to the Arabian area in the 8th century, and to Europe through the Arabians.
• The invention of paper greatly facilitated information and storage and cultural spread and exchanges, and thus had an epochal significance in promoting the development of human civilizations

2. GUN POWDER

• The formula of gun powder was first discovered by Taoist alchemists of ancient China while trying to make pills to achieve immortality.
• Later, people made black gun powder with niter, sulfur and charcoal of certain proportions on the basis of the formula.
• Books of the middle Tang Dynasty (618 - 907 AD) recorded the method of producing this kind of gun powder. 
• It was first used to make firecrackers and fireworks and then in military affairs in the late Tang Dynasty.
• In the Northern Song Dynasty (960 - 1127 AD), gun powder based weapons such as rockets and cannons were widely used.

3. COMPASS

• As early as in the Warring States Period (475 - 221 BC), Chinese discovered that a magnet could indicate south and north, and on the basis of this feature, made a southward-pointing instrument that was the prototype of the compass. 
• The instrument comprised a smooth magnetic spoon and a copper plate carved with directions; the handle of the spoon points south.  I
• n the Song Dynasty, such prototype evolved into a southward-pointing fish and a southward-pointing needle. 
• A southward-point fish was a magnetized fish-shaped thin icon slice, whose head would point southward when it floated on the surface of water.
• A southward-pointing needle was a magnetized steel needle, which was able to indicate directions when it was placed on such smooth surfaces as water, nails or a bowl or hung in the windless air.
• In the Song Dynasty, the compass was spread to Arabia and was affectionately called 'the Eye of Sailors'.
• Around 1180, the compass was introduced into Europe via Arabia. The invention of the compass pushed forward the rapid development of navigation, making it possible for Zheng He to make his seven voyages across seas to Southeast Asia and around the Indian Ocean in the early Ming Dynasty (1368 - 1644 AD), Christopher Columbus to discover the New World, and Ferdinand Magellan to sail around the world and facilitated the startup of European colonies and the establishment of world markets.

4. MOVABLE-TYPE PRINTING

• Before printing techniques was introduced, a scholar had to copy characters one by one if he wanted get a new book. 
• In the Sui and Tang Dynasties, block technology was invented which improved the speed of printing.
• In block technology, Chinese characters were engraved on a wooden plate and coated with Chinese ink and the covered with paper to print.
• Block technology sped up the printing of books, but was still impractical because engraving blocks was time-consuming, such blocks could not be easily preserved and misplaced would not be easily corrected.
• During the Northern Song Dynasty, Bi Sheng finally invented movable-type printing.
• He engraved the characters could be repeatedly used for the type setting and printing of different printed sheets.
• This method was both economical and time saving, ushering in a new age of printing. 
• In the development afterwards, clay used to make movable types were replaced with tin, wood, copper, lead and so on.
• Mankind had been using Bi Sheng's movable-type print until the emergence of the electronic typeset system in the 20th century
• China's movable-type printing first spread eastward into Korean and Japan and then westward into Persia and Egypt and at last across the world.
• The invention of printing greatly sped up the development of exchanges between cultures of all the countries throughout the world.

Cardio-Pulmonary Resuscitation (CPR) - Part 2: CPR for an adult

Cardio-Pulmonary Resuscitation (CPR) - Part 2: CPR for an adult

It's far better to do something than to do nothing at all if you are fearful that your knowledge or abilities are not sufficient enough. Remember, the difference between your doing something and doing nothing could be someone's life.

Here is advice from the American Heart Association:

• Untrained. If you are not trained in CPR, then provided hands-only CPR. That means uninterrupted chest compression of 100 to 120 a minute until the paramedics arrive. You don't need to try rescue breathing.
• Trained and ready to do so. If you're well-trained and confident in your ability, check to see if there is a pulse and breathing. If there is a pulse and breathing. If there is no breathing or pulse within 10 seconds, begin chest compression. Start CPR with 30 chest compression before giving two rescue breaths.
• Trained but rusty. If you have previously received CPR training but you are not confident in your abilities, then just do chest compression at a rate of 100 to 120 a minute.

The above advice applies to adults, children and infants needing CPR, but not newborns (infants up to 4 weeks old).

CPR can keep oxygenated blood flowing to the brain and other vital organs until more definitive medical treatment can restore a normal heart rhythm.

When the heart stops, the lack of oxygenated blood can cause brain damage in only a few minutes. A person may die within 8 to 10 minutes.

To learn CPR properly, take an accredited first-aid training course, including CPR and how to use an Automated External Defibrillator (AED). If you are untrained and have immediate access to a phone, call 911 or your local emergency number before beginning CPR. The dispatcher can instruct you in the proper procedures until help arrives.

CPR GUARD LINE 2010

• A compression rate of at least 100 per min
• At least 5 cm (2.5 inch) for chest compression depth
• Push hard and fast
• Chest must fully recoil before next compression
• One complete cycle: 30 chest compression to 2 rescue breath
• Each ventilation must over 1 second, just enough to see chest rise
• Call for help

STEPS TO DO CPR 

1. Danger
2. Response
3. Compression / Circulation
4. Airway
5. Breathing

1. DANGER

• Before doing CPR, we must make sure that surrounding are safe and no danger will harm the casualty.
• Ask for help (Call 990 for the ambulance)

2. RESPONSE

• Check for the casualty's response to command, touch and pain
• Casualty may response by eye movement, movement or show verbal response
• The level of responsiveness (Conscious to Unconscious):-
• Alert
• Voice 
• Pain
• Unconscious
• If the casualty is unconscious, start the chest compression.

3. COMPRESSION

• Put the person on his or her back on a firm surface.
• Kneel next to the person's neck and shoulders.
• Place the heel of one hand over the center of the person's chest, between the nipples. Place your other hand on top of the first hand. Keep your elbows straight and position your shoulders directly above your hands.
• Use your upper body weight (not just your arms) as you push straight down on (compress) the chest at least 2.5 inches (approximately 5 centimeters). Push hard at a rate of 100 to 120 compression a minute.
• If you haven't been trained in CPR, continue chest compression until there are signs of movement or until emergency medical personnel take over. If you have been trained in CPR, go on to opening the airway and rescue breathing.

4. AIRWAY

• If you're trained in CPR and you've performed 30 chest compression, open the person's airway using the head-tilt, chin-lift maneuver. 
• Put your palm on the person's forehead and gently tilt the head back. Then with the other hand, gently lift the chin forward to open the airway.

5. BREATHING

• Rescue breathing can be mouth-to-mouth breathing or mouth-to-nose breathing if the mouth is seriously injured or can't be opened.
• With the airway open (using the head-tilt, chin-lift maneuver), pinch the nostrils shut for mouth-to-mouth breathing and cover the person's mouth with yours, making a seal.
• Prepare to give two rescue breaths. Give the first rescue breath — lasting one second — and watch to see if the chest rises. If it does rise, give the second breath. If the chest doesn't rise, repeat the head-tilt, chin-lift maneuver and then give the second breath. Thirty chest compressions followed by two rescue breaths is considered one cycle. Be careful not to provide too many breaths or to breathe with too much force.
• Resume chest compressions to restore circulation.
• As soon as an automated external defibrillator (AED) is available, apply it and follow the prompts. Administer one shock, then resume CPR — starting with chest compressions — for two more minutes before administering a second shock. If you're not trained to use an AED, a 911 or other emergency medical operator may be able to guide you in its use. If an AED isn't available, go to step 5 below.
• Continue CPR until there are signs of movement or emergency medical personnel take over.

NOTE

• If there is sign of life (Eg: coughing), please check breathing and place the casualty into recovery position. 
• Check vital signs (pulse and breathing) every 3 to 5 minutes.

First Aid Kit (Part 1)

First Aid Kit (Part 1)

FIRST AID KIT

• All workplaces, leisure centers, cars and homes should have first aid kits.
• First aid kits for workplaces or public places must conform to legal requirements and be clearly marked in a white box with a green cross or a red box with a white cross and easily accessible.
• Home is the place that we often spend our time other than our workplaces, officers and other venues.
• Many unwanted accidents happened in our home due to our carelessness. For example, we accidentally cut our fingers when preparing meal in kitchen.
• So, there is a must for us to prepare a first aid kit in home for our own safety. If any accidents happened, we can use the content in first aid kit to treat our wound to prevent the situation from deteriorating.
• We can actually buy a kit or put together first aid items by ourselves and keep those first aid items in a clean, waterproof container.
• Any first aid kit must be kept in a dry place, and checked and replenished regularly.
• We can also add pain-relief tablets such as paracetamol in first aid kit

CONTENT OF FIRST AID KIT

1. Yellow solution
2. Savlon
3. Adhesive dressings / plasters
4. Triangular bandage
5. Crepe bandage
6. Roller bandage
7. Cotton Ball
8. Gauze pad
9. Disposable gloves
10. Forceps
11. Scissors

Chinese Knotting

Chinese Knotting

At the beginning, the practice of tying knots proceeded from production and daily life needs. The typing of knots was a laboring skill, such as in tying objects and weaving fishing nets; meanwhile, it was a method for assisting memory. Before the invention of characters or letters, people represent different things using knots of varying sizes and shapes.

The well-developed knotting skills of ancient China were directly related to the extensive use of knots in people's daily life. Traditional Chinese costumes are mainly tied with belts and the wearing of jade ornaments has been popular in the Chinese society; these two have also help to improve the development of knotting skills. In addition, many articles of everyday use, such as window curtains, bed curtains, flutes, sachets, tobacco bags and fans, have to be fixed or decorated with knots, or kept contained with knots. Therefore, Chinese knotting was an important skill that Chinese women required to grasp in ancient times, and some related customs were even formed. For example, before Duanwu Festival, women knitted many 'longevity plaits' with five-coloured threads and presented them to relatives and friends on the Festival. It is said that such plaits tied to one's wrists could prevent wicked things and diseases.

Chinese knotting is different from the knotting methods of other ethnic groups mainly in the following aspects:-

• Chinese knots are woven with one single strand
• Tight and complicated in structure
• Do not become loose easily
• Very practical in use
• Symmetrical with both left and right sides and front and 
• Symmetrical with both front and reverse sides
• Confirming to the traditional Chinese habit and aesthetic view of decoration
• Weaving methods of many basic knots can be combined together to indicate strong changeability and decorative

Chinese knots have a wide range of patterns, including true love knots, panchang knots, wanzi knots and wintersweet knots. These patterns are not only exquisite and beautiful, but also carry auspicious and celebrative meanings. One example is true love knots which use two coloured strands tangled together. In the weedings of ancient times, true love knots were used in many ceremonies between bride and bridegroom. True love knots are often used to express love. It said that Su Xiaoxiao, a beauty of the Qi Dynasty (479-502 AD), once came across a man and fell in love with him while taking a ride outdoors. She wrote a poem to express her eelings, writing "Where to make our truelove knots? "

In the 1980s and 1990s, Chinese knots were in vogue both in China and among overseas Chinese, thus becoming craft works full of the characteristics of Chinese culture.

First Aid Kit (Part 2) - Function of First Aid Materials

First Aid Kit (Part 2) - Function of First Aid Materials

FUNCTION OF FIRST AID MATERIALS

1. Yellow Lotion / Iodine Lotion

• Protect wounds from inflection and promote recovery 
• Apply after Salvon 

2. Salvon

• Kill the germs and bacteria on the wounds / injured parts
• Wounds / injure parts must be cleaned first before applying Salvo

3. Adhesive dressings / plasters

• Made up of fabric or waterproof plastic
• Are applied to small cuts and grazes
• REMINDER: Use hypoallergenic plasters for anyone who is allergic to the regular adhesive plasters
• People who work with food are required to use blue plasters
• Special gel plasters can protect blisters

Clear Plasters

Blue Catering Plasters

Gel Blister Plaster

4. Triangular bandage

• Made of cloth or fabric
• Standard measurement: 90 cm X 90 cm X 130 cm
• Can be used folded as bandages or slings

5. Roller bandages

• Used to give support to injured joints / parts
• Absorb fluid from injured parts (bleeding wound)

6. Crepe bandages

• Used to give support to injured joints, secure dressings in place, maintain pressure on wounds and limit swelling
• Mainly used to immobilize injured joints / parts (non-bleeding wound)

7. Cotton balls / Gauze pads

• Used as dressings or as swabs to clean around wounds
• ONLY can be used once

Cotton balls

Gauze pads

8. Disposable gloves

• Wear gloves, if available, whenever you dress wounds or when you handle body fluids or waste materials
• Purpose: to prevent inflection
• REMINDER: Use latex-free gloves because some people are allergic to latex
• ONLY can be used once