FIRST AID INFORMATION
ITP is rarely a fatal disorder, however, it does have the capacity to complicate even minor injuries and quickly turn them into major ones. If you have a bleeding disorder or live with someone who does, you will already know that even the smallest cuts and bruises need first aid and attention. Taking a serious approach to minor injuries will not only, minimize the bleed, keep the bruise small but also hasten the recovery.
A bruise does not involve a break in the skin and as there is no visible blood, bruises are often seen as less critical than a cut or abrasion but they do still need proper first aid. If you take the time to get to know your bruises, you will soon realise that there are a variety of types of bruises that can give you an insight into your bleeding. The colour, size and location of the bruise are all indicators of your health and platelet count.
In terms of location, the difference between a bruise on the front of your body and the back of you body is huge. As most bruises are caused from blunt trauma they will appear on the front or side of your body as you are more likely to hurt yourself moving or falling forward. Therefore a bruise on the back of the calf is very different to a bruise on the knee or front of the thigh. A bruise on your hand is very different to a bruise in your armpit. Unless you can remember being struck there, bruises in hidden locations tend to be a spontaneous bleed that will indicate a lower platelet count.
Treating a Bruise is as simple as following the RICE Method. Rest, Ice, Compression and Elevation.
REST – To Rest the area, you may need to stop what you are doing, sit still or lay down. A resting body has a lower heat rate this will help slow the blood flow to the injured area.
ICE – Apply ice or a cold pack to the injured area to reduce swelling and slow the flow of blood. This will help ease the pain of the bruise and the sight of it, over the next few days.
COMPPRESSION – Apply a small amount of pressure if it looks to be a big bruise, but try not to hurt yourself further.
ELEVATION – This is about getting the injury above the heart. If that seems difficult, remember that you can always lower the heart, by lying on the ground. By elevating the injury, you tend to be still and focus on the injury.
Cuts and Abrasions
Minor cuts and abrasions tend to take longer to dress because of the presence of flowing blood. With ITP, you know the injury is going to bleed a lot so allow yourself more time. Be patient with yourself, or someone with itp, trying not to get fed up with how much blood is flowing, or how much more difficult it is to fix in comparison to a ‘normal’ person.
If you or someone with itp has just injured themselves and needs help, the last thing they want is to feel like a bother. What might look like a tiny injury to you, will be a big deal to them? What people with itp need is someone who will embrace the bleeding, hold your finger in the hair, make you laugh and make a decent call about whether or not you need a doctor.
Treating a cut, bleed or abrasion follows the same steps as treating a bruise, however, you will need to consider, at the end of your initial first aid, whether or not the patient with itp will need a stitch, a doctor or a professional to dress the wound.
REST – To Rest the area, stop what you are doing, sit still or lay down. A resting body has a lower heart rate and this will help slow the blood flow to the injured area.
ICE – Apply ice or a cold pack to the injured area to reduce swelling and slow the flow of blood. During this step, you can clean the wound quickly with cool water or a cool cloth before you compress to stop the bleeding.
COMPRESSION – Apply pressure to the area until you can see a visible reduction in the flow of blood. This may take up to ten minutes. At this point, if you feel uncomfortable with the amount of blood loss, call a doctor immediately.
ELEVATION – This is about getting the injury above the heart. If that seems too difficult, remember that you can always lower the heart, by lying on the ground. By elevating the injury, you tend to be still and focus on the injury which is great to help the resting as well. Compression and Elevation should ideally be done at the same time.
Try and stop the bleeding for ten minutes and if nothing changes, see a doctor to get a stitch or a professional dressing
Blood Test Bruises
When patients with itp get their regular blood tests, they are often left with an unsightly bruise in the corner of their elbow. These bruises are obviously from a blood test and tend to draw a lot of attention from others. These are the bruises to try and avoid. To reduce the size and colour of a Blood Test Bruise, remember that the needle has not only put a hole in the surface of your skin, but it has punctured the vein deep in your arm.
When the Nurse asks you to apply pressure to the blood test site, apply pressure to the vein deep in your arm, not the surface of your skin. I used to get really bad blood test bruises until it was explained to me that I should apply a lot more pressure than I thought. I was just trying to stop the blood coming out the hole in my skin, not the hole in my vein.
When does a small injury become a serious injury? Patients with itp may worry about being too much of a bother to others, and may downplay their symptoms or injuries. But when should you call for help?
I have decided on this rule. I call for help the moment I feel like I am not in control anymore. If I have injured myself, I call for help if I feel confused, out of my depth, worried, sick, faint, uneasy, irrational or scared. I call Doctors, or friends or family members just to get a second opinion.
- Band-Aids and Bandages – These are great for in your bag or pocket because they are so small. I always have a couple on me so I don’t have to make a big deal of little cuts and ask others for help. I feel far more self-sufficient with band-aids in my handbag and can pop a band-aid on my finger, no problems.
- Pads and Tampons – Tampons and pads are fantastic at absorbing blood and applying pressure with. Pads are easily taped to injuries and help keep a wound clean until it can be properly dressed. Tampons are good for nosebleeds, and dare I say it . . . .Gum Bleeds (I know, I know). You can also never tell if a period will be on time.
- Strapping tapes – Good for applying pressure when band-aids don’t quite go on as tight as you want. Great strapping tape can be found here.
- Antiseptic wipes – tissues – For quickly cleaning the wound, so the dressing can stay on after it has been applied.
Portable Instant Icepacks – It is easy to keep Ice packs in the freezer at home. Every school and workplace will also have a freezer somewhere you can keep a cold pack in, remembering that ice packs kept at school should be kept in a freezer that the student with itp can access at any time. For travel, weekends, heading out for the day or when children are staying away from the home, there are also portable instant ice packs available. They are something that my sister recommended to me, as she has them in the first aid boxes as a High School teacher. They are fantastic to get ice onto a bleed or a bruise really easily. These ice packs work as part of a chemical reaction within the bag that begins when you break apart the crystals with your fingertips. They are a bit large, and not reusable, but very worth it. I have always travelled with a couple in my carry on.
In Case of Emergencies – ‘ICE’
Conceived and promoted by a British paramedic in 2005, the ICE program encourages people to enter emergency contacts in their mobile phone under the name “ICE”. Alternatively, a person can list multiple emergency contacts as “ICE1” and “ICE2”. The popularity of the program has spread through English speaking countries in Europe, Australia and North America. The number saved as ICE in your phone should be aware that you have saved them as your ICE contact and be able to verbalise you medical condition quickly, ideally knowing your blood type and most recent blood count.
The problem with this program is that for security purposes, many mobile phone owners have a lock on their mobiles, that require a password to access. A few phone companies have addressed this with ICE information and lost & found information being accessible when the phone is still locked. Some handsets provide access to a list of ICE contacts directly from the “locked” screen. In the iphone 4S, the Siri service can access the ICE emergency contact details by asking Siri verbally to ‘Contact ICE’ even if the phone is locked. Check with your mobile phone carrier or device manufacturer to see what your options are. These details may help you choose a phone for a child with ITP.
Medical Alert Bracelets
You can also consider getting a medical alert bracelet that carries details of your condition, blood type and ICE contacts. You may even include the details of you hematologist or GP. I personally do not wear a Medical Alert Bracelet, but that is a personal choice. A number of styles, necklaces and bracelets are available. Check them out here
Children with ITP – First Aid in Schools
There is a great deal of information out there for Teachers, Staff and Students dealing with illness and bleeding disorders in the classroom. Teachers and staff are trained to deal with first aid and having taught as a teacher myself, I know the care that is taken in schools with other peoples children. As a parent, I would not underestimate a teachers ability to deal with an emergency.
Call an Ambulance if. . . You or anyone you know with itp has suffered a Head Injury of any kind. Call the Ambulance if you feel uncomfortable or out of control. Call the ambulance if there is a lot of blood. Call the Ambulance if your emotions are getting in the way of your ability to deal with the injury or bleed.