IMO Conventions

Lifestyle

These links go to the Prevention section of this site.  

            Following a Healthy Eating Pattern

Reducing Salt and Sodium in Your Diet

Maintaining a Healthy Weight

Being Physically Active

Limiting Alcohol Intake

Quitting Smoking

Other Factors Affecting Blood Pressure

 

• Treatment of low blood pressure

 

Low blood pressure that either doesn't cause signs or symptoms, or causes only mild symptoms, such as brief episodes of dizziness when standing, rarely requires treatment. If you have symptoms, the best treatment depends on the underlying cause, and doctors usually try to address the primary health problem — dehydration, heart failure, diabetes or hypothyroidism, for example — rather than the low blood pressure itself. When low blood pressure is caused by medications, treatment usually involves changing the dose of the medication or stopping it entirely.

 

If it's not clear what's causing low blood pressure or no effective treatment exists, the goal is to raise your blood pressure and reduce signs and symptoms. Depending on your age, health status and the type of low blood pressure you have, you can do this in several ways:

Use more salt. Experts usually recommend limiting the amount of salt in your diet because sodium can raise blood pressure, sometimes dramatically. For people with low blood pressure, that can be a good thing. But because excess sodium can lead to heart failure, especially in older adults, it's important to check with your doctor before increasing the salt in your diet.

Drink more water. Although nearly everyone can benefit from drinking enough water, this is especially true if you have low blood pressure. Fluids increase blood volume and help prevent dehydration, both of which are important in treating hypotension.

Wear compression stockings. The same elastic stockings commonly used to relieve the pain and swelling of varicose veins may help reduce the pooling of blood in your legs.

Medications. Several medications, either used alone or together, can be used to treat low blood pressure that occurs when you stand up (orthostatic hypotension). For example, the drug fludrocortisone is often used to treat this form of low blood pressure. This drug helps boost your blood volume, which raises blood pressure. Doctors often use the drug midodrine (Orvaten, Proamatine) to raise standing blood pressure levels in people with chronic orthostatic hypotension. It works by restricting the ability of your blood vessels to expand, which raises blood pressure.

 

 

 

 

What is low blood pressure?

 

Low blood pressure means that your blood pressure is lower than normal. Another name for low blood pressure is hypotension (say “hy-poh-TEN-shun”).

 

In most healthy adults, low blood pressure does not cause problems or symptoms. In fact, it may be normal for you. For example, people who exercise regularly often have lower blood pressure than people who are not as fit.

 

But if your blood pressure drops suddenly or causes symptoms like dizziness or fainting, it is too low. It can cause shock. Shock can be dangerous if it is not treated right away.

 

Blood pressure is a measure of how hard the blood pushes against the walls of your arteries as it moves through your body. Blood pressure consists of two numbers: systolic and diastolic.

The systolic (higher) number shows how hard the blood pushes when the heart is pumping.

The diastolic (lower) number shows how hard the blood pushes between heartbeats, when the heart is relaxed and filling with blood.

 

Someone with a systolic pressure of 120 and a diastolic pressure of 80 has a blood pressure of 120/80, or "120 over 80." Normal blood pressure is lower than 120/80.

 

Low blood pressure does not have a specific number where it is too low. Most doctors consider blood pressure to be too low when it causes symptoms or drops suddenly. In general, low blood pressure symptoms happen when blood pressure is less than 90/60.

 

What causes low blood pressure?

 

Some of the causes of low blood pressure include:

Getting up after you sit or lie down. This can cause a quick drop in blood pressure called orthostatic hypotension.

Standing for a long time.

Not drinking enough fluids (dehydration).

Medicines, such as high blood pressure medicine or other heart medicines.

Health problems such as thyroid disease, severe infection, bleeding in the intestines, or heart problems.

Trauma, such as major bleeding or severe burns.

 

What are the symptoms?

 

Many people with low blood pressure don't have any symptoms.

 

Symptoms to watch for include:

Feeling dizzy, lightheaded, or faint.

Having a fast or irregular heartbeat.

Feeling sick to your stomach or vomiting.

Feeling more thirsty than usual.

Having blurry vision.

Feeling weak.

Being confused.

Being tired.

Having cold, clammy skin.

Breathing very fast.

Having black, tarry stools.

Having a fever.

 

If you have symptoms of low blood pressure, especially dizziness or fainting, call your doctor.

 

Watch for symptoms of low blood pressure. Tell your doctor when the symptoms happen so he or she can treat them.

 

How is low blood pressure diagnosed?

 

Often people learn that they have low blood pressure when their doctor checks it. Or you may find that you have low blood pressure when you check it at home.

 

To check for the causes of your low blood pressure, your doctor will ask about your past health, your symptoms, and the medicines you take. He or she will do a physical exam and may do other tests. Your doctor may check for another health problem that could be causing your low blood pressure.

 

Will your doctor treat low blood pressure?

 

You will likely get treated for low blood pressure only if it is causing symptoms or if your blood pressure drops suddenly. Treatment depends on your symptoms, how severe they are, and the reasons for the low blood pressure.

 

Your doctor may have you:

Add more salt to your diet.

Get fluid through an intravenous (IV) line if you are very dehydrated.

Change or stop medicines that lower your blood pressure.

Take medicine to treat the problem that is causing low blood pressure. For example, you may need antibiotics to treat infection or medicines to stop vomiting or diarrhea.

 

Be sure to talk with your doctor before you add more salt to your diet or make any changes in your medicines.

 

How can you prevent low blood pressure symptoms?

 

If you have orthostatic hypotension, your doctor may suggest that you try some simple ways to prevent symptoms like dizziness. For example, you can:

Stand up slowly.

Drink more water.

Drink little or no alcohol.

Limit or avoid caffeine.

Wear compression stockings.

 

If you feel dizzy or lightheaded, sit down or lie down for a few minutes. Or you can sit down and put your head between your knees. This will help your blood pressure go back to normal and help your symptoms go away.

 

 

 

Lesson 5.

Heart attack.

Heart attack facts

- A heart attack results when a blood clot completely obstructs a coronary artery supplying blood to the heart muscle and heart muscle dies.

- The blood clot that causes the heart attack usually forms at the site of rupture of an atherosclerotic, cholesterol plaque on the inner wall of a coronary artery.

- The most common symptom of heart attack is chest pain.

- The most common complications of a heart attack are heart failure and ventricular fibrillation.

- The risk factors for atherosclerosis and heart attack include elevated cholesterol levels, increased blood pressure, tobacco use, diabetes, male gender, and a family history of heart attacks at an early age.

- Heart attacks are diagnosed with electrocardiograms and measurement of cardiac enzymes in blood.

- Early reopening of blocked coronary arteries reduces the amount of damage to the heart and improves the prognosis for a heart attack.

- Medical treatment for heart attacks may include antiplatelet, anticoagulant, and clot dissolving drugs as well as angiotensin converting enzyme (ACE) inhibitors, beta blockers, and oxygen.

Interventional treatment for heart attacks may include coronary angiography with percutaneous transluminal coronary angioplasty (PTCA), coronary artery stents, and coronary artery bypass grafting (CABG).

- Patients suffering a heart attack are hospitalized for several days to detect heart rhythm disturbances, shortness of breath, and chest pain.

- Further heart attacks can be prevented by aspirin, beta blockers, ACE inhibitors, discontinuing smoking, weight reduction, exercise, good control of blood pressure and diabetes, following a low cholesterol and low saturated fat diet that is high in omega-3-fatty acids, taking multivitamins with an increased amount of folic acid, decreasing LDL cholesterol, and increasing HDL cholesterol.

 

Heart Attack Causes

 

Over time, plaque can build up along the course of an artery and narrow the channel through which blood flows. Plaque is made up of cholesterol buildup and eventually may calcify or harden, with calcium deposits. If the artery becomes too narrow, it cannot supply enough blood to the heart muscle when it becomes stressed. Just like arm muscles that begin to ache or hurt when heavy things are lifted, or legs that ache when you run too fast; the heart muscle will ache if it doesn't get adequate blood supply. This ache or pain is called angina. It is important to know that angina can manifest in many different ways and does not always need to be experienced as chest pain.

 

If the plaque ruptures, a small blood clot can form within the blood vessel, acting like a dam and acutely blocking the blood flow beyond the clot. When that part of the heart loses its blood supply completely, the muscle dies. This is called a heart attack, or an MI - a myocardial infarction (myo=muscle +cardial=heart; infarction=death due to lack of oxygen).

 

 

Home task.

Treatment

 

You will most likely first be treated in the emergency room.

You will be hooked up to a heart monitor, so the health care team can look at how your heart is beating.

The health care team will give you oxygen so that your heart doesn't have to work as hard.

An intravenous line (IV) will be placed into one of your veins. Medicines and fluids pass through this IV.

You may get nitroglycerin and morphine to help reduce chest pain.

 

Abnormal heartbeats (arrhythmias) are the leading cause of death in the first few hours of a heart attack. These arrythmias may be treated with medications or cardioversion.

 

EMERGENCY TREATMENTS

 

Angioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to the heart. Usually a small, metal mesh tube called a stent is placed at the same time.

Angioplasty is often the first choice of treatment. It should be done within 90 minutes after you get to the hospital, and no later than 12 hours after a heart attack.

A stent is a small, metal mesh tube that opens up (expands) inside a coronary artery. A stent is often placed after angioplasty. It helps prevent the artery from closing up again.

 

You may be given drugs to break up the clot. It is best if these drugs are given within 3 hours of when you first felt the chest pain. This is called thrombolytic therapy.

 

Some patients may also have heart bypass surgery to open narrowed or blocked blood vessels that supply blood to the heart. This procedure is also called open heart surgery.

 

AFTER YOUR HEART ATTACK

 

The following drugs are given to most people after they have a heart attack. These drugs can help prevent another heart attack. Ask your doctor or nurse about these drugs:

Antiplatelet drugs (blood thinners) such as aspirin, clopidogrel (Plavix), or warfarin (Coumadin), to help keep your blood from clotting

Beta-blockers and ACE inhibitor medicines to help protect your heart

Statins or other drugs to improve your cholesterol levels

 

You may need to take some of these medicines for the rest of your life. Always talk to your health care provider before stopping or changing how you take any medicines. Any changes may be life threatening.

 

After a heart attack, you may feel sad. You may feel anxious and worry about being careful in everything you do. All of these feelings are normal. They go away for most people after 2 or 3 weeks. You may also feel tired when you leave the hospital to go home.

 

Most people who have had a heart attack take part in a cardiac rehab program. While under the care of a doctor and nurses, you will:

Slowly increase your exercise level

Learn how to follow a healthy lifestyle

 

LIVING A HEALTHY LIFESTYLE

 

To prevent another heart attack:

Keep your blood pressure, blood sugar, and cholesterol under control.

Don't smoke.

Eat a heart-healthy diet rich in fruits, vegetables, and whole grains, and low in animal fat.

Get plenty of exercise, at least 30 minutes a day, at least 5 days a week (talk to your doctor first).

Get checked and treated for depression.

Limit yourself to no more than one drink a day for women, and no more than two drinks a day for men.

Stay at a healthy weight. Aim for a body mass index (BMI) of between 18.5 and 24.9.

 

If you or someone else may be having a heart attack

Call 911 or your local emergency medical assistance number. Don't tough out the symptoms of a heart attack for more than five minutes. If you don't have access to emergency medical services, have a neighbor or a friend drive you to the nearest hospital. Drive yourself only as a last resort, if there are absolutely no other options, and realize that it places you and others at risk when you drive under these circumstances.

Chew and swallow an aspirin, unless you're allergic to aspirin or have been told by your doctor never to take aspirin. But seek emergency help first, such as calling 911.

Take nitroglycerin, if prescribed. If you think you're having a heart attack and your doctor has previously prescribed nitroglycerin for you, take it as directed. Do not take anyone else's nitroglycerin, because that could put you in more danger.

Begin CPR if the person is unconscious. If you're with a person who might be having a heart attack and he or she is unconscious, tell the 911 dispatcher or another emergency medical specialist. You may be advised to begin cardiopulmonary resuscitation (CPR). If you haven't received CPR training, doctors recommend skipping mouth-to-mouth rescue breathing and performing only chest compressions (about 100 per minute). The dispatcher can instruct you in the proper procedures until help arrives.

 

 

 

 

Lesson 6.

An injury is damage to your body. It is a general term that refers to harm caused by accidents, falls, blows, burns, weapons and more. In the U.S., millions of people injure themselves every year. These injuries range from minor to life-threatening. Injuries can happen at work or play, indoors or outdoors, driving a car or walking across the street.

 

Common injuries include

Burns

Dislocations

Fractures

Sprains and strains

 

A burn is damage to your body's tissues caused by heat, chemicals, electricity, sunlight or radiation. Scalds from hot liquids and steam, building fires and flammable liquids and gases are the most common causes of burns.

 

There are three types of burns:

First-degree burns damage only the outer layer of skin

Second-degree burns damage the outer layer and the layer underneath

Third-degree burns damage or destroy the deepest layer of skin and tissues underneath

 

Burns can cause swelling, blistering, scarring and, in serious cases, shock and even death. They also can lead to infections because they damage your skin's protective barrier. Antibiotic creams can prevent or treat infections. After a third-degree burn, you need skin or synthetic grafts to cover exposed tissue and encourage new skin to grow. First- and second-degree burns usually heal without grafts.

 

To distinguish a minor burn from a serious burn, the first step is to determine the extent of damage to body tissues. The three burn classifications of first-degree burn, second-degree burn and third-degree burn will help you determine emergency care.

 

1st-degree burn

The least serious burns are those in which only the outer layer of skin is burned, but not all the way through.

The skin is usually red

Often there is swelling

Pain sometimes is present

 

Treat a first-degree burn as a minor burn unless it involves substantial portions of the hands, feet, face, groin or buttocks, or a major joint, which requires emergency medical attention.

 

2nd-degree burn

When the first layer of skin has been burned through and the second layer of skin (dermis) also is burned, the injury is called a second-degree burn.

Blisters develop

Skin takes on an intensely reddened, splotchy appearance

There is severe pain and swelling.

 

If the second-degree burn is no larger than 3 inches (7.6 centimeters) in diameter, treat it as a minor burn. If the burned area is larger or if the burn is on the hands, feet, face, groin or buttocks, or over a major joint, treat it as a major burn and get medical help immediately.

 

For minor burns, including first-degree burns and second-degree burns limited to an area no larger than 3 inches (7.6 centimeters) in diameter, take the following action:

Cool the burn. Hold the burned area under cool (not cold) running water for 10 or 15 minutes or until the pain subsides. If this is impractical, immerse the burn in cool water or cool it with cold compresses. Cooling the burn reduces swelling by conducting heat away from the skin. Don't put ice on the burn.

Cover the burn with a sterile gauze bandage. Don't use fluffy cotton, or other material that may get lint in the wound. Wrap the gauze loosely to avoid putting pressure on burned skin. Bandaging keeps air off the burn, reduces pain and protects blistered skin.

Take an over-the-counter pain reliever. These include aspirin, ibuprofen (Advil, Motrin, others), naproxen (Aleve) or acetaminophen (Tylenol, others). Use caution when giving aspirin to children or teenagers. Though aspirin is approved for use in children older than age 2, children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. Talk to your doctor if you have concerns.

 

Minor burns usually heal without further treatment. They may heal with pigment changes, meaning the healed area may be a different color from the surrounding skin. Watch for signs of infection, such as increased pain, redness, fever, swelling or oozing. If infection develops, seek medical help. Avoid re-injuring or tanning if the burns are less than a year old — doing so may cause more extensive pigmentation changes. Use sunscreen on the area for at least a year.

 

Caution

Don't use ice. Putting ice directly on a burn can cause a person's body to become too cold and cause further damage to the wound.

Don't apply egg whites, butter or ointments to the burn. This could cause infection.

Don't break blisters. Broken blisters are more vulnerable to infection.

 

3rd-degree burn

The most serious burns involve all layers of the skin and cause permanent tissue damage. Fat, muscle and even bone may be affected. Areas may be charred black or appear dry and white. Difficulty inhaling and exhaling, carbon monoxide poisoning, or other toxic effects may occur if smoke inhalation accompanies the burn.

 

For major burns, call 911 or emergency medical help. Until an emergency unit arrives, follow these steps:

Don't remove burned clothing. However, do make sure the victim is no longer in contact with smoldering materials or exposed to smoke or heat.

Don't immerse large severe burns in cold water. Doing so could cause a drop in body temperature (hypothermia) and deterioration of blood pressure and circulation (shock).

Check for signs of circulation (breathing, coughing or movement). If there is no breathing or other sign of circulation, begin CPR.

Elevate the burned body part or parts. Raise above heart level, when possible.

Cover the area of the burn. Use a cool, moist, sterile bandage; clean, moist cloth; or moist cloth towels.

 

Get a tetanus shot. Burns are susceptible to tetanus. Doctors recommend you get a tetanus shot every 10 years. If your last shot was more than five years ago, your doctor may recommend a tetanus shot booster.

 

Dislocations are joint injuries that force the ends of your bones out of position. The cause is often a fall or a blow, sometimes from playing a contact sport. When a dislocation occurs, you can't move the joint. You can dislocate your ankles, knees, shoulders, hips and elbows. You can also dislocate your finger and toe joints. Dislocated joints often are swollen, very painful and visibly out of place.

 

If you dislocate a joint, seek medical attention. Treatment depends on which joint you dislocate and the severity of the injury. It might include manipulations to reposition your bones, medicine, a splint or sling, and rehabilitation. When properly repositioned, a joint will usually function and move normally again in a few weeks. Once you dislocate a shoulder or kneecap, you are more likely to dislocate it again. Wearing protective gear during sports may help prevent dislocations.

First Aid for Dislocations

Get medical attention as soon as possible with any suspected dislocation so that you can have the bones repositioned properly. Until you can get medical attention, do the following:

Splint and immobilize the affected joint and never try force it back into place, which can potentially damage the joint, surrounding muscles, ligaments, nerves, or blood vessels.

Apply an ice pack to reduce any swelling caused by internal bleeding and the buildup of fluids

 

 

A fracture is a break, usually in a bone. If the broken bone punctures the skin, it is called an open or compound fracture. Fractures commonly happen because of car accidents, falls or sports injuries. Other causes are low bone density and osteoporosis, which cause weakening of the bones. Overuse can cause stress fractures, which are very small cracks in the bone.

 

Symptoms of a fracture are

Out-of-place or misshapen limb or joint

Swelling, bruising or bleeding

Intense pain

Numbness and tingling

Limited mobility or inability to move a limb

 

You need to get medical care right away for any fracture. You may need to wear a cast or splint. Sometimes you need surgery to put in plates, pins or screws to keep the bone in place.

 

A sprain is a stretched or torn ligament. Ligaments are tissues that connect bones at a joint. Falling, twisting, or getting hit can all cause a sprain. Ankle and wrist sprains are common. Symptoms include pain, swelling, bruising and being unable to move your joint. You might feel a pop or tear when the injury happens.

 

 

Your ligaments are tough, elastic-like bands that connect bone to bone and hold your joints in place. A sprain is an injury to a ligament caused by tearing of the fibers of the ligament. The ligament can have a partial tear, or it can be completely torn apart.

 

Of all sprains, ankle and knee sprains occur most often. Sprained ligaments swell rapidly and are painful. Generally, the greater the pain and swelling, the more severe the injury is. For most minor sprains, you probably can treat the injury yourself.

 

Follow the instructions for R.I.C.E.

Rest the injured limb. Your doctor may recommend not putting any weight on the injured area for 48 hours. But don't avoid all activity. Even with an ankle sprain, you can usually still exercise other muscles to minimize deconditioning. For example, you can use an exercise bicycle with arm exercise handles, working both your arms and the uninjured leg while resting the injured ankle on another part of the bike. That way you still get three-limb exercise to keep up your cardiovascular conditioning.

Ice the area. Use a cold pack, a slush bath or a compression sleeve filled with cold water to help limit swelling after an injury. Try to ice the area as soon as possible after the injury and continue to ice it for 15 to 20 minutes, four to eight times a day, for the first 48 hours or until swelling improves. If you use ice, be careful not to use it too long, as this could cause tissue damage.