FROM NOSEBLEEDS TO DIABETES

SHOCK THIS IS a life- threatening condition and not to be confused with emotional shock. It happens when a person’s cells don’t receive enough blood and oxygen to function properly, leading to damage of vital organs such as the heart and the brain. Shock can be caused by anything that reduces the flow of blood, including:

Heart problems, such as a heart attack, or heart failure Severe bleeding Loss of body fluids, from dehydration, diarrhoea, vomiting or burns

Severe allergic reactions and severe infection

WHAT TO DO

Lie the older person down and raise their legs to improve blood supply to vital organs. But do not raise their legs if you suspect a fractured leg.

Cover them with a blanket to keep them warm.

Try to keep them calm and breathing regularly.

If they become unresponsive prepare to administer CPR (see back page) and call 999 or 112.

CUTS AND BLEEDS

An OLDER person may bleed more profusely than a younger one after sustaining a cut, particularly if they are on medications, such as warfarin, that serve to thin the blood, or if they have high blood pressure. This makes stopping the bleeding a vital priority to prevent undue blood loss. WHAT TO DO

Sit or lay the person down and examine the wound.

If the wound is dirty, clean it by rinsing it under running water or using alcohol-free wipes.

Apply direct pressure with a clean non-fluffy cloth or gauze to stop the bleeding.

Dress the wound and seek help if the bleeding hasn’t stopped after 20 minutes.

NOSEBLEEDS

nOSEBLEEDS are caused when tiny blood vessels inside the nostrils are ruptured. This can be due to hitting, sneezing or blowing the nose. High blood pressure and taking anti- clotting medication such as warfarin can also cause nosebleeds, which is why they can be prevalent in older people. WHAT TO DO

Ask the older person to sit down and lean their head forward. Do not tilt the head back. Pinch the soft part of the nose. Give them a tissue. Once bleeding has stopped, advise them to rest.

Call 999 or 112 if the bleeding is severe or hasn’t stopped after 30 minutes.

If a nosebleed has been caused by trauma you may not be able to stop the bleeding. You need to apply pressure to try to reduce the flow as blood loss is dangerous. With a wrapped ice-pack apply pressure until help arrives.

CONCUSSION

OLDER people are more likely to fall and knock their heads. Most blows to the head lead to a cut or wound and possibly concussion. Cuts can bleed profusely — particularly if the casualty is taking blood-thinning medication.

All head injuries are potentially serious because they can damage the brain. Concussion is a common form of brain injury that usually results from a blow to the head and may lead to a brief period of unresponsiveness. SYMPTOMS

Brief period of unresponsiveness Confusion Loss of memory surrounding the accident Headache Nausea WHAT TO DO

Check their responsiveness particularly focusing on whether they can respond to questions and a gentle shake.

Call 999/112 if they are unresponsive; there is blood or fluid leaking from the nose or mouth; they have unequal pupil sizes; or they take blood-thinning medication.

Sit them down and give them something cold to hold against the injury, such as a cold gel pack or a bag of frozen vegetables.

If there are scalp wounds, treat them as a bleed, applying pressure with a clean cloth or dressing.

DIABETES EMERGENCIES

THERE are two types of diabetes: type 1, or insulin- dependent diabetes, and type 2, also known as non- insulindependent diabetes. Sometimes people who have diabetes may have a diabetic emergency, where their blood sugar becomes either too high or too low. sugar levels, but for someone with diabetes their body can’t.

Instead, they have to control the blood sugar level themselves by monitoring what they eat, and taking medication or insulin injections.

HYPERGLYCAEMIA

TOO little insulin can cause high blood sugar. If untreated, the person can go into a diabetic coma. SYMPTOMS Warm, dry skin Rapid pulse and breathing Fruity, sweet-smelling breath Feeling really thirsty Drowsiness, leading to unresponsiveness if not treated WHAT TO DO

Call 999 or 112 straight away fo medical help and say that yo suspect hyperglycaemia.

While you wait for help to arriv keep checking their breathin pulse and level of response.

If they lose responsiveness at an point, open their airway, check the breathing and prepare to either pu

them in the recovery position or administer CPR (next page).

HYPOGLYCAEMIA

Too much insulin can cause low blood sugar or hypoglycaemia (hypo). This often happens when someone with diabetes misses a meal or does too much exercise.

It can also happen after someone has had an epileptic seizure or has been binge drinking.

If someone knows they are diabetic, they may recognise the start of a hypo episode, but without help they may quickly become weak and unresponsive. However, older people may have added risk factors that can lead to a hypo.

These include being prescribed five or more medications, chronic kidney problems, poor food intake and other illnesses. In addition they may find their hypo warning signs are more difficult to identify due to an inability to concentrate or if they suffer from headaches or sleep disturbances. SYMPTOMS Weakness, faintness or hunger Confused and irrational Sweating, cold, clammy Rapid pulse Deteriorating response Trembling Check for a medical warning bracelet or chain and if they are carrying glucose gel or sweets

Check if they are carrying an insulin pen or tablets and a glucose testing kit WHAT TO DO Help them sit down.

If they have their own glucose gel, help them take it.

If not, you need to give them something sugary such as fruit juice, a fizzy drink, three teaspoons of sugar, or sugary sweets.

If they improve quickly, give them more sugary food or drink and let them rest.

If they have their glucose testing kit with them, help them use it to check their glucose level.

Stay with them until they feel completely better.

If they do not improve quickly, look for any other possible causes and then call 999 or 112.

If they lose responsiveness at any point, open their airway, check their breathing and prepare to treat someone who’s become unresponsive by putting them in the recovery position or administering CPR.

HYPOTHERMIA

HyPoTHeRmIa is a condition that occurs when someone’s body temperature drops below 35c (95f). Normal body temperature is around 37c (98.6f).

It is common in older people who don’t move much. Hypothermia can become life- threatening quickly, so it’s important to treat hypothermia straight away.

move them somewhere warm and sheltered.

Remove and replace any wet clothes.

Wrap them in blankets. If outside, protect them from the cold of the ground, too. Call 999 for emergency help. monitor breathing, level of response and temperature.

If they are alert, give them a warm drink or some chocolate to eat.