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  • 04 Apr 2012 7:39 PM | Anonymous member
     
    The Pool Activity Level (PAL) Instrument for Dementia Care







    Developed by Jackie Pool, a leading UK specialist in dementia care, the Pool Activity Level (PAL) instrument has become the framework for care in settings across the UK for clients with cognitive impairments caused by conditions related to dementia, strokes and learning disabilities.

    The PAL Instrument contains a valid and reliable tool for assessing level of ability which is recommended in the National Clinical Practice Guideline for Dementia (NICE, 2006), for activity of daily living skill training and for activity planning. The instrument also contains profiling tools for interpreting the assessment in order to plan and deliver effective, enabling care and support.

    The PAL Instrument is available to photocopy from the PAL Instrument book or as a free electronic version by following the link below. Users of the PAL Instrument will need a PAL book.

    The PAL book is published by Jessica Kingsley publishers. It contains background information, statistical evidence from the research study, case studies and a selection of possible activities, with sources for obtaining them and guidance for carrying them out with individuals who have different levels of ability as revealed by the completion of the PAL Instrument

    To order the PAL book click here

    To use the free electronic version of the PAL Instrument, follow this link


    Jackie Pool

    t:   +44 (0)844 826 3101

    m: +44 (0)7947 741249

    e:   jackie.pool@jackiepoolassociates.org

    w: www.jackiepoolassociates.org 

  • 04 Apr 2012 1:25 PM | Anonymous member


    Medical Emergencies
    within the
    Dental Practice

    ANGINA and HEART ATTACK (MYOCARDIAL INFARCTION - MI)





    ANGINA and HEART ATTACK (MYOCARDIAL INFARCTION – MI)

    DEFINITIONS

    Angina: Pain or discomfort in the chest due to reduced blood and oxygen flow to the heart.

    Myocardial Infarction (MI): Damage or death to an area of the heart muscle resulting from a reduced or blocked blood supply. (Also known as a coronary thrombosis or heart attack).

    Angina is a condition usually caused by the build up of a cholesterol plaque on the inner lining of the coronary arteries. Cholesterol is a fatty chemical which is part of the outer lining of cells in the body, and a cholesterol plaque is a hard, thick substance caused by deposits of cholesterol on the artery wall. Over time, the build up of the plaque causes narrowing and hardening of the arteries, and this significantly reduces the blood flow to the heart muscle. When a person is resting the heart is beating at its resting rate; when any type of exertion is undertaken the heart is required to beat more strongly and at a faster rate to ensure that an adequate supply of oxygenated blood is being circulated. This is a case of “supply and demand”, and the more exertion, the more cardiac effort is required, and the more oxygen the heart will need.

    When the coronary arteries are narrowed less blood can be supplied to the heart muscle, so a situation will be reached where the demand of the heart muscle for blood will exceed that which the coronary arteries can supply. The heart muscle will therefore be deprived of oxygen and “cramps”, producing pain.

    Typically, an angina attack occurs with exertion, and subsides with rest. If the narrowing of an artery reaches a critical level, angina can occur at rest (unstable angina).

    A person with angina, especially “unstable angina” has a high risk of suffering a heart attack in the future.

    Myocardial Infarction is the medical term for a heart attack. It is caused by a complete blockage of one of the coronary arteries, which results in the area of the heart supplied by that vessel becoming completely deprived of its blood supply causing the affected area to die. The usual cause of this is either for a clot (thrombus) to form on the wall of the blood vessel or for a plaque to rupture and cause a blockage. If the blockage occurs in a vessel supplying a large area of the heart then it is unlikely to be able to function normally and a cardiac arrest will result. If the area supplied is relatively small then it may be possible for the rest of the heart to compensate and normal cardiac function may be re-established.




    POSSIBLE SIGNS AND SYMPTOMS

    The symptoms of angina can be variable depending on the severity of the coronary disease, and can also be triggered by emotionally stressful situations which also increase the heart rate (supply and demand). However, on rest, the heart rate will slow down again and the symptoms should pass within approximately 5-10 minutes. Use of a glyceryl tri-nitrate (G.T.N.) spray will help to relieve the symptoms. If the symptoms persist despite rest and the use of G.T.N. spray the diagnosis should be reconsidered as it is likely that the casualty is having a myocardial infarction.

    The signs and symptoms of a myocardial infarction can also be variable and it is important to remember that 30% of heart attacks are “silent” as they produce no obvious symptoms. A heart attack can happen at any time, including during rest. The pain is similar to that of angina, but is often more severe. Unlike angina, the symptoms of MI will not be relieved by the use of the G.T.N. spray. If the symptoms last longer than 10 minutes the casualty is probably experiencing a heart attack.


    ANGINA

    Crushing, vice-like pain, usually in the central area of the chest, can radiate to the left arm, neck or jaw

    Breathlessness

    Sweating/Pallor

    Regular, fast pulse

    Anxiety


    MYOCARDIAL INFARCTION

    Crushing, vice-like pain in the centre of the chest, possibly radiating to the left arm, neck or jaw. Can sometimes be described as indigestion. 30% of casualties experience no pain.

    Breathlessness

    Sweating/Pallor

    Irregular pulse, often missing beats

    Nausea

    Anxiety

    Light-headedness

    Collapse


    MANAGEMENT

    Angina Sit the casualty upright and allow them to lean slightly forward as this makes it easier to breath. The dental chair in its upright position is ideal, otherwise it is best to sit them on the floor with their back to a wall. Under no circumstances insist that the person lies flat as this will not help with breathing and will put the heart under more pressure. High flow oxygen must be administered via the non-rebreathing mask and if the casualty carries their own glyceryl tri-nitrate (G.T.N.) spray they should be encouraged to use it by delivering 1-2 sprays sublingually. If they do not have their medication, or if it is out of date, then use your own supply from the drug box in the same way. The G.T.N. spray works by causing the blood vessels to dilate which will increase the blood flow to the heart.

    If the pain does not reduce despite the G.T.N., then a myocardial infarction should be suspected and the paramedics must be called. A person who has angina will be familiar with their own condition and will tell you what is “normal” for them during an attack. If the symptoms are worse than normal or less responsive to treatment, then immediate transfer to hospital is required. If you are worried it is also a good idea to make the call, even if it is just for reassurance. Otherwise, once the symptoms have improved it is best to allow the casualty to rest before going home, as the G.T.N. will also have increased the blood flow to other organs and can result in a painful headache. Because of this, and the fact that they have just experienced an angina attack, it is best to arrange for someone to collect them if they have attended the appointment alone.

    Myocardial Infarction Early recognition is very important because the casualty needs to be transferred to a coronary care unit as soon as possible, so telephone for an ambulance immediately if it hasn’t been done already. The casualty should be placed in the upright position as mentioned earlier and high flow oxygen administered via the non-rebreathing face mask. It may also be beneficial to administer dispersible aspirin. Make sure that the casualty is not allergic to aspirin and not already taking “anti-coagulant” drugs (such as Warfarin). If this is the case, allowing them to slowly chew a dispersible aspirin may help. However, it is still important to telephone for a paramedic immediately, and if you are unsure you can ask for advice.

    Aspirin reduces the clotting ability of the blood, and chewing the tablet instead of swallowing whole allows the drug to be absorbed quickly into the bloodstream through the buccal sulcus.  Ensure, therefore, that you have dispersible aspirin. The ideal dose is 300mg, although any strength will do.

    If the casualty becomes unconscious then the airway must be opened and the breathing checked. If they are breathing then they must be placed into the recovery position as they are likely to vomit. Continue giving high flow oxygen via the non-rebreathing mask. Monitor the casualty constantly (ABCDE) and if at any time the breathing stops, the rate becomes abnormal, or you are unsure, then start CPR immediately.



    Wendy Berridge has worked within the dental profession for over 26 years and delivers CPR, Medical Emergencies and Defibrillation training to dental practices within Yorkshire and Lincolnshire.

    All training qualifies for Verifiable CPD and meets with current UK Resuscitation Council and GDC guidelines. It takes place at each individual practice, allowing for a personal approach, and resulting in a more relaxed atmosphere!



    Contact details:

    Tel:  07771590513

    Email:  info@berridgemedicaltraining.com

    Website:  www.berridgemedicaltraining.com

  • 14 Mar 2012 11:35 PM | Anonymous member

    AMBULANCE SERVICES BENEVOLENT FUND

    NEWS March 2012




    Two separate fund raising events are being organised by staff from East of England Ambulance Service.

    A team of paramedics are riding on bicycles from Lands End to John O Groats in May 2012. Details/help please contact Pete Davison:

    pete.davison@tscali.co.uk


    A member of the emergency control is organising a dance to raise funds in Milton Keynes at ‘Bistro Live’- Wednesday 23rd May 2012 -19.15 to midnight – tickets £20 includes three course meal. Tickets direct from: http:/www.bistrolive.com/customers/additonalPayments.asp?BookingCode=K8qU2o1. Further details please contact: craig.borrett@eastamb.nhs.uk Or phone Craig on : 07716 890070


    Help raise funds by entering to run in the London 10k in May – the ASBF have 12 free places available. Applications can only be made through Simon Fermor ASBF Secretary:-

    asbf.enquiries@hotmail.co.uk


    VUE National Triathlon emergency services competition – teams welcome with the overall winners presented with a £1000 donation for their service charity – ambulance service competitors would choose the ASBF.

    www.vue-cctv.co.uk


    The ASBF has recently registered with Vodafone’s ‘JustTextGiving’ service – which allows mobile phone users of any network to give donations to charity. Enter 70070 into the “to” box – Write in the code ‘ASBF44’ add the amount you want to donate – Your text might look like this ‘ASBF44 £5’ Press ‘Send.’  The text itself is FREE! Smart phone users will have the option to claim Gift Aid immediately via their phone to increase at no cost to them which will increase their donation by 25%!

    Other ways to raise money for the ASBF for ‘FREE’ – make Everyclick.co your search engine by following this link:-

    www.everyclick.com/uk/ambulanceservicesbenevolentfund

    and then select the ASBF as your chosen charity.

    A further development to’ Everyclick’ is another simple and free method of fund raising –

    ‘Give as you Live’:- www,giveasyoulive.com/join/ambulanceservicesbenevolentfund

    Shopping with ‘Give as you Live’ can raise up to 4% of your purchase expense for the ASBF at no extra cost to you 


    The ASBF will have a stand at the following event so if you’re visiting please go along and say hello and have a chat, we will be pleased to see you.

    AMBULEX – at the Fire Service College, Morton in the Marsh – 13th – 14th June 2012.

    For information visit: www.ambulex.com

     

    Visit the ASBF website where you can purchase ambulance service car stickers, pins, blazer badges, Diamond jubilee medals and the new enamelled medal bars and much, much more.

    Or, to make a regular donation please sign up to one of the donation from salary schemes like ‘Give As You Earn’.

    For more information about your charity please visit:

    www.asbf.co.uk

    Or email:-

     asbf.enquiries@hotmail.co.uk

     

    THE AMBULANCE SERVICES BENEVOLENT FUND HAS BEEN CARING FOR THE CARES FOR OVER 25 YEARS – WE NEED YOUR HELP TO RAISE FUNDS SO THAT  WE CAN CONTINUE TO THRIVE AND DEVELOP OUR FUTURE CARE PROGRAMMES – TOGETHER WE CAN MAKE THE DIFFERENCE!

    PATRON: SIMON WESTON OBE.

    REGISTERED CHARITY # 800434

    (438 words)

  • 14 Mar 2012 10:58 PM | Anonymous member


    CHILD CPR by Tony Clough










    A child is defined as being aged under puberty and an infant under 1-year old. What you need to remember, children are not small adults they have many physiological differences that will need to be discussed in a separate article.

    It is not unknown, but highly unlikely, that a child will have a cardiac arrest; when requiring CPR it is more common for a child to have had an accident or illness that caused them to stop breathing (respiratory arrest) and then for their heart to stop beating (Cardiac Arrest). So it is with this in mind that the Resuscitation Council (UK) guidelines for Child CPR differ to Adult CPR.

    Child CPR (Newborn to Puberty)

    ·         Method - Danger/Response/Airway/Breathing

    ·         Result – Unresponsive/Non-Breathing infant

    ·         5-Rescue Breaths

    ·         30-chest compressions

    ·         2-Rescue Breaths

    ·         Repeat – CPR at ratio 30:2 for 1-minute (Approx. 3 reps of 30:2)

    ·         999 – If no one has called emergency services it must  be done now

    ·         Continue - CPR at ratio of 30:2

    Previous articles have referred to the primary survey Danger Response Airway Breathing (DRAB) to define whether a casualty is in the state of dying and requiring Cardio Pulmonary Resuscitation (CPR). Once again this approach needs to be adhered to, but obviously the language you speak to a child needs to be refined slightly for them to be able to understand.

    Danger – Children don’t have life experiences and the foresight to see they are getting themselves into perilous situations and sometimes the scene can be amusing but it can make it difficult for would-be-rescuers to assist. Circumstances involving children are highly sensitive and emotional; the highly charged scene can drive first aiders into putting themselves in danger and becoming a casualty. If you cannot access a scene because of safety issues please call the emergency services – they have the equipment and training to deal with these situations – a call to the emergency services is a positive first aid action.

    It is extremely likely that you will have more than one casualty to deal with. Children are not usually alone; they will have parents, grandparents, brothers, sisters or other guardians in close proximity. They may not just put themselves into danger but may suffer from ‘shock’ which is perilous situation in its own right.

    Response – Once you know the scene and bystanders are safe you need to quickly decipher the conscious ability of the child by using the Alert Voice Pain Unresponsive (AVPU) scale. With an infant it’s difficult to strike up a conversation to decide whether they are Alert or responding to Voice; nevertheless, talk to the baby in a very calm manor but use your senses – they are never usually wrong! – Babies usually have good colour and are constantly on the move- a silent, limp, pale child is very rarely healthy; use these early visual clues.

    To confirm the infant is Unresponsive we need to check their Pain response; this is done by the ‘Tap-and-tickle’ method. Tap the child’s arms, shoulders and hips as if tickling and look for a normal reaction; if you’re still unsure, run your finger-nails along the soles of the feet – the normal reaction is to move away from the response. If the child fails these basic tests you can diagnose your patient has being Unresponsive.

    Airway – The delicate airway of an infant needs to be protected. If you look at an adult head it is a pea-on-a-drum; while a baby’s head is larger and has a bulbous back. When a baby is unresponsive and on its back with its shoulders on the floor the bulbous rear part can push the head into the bowing position with the chin almost of the chest and compromising the airway. With this in mind it is best practise to raise the shoulders slightly by either, putting the palm of your hand beneath the Childs shoulders and cupping your thumb and forefinger around the neck for support or, placing a folded magazine/newspaper or towel beneath the shoulders of the child and position the head in the flat neutral position.

    With young children do not perform a full Head-Tilt-Chin-Lift as you would to an Adult; you can equally kink and compromise the airway by over extension; start with the ‘sniffing’ position; increase the tilt the nearer the child is to puberty and adulthood.

    Once you have positioned the child correctly you need to take a look in the mouth and remove any foreign objects you may find using your thumb and forefinger as pincers.

    Tip: The infant’s pallet is very delicate and has the consistency of a fine membrane. Never blind sweep the mouth for objects with your finger has you can do untold damage and penetrate the pallet.

    When you know the airway is clear, leave the head in the correct position and place yourself so you can look down the Childs chest, listen at the airway for breathing and feel any breath on your cheek (Look, Listen and Feel). An infant breathes at a more rapid rate than an adult (20-40 breaths/min) and is more diaphragm orientated – they breathe from their tummy muscles. So when you look, listen and feel watch their breathing mechanism and look for 4-8 normal breaths in 10 seconds. If you have any doubts about normal breathing and the child remains unresponsive you must commence CPR immediately.

    Tip: At this stage - If there are bystanders available allow them to call the emergency services but if you are alone remain with the casualty and perform CPR for 1-minute.

    Start CPR by giving 5-rescue breaths; with small infants the best technique can be ‘mouth over nose and mouth’ – this is where the rescuer places their mouth over the nose and mouth of the infant to give rescue breaths.  Use the usual technique of pinching the soft part of the nose and breathing through the mouth of older children.

    Tip: Don’t over inflate the child’s lungs; over inflation may damage the lungs and air may spill into the casualty’s stomach causing them to vomit.

    Follow the 5-rescue breaths with 30-chest compressions. Force needs to be applied to the central chest between the nipples; with infants the pressure of two-fingers may be sufficient, the pressure of one-hand to small children and adult two-handed method for children close to puberty. Nevertheless, the compression must be at least a third of the depth of the chest of all casualties under the age of puberty and at a pace of 100 to 120 compressions per minute.

    Following chest compressions give two-rescue breaths.

    Repeat the process of 30-chest compressions to 2-rescue breaths (30:2) for 3-repetitions; this is approximately 1-minute of CPR; if an ambulance has not yet been called it is now time to do so – it may be necessary for the rescuer to leave the casualty to make the call. For children over 1-year old a defibrillator needs to be requested. Once it is confirmed an ambulance is enroute CPR must be returned to immediately at a ratio of 30:2 and be continuous until assistance arrives and takes over the care of the casualty.

    This adapted CPR is known as ‘Child/Infant CPR’ and is best care practise for all casualties under puberty who are unresponsive and not breathing normally. This practise can also be used when casualties are brought from non-oxygenated atmospheres such as drowning or toxic atmospheres. If the lay person has not been taught in these techniques then Adult CPR should be performed.

    By

    Tony Clough


    Tony Clough FIRST AID TRAINING Ltd

    http://www.tcfirstaidtraining.co.uk



  • 12 Mar 2012 11:46 PM | Anonymous member

    Medical Emergencies
    within the
    Dental Practice


    HYPERVENTILATION

    (PANIC ATTACK)





    DEFINITION  Breathing at an abnormally rapid rate whilst at rest.

    Hyperventilation is literally “excessive breathing”. When we breath in, there is only a trace of carbon dioxide in the air. When we breath out, we breath out 4 percent carbon dioxide. Hyperventilating results in low levels of carbon dioxide in the blood, which causes the signs and symptoms of this condition.

    A hyperventilation attack can often result from anxiousness, or a sudden fright. The condition of hyperventilation is often mistaken for asthma. Asthmatics may hyperventilate immediately after an inhaler has taken effect by opening the airway, however the difference between the two conditions is the large volumes of air can be heard entering the lungs during hyperventilation, compared with the tight wheeze of the asthmatic.

    A panic attack can also occur at any time – it can occur when people are alone, in public, or even when they are asleep. There is often no known trigger. Panic attacks usually begin very suddenly, reach a maximum intensity after about 10 minutes and then slowly subside over the next 30 minutes.

    Respiration is an important system in the maintenance of blood pH, (which is slightly alkaline with a pH of 7.4) and the levels of carbon dioxide in the body have a direct effect on this level. A decreased or low pH is called “acidosis” and a rise in pH is called “alkalosis”. If there is a reduction in carbon dioxide in the body this will cause the blood pH to rise producing an alkalosis. This begins to have an effect on the body’s metabolism and one of the first things to be affected is the drop in the available level of calcium to be used by the nervous system. If a person hyperventilates they “blow off” far too much carbon dioxide, this raises the blood pH and lowers the calcium concentration, resulting in muscle spasms and sensory disturbances such as tingling.


    POSSIBLE SIGNS AND SYMPTOMS

    Unnaturally deep, fast breathing

    Dizziness, weakness

    Feeling of a “tight” chest

    Muscle spasms and cramps, (often felt as “pins and needles”) typically in the hands and feet

    Sweating

    Increased heart rate (tachycardia), palpitations

    Loss of consciousness is uncommon, but can occur


    MANAGEMENT

    It is essential to reduce the rate and increase the depth of respiration. Be firm and calm, but reassuring, asking the casualty to concentrate on breathing slowly. The levels of carbon dioxide can be raised further by asking them to hold their breath for as long as possible, or by “re-breathing” their expired air as this has higher carbon dioxide levels. The simplest re-breathing method is to ask the casualty to breath in and out of their cupped hands that are placed around the mouth and nose. Another effective method is to use the non-rebreathing face mask, without turning the oxygen on, taking care not to cover the air holes with your fingers. This has the added benefit of persuading the casualty to take long, slow breaths, as they will think that they are receiving oxygen. Once the breathing rate has slowed sufficiently the mask can be removed. Another method is to use a paper bag, although they are not always available, and some authorities suggest that there is a risk of hypoxia with this method. As the carbon dioxide level rises the symptoms will disappear very quickly, especially the sensory symptoms. It is important to remember that the symptoms are very frightening and distressing for the casualty, so it is therefore essential to constantly reassure them that the symptoms will resolve soon and that nothing serious is happening. If the chest pains remain, or you are in doubt, ring for medical advice.

    PREVENTION

    Situations of extreme fear or stress can result in a panic attack, and hyperventilation is the main symptom. It is necessary for a healthcare professional to have an understanding of the causes and effects of panic attacks as many patients who attend for dental treatment do suffer from them. When the patient is calm it is helpful to identify the triggers.

    The main management method is to use the mind’s cognitive powers to reverse the effects by recognising that no specific threat exists. This can be helped by breathing awareness and allowing the patient to lie in a semi-reclined position. The use of restful music often helps. Talking quietly and calmly to the patient may also be useful, but some people find this an irritating distraction and it is best to ask the person beforehand what method they find works the best for them. Sedation may be required to undertake dental treatment for some patients, and referral for behavioural therapy may also be beneficial.


    Wendy delivers CPR, Medical Emergencies and AED training to dental practices throughout Yorkshire and Lincolnshire.

    Contact details:    tel: 07771590513    email: wendyberridge@hotmail.co.uk


  • 01 Mar 2012 10:40 PM | Anonymous member

    CPDme Competition Winners

    Announcing the winners of the competition on the PAFO website. 




    Our recent competition run in association with CPDme has come to a close and the winners are:

     

     

    Christopher McGonigall - Private Sector EMT from West Sussex 

    and

      Els Freshwater - HPC Registered Emergency Care Practitioner from Hampshire.

     

    they both WIN A 12 MONTH MEMBERSHIP TO CPDme - Congratulations

     

    winner

    www.pafo.co.uk




    ---------------------------------------------------------------------------------------------------------------------------


    Editor's Note:  Please visit the PAFO website (www.pafo.co.uk) for other competitions and discounts.

  • 29 Feb 2012 12:52 PM | Anonymous member

    Share your News with CPDme









    Do you have a news story that you would like to share with CPDme? The CPDme Communications Team wants to hear from you!


    Email our Newsletter Editor with details of any noteworthy health or social care:

    * Continuing Professional Development (CPD) initiatives in your organisation

    *  Community events

    *  New products

    *  Awards

    *  Individual achievements

    *  Service achievements

    *  Charity events


    There is plenty of space on our website so all articles are welcome.


    You can also connect with CPDme on:

    *  Facebook

    *  LinkedIn

    *  Twitter

    *  YouTube


    Please contact us with ideas for sharing news about health & social care development.  We are particularly interested in hearing from you if you are the Communications Team for your organisation. Please forward this message to your organisation's Communications Team.

  • 28 Feb 2012 5:23 PM | Anonymous member

    AMBULANCE SERVICES BENEVOLENT FUND


    NEWS FEBRUARY 2012




    Two separate fund raising events are being organised by staff from East of England Ambulance Service.

    A team of paramedics are riding on bicycles from Lands End to John O Groats in May 2012. Details/help please contact Pete Davison:

    pete.davison@tscali.co.uk

    A member of the emergency control is organising a dance to raise funds in Milton Keynes. Details please contact: craig.borrett@eastamb.nhs.uk

    Help raise funds by entering to run in the London 10k in May – the ASBF have 12 free places available. Applications can only be made through Simon Fermor ASBF Secretary:

    Asbf.enquiries@hotmail.co.uk

    VUE National Triathlon emergency services completion – teams welcome with the overall winners presented with a £1000 donation for their service charity. It would helpful if individuals and teams obtain sponsorship for the event. Posters with details from VUE the organisers will be sent to all Ambulance Services shortly.

    www.vue-cctv.co.uk

    The ASBF will have a stand at the following events so if you’re visiting please go along and say hello and have a chat, we will be pleased to see you.

    Life Connections2012 – Kettering Conference Centre, Northampton 3rd – 4th May 2012.

    For information visit: www.lifeconnections.uk.com

    AMBULEX – at the Fire Service College, Morton in the Marsh – 13th – 14th June 2012.

    For information visit: www.ambulex.com


    THE AMBULANCE SERVICES BENEVOLENT FUND HAS BEEN CARING FOR THE CARES FOR OVER 25 YEARS – WITH YOUR SUPPORT WE WILL CONTINUE TO THRIVE AND DEVELOP OUR FUTURE CARE PROGRAMMES – TOGETHER WE CAN MAKE THE DIFFERENCE!

     

    VISIT OUR WEBSITE:

    www.asbf.co.uk

    Or email:

    asbf.enquiries@hotmail.co.uk

    PATRON: SIMON WESTON OBE

    REGISTERED CHARITY # 800434

    (WORD COUNT 263)

  • 28 Feb 2012 4:21 PM | Anonymous member


    SAFETY IN CONFINED SPACES
    By
    Eric Dempsey GIFireE





    As a Training Company specialising in Confined Space Entry training, we wondered why there was a recent surge in enquiries for Confined Space Entry training from around the UK. The answer wasn‘t very hard to find and a five second Google search came up with the following sad statement:

    "UK Health and Safety Executive alerts employers to the dangers of Confined Spaces following four deaths in four weeks."

    Now this is not just a problem for the UK as further research with OSHA and other safety bodies around the World unveils the terrible statistics of those who work in Confined Spaces perishing and/or becoming seriously injured by exposure to H2S, Methane, CO and CO2 gases - to name but a few – when entering Confined Spaces, not to mention the problems with flooding, tunnel collapse, shifting solids and the total lack of an emergency procedure should things go wrong.

    It doesn’t have to be like this.

    JOIFF is obviously aware of the problem and has only recently published an extensive Guideline on Confined Space Entry after canvassing opinion from their extensive list of member Organisations. This document is available for free download from the JOIFF website at www.joiff.com

    So what is a Confined Space ??

    A Confined Space is an enclosed, restricted or limited space which by virtue of its enclosed nature, creates conditions that give rise to a possibility of an accident, harm or injury to those partially or fully entering the space. These spaces include but are not limited to:
    • Underground vaults
    • Tanks
    • Storage bins
    • Pits and diced areas
    • Vessels
    • Sewers
    • Silos
    Confined Spaces are significantly more hazardous than normal workplaces. The hazards involved may not be unique to confined spaces but are always exacerbated by the enclosed nature of the confined space. Persons should only enter a confined space for any purpose when it is not reasonable practicable to achieve that purpose without entering the space.

    Another practical way of identifying a Confined Space is a place that can be entered, but isn‘t usually, with difficulty or otherwise.

    The key to safe Confined Space working is the Risk Assessment. Often minor risk Confined Spaces are those where testing and experience have shown that they are sufficiently safe under normal operating conditions and that there is unlikely to be serious risk to health as identified by the risk assessment. However it is always better to be safe than sorry and Risk Assess every time.

    Or, another was of defining that a Confined Space risk is small but with the potential to escalate is when the Risk Assessment identifies that a typical or known risk such as gas, solids, floods or entanglements are not present – at the moment – or are controlled, and the space normally remains safe. However precautions are still necessary to ensure that it is safe to enter and that it remains safe during the occupation of the space. You are simply stepping up a level where the risk assessment deems it to be necessary.

    However there will always be "High Risk Confined Spaces" which will require the use of Compressed Air Breathing Apparatus with a full time rescue team available. Higher Risk operations are those where in addition to normal risks encountered, specific safety arrangements have to be undertaken to provide for safe working prior to entry and during the occupation of the space. This could mean that a permanent rescue team, suitably equipped should be available. It is in this area that the training of your Supervisor/Top Man or Attendant – whatever h/she is known as is vital. All too often the danger of a Confined Space worker becoming overcome is made worse by the Supervisor rushing in without first taking the proper precautions.

    Only suitable training can provide the answers.

    Always remember, if you haven‘t done a risk assessment, or you don‘t have all the required equipment or your staff haven‘t been trained – then don‘t do it.

    Consider fully the dangers:
    • Asphyxiation by H2S, CO, CO2 or Methane
    • sudden floods or solids
    • moving ground
    • collapse of a trench
    • O2 depletion caused by oxidization or enrichment caused by process resulting in an explosive atmosphere.
    All levels need to be tested for dangerous gases as they all have different specific gravities. CO is similar to O2 and will hang around at mid levels. H2S is heavier than air and will be at the ground level. Methane is lighter than air and will be at the roof level. Conditions can change so gas monitoring must not be done only at the beginning. It must be carried out constantly – before and during the entry and continuously while working in a Confined Space.

    DON’T BECOME JUST ANOTHER STATISTIC !!!

    ----------------------------------------------------------------------------------------------------


    Editor’s note : Eric Dempsey has 35 years’ experience and is Owner & Manager of Arc Fire Training Services Ltd - providing First Aid, Manual Handling, Fire Safety Awareness, Confined Space Training and more. For further information contact Eric at arcfiretraining@ntlworld.com
  • 16 Feb 2012 10:23 PM | Anonymous member
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    Focus on Disability - Serving Disabled People





    Focus on Disability ( http://www.focusondisability.org.uk ) was started in 1999 by David Cross as a not for profit online resource for advice, information and contacts for disabled people, the elderly and their carer's in the UK. 

    David's interest in disability issues stems from 10 years working in Occupational Therapy Departments and Orthopaedic Workshops in North Staffordshire. He trained in engineering and is a member of the Institute of Engineering and Technology (IET). 

    Apart from the information and advice on the site, available by using the homepage category links, "Search Site" function or sitemap, help is offered by email via the "contact" link . All outbound links have a relationship or usefulness for those people with a disability, the elderly or their carers. Most requests for inclusion on the site are turned down as being unsuitable for the sites intenton of being solely devoted to disability issues. 

    As well as the information and advice pages, the site now offers access to a comprehensive selection of aids and equipment for disabled people and the elderly and also a wide range of health and nutritional products and therapies. 

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