Fisherman’s first aid kit. Part 2

Summer is a long-awaited time when you can go fishing somewhere far from civilization. Such trips bring not only the joy of communicating with nature, but also a certain risk associated with the lack of qualified medical care nearby. Igor Golishchenko, a doctor by profession and a fisherman by hobby, continues to talk about what medicines should always be in a fishing first-aid kit and when they should be used.

DEALS OF HEART

The next formidable situation that anyone can face is an attack of angina pectoris: a manifestation of coronary heart disease (IHD). It develops rapidly, and if you do not provide help in the first minutes, everything can end in extensive myocardial infarction or death from acute heart failure. I myself have twice witnessed such ridiculous fishing deaths in the last ten years, and last year a good friend of mine died of acute heart failure. He was fishing alone and simply could not use the nitroglycerin in his backpack. IHD can be secretive, and increased physical activity, hot weather or excess alcohol taken the day before will help provoke an attack. The attack develops very quickly, and a person’s life depends on how quickly he is helped. It is widely believed that ischemic heart disease is the lot of older people, but this is not the case: the highest risk group includes men aged 30-50 years.

The main symptoms of an angina attack are severe pain behind the sternum (pain in the left scapula, collarbone or shoulder), severe weakness, lack of air. The first aid for an attack of angina pectoris is to take one or two nitroglycerin tablets under the tongue. It is in any car medical kit, but its quality can fail. Tableted nitroglycerin is poorly stored, and it is very inconvenient to use microscopic tablets. It is best to have a small can of Nitromint spray in your medicine cabinet. Pressing the cap releases a dose of the drug equivalent to one tablet. It is much more convenient to use it, especially if you are alone and an attack of pain caught you at the wrong moment.

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If a misfortune happened to a friend, a patient with an attack of angina pectoris should be laid down, limited any physical activity, unbuttoned clothes on his chest, ensuring free breathing, and help to take nitroglycerin as soon as possible. If the pain attack has diminished, but has not completely passed, the patient must be taken to the nearest medical facility as soon as possible, since there is a danger that he has developed a myocardial infarction. An attack of angina pectoris does not occur without a reason. Most often this is a complication of hypertension, and it can be prevented by taking half of the Capoten tablet under the tongue. This drug, an ACE enzyme inhibitor, interferes with the conversion of angiotensin-1 to angiotensin-2. One tablet contains 25 mg of captopril. The therapeutic effect develops quickly and lasts up to 6-10 hours.

SEVEN TROUBLES – ONE ANSWER: ASPIRIN

Signs of high blood pressure include a purplish complexion, headache, shortness of breath, weakness during exercise, and nosebleeds. Most often this happens after plentiful evening libations or being in the hot summer daytime sun. The body is imperceptibly, but seriously dehydrated, the blood thickens, it is more difficult for it to flow through the capillaries, and the risk of blood clots also increases. To prevent this, antiaggregants are needed. Therefore, acetylsalicylic acid – aspirin is an absolutely necessary medicine in the medicine cabinet. This is a universal drug that saves you from many troubles. Aspirin has antipyretic, analgesic and antiplatelet effects. Its last property is the most important: by thinning the blood and improving its fluidity, it avoids many formidable complications from the cardiovascular system, such as heart attack and stroke, thrombosis of the great vessels.

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Acetylsalicylic acid has many trade names and is usually produced in dosages of 0.5 g and 0.33 g. The maximum single dose is 1 g, the daily dose is 2 g. It should be remembered that it is necessary to take aspirin after meals. Taken on an empty stomach, it irritates the stomach lining and contributes to the exacerbation of gastritis and peptic ulcer disease. It is best to take aspirin prophylactically, in advance. First of all, when you have to fish in the heat or intense physical activity and it is clear that dehydration cannot be avoided. Here, a dosage of 0.25-0.33 g is enough. Also, if in the evening you overdid it with alcohol (in a good company it is not difficult to do this), 0.5-1.0 g of aspirin relieves the hangover syndrome and avoids the development of a hypertensive crisis …

Aspirin is also needed for sunburn. Here, its analgesic and anti-inflammatory effect is already important. Take it at 0.50.7 g twice a day for the first two to three days after the burn. The spring sun is tricky, and you can get a massive skin burn in just a few hours. This can seriously ruin the entire upcoming vacation, so a tube of high-quality sunscreen will not be superfluous in the first aid kit.

ALLERGY IS A SERIOUS THING

The next group of drugs that must be with you is antihistamines. An allergic reaction is a serious thing, especially in nature, far from qualified medical care. It can be provoked by insect bites (especially wasps, bees and hornets), as well as the pollen of some flowering plants. Signs of an allergic reaction are local and generalized (common). The first include edema, redness of the skin (hyperemia), pronounced itching at the site of the bite, conjunctivitis. Common ones include urticaria, soft tissue edema, dry mucous membranes or Quincke’s edema, and collapse caused by a sharp drop in blood pressure. Quincke’s edema is an immediate-type allergic reaction that causes swelling of soft tissues, including the larynx, vocal cords – the upper respiratory tract. As a rule, this causes a sharp difficulty in breathing up to suffocation.

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To treat allergies, you need to take antihistamines. The first aid kit requires at least one of them. You can use “Tavegil” or “Claretin”. These drugs relieve local allergic manifestations well and do not cause drowsiness. Tavegil is more versatile. The tablet contains 1 mg of the drug. Take it one tablet twice a day, in severe cases, the dose can be increased to 6 tablets. “Claretin” (tablets of 10 mg of active substance) has a less pronounced, but prolonged effect. One tablet is taken once a day for manifestations of allergic rhinitis or conjunctivitis.

In the event of signs of a generalized allergic reaction (difficulty breathing, shortness of breath, severe weakness), qualified medical attention is required. This happens unexpectedly and is most often associated with bee or wasp stings. The victim must be taken to the nearest medical facility as soon as possible. Immediate administration of intravenous corticosteroids (prednisolone, hydrocortisone) can stop deadly manifestations of an allergic reaction, but requires some skill and knowledge. It makes sense in advance, before the trip, to find out from the members of the expedition if anyone suffers from an intolerance to bee venom. If there is one, it is necessary to specially stock up on packaging of ampoules of prednisolone and disposable syringes. Intravenous injection usually does not require serious skills, but in an emergency it can save someone’s life.

Igor GOLISHCHENKO