Monday, June 11, 2012

Kitchen Basics #1 - Emergencies

Internet guidelines are not a substitute for professional advice.  I do not have a medical background, my first aid experience is past employment of more than a decade in law enforcement, with the accompanying Red Cross certifications.  In case of emergency, call 911/Emergency Services or contact a physician as appropriate.  If you are unsure of the severity of an injury or incident, contact Emergency Services.  Over-cautious is better than the alternative.

I've had this post in bits and pieces for a few weeks now, and it was only today, when searching for statistics, that I discovered that June is National Safety Month.  So an especially good time to be discussing the subject. 

Accidents happen.  According to the US National Safety Council, 54,500 unintentional injury deaths occurred at home in 2008, due to poisoning, falls, fires/burns, and choking.  In 2009, 21.1 million unintentional injuries occurred at home.  One of the best ways to avoid being one of these statistics is to be mindful in your actions, and the kitchen is a good place to start.

The most basic safety precaution is to have a properly stocked first aid kit in your home.  Plenty of these are available to purchase as an already prepared kit, at Amazon, Target, WalMart, your local drugstore, or often your pharmacy.  It's generally less expensive to buy an assembled kit than to put one together yourself, though doing it yourself can mean stocking more of some items, if you find a large enough container.  Regardless of whether you buy one pre-made or create your own, here's a list--again from the NSC--of items to keep in it: Adhesive strip bandages in several sizes; Bandage compress; Sterile rolled/flexible bandages; Triangle bandages; Sterile bandage tape; Disposable latex and non-latex gloves; Scissors; CPR breathing barrier (face shield); Tweezers; Antibiotic treatment; Antiseptic wipes/towelettes; Germicidal hand wipes or alcohol-based hand sanitizer; Cold pack; Disposable bags; Non-prescription medication acetaminophen, ibuprofen, anti-diarrhea medicine, antacids, laxatives; First aid manual.  It is also very useful to have a working fire extinguisher in the home, and once you've gotten one, an understanding of how to use it (read through the instructions when you buy the extinguisher, and review them periodically.  Don't wait until you have a fire to try to figure it out).

Burns

A serious burn may appear charred black or dry and white.  For serious burns, do not immerse the burn in water, as this can cause shock.  Do not remove any clothing that is stuck to the burnt area.  Elevate the burned body part, above the heart if possible.  Cover the burn with a sterile nonstick bandage--just cover, don't fasten or tape, this is a temporary measure to protect the burn from bacteria and infection--do not put gauze or towels or any material that may stick to the wound onto the burn.  Call emergency services and follow the instructions given while you wait for paramedics to respond.  If the injured person would not need to be the driver, and you feel comfortable transporting them, proceed to the nearest emergency room.

Minor burns fall into two categories: 1st degree and 2nd degree.  A 1st degree burn has skin which is usually red, often swollen, and may be painful.  2nd degree burns involve blisters, intensely red or blotchy skin, and severe pain and swelling.  If a 1st or 2nd degree burn is large or covers substantial portions of the hands, feet, face, groin or buttocks, or is over a major joint, treat it as a serious burn and follow the instructions in the previous paragraph.  Otherwise, cool the burn by holding the burned area under cool (not cold) running water for 10-15 minutes or until the pain eases.  Another option is to immerse the burn in cool water or cover it with cold compresses.  This is the best option if the pressure of running water increases pain to the burned area.  Do not put ice on a burn.  Cover the burn loosely with a sterile gauze bandage to keep air off the burn and protect the skin from infection.  Do not use fluffy cottons or any material that may get lint in the burn.  Take whatever over-the-counter pain reliever you usually use (aspirin, acetaminophen, etc.).

Do not apply egg whites, butter, or ointments to a burn.  These are old wives' tales and can cause infection.  Do not break blisters, as this can cause infection.  Blisters will heal on their own.

Cuts

Serious cuts need emergency medical treatment.  These include stabbing injuries, partial or complete digit loss, and deep cuts.  If there is severe bleeding or blood spurting from the wound, apply direct pressure with a clean cloth while contacting emergency services for further instructions.  If, after 10 minutes of direct pressure to an apparently less severe injury, the bleeding has not stopped, continue direct pressure and contact emergency services.  In case of partial or complete amputation, control bleeding with direct pressure.  If complete amputation, save the severed body part, wrap it in a clean damp cloth, place it in a bag, and place the bag in another bag filled with cold water (ice water if possible).  Do not put the body part directly in water or directly on ice.  Contact emergency services and follow their instructions.  Keep warm, and do not try to push any partially severed body part back into place.  In case of a stabbing injury, if the item is still in the wound, try to avoid touching it.  Pulling it out will increase blood loss, and if it gets pressed further in, it can cause additional injury.  As you're contacting emergency services, try to apply pressure with a clean cloth around the object.  In all situations, do not remove the cloth if bleeding soaks through.  Apply another cloth on top of the first and continue to apply pressure. 

For less-serious cuts, the first thing to remember is that you are not in a professional kitchen or television reality show.  You do not need to "power through" or ignore a cooking injury.  Stop cooking and deal with the cut, turning off all heating elements.  Better a poorly-finished meal than a poorly-dressed injury that leads to an infection.  Stop the bleeding by applying direct pressure (preferably elevating the injury) with a clean cloth for 20 minutes.  Do not lift the cloth to check whether the bleeding has stopped, as this may interrupt the clotting process.  Once bleeding has halted, rinse the wound with clear water.  If there are any particles in the wound after rinsing, use alcohol-soaked tweezers to remove them carefully.  Apply an antibiotic cream and cover the wound with a bandage.  A wound that is more than 1/4 inch deep or has muscle or fat protruding will probably need stitches.  Contact your physician or urgent care if one is available, as soon as possible (it's best to get stitches within hours of the injury).  If the cut is located on a joint where the wrapping is likely to get loosened as you finish cooking, consider wearing a non-powdered latex glove on that hand, both to protect the cut from food (imagine lemon juice or salt making their way into your wound) and to protect the food from your cut.  If the injury has dampened your enthusiasm, yield for the time being, wrap up any food that can go into the fridge, discard the rest, and go for pizza or something.  There is no shame in not wanting to continue when you're hurt and demoralized.

Fires 

"When in doubt, just get out."

I've been present for two house fires.  One was a kitchen fire caused by my boyfriend-of-the-time putting a plastic colander in the oven when he couldn't remember which cupboard it belonged in.  When I later preheated the oven without looking inside first, the plastic melted and then caught fire.  Upon smelling the burning plastic, I checked the oven, and flames came shooting out at me, so high that they were inches from the ceiling.  The other was when neighbor children were playing with firecrackers and set the side of our apartment on fire.  Fortunately I had my window open and heard the crackling of the flames (which were literally inches away from where I was sitting and were climbing the wall, the fence, and the wooden telephone pole).  In the first instance, I felt confident handling the fire myself, and I did.  In the second, I knew it was far beyond my control, so I evacuated while calling 911 on my cell phone.  If you doubt your ability to control a fire for any reason, get everyone out of the house to safety and call emergency services.

In case of a fire in the oven or microwave, keep the door shut and turn off the appliance.  Do not open the door.  Fire needs oxygen, and it will burn through what's inside, suffocating the fire.  Opening the door provides the fire with more oxygen, and flames will pour out to consume the air in the kitchen.  If smoke continues, or if you'd like confirmation that the fire is out, call the fire department.  After I dealt with my long-ago oven fire, I called the fire department and asked them to come out and check for extensions.  We were living in an apartment at the time, and I wanted to be sure the fire hadn't gotten into the walls or ceiling where it would endanger other residents.  Just because the fire was out on my side didn't necessarily mean it hadn't found a way into another apartment.

In case of fire in a pan, use an oven mitt to cover the pan with its lid, move the pan off the burner, and turn off the stove.  If you can't safely cover the pan with its lid, or you don't have a lid for that pan, use your fire extinguisher.  Aim the extinguisher at the base of the fire, not at the flames.  For a grease fire, DO NOT use water, as it repels grease and will likely splatter the grease, spreading the fire.  If covering the pan is not an option for a grease fire, pour lots of salt or baking soda onto the fire to smother it.  Never flour, as flour can explode and seriously increase your fire problems.  If salt or baking soda aren't available, smother the fire with a wet towel or use your fire extinguisher.  Do not swat at a fire with a towel, apron, oven mitt, or similar.  This is likely to fan the flames and spread the fire.

Again, if the fire is spreading or you are overwhelmed, get everyone out of the house and call emergency services.

Food-Borne Illness

The best way to deal with food poisoning is not to get it in the first place, which means being cautious, aware, and observant.  If you do find yourself exhibiting the symptoms of food poisoning (generally diarrhea, nausea, abdominal pain; sometimes vomiting and/or dehydration), and if you are not a high-risk group, rest, drink plenty of liquids, and avoid anti-diarrheal medications that will slow the release of the bacteria from your system.  If symptoms do not improve in 48 hours, if you are part of a high-risk group (the elderly, infants and young children, people with chronic illnesses), or if there is blood in your stool, contact your physician immediately.

If you suspect botulism, or if you think the food poisoning is from seafood or mushrooms, contact emergency services or proceed to an emergency room.  

Safety Tips

  • Keep knives sharp.  Dull knives cause the user to apply more pressure, which means both less control and more force behind the knife if it does slip.  
  • Do not place sharp knives in the dishwasher.  Not only is this bad for the knives (dulling them) and for other objects in the dishwasher (that can get knocked against the knives), but it's dangerous for people reaching into the dishwasher.
  • Do not leave sharp knives in the bottom of the sink.  People reaching into the sink, especially once it's filled with soap and water, may not see them.
  • Do not gesture with knives in your hand.
  • Do not use knives for anything other than their intended purpose (for example, knives are not meant to open jars/cans or plastic packaging).  
  • Do not dispose of broken glass in the regular trash where people reaching in can cut themselves.  
  • Use the handguard if you have a mandoline.
  • Use oven mitts or pads every time you move things in or out of the oven.
  • Pull long hair back while cooking, so that it doesn't get caught in anything or catch fire.  
  • Do not wear loose or flowing clothing when cooking.
  • Keep flammable materials, such as pot holders and towels, away from the stove.
  • Do not disable smoke detectors, and have them placed in sensible locations in your home to avoid constant false alarms.
  • Keep pot handles pointed to the sides, where they won't get knocked into or snagged by movement in front of the stove.  That can cause grease burns or water scalding.  
  • Have the dial gauge of pressure canners checked for accuracy by the local county extension every year.  
  • Do not use any canned food that bulges outward, has holes in it, or rust.
  • Do not eat food if the freshness is questionable or it appears partially spoiled.  
  • Use separate cutting boards for poultry, meat, and vegetables.  
  • Do not eat wild-harvested mushrooms unless checked for safety by a mycologist.  
  • Do not use wild-harvested herbs that you cannot identify.  
  • Keep poisonous cleaning products and insecticides away from food preparation areas.
  • Ask guests about food allergies before planning a meal.
  • Change kitchen linen regularly to avoid breeding bacteria.  
  • Do not refreeze thawed frozen food.
  • Take extra care with uncooked eggs and chicken.
  • Leftovers should be cooled, properly packaged, and refrigerated within one hour.  Do not put hot food directly into the fridge.
  • Wash hands regularly.
  • Fully wash cooking utensils and workstations between uses.
  • Consider taking a basic first aid course, preferably one that includes CPR and Heimlich Maneuver instructions.
A note about contacting emergency services: when you call for emergency medical help, the call-taker will usually provide you with what are known as pre-arrival instructions, which are basic steps you can take to keep the patient safe and prepare them for the arrival of paramedics.  While the call-taker is giving you these instructions, the paramedics are simultaneously being notified of the emergency call, your location, and the basic information.  It is not necessary for the call-taker to stop talking to you in order for responders to be sent.  Do not tell the call-taker to "shut up and send someone", do not tell them you already know everything they're saying, do not try to hurry them up or shout them down.  The call-taker may have questions for you during the pre-arrival instructions, and your answers to those questions may increase the speed or level of paramedic response.  Stay on the phone as long as the call-taker requests you to, remain as calm as possible, answer their questions, and follow the instructions given.  Help will arrive as quickly as possible.  

Again, as I am not a medical professional, I cannot take responsibility for your in-the-moment decision making.  If an incident has occurred, use your best judgement and contact emergency services or your physician when appropriate.

Kitchen Basics are reminders or refreshers for those who have been cooking a long time, and information for newer cooks who may not know to ask certain questions.

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