First Aid/Extended Assessment
Checking for underlying causes
While waiting for professional help to arrive with a patient who is sick or injured, you can check a number of things which may indicate the cause of an illness. This information should then be given to the ambulance crew or doctor to speed up their diagnosis. If you spot any of these signs, it is imperative to seek professional medical assistance, if you have not already done so. The key things to look for can be summarized in the mnemonic JACCOL, which stands for:
- Jaundice - Jaundice is a yellowing of the skin, and is most obvious under the eyelids in adults. To check, ask permission, and then gently peel back the patient's eyelid to observe the colour.
- Anemia - Anemia is the lack of iron in the blood, and it causes pallor also under the eyelids, but possible also around the gums. Look for this at the same time as jaundice.
- Cyanosis - Cyanosis (cyan=blue) is the blue tinge that comes with lack of oxygen reaching the body tissues. This can be seen best on the lips and gums, and sometimes on extremities such as fingers.
- Clubbing - Clubbing is an indicator of an underlying body chemistry problem. The test for this is simple. Ask the patient to place the fingernails of their right and left index fingers together (flat against each other, facing the same direction). If you can see a gap (diamond shaped) between the fingers where the cuticle is, then everything is normal. If their fingernails and fingers form a flat interface, then medical advice should be sought.
- Oedema - Oedema is a swelling, usually seen in the lower legs. You can tell oedaema from other types of swelling by gently pushing it with a finger. If your finger leaves a dent, then the swelling is likely oedaema.
- Lymph nodes - The lymph nodes are in your neck, and quite often become 'puffy' when a patient is ill. Look at the patient to see if they seem to be swelled up around the sides of the neck.
Additional tests for spinal injuries
There are some additional neurological tests that can be done, if you have the proper training, to help you assess whether the victim has a spinal injury.