That we’all might find this of interest:
— In OzCanyons@yahoogroups.com, “Roderick Smith”
My understanding, from doing the first aid course earlier this > year, is that:
> Whoever is first on the scene and providing any sort of medical > assistance is the first aider, whether qualified or not. > You cannot legally offer painkillers to a casuality, they have to > ask. If they ask for painkillers then you can give it to them IF > they have had the painkillers before and have had no allergic or > adverse reaction to them.
> There are cases where you wouldn’t give them painkillers anyway, > such as head injuries.
> If the casualty is not cognecent enough to advise of dosage and > properties then you probably shouldn’t be giving them painkillers > anyway. >
Rod’s understanding is correct. There are very few first aid courses that qualify people to offer pain relief (outside ambulance etc which a bit beyond what we are on about). Those that do this of which I am aware STILL require it to be self administered – i.e. that the casualty gives it to themselves, with usage instructions for some types.
The important thing that everyone should understand about pain (and shock) is how it works, because if you do understand it you’ll realise that we all carry one of the most effective pain reliefs avauilable in our heads (Ok, with some limits).
Firstly people have different pain thresholds – what is very uncomfortable for one is hardly noticed by another.
Secondly the circumstances influence the impact of an short term injury – how often has someone smacked you one in the pub that you hardly noticed because you were all fired up about something? (Well hopefully not too often.)
Thirdly and what’s really important for first aiders to utilise is that the primary treatments for pain are to reassure the casualty, and to reduce or prevent further pain by stabilising the injury. It is amazing how effective someone taking a caring reassuring approach is when someone is in pain. Convince the casualty (by being confident and calm yourself) that everything will be alright, that help is on its way, keep them warm and comfortable and keep talking. Sure it still hurts, but it works really well and depending on the tolerance of pain for the casualty is often all that is required. I carry a penthrane (methoxyfluorane) inhaler when working as a first aider and hardly ever have to use it because reassurance works so well (and is so much cheaper, which penthrane isn’t).
Why does this all work? Because pain can be blocked mentally. It travels up the spinal cord and to the brain – extract from a first aid manual below for the fact-hungry.
The general situations where you should NOT use ANY KIND of drug / chemical pain relief are:
– head injury or any other lowered level of consciousness (where you do not want to add anything to the mic to change the level of consciousness). This includes drug or alcohol effected casualties.
– spinal injury (where you do not want to mask pain as it might be doing some serious damage if it goes un-noticed)
Specific drugs have specific other injuries or conditions for which they should not be used. David mentioned one such case already. If you’re going to have them with you, know what they are whatever your decision is about offering them to a casualty (and don’t offer them and then withdraw the offer because you forgot to check).
Rowan.
“Mechanism of Pain:
The application of an injurious stimulus to part of the body causes a chemical reaction in specific sensory nerve endings that subserve pain sensation. The painful sensation is then transmitted to the spinal cord via peripheral nerves.
At the spinal cord some fibres link up neurons which produce a withdrawal reflex often occurring before the pain message reaches the brain. Other fibres travel up the spinal cord to the brain where the painful stimulus is interpreted and other psychological responses are elicited.
A specialised chemical mechanism within the brain and spinal cord allows the body to produce substances which decrease pain sensation (endorphins). This system is very active in times of high physical and mental stress. Many people will have experienced an injury during intense activity and only notice it later when relaxed. Among the host of chemicals produced are Endogenous Opiates (morphine-like substances).
Control of Pain:
Physical, chemical and psychological factors may be specifically targeted in the management of pain. Any agent or technique that reduces pain is known as an Analgesic.
Control of pain through psychological factors is usually the simplest and most effective method. Reassurance of the casualty and an efficient, professional management of injuries go a long way toward decreasing discomfort. Many medical studies have proven a direct correlation between pain and anxiety. Thus, reassurance is always the first step in the management of any injury. As part of reassurance, the first aider should attempt to have the casualty control and slow the rate of breathing.
Physical factors such as the splinting of fractures, dressing and bandaging of wounds and application of ice to soft tissue injuries are very helpful in decreasing the pain felt by the casualty, as well as minimising further injury.”
PS canyon water is near enough to ice to be effective in many cases.