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Reader's Digest highlights nursing knowledge

September 2004 -- A half-page item in this month's Reader's Digest (p. 210), Cynthia Dermody's "Nurse Your Health," provides several pieces of practical health advice from Pat Carroll, RN, author of the very good new book What Nurses Know and Doctors Don't Have Time to Tell You.

The piece's concision allows it to provide useful information on headaches, allergies, fevers, colds, digestive problems and taking medicines, a good sample of what is available in Ms. Carroll's book, and a good example of Ms. Carroll's commendable efforts to link her advice to her nursing qualifications. Despite the awkward article headline, which suggests that the reader will be doing the nursing, and a somewhat regressive graphic showing a nurse in a cap, we salute Ms. Dermody and Reader's Digest for linking nursing with valuable health care knowledge in such a prominent forum.

In connection with her new book, Ms. Carroll has recently been able to provide this kind of nursing knowledge through mainstream media outlets including in her new weekly column in the New York Daily News appearing every Wednesday. Also see an August 27 piece with an appearance by Ms. Carroll in USA Today.

See our review of Ms. Carroll's book: What Nurses Know and Doctors Don't Have Time to Tell You.

See an example the practical health knowledge she communicates in her latest newsletter which prepares her readers for the approaching Hurricaine Frances below:

What Nurses Know Newsletter

Special Edition September 1, 2004

Our home page http://www.WhatNursesKnow.com

Written by Patricia Carroll, RN, RRT

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This is a special edition with storm preparedness tips originally written for NursesNotebook.com. Please forward this newsletter to anyone who may benefit from this information. If you are in the path of Hurricaine Frances, follow the instructions of your civil preparedness teams. Here are tips for people who will be affected by wind, rain and potential power outages who are not directly in the storm's path. The regular newsletter will be back on Friday.

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Nurses and respiratory therapists up and down the East coast are helping patients with special health needs prepare in case the storm comes their way. If you, a member of your household, or a loved one (even in a different part of the country) has any health conditions that require medication or special equipment, you need to plan ahead, whether it's a hurricane or winter storm. (In this article, I'll write as if you have the health condition, but all this information also applies to someone you know and may be looking out for.) Standing in line the day before a storm arrives to buy bread is one thing; you can't wait ‘til it's that late if you depend on medicines or equipment.

Here's how I helped my patients prepare.

General Advance Planning: Should I Stay or Should I GO?

If local authorities issue an evacuation order, go. We learned the hard way from Hurricane Charley that this powerful storms are unpredictable -- and deadly.

First, evaluate your physical condition – this will help determine if you should be one of the first to evacuate (or go to a friend or relative's home), particularly if a power outage is likely:

*Do you rely on electricity for special equipment related to a health condition, or could your health be seriously affected if you are without power for a number of days (for example, if your water comes from a well with an electric pump, or if you'd be without heat in the dead of winter)?

*Do others run errands for you? For example, if you depend on a neighbor to stop at the pharmacy, or Meals-on-Wheels for lunch every day, or a nurse to visit, those people may not be able to get to you. Bottom line? Can you survive on your own with what's in your house for up to a week, even without power?

*Do you use an elevator where you live? If you live in an apartment building, would you be able to get out if there was no power?

*Can you carry a gallon of water by yourself? That's how much water you'll need every day if your tap is dry, or the water is contaminated.

Next, think about your home:

*Do you live in an area that has one road in and out, such as a bridge or causeway, or do you live on a cul-de-sac or dead end street? If so, if the road is blocked by downed trees or power lines or if it's washed away, you can be isolated for days.

*Can you get in and out of your home if there is no power? Many people are so used to their electric garage door openers that they haven't opened the regular doors in their house in a year or more. Do you know how to open your garage door if there is no power? Are you physically able to do this?

*Is your home at risk? If you live in a mobile home and winds of 74mph or higher are forecast, get out.

*Do you have neighbors that can and will help you?

Finally, evaluate community resources:

*Are shelter facilities such as senior centers available for people with health conditions, or are you better off being admitted to the hospital for safety (not necessarily because you're sick)?

*Be sure to notify the fire department, electric company, and your local emergency management agency if you require electricity for life sustaining equipment such as a ventilator (you may want to consider having a generator professionally installed for protection during any power interruption).

If you have any concerns about these issues, before there is any threat, determine two or three options where you could go A) if your whole community is evacuated or B) if your health needs are such that you would be safer in another location but you can stay in your community. If a storm is possible, get out of your home now -- days before the storm may or may not hit. If it misses your area, you've lost nothing; if you wait too long, you could lose a lot -- your well-being or even your life. Don't take that chance.

Prepare for the Worst, Pray for the Best

Whether you are staying put or going someplace else, you need to think about a long-term loss of power and the potential for stores and pharmacies being closed and delivery trucks not getting through. This means:

*Get a cheap old-fashioned telephone you can plug into a jack in the wall. Most cordless phones for the home today that are so helpful for people with special health needs will not work if the power goes out. If you have a traditional phone that simply plugs into the jack, you can still have phone service even if you don't have power. Granted, all the wires may go down, but you'll never know if your phone service is working if your phone relies on electricity to work

*NO candles for light! Sensitive people may be irritated by some candles' fumes; they start fires easily. Get plenty of battery-powered lights.

*Fresh drinking water -- one gallon per person in your household per day; my preference is spring water since it has virtually no expiration date -- our gallon jugs are in our garage since we have a well

*Make sure your refrigerator temperature is at least as low as 40 degrees -- if it is 45 degrees or higher, food will spoil sooner during a power outage

*Keep two to three weeks ahead on medication prescription refills at all times, particularly if you get your medicines by mail. Refill your prescription when you have 10-14 days of medicine left, so there won't be a risk that you'll run out, particularly if mail delivery is delayed

*Always have a drug list -- the name of your medicine(s), the dose, how often you take it, the condition it treats, the person who prescribed it (with the phone numbers of the prescriber and your local pharmacy)

*If you use any supplies such as oxygen that needs to be refilled, talk with your company about their emergency plans. Some companies will loan you an extra reservoir so you can store double the oxygen you usually have in case deliveries can't get through; others may provide you with an oxygen tank as a back-up if you use a liquid oxygen system.

*If you leave your home, be sure to talk with your medical supplier so you can get deliveries where you'll be staying

*If you rely on specialized medical equipment, put together a small kit of replacement parts you might need; see if your equipment can run on a battery back up. If so, for how long? Can you store more than one battery pack?

*Instead of leaving, does it make more sense for someone to come and stay with you to ride out the storm because of your set-up at home?

*Have an extra pair of eyeglasses on hand

*Fill bathtub(s) with water so you will have a supply, particularly if you have a well

*Make sure everyone in the household knows how to turn off the water, electricity and gas if necessary

*Get cash from the bank because ATMs won't work without power

*Fill your car with gasoline

*Check on neighbors, friends and relatives before the storm to see if they are prepared or if you can help in any way

*People with health needs have to pay special attention to food. If you need to follow a special diet, such as a salt-restricted diet, you won't have the option of canned vegetables because the sodium levels are so high. For many people with heart disease, eating too much salt can cause heart failure -- something you don't need in a storm emergency.

*Choose ready-to-eat foods that you can fit into your diet plan, whether you have heart disease, high blood pressure, diabetes, food allergies, or any other special dietary requirements. Shelters will not have foods to meet special needs. Three days of food is minimum.

* Foods should not require refrigeration or cooking

The Power is Out -- Now What?

*Check with your pharmacist if you take medicine you keep in the refrigerator. Some medicines will not harm you if they're not refrigerated, but their shelf life may be shortened

*A full freezer should keep food frozen for about 2 days; if the freezer is half-filled, figure about a day

* Now -- fill plastic bags with ice and keep making more. You can fill a cooler with the saved ice if the power goes out, if you never lose power, you can dump it in the sink

* Keep the freezer door shut unless you are adding ice to the freezer to keep food frozen

* Refrigerated foods will be fine for about 6 hours. To learn what to toss, visit the US Department of Agriculture food safety site

* If you're in a winter storm, remember you can put things like milk outside your door or window (if you have a large ledge) to keep it cold

* Never use a charcoal grill indoors – it releases carbon monoxide that can kill you; gas grills are also hazardous

* You may use a small camp grill indoors for a short time, with windows open for ventilation and the grill positioned so that blowing drapes or nearby furniture cannot catch fire

After the Storm

*Walk around your home (if it is safe to do so) to see if there is any damage or serious hazards such as live power lines on the ground: notify authorities of any hazards, and board up any broken windows or make other temporary repairs you can accomplish safely

*Don't go sightseeing; many injuries occur after the storm has passed

*Do not drink tap water unless you know it is safe to do so (water supplies have not been contaminated)

*Check in with neighbors, and if you have telephone service, relatives and friends to let them know you're okay, and see how they're doing

*Restock your storm kit

*Count your blessings

Hey, let's be careful out there.

 

Until next week ~~

Pat Carroll, RN, RRT

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