Salomon X-Trail Run 2009

Here are some photos from the Salomon X-trail Run 2009 event which drew a crowd of 900 entries from all walks of life. Congratulations to the event organisers. There was supply of water for rehydration and orange cuts too. The Gardenia van was also there to provide tasty buns for immediate carbohydrate intake for recovery. The photos show the RICE treatment that comes in really useful for first-aid and some wound care for abrasions suffered by some of the participants. Remember, do not ice for more than 20 minutes and use gloves if there are open wounds.

Subcutaneous hematoma in distal part of left leg

A 10 months old toddler was brought by his mother yesterday with a painful lump in the distal part of her left leg. She apparently fell 4 days earlier but his mother noticed the swelling only after 2 days when she was attending to her.

She was still able to hobble from one end of the table to the other end while hanging on to the sides. She only grimaced slightly when we examined the swelling. We did an Ultrasound scan for her showing a cystic swelling adjacent (but separate) to the Achilles tendon. He plain X-ray of the andkle and leg was normal.

The swelling subsided significantly with RICE treatment and topical Reparil gel. Her mother was advised to continue the same treatment for another few days. She was not given any NSAIDS.

Medical Coverage for Karatedo

Every time I am asked to assist in medical coverage of a martial event, I would ask for the assistance of hospital teams to ensure that the whole mechanism for emergency care is activated. During the 8th AKF, the organisers had the commitment of the Negeri Sembilan Health Department to ensure that the medical services offered during the 3 day competition was adequate and did not endanger the participants' lives.

The most important factors responsible for keeping the injury risks low were:-
1. The high standards of referreeing
2. The high fitness and skill levels of participants
3. Adequate rehydration in between bouts

Despite having a team for each 'tatami', we were busy with minor lacerations, bruises, contusions, muscle strains and mild joint sprains. We only had one participant who injured her neck, was immobilised using the hard cervical collar and long spinal board and transferred safely to the hospital. Two participants had mild concussion and were sent to hospital for further evaluation and observation for 24 hours. We only had to stitch up a bad laceration on an official who had fallen before the second day's competition. The Atomated External Defibrillator (AED) was available on stand-by in the event of patient collapse due to cardiac arrhythmias.

This is definitely a competition involving the whole team of referrees (rules and regulations), officials (traffic), doctors and paramedics, ambulance driver, registar-on-call and surgeon-on-call (immediate hospital care).

We still need qualified volunteers to provide a safer medical coverage during such sports events. You may contact me at draston@gmail.com.

BLOODCARE spray

I have found a useful new product for First-Aid kits called BLOODCARE spray recently. It is an aerosol type of a local haemostatic preparation formed hydrogencalcium salt of oxidised cellulose and pressurised propellant. I have used it several times on skin abrasions and found it useful in stopping bleeding during matchplay.

According to the product description, the content of carboxyl groups (16-24%) and calcium ions present in active powder substance supports the biological healing process, and has the proven features of being bactericidal and bacteriostatic.

To apply the spray, ensure that the superficial wound is cleaned with a running water or disinfectant, apply pressure to dry the wound, shake the can well, hold the can upright and spray from a distance of 10-15cm for 2-3 seconds. The layer formed saturated with blood does not need to be removed. If necessary apply bandage or plaster.

Find out more about Bloodcare spray here.

Cardiopulmonary Resuscitation Update in Sports Emergencies

Oxford UK, 28 November 2005. New guidelines for the resuscitation of adults and children have been published today (28th November) in the international journal Resuscitation, announced the European Resuscitation Council (ERC) and Elsevier Ltd.

The guidelines are aimed at all healthcare workers; a section on basic life support also provides information for laypeople and first responders. The recommendations made by the ERC are based on a comprehensive, evidence-based review of resuscitation science that was undertaken over the last two years by experts from all over the world. These experts debated their findings in a Consensus meeting held in Dallas in January 2005 and their conclusions, also published today, form the basis for establishing best practice worldwide.

The last CPR guidelines were published in 2000; since then, science has moved forward and our understanding of the evidence has improved. The new CPR guidelines focus on a ‘back-to-basics’ approach and are easier for lay-people and healthcare professionals to learn. The steps to successful resuscitation are described by the links in the revised Chain of Survival. Early recognition of the patient who is very ill will enable medical assistance to be called immediately, providing an opportunity for early treatment and the prevention of cardiac arrest. In the event of cardiac arrest, early chest compressions and breathing may keep enough blood going to the heart and brain to buy time until the heart can be restarted by an electric shock (defibrillation). Once the heart has been restarted new treatments aim to improve the chances of the patient making a full recovery.

In comparison with the 2000 guidelines, the 2005 guidelines recommend giving more chest compressions (30 compressions for every 2 breaths instead of the traditional 15 compressions for every 2 breaths). The ratio of 30:2 applies to all adults and children (except for newborn babies) — this should make it easier for everyone to learn and remember. Advances in defibrillator technology (the device that gives an electric shock to restart the heart) enables healthcare workers and trained lay-people to give an electric shock earlier and more effectively to a person in cardiac arrest.

It's almost 2 years since the International Resuscitation 2005 guidelines are available. The European Resuscitation Council and American Heart Association guidelines are available on their websites. Athletes, coaches and sports officials are encouraged to undergo the basic life support training in the event of collapse of a participant during sports. Sports event organisers are advised to ascertain that medical services covering sporting events have AED equipment and trained personnel.

Basics in First-Aid

Rest: Modified your physical activity to reduce or stop moving the injured part to ensure that you do not worsen the injury. You could do so by reducing the intensity and duration of training. If the injury is serious, you may have to stop training altogether.





Ice: Apply a towel on the injured part before you apply a bag of crushed ice or ice cubes. Do not apply ice directly on skin and do not wrap the crepe bandage too tightly as this may cause cold burns. Only apply for 15-20 minutes and you may repeat the procedure every 4 hourly if swelling and pain remains.






Compression: Apply a crepe bandage to compress the affected part to reduce swelling. Do not wrap the bandage too tightly as it may interfere with blood circulation. Check by pressing the fingers and you should see the colour return immediately. Often the athlete will tell you that he/she has more pain due to a very tight compression strangulating the blood supply.




Elevation: Keep the affected limb elevated above the level of the heart to 'drain' the swelling and hence reduce pain. As long as there is still visible swelling this may be beneficial.