The 12 injuries of Christmas

We all know the 12 days of Christmas song, or at least up to the point we can really go for it on ‘fiiiiiiiiive  goooooooooooold riiiiiiiiiiiiiings’. But did you know it’s based on 3 different families in a street who all had terrible a Christmas one year and made a song about it. Super-duper true and will definitely not have me removed from Santa’s nice list….

Anyway let’s join the first loving family on their nightmare Christmas health journey…

In the First Aid of Christmas, my true love’s injury…. A Partridge with D and V

So you have Diarrhoea and Vomiting and it’s the week before Christmas! Disaster! Especially when the thought of your favourite Christmas food with all the trimmings is making you feel bad.

How do we best deal with this common little issue and what causes it?

Gastroenteritis is the most common reason, being triggered by a virus or bacteria, with the rotavirus (children) and norovirus (adults) being the most likely suspects. It can also occur with food poisoning, so make sure that turkey for Christmas dinner is properly cooked.

Most of the time it will pass (pun intended) within a week and there is usually no need to see a doctor for it. They are also not keen on you coming in either as it is passed around really easily. Instead, if you have concerns ask for a telephone consultation or call 112 (in the UK) unless there is blood in your stool, in which case, chase up seeing a GP as that can be a sign of something nasty from Krampus.

What can you do in the meantime?

Keep those fluids up. Drink a lot! No, not eggnog. Even if it’s in small sips, get plenty of water in. It’s important to avoid dehydration. You should try to eat what you can, when you can as you need energy, though maybe take it easy on all the mince pies. Paracetamol for any discomfort can be taken if you feel you need it too.

Keep hygiene up as much as possible and remember you are still infectious up to 2 days after your last event. So keep away from people. Good excuse for getting away from an unwanted family visit?

Let’s look at some don’ts now. Children should not take meds to stop diarrhoea unless explicitly designed for children. Also don’t give them aspirin. I would strongly avoid fizzy or fruit juice drinks too as they can make your toilet visits even more frequent and land you on the naughty list.

Good thing it has settled down as it’s now Christmas Eve.

On the second day of Christmas, another injury…. Two Broken Bones

Picture it now, it’s Christmas eve and all is quiet when BANG! There is a crash at the bottom of the chimney and Santa is in a heap on the floor. He mistimed his landing and has broken his legs and sprained his wrist!

What can we do? What kinds of breaks are there?

Let’s start with the types of fractures: Stable and unstable fractures and open and closed fractures. If a break is stable that means that the ends of the breaks are in place, but unstable is the more ‘OUCH’ looking ones where the ends are off from each other. Open is just that, the bone is sticking out through the skin, with closed being a break that hasn’t come through.

Back to Santa. He’s checked his list and you’re a first aider, brilliant. So what to do? Call for professional help, and not the elf kind. Then you can administer emergency first aid.

Let’s start with the closed fracture. Doesn’t look too bad but we don’t know how stable it is, so let’s not take any chances. We need to immobilise it. Get help to stay next to the leg and help keep it still, or use pillows or whatever you have at hand to help Santa not move his leg. Now to the horrible looking other leg! The bone is poking out of the shin and there is blood. Lucky for Santa his suit is red, but the faux fur trim has taken a hit. We need to control the bleeding with sterile dressings ideally. Get Santa, using his good arm, to apply some pressure on the area. Best he does it because he knows his own pain threshold. Now get a bandage around it as best you can and immobilise again.

Next up to his sprained wrist. We need some RICE. That’s Rest, Ice, Compression and Elevation. So let’s strap up that wrist but not too tight. We want good Christmas wrapping style, not trying to wind up your mate with impossible to open style. Once that’s done, use a triangle bandage to make a sling, or get them to rest their hand across their chest. Then something nice and cold, maybe a bag of sprouts from the freezer, wrapped in a tea towel.

You saved Christmas! Extra gift for you.

On the third day of Christmas, another injury…. Three French Burns

You’re in the kitchen making the world’s greatest ever Christmas dinner. You are using some of the epic Role Play Gourmet recipes and everything is going great until disaster!! Somehow hot fat, a cup of tea and an open flame have all managed to make their way onto your partner’s skin! You can’t leave them alone for 5 minutes!

We need to assess the damage, using SCALD.

• Size – how big is it? On an average person about one of their open palms equates to around 5% of their body surface. We’ll need this data soon.
• Cause – What caused the burn? Electric or chemical burns needs to go to a hospital sooner rather than later. Don’t risk it.
• Age – Kids and old people should go to a hospital regardless of severity.
• Location – where on the body is burned? Face, head, genitals, hands and feet burns should go to a hospital regardless of severity.
• Depth – this broken into three types and we’ll need that percentage here.

Superficial burns are burns that cause reddening of the skin. Any more than 5% needs hospital treatment.

Partial thickness burns are burns that blister and any more than 1% coverage needs hospital treatment.

Full thickness burns are ones where they no longer hurt. Those are bad. They need hospital regardless of the size. Like now.

Let’s go back to our cumbersome partner. Run the burns under cool water for a minimum of 10 minutes and carry on until the burning pain has gone. Remove any clothing from the area. Drape over cling film to keep the area clean then off to the hospital if needed. If not, don’t use greasy or oily products over it as they create a barrier keeping heat in, but moisturising is good.

On the fourth day of Christmas, another injury…. Four Signs of Stroke

Stroke is a very serious medical condition and needs to be treated FAST!

Like, quicker than those reindeer can get Santa around the world in a night…

Strokes happen when there is a loss of blood supply to the brain, with a clot being the most common cause.

You have left your partner in the kitchen with their burns under the cool water, only to be met in the front room by one of your in-laws looking rather peculiar. And you have that oh so horrible gut feeling…

But luckily you are a first aider and you know to act FAST…

Face – drooping on once side, can’t smile, eye dropped and/or mouth dropped.

Arms – can’t lift both sides equally, weakness or numbness in one side.

Speech – slurred and difficult

Time – call 999 urgently

You have done this, help is on its way so go and sit next to the in-law on the sofa, on the bad side, to help steady them and sing Christmas songs with them to help keep them calm.

Come back next week for part 2 of our 12 injuries of Christmas where our accident-prone families continue to suffer, so you don’t have to.

Merry Christmas!

As always, take care of yourselves and happy geeking!

PART TWO

On the fifth day of Christmas, another injury…. Five (rounds of) CPR

It’s Christmas Day; the house is full, lots of people and lots of presents. You’re having a massive get together with lots of friends and family, 26 in total in fact! Then catastrophe, someone gave Robin a pair of socks and he is kicking off (I actually LOVE getting socks! – Robin). Then bigger catastrophe, a quiet Monopoly game  now erupts and leaves people everywhere. In fact it looks like only you and 4 others are uninjured. 

Let’s prioritise your uncle who’s lying motionless in the middle of the floor. You make sure the area is now danger-free, from rogue monopoly pieces, dice, pint glasses, and then you see if he is responsive.

He doesn’t react to your voice, nor pain stimuli you give by grabbing at his shoulder hard. He is unresponsive. You look, listen and feel for breaths for 10 seconds by placing your cheek next to his mouth and looking at the chest to count breaths. Nope. Nothing. Just like what Robin wished he had received other than socks (Please mum I still want socks! – Robin). So we know we need to do CPR…

You send one of your 4 non-injured people to call for help and tell them to come back to you as soon as it is done. You tell them to advise that we have a non-responsive male, suspected heart attack, and to give VERY specific instructions as to where you are.

You get another one on the floor with you to do CPR. You get on the chest as soon as you can:

• You want the base of the palm to be in the centre of the chest (on the breast bone) roughly at nipple height
• Place your other hand on top of your placed hand
• Straighten out your arms as you want the power to come from the hips, not the arms
• Get your body straight over the chest so the pressure is directly down on the chest
• Compress the chest down 1 third the depth of the chest (still the same whether achieved by 2 fingers on an infant or 2 hands and whole body weight on a huge rugby player) at a rate of between 100 and 120 BPM
• Recoil! Make sure you come fully up off the chest to allow the heart to refill properly
• Swap every 2 minutes to keep each other as fresh as possible
• Don’t be disheartened if you feel ribs dislocate

Your helper has returned after making the phone call, so they can start taking turns doing CPR. CPR is tiring, and you’ll need help to keep going until the paramedics arrive.

Later you can assess the Great Monopoly Disaster of 2018.

On the sixth day of Christmas, another injury… Six People Lying (in the recovery position)

You move on with the other two members of your first aid crew. There are 6 people spread around not really making any noise. You roll up your Christmas jumper sleeves and do the same assessment on all 6 of the casualties lying around the place. Great news, they are all breathing and groaning like when the first Christmas song came on the radio on the 1st of November.

We better roll them into the recovery position.

• Let’s quickly check their pockets so we’re not rolling them onto anything
• Take the far hand and move it to their cheek and hold it there
• Using your free arm pull up the leg on the same side as the arm and hold the knee
• Whilst supporting the head bring the knee towards you, rolling the casualty
• Position the leg comfortably at a right angle
• Tilt the head up to open the airway
• Support as needed

All six are now comfortably supported on their sides and you leave one of your Christmas comrades’ to look after them.

Now onto the next few victims of the Christmas catastrophe.

On the seventh day of Christmas, another injury…. Seven Swans a-Bleeding

Not actual swans, but aunt Joan does like a bit of dressing up like Swan Lake. We have a right variety of cuts here. Obviously caused by the shrapnel from the game board.

First 3 bleeders… it’s just grazes, thankfully not much to do here but make sure it’s clean.

So you move onto the next Christmas cracker. A bit more blood as it’s a proper cut along the forearm. Being the amazing first aider you are, you get a dressing out of, get the injured to press it down on the wound with good pressure and then get your glamorous first aid elf to clean and dress properly once the bleeding has stopped.

Moving along. Wow, this one is a bit more severe. Really gushing and probably will need stitches at the hospital. Probably should have dealt with this one first. But you have to deal with it now. The cuts a deep one across the palm of the hand this time, which is manageable. You get them to hold a dressing and close their hand. This puts pressure on the wound for you and means you can dive into your first aid stocking again and get a bandage. You are going to bandage the whole fist. Be nice and leave the thumb hanging out though if it’s not affected, but make sure the bandage is tight enough they can’t open their hand.

Then we need to get that limb elevated. Across the chest works best for this, and that can be in a triangle bandage or just hold it in place.

Getting pretty tired now but still lots to do… The last one seems to have had the worst of it. There is a long piece of game board penetrating their hand. All the way through! Being the great first aider you are you already know not to take it out. How best to wrap this up? Like a delicate gift for a loved one. You are going to build up dressings on either side of the object, with no pressure going down, but pinching it closed from the sides. With the sides all padded up we then dress it as normal and elevate before getting to the hospital.

Phew, a few lives saved there for sure. Your last helper is keeping an eye on them.

Time for a nice glass of mulled wine?

On the eighth day of Christmas, another injury… Eight Maids in Shock

Not quite time for that mulled wine yet. We now get to our 8 maids. They are all feeling a little queasy and looking a little pale, cold and clammy. Not good. Pretty sure they are all in shock. So let’s deal with them.

Shock is when there is a sudden drop in blood pressure. The drop in blood flow to the vital organs and brain can cause the body to shut down as it tries to preserve life. This means the extremities lose blood as the vital organs come first, so they go pale, cold and clammy. Blood doesn’t get to the brain making them confused and feeling faint, and nausea will come from no blood getting to the stomach. Shock can be fatal and shouldn’t be taken lightly. Shock can be from bleeding, allergic reactions, burns, or in this case, trauma.

Our poor maids’ blood pressures have all dropped off and most look close to passing out. So let’s move quickly.

You help all eight onto the floor, getting them to lie on their backs. A pillow goes under the head for comfort but importantly, you take a load of the chairs from around the dinner table, where the now-ruined Christmas feast was going to happen, and you get all of them to elevate their legs on the chairs, to help blood return from their legs and to keep their blood pressure up in their chest as much as possible.

Then we want a blanket on each of them as they will feel cold, but we don’t want to make them hot as that will cause the blood vessels to dilate more, making it worse.

The Christmas sirens are ringing from the ambulance, thankfully. Now to sit down, pour yourself a nice drink and take a nice big deep breath.

Bet the neighbour’s Christmas was less dramatic…

Come back next week for part 3

Merry Christmas

As always, take care of yourselves and happy geeking!

PART THREE

On the ninth day of Christmas, another injury…. Nine Ladies Choking

Welcome all to this festive extravaganza! It’s Christmas Eve and you are having a party. As you do. Nine ladies and ten lords. Obviously this is a very well connected house. So you put on a little spread, and some simple games ready to help these very posh people have a little bit of fun.

Shockingly though, things go sideways when all the Ladies start choking on the olives in their martinis! No fear as you and your two neighbours all went on the same Coaching for Geeks first aid course and you remember what to do!

First you try to get all of them to cough. A good cough, if they are able, is a really good way to dislodge something that is stuck. Two of the ladies cough up the blockage. Two down, seven to go.

Now to back blows. Get them to lean forward and using the base of your hand you are going to hit them, with some force I may add, right between the shoulder blades. You should check after each blow to see if the airway has become clear again. After the 5 blows, good news, three have coughed up their blockers. Four ladies left.

Now you need to move onto abdominal thrusts. From behind you need to make a fist with your thumb wrapped in, place your fist below the bottom of the sternum, in the middle. Your other hand comes around and grabs your wrist firmly. The motion is in and up in one smooth sharp motion. Cough, cough, cough! Three more chunks of martini blockage come flying up! Brilliant!

But there is still one more lady who is choking. So we need to go back to are 5 back blows and rotate them with the 5 abdominal thrusts.

Still not working. Slight panic now…

The last lady has now passed out. At this point we go straight into CPR. This is where you show your ten lords what to do, so they can take over so you can get the appropriate help. The ambulance arrives in great time for a Christmas miracle! All the ladies saved and the paramedics take our last lady to the hospital.

On the tenth day of Christmas, another injury…. Ten Lords a Wheezing

All that CPR seems to have had an effect on all our lords. Wouldn’t you know it, all of them are asthmatic!

Let’s keep as calm as the kid who is top of the nice list.

The lords all take a seat and sit them upright and comfortable. Loosen their festive ties so there is nothing tight around their necks and encourage slow, controlled deep breaths.

If they have inhalers get them to take a puff, and if they have a spacer then definitely get them to have a puff through that.

Each lord can take one puff per minute (either as 1 a minute or 2 every 2 minutes) with 6 big deep breaths.

Five of the lords are settling. Cracking. But the other five… less cracking.

If the inhaler doesn’t seem to be making any improvements, or breathing gets harder and they become exhausted, them time to get our lovely paramedics back out.

Paramedics arrive and the nebulisers help. What a horrible Christmas eve. Let’s hope for a better day tomorrow. Your sister and brother in law and their 12 kids are coming around for Christmas dinner tomorrow so today’s horrible day can be forgotten…

On the eleventh day of Christmas, another injury…. -11 degrees of Hypothermia

It’s Christmaaaassss! Yay! You get up, have a nice relaxing morning in front of the fire, chestnuts roasting, the works. Readying yourself for the fun of all the kids coming over. Then you get a “knock knock” at the door. It’s one of Santa’s helpers! He looks freezing! Apparently something happened to Santa during the night and this poor helper has been stuck outside all night in nothing but surf shorts and a T-shirt with a decorated Christmas Bulbasaur on it. They must have just done the southern hemisphere before getting to your street. You bring him in.

He is shivering badly, struggling to talk, nausea, and has really slow shallow breaths. It doesn’t look good. He is clumsy and seems really confused. His pulse is really weak and all his limbs are very pale. That’s it, you are sure he is hypothermic and you know it can be fatal.

How are we treating this? Firstly we need to get all the cold and or wet clothes off. Then we need to warm the torso before we worry about limbs, and we have to warm them up gradually. This is important as doing the limbs first can cause shock which can also be fatal. Then we need nice warm clothes and blankets.

Well that was a bit of excitement we could have done without. Let alone the weird loud bang from next door. Could have sworn that sounded like a board game explosion.

With that, the family turns up ready for a fun Christmas dinner.

On the twelfth day of Christmas, another injury…. Twelve Allergic Reactions

Well finally, and amazing dinner and wonderful fun was had. Crackers pulled, bad jokes told and dinner went down a treat. You moved onto the Christmas pudding, goes down well as well, but then all 12 kids start to feel a little off…

Oh no, the puddings must all have contained nuts! And you were sure you were safe!

You see before you a wide variety of symptoms:-

• Rashes
• Itching
• Hives
• Pins and needles/tingling
• Swelling of varying body parts
• Difficulty breathing
• Snotty noses
• Dizziness/fainting
• Abdominal pain
• D and V

Luckily 4 of the 12 are not anaphylactic to nuts, but do still have reactions. They can have simple antihistamines and decongestants. Small rash and blocked noses slowly go away for these 4.  

Any trigger to reactions should be removed from the area as early as possible. Get rid of the pud!

The other 8 are badly allergic and all have their epipens at hand thankfully. You know the needle needs to be shot into nice big muscle areas, so the thigh or bum works well. Once done they should lie down.

Get that ambulance back!

4 seem to be responding to the epipens, but if they struggle they can use a second one after 5 minutes if needed.

Looks like trouble with the last 4 though. They are not responding to the injections and they have swelling in their faces, so we are worried this is going to occlude their airways. We keep going with the epipens if we have spare (thankfully we do), every 5 minutes, but if they pass out we have to move straight onto CPR.

The ambulance arrives, apparently they have been really busy today, and takes the last 4 off to hospital where they are treated and are fine. Phew!

Wait till the neighbours hear about your crazy Christmas!

Thank you for joining us on this wonderful journey through the magic of Christmas and the injuries that goes along with it.

We’re not here to make you fear Christmas, just to be as safe as possible.

Merry Christmas!

As always, take care of yoursELFS and happy geeking!

Robert House – Operating Department Practitioner and Coaching for Geeks health correspondent

Follow Robert on Twitter @Roberthouse1985