First Aid

If you encounter a conscious, choking individual that is coughing, encourage continued coughing. If the victim is unable to cough, speak, or breathe, complete the following:

• Send someone to call 9-1-1
• Lean person forward and give 5 back blows with heel of your hand.
• Give 5 quick abdominal thrusts by placing the thumbside of your fist against the middle of the victim's abdomen, just above the navel. Grab your fist with the other hand.
• Repeat until the object the person is choking on is forced out and person breathes or coughs on his or her own.

To be an effective first aider, a person need to:

• be reliable and confident
• be able to stay calm in an emergency
• have a good standard of personal hygiene
• be fit enough to rapidly attend an incident
• be competent and devoted to what he is doing
• be highly skilled
• be able to recall details and work well without supervision
• be patient and have a comforting and reassuring personality as they interact with people of all ages, races and creeds
• be resourceful, particularly in disaster zones where getting supplies and ambulances to the scene are dangerous

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There are two main reasons to use correct form: First, the body is limited in its range of motion, and second, the body works better when the forces and movements are "aligned" in the way that allows the body to work best.

These two issues apply for all human physical activities, whether one considers sports or job activities, or simple day-to-day movement.

Here is some explanation of both reasons:

FIRST: human joints are not infinitely movable. Certain athletes (such as gymnasts and ballerinas) are very flexible, but even they cannot move their arms and legs in any way they please. Thus, proper technique ensures you do not exceed your own range of motion for your joints.

SECOND: Consider the body to be made up of a bunch of levers. Bones are the lever arm, and muscles provide the force to move the levers which in turn allow the body to do the physical things the body does. Levers essentially work in 2 dimensions -- up and down, and along the lever arm. When work is done along those dimensions, maximum force is provided through the least exertion, AND this happens to be the form of movement that results in the least strain on tendons, ligaments, and connective tissues inside joints. When work is done in a manner that includes the third dimension (consider "side to side" to be third dimension), all of the tissues in a particular joint are stressed, and may be over-stressed quite easily.

The result of this over-stress are often "soft tissue" injuries: tendonitis, sprains and strains, muscle tears. Occasionally the over-stress can result in broken bones, particularly the bones of the ankle and wrist.

Extremity arteriography is a test that uses x-rays and a special dye (contrast material) to see the arteries in the hands, arms, feet, or legs.

Angiography/arteriography of the extremity

Extremity arteriography is done in a hospital or medical center. You will lie on an x-ray table. You may ask for a sedative if you are anxious about the test.

The health care provider will shave and clean an area, usually in the groin area. A numbing medicine (anesthetic) is applied, and a needle inserted into an artery. A thin plastic tube called a catheter is passed through the needle, into the artery, and up into the area of the body being studied. The doctor can see live images of the area on a TV-like monitor, and uses them as a guide.

The dye flows through the catheter. X-ray images are taken. The catheter is occasionally flushed with saline solution to help keep blood in the tube from clotting.

Certain treatments can be done during this procedure. They include dissolving a blood clot with medicine, opening a partially blocked artery with a balloon, or placing a small tube called a stent into an artery to help hold it open. These items are passed through the catheter to the site of interest.

The health care team will check your pulse (heart rate), blood pressure, and breathing during the procedure.

After the x-rays are taken, the needle and catheter are withdrawn. Pressure is immediately applied on the leg at the site of insertion for 10 - 15 minutes to stop the bleeding. After that time, the area is checked and a bandage is applied.

The leg should be kept straight for 6 hours after the procedure. You should avoid strenuous activity, such as heavy lifting, for 24 - 48 hours.

You should not eat or drink anything for 8 hours before the test.

You may be told to stop taking certain medications such as aspirin or other blood thinners for a short while before the test. However, do NOT stop taking any medicines unless told to do so by your health care provider. Make sure your doctor knows about all medications you are taking, including all over-the-counter and herbal preparations.

You will be asked to wear a hospital gown and sign a consent form. Jewelery should be removed from the area being studied.

Tell your health care provider if you are pregnant, if you are allergic to any medications, and if you have ever had an allergic reactions to x-ray contrast material or iodine substances.

Also tell the health care provider if you have ever had any bleeding problems.

The x-ray table is hard and cold, so you may want to ask for a blanket or pillow. There is a sting when the numbing medicine is injected. You may also feel some pressure as the catheter is positioned.

The dye can cause a feeling of warmth and flushing. This is normal and usually goes away in a few seconds.

You may have tenderness and bruising at the site of the injection after the test. If you have swelling, bleeding that doesn't go away, or severe pain in an arm or leg, seek immediate medical care.

The test is done when someone has symptoms of blood vessel disease in the arms, hands, legs, or feet. It can help identify and locate:

• Areas of bleeding
• Closings of a blood vessel (occlusions)
• Narrowing of a blood vessel (stenosis)

The x-ray shows normal structures for the age of the patient.

The x-ray may show blockage in the vessels caused by the following:

• Aneurysms
• Blood clots
• Hardening of the arteries in the arms or legs (arteriosclerosis of the extremities)
• Other diseases of the arteries

Abnormal results may also be due to:

• Deep venous thrombosis
• Inflammation of the blood vessels
• Injury to the blood vessels
• Thromboangiitis obliterans

Complications may include:

• Allergic reaction to the contrast dye
• Blockage of blood flow, leading to tissue damage or stroke (rare)
• Clot or bleeding where the catheter entered the artery
• Dissection (separation) of a blood vessel

There is low-level radiation exposure. However, most experts feel that the risk of most x-rays is smaller than other risks we take every day. Pregnant women and children are more sensitive to the risks of the x-ray.

This COULD mean that blood is not circulating to the toes or fingers. You could check by looking for a capillary bed refill (CBR).

However it could be a sign of a medical condition.

Regardless of this, if you see this, then this is not 'normal' and you should seek further medical attention.