Domesticaccidents 190413180218

community health nursing

1. Domestic Accidents Mrs. siji c.v

2. Definition An accident is an unexpected, unplanned occurrence which may involves injury . And those accidents which takes place in the home or in its immediate surroundings, which are not connected with traffic vehicles and sports.

3. Common Domestic Accidents are- Drowning Burns Fal ls Injuries Poisoning Animal bites

4. DROWNING Drowning is the process of experiencing respiratory impairment from submersion/immersion in liquid. Victim loses consciousness after approximately 2 minutes of immersion. Irreversible brain damage can take place after 4-6 minutes .

5. The problem Drowning is the 3 rd leading cause of unintentional injury death worldwide, accounting for 7% of all injury related deaths There are an estimated 3,20000 annual drowning deaths world wide. Low and middle income countries account for over905 of unintentional drowning deaths

6. Risk Factors - AGE - In general, children under 5 years of age have the highest drowning mortality rates worldwide. Canada and New Zealand are the only exceptions, adult males drown at higher rates. GENDER - Males are especially at risk of drowning with twice the overall mortality rate of females due to increased exposure to water and riskier behaviour such as swimming alone, drinking alcohol before swimming and boating. ACCESS TO WATER – Commercial fisherman, children playing near ponds or any water body.

7. OTHER FACTORS – infants left unsupervised, or with another child in a bathtub. medical conditions, such as epilepsy tourists unfamiliar with local water risks and features floods and other cataclysmic events like tsunamis

8. Prevention of DROWNING ENGINEERING methods which help to remove the hazard(Most effective strategy) includes :- a) development and implementation of safe water systems, such as drainage systems, pi ped watersystems , flood control embankments in flood prone areas. building four-sided pool fences or barriers preventing access to standing water. creating and maintaining safe water zones for recreation. covering of wells or open cisterns. emptying buckets and bathtubs, and storing them upside down.

9. LEGISLATION to enforce prevention and assure decreased exposure and laws including regular safety checks of transportation vessels, and laws on alcohol use while boating or swimming EDUCATION for individuals and communities on drowning awareness, learning water survival skills and ensuring the presence of lifeguards at swimming areas are promising strategy to prevent drowning.

10. BURNS A burn is an injury to the skin or other organic tissue primarily caused by Heat or due to radiation, radioactivity ; electricity, friction or contact with chemicals. T hermal burns occur when some or all of the cells in the skin or other tissues are destroyed by: -hot liquids -hot solids -flames

11. The problem Burns are global public health problem, accounting for an estimated 1,80000 deaths annually. About 11 million people world wide require medical attention due to severe burns The majority of these occur in low and middle income countries and almost half occur in South East Asia Region Around one million people are moderately or severely burnt every year in India In Bangladesh 17% of children with burns have temporary disability and 18% have a permanent disability

12. Risk Factors- Gender : Females suffer burns more frequently than males due to open fire cooking, or inherently unsafe stoves, which can ignite loose clothing . Age : Along with adult women, children particularly 1-9yrs are vulnerable to burns and death because of improper adult supervision or Maltreatment . Socioeconomic factors: people living in low and middle income countries are at higher risk.

13. Other Factors : occupations that increase exposure to fire. poverty, overcrowding and lack of proper safety measures. placement of young girls in household roles such as cooking and care of small children. underlying medical conditions, including epilepsy , peripheral neuropathy. alcohol abuse and smoking. easy access to chemicals used for assault (such as in acid violence attacks). use of kerosene (paraffin) as a fuel source for non-electric domestic appliances. inadequate safety measures for liquefied petroleum gas and electricity.

14. Prevention of burns Instal l ation of fire and smoke alarms. Replace pressure stoves with gas stoves. Don’t carry or hold a child while cooking at the stove Keep hot liquids away from children

15. FIRST AID DO’S DON’Ts Stop burning by removing clothes. Do not Start first-aid before ensuring your own safety(wear gloves for chemicals). Use cool running water to reduce the temperature do not Apply paste, oil, haldi (turmeric) or raw cotton to the burn. Extinguish flames by allowing person to roll on floor , and by applying other fire extinguishing methods , like water, blanket. do not Apply ice because it deepens the injury. In CHEMICAL burns, dilute or remove the chemical by irrigating with water. Avoid Prolong cooling with water because it may lead to hypothermia. Warm the patient in clean cloths. Do not Open blisters until topical antimicrobials can be applied , by a health-care provider. Provide Medical Care ASAP. Avoid Appl ication of any material(as it might be infected ). Avoid application of topical medication until the patient has been placed under appropriate medical care

16. FALLS  Falls are responsible for the largest number of hospital visits for non-fatal injuries, especially for children and young adults .

17. Problem Fallls are the second leading cause of accidental or unintentional injury deaths worldwide Each year estimated 6,46000 individuals die from falls globally over 80% of fall related fatalities occur in low and middle income countries. Adults older than 60 years of age suffer the greatest number of fatal falls. 37.3 million falls that are severe enough to require medical attention occur each year

18. Falls from rooftops, balconies, windows and stair cases are common.

19. Factors specific to SEAR countries are falls from trees of workers picking fruits or coconuts, children falling from rooftops while flying kites, high incidence of falls among construction and forestry workers.

20. Risk Factors Occupations at elevated heights or other hazardous working conditions alcohol or substance use. Socio-economic factors including poverty, overcrowded housing, young maternal age. Underlying medical conditions, such as neurological, cardiac or other disabling conditions Side-effects of medication, physical inactivity and loss of balance , particularly among older people. Unsafe environments, particularly for those with poor balance and limited vision.

21. Prevention of FALLS For CHILDREN - Effective interventions include multifaceted community programmes. Engineering modifications of nursery furniture, playground equipment, and other Products. Legislation for the use of window guard .

22. For OLDER INDIVIDUALS - Screening within living environments for risks for falls. Clinical interventions to identify risk factors, such as medication review and modification, treatment of low blood pressure, Vitamin D and calcium supplementation, treatment of correctable visual impairment. Home assessment and environmental modification for those with known risk factors or a history of falling. Prescription of appropriate assistive devices to address physical and sensory impairments. Muscle strengthening and balance retraining prescribed by a trained health professional.

23. Poisoning Most Common agents responsible for poisoning are :- Kerosene Pesticides Household chemicals Drugs Many countries also report accidental ingestion of kerosene as a leading cause of poisoning, especially among children. A study from Thailand revealed that 54 percent of cases of poisoning among pre- school children involved therapeutic drugs.

24. SNAKE BITE Snake bite is a neglected public health issue in many tropical and subtropical countries. Women, children and farmers in poor rural communities in low and middle-income countries are more often injured Globally About 5.4 million snake bites occur each year There are between 81410 and 137880 deaths and around three times as many amputations and other permanent disabilities each year

25. Outcome of snake bite depends on numerous factors: Species of snake Area of the body bitten Amount of venom injected Health condition of the victim Feelings of terror and panic are common after a snake bite and can produce a characteristic set of symptoms mediated by autonomic nervous system such as a tachycardia and nausea . A bite may also trigger an anaphylactic reaction, which is potentially fatal .

26. NEUROTOXIC CYTOTOXIC Causes Respiratory Paralysis Causes tissue destruction by digestion and haemorrhage (Haemolysis & Endothelial damage). Example:- Cobra, Kraits. Example:- Russell’s viper, Pit viper. MYOTOXIC Venom is seen in SEA SNAKES(Hydrophidae ) SNAKE VENOM

27. Early clues that a patient has Severe Envenoming Snake identified as a very dangerous one. Rapid early extension of local swelling from the site of the bite. Early tender enlargement of local lymph nodes, indicating spread of venom in the lymphatic system. Early systemic symptoms: collapse (hypotension, shock ), nausea , vomiting, diarrhoea, severe headache, "heaviness" of the eyelids , inappropriate (pathological) drowsiness or early ptosis / Ophthalmoplegia . Early spontaneous systemic bleeding Passage of dark brown/black urine .

28. FIRST AID Reassure the patient. 70% of all snake bites are from non-venomous species. Only 50% of bites by venomous species actually envenomate the patient. Immobilize in the same way as a fractured limb. Use bandages or cloth to hold the splints, not to block the blood supply or apply pressure. Do not apply any compression in the form of tight ligatures, they don't work and can be dangerous. Do not give alcoholic beverages or stimulants. They are known vasodilators and they speed up the absorption of venom. Remove any items or clothings which may constrict the bitten limb if it swells (rings, bracelets, watches, footwear, etc.). Do not incise or manipulate the bitten site. Do not apply ice. Transport the patient to a medical faculty for definitive treatment.

29. ANTIVENOM  First Antivenom was developed in 1895 by French physician Albert Calmette for the treatment of Indian cobra bites.

30. how anti venom prepared  Antivenom is made by injecting a small amount of venom "into an animal (usually a horse or sheep) to initiate an immune system response. The resulting antibodies are then harvested from the animal's blood. MECHANISMOF ACTION :-Antivenom is injected into the person intravenously, and works by binding to, and neutralizing venom enzymes. It cannot undo damage already caused by venom, so antivenom treatment should be sought as soon as possible.

31. Newer advances & facts Modern antivenoms are usually polyvalent(except in AUSTRALIA), making them effective against the venom of numerous snake species. Pharmaceutical companies which produce antivenom target their products against the species native to a particular area. Although some people may develop serious adverse reactions to antivenom, such as anaphylaxis, in emergency situations this is usually treatable and hence the benefit outweighs the potential consequences of not using antivenom