Wednesday, 5 November 2008
Courses Conducted At Tampines Swimming Complex
Monday:
4.30pm - 5.30pm (Beginner)
Friday:
6pm - 7pm (Beginner)
Saturday:
8am - 9am (Advance)
9am - 10am (Beginner)
3pm - 4pm (Advance)
4pm - 5pm (Beginner)
5pm - 6pm (Advance)
6pm - 7pm (Beginner)
7pm - 8pm (Adult Learning)
Sunday:
8am - 9am (Advance)
9am - 10am (Survival)
3pm - 4pm (Beginner)
4pm - 5pm (Advance)
5pm - 6pm (Advance)
6pm - 7pm (Advance)
I will start a class with a minimum of 4 children of the same level in swimming skills.
Please do not hesitate to contact me via handphone at +65 90043742 to enquire about other timing slots. I will do my best to fit into your schedule if possible.
Side note:-
Classes will be conducted either by Mr Chan Kok Hong (Snr) or Mr Chan Yan Jun (Jr) for an hour per session for 4 sessions in a month for a monthly fee of $50 per child.
There will not be any swimming lessons conducted on a public holiday and the 5th week of the month. Should a lesson falls on a public holiday, it will be considered as 1 lesson conducted.
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LifeSaving Classes
Courses offered: Lifesaving 123; BM & CPR; AM & Snr Resus; Distinction; Bronze Cross; Silver Cross; Pool Lifeguard.
New Classes:
1) NIL
Existing Classes:
Wednesday, Thursday and Sunday:
7pm - 9pm (Lifesaving Competitive Team Training)
Sunday:
7pm - 8pm (BM & CPR)
8pm - 9pm (AM/DA & Snr Resus)
The Lifesaving Classes will be conducted by Mr Chan Yan Jun (Lifesaving Teacher/Grade Three Examiner) or by Mr Chan Kok Hong (Lifesaving Instructor).
Saturday, 1 November 2008
Some information consolidated
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Pay attention to your pain | ||
Your foot hurts A herniated or prolapsed disc can produce a sharp pain in the foot. This disc problem can be missed because there's no back pain. Act now A simple test would be to do 10 cobra poses: Lie on your stomach and while keeping your hips on the floor, arch your back up and slowly straighten your arms. If the pain eases, you could have a slipped disc since these extensions relieve the pressure, so consult a doctor next. Your leg hurts Take note if your leg hurts only when you are walking, running or bearing weight, since this is a common symptom of cardiovascular disease. This kind of pain arises because the arteries supplying the lower limbs narrow. Act now Get a GP to check your cholesterol and blood pressure, since you may be at risk of a heart attack or stroke. Your breath smells bad While 90 per cent of bad breath cases is caused by poor dental hygiene, the rest signal something more sinister. Lung disease, asthma and cystic fibrosis are examples of conditions that can cause highly acidic breath. Act now Visit the dentist to determine if your bad breath is the result of common causes like dry mouth, sinus infection, gum |
Beware that tickle in your throat | ||
By Dr Patrick Chan IT usually starts with a little tickle at the throat. The tickle increases in intensity, and before we know it, we are coughing away. A cough usually goes away after some time. Sometimes, however, it may become frequent and prolonged when the respiratory system is infected or continue to be inhaled by exposure to environmental pollutants such as vehicle fumes, smoke or haze. |
7. Postnasal Drainage (PND) - an irritating trickling of mucous from the nasal passage into the throat caused by nasal allergies.
8. Asthma - an inflammatory condition of the lungs airways.
9. Gastroesophageal Reflux (GERD) - a condition where stomach acid backs up into the oesophagus and upper throat, causing irritation especially when the patient is lying down.
10. Side effects of medications - such as beta-blockers and ACE inhibitors, drugs used to treat high blood pressure.
Complications
Most people think of cough only as an inconvenience. However, prolonged violent chronic cough can bring about complications as a result of the constant intra-thoracic and intra-abdominal pressure to the body system.
These may include headaches, cardiac dysrhythmias (irregular heart beat), insomnia, subconjunctival haemorrhage (red eye), cough-induced vomiting, inguinal herniation, and gastroesophageal reflux.
Hence, do see a doctor if:
- Your cough lasts for more than three weeks.
- You are experiencing shortness of breath, severe pain or fainting.
- You are coughing up blood.
- Your cough is so severe you cannot sleep at night.
- You have concerns about the cause of the cough.
How to prevent coughs
- Avoid direct contact with those with colds and flu, and quarantine yourself if you have similar conditions to avoid passing the germs around.
- Wash your hands frequently during the cough and colds season.
- Wear a mask when the level of air pollutants is high such as during a haze.
- Avoid smoking and smoke-infested places.
- Ensure you meet your children's vaccination schedule to help reduce the risk of diseases such as whooping cough or tuberculosis.
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The most serious fracture | ||
By Jovanda Biston Osteoporosis can lead to fragility fractures (from low trauma) resulting from a fall from standing height or less. Dr Lau Tang Ching, a senior consultant at National University Hospital's division of rheumatology, said that fractures of the hip or spine among the elderly can lead to premature death and loss of mobility. He said that the incidence of osteoporosis-induced hip fractures in Singapore has increased 4 1/2-fold since the 1960s. As the population of Singapore is ageing rapidly, osteoporosis is likely to become an increasingly important health problem. The World Health Organisation said that hip fractures are the most serious form of fracture associated with osteoporosis: they nearly always require hospitalisation, are fatal about 20 per cent of the time and patients become permanently disabled about half the time. Fracture rates increase rapidly with age and the risk of fracture in women over 50 is about 40 per cent, similar to the risk for coronary heart disease. In 1990, there were 1.7 million hip fractures worldwide. With changes in population demographics, this figure is expected to rise to six million by 2050. Dr Leonard Koh, a consultant endocrinologist at Gleneagles Medical Centre, said women are more prone to osteoporosis and osteoporosis-related fractures for several reasons including: - Women undergo menopause, resulting in accelerated bone loss. - Women tend to live longer, hence there are more elderly women than men. - Elderly women may have a weaker muscular system in their bodies than elderly men and hence they have a greater tendency of falling. |
What you can do to keep your bones strong | ||
Regular exercise and the right diet can help reduce the likelihood of bone fractures for those with osteoporosis. Dr Leonard Koh, a consultant endocrinologist at Gleneagles Medical Centre, has this healthy advice: - Exercise 30 to 40 minutes at least three times a week. - Weight-bearing exercises, such as walking, tennis or dancing are beneficial. - Balance exercises such as taiji are good for the elderly. - Include resistance exercises such as free weights too. - Do not over-exercise however. Excessive weight loss or cessation of menstruation can be detrimental to bones. - A balanced diet that is rich in calcium from various food sources is better than relying on a single calcium source such as milk or calcium supplements. - Do include dairy products high in calcium such as milk, cheese and yogurt in your diet. -Those who are lactose intolerant should eat calcium-rich foods such as kai lan, chye sim, spinach, yellow dahl, soya products fortified with calcium and fish such as ikan bilis and sardines. - Calcium supplements are a good and convenient form of calcium. - Vitamin D helps the intestines to absorb calcium from one's diet. To obtain vitamin D, sun exposure on the face, hands and arms is recommended. For fair-skinned individuals, spending about 10 minutes in the sun two to three times a week is adequate. Darker-skinned individuals may require longer exposure. |
Eating right for bone health | ||
By Jovanda Biston Osteoporosis is normally associated with older women. That is because this disease of the skeleton, in which bones become brittle and are prone to fracture, usually occurs in women over 55 years of age. But it can also affect men and younger women. What may be even less well-known is that steps to prevent primary osteoporosis, which commonly occurs after menopause or develops due to age-related bone loss, should ideally be taken from as early as childhood. The World Health Organisation said bone formation is most active during childhood and adolescence and that bone length and girth increase as the teenager grows, ending at early adulthood when peak bone mass is attained. Dr Manju Chandran, a consultant endocrinologist at Singapore General Hospital (SGH), said: "It has often been said that osteoporosis is a paediatric disease that manifests in geriatric times." Dr Chandran is director of SGH's osteoporosis and bone metabolism unit, the country's first and only unit that caters specifically to the management of patients with osteoporosis and other bone disorders. He explained that getting your bones in peak shape during the growth period from puberty to the early 20s is extremely important. It will pay off in your later years. The attainment of peak bone density or mass is heavily influenced by nutrition, hereditary factors, hormonal effects and the environment. The growth years are thus crucial to averting the risk of osteoporosis in later life. Dr Chandran said that people who have a history of an eating disorder in their growing years can develop secondary osteoporosis. This type of osteoporosis occurs as a result of the treatment of another disease or condition, or as a result of the condition itself. Eating disorders such as anorexia and bulimia typically occur during mid to late adolescence - a critical period for bone development. The National Institute of Arthritis and Musculoskeletal and Skin Diseases, the United States government's key agency researching into diseases that affect the bones and joints, found that osteopaenia, or low bone mass, is common in people with anorexia and that it occurs early in the course of the disease. Girls with anorexia are less likely to reach their peak bone density and will thus have a higher risk of getting osteoporosis and fractures throughout their lives. Moreover, Dr Leonard Koh, a consultant endocrinologist at Gleneagles Medical Centre, noted that the primary medical goal when individuals are diagnosed as anorexic, is weight gain and, in females, the return of normal menstrual periods. He said: "For people with eating disorders and osteopaenia or osteoporosis, the eating disorder has to be treated first before the doctor can effectively treat the bone health issues. However, it is often very challenging to get young girls with eating disorders like anorexia to grasp what they are doing to their bodies." Osteoporosis can happen to men too. Dr Koh said that although bone loss in men over 50 years is more gradual as men do not experience menopause, men are not spared from developing osteoporosis. Although the incidence of primary osteoporosis is lower in men, the consequences of osteoporotic fractures are much more serious for men. Dr Koh said a greater proportion of men die after osteoporotic hip fractures than women. Dr Chandran said a man's lifetime risk of suffering from osteoporosis-related hip fracture is greater than that of getting prostate cancer. She added that secondary causes of osteoporosis are also more frequently identified in men than in women. David (not his real name) developed secondary osteoporosis after he started taking steroid medication for his auto-immune hepatitis in April last year. The 40-year-old father of three was referred to Dr Chandran two months later because he complained of frequent backaches. A scan showed that the bone density at his spine and hip was low and in the osteoporotic range. Dr Chandran said the chronic use of steroids can lead to osteoporosis and that David's steroid use was a likely cause of his low bone mass density. David and his wife were surprised by the diagnosis. He said: "We thought osteoporosis was something that happened to people in their 60s and 70s." He added that after Dr Chandran started him on medication for his osteoporosis, he has had fewer episodes of spine and hip aches. But David, who works in the engineering industry, cannot stand or walk for long periods without rest. He said: "I've always enjoyed doing carpentry and home improvement projects. Now I need the help of my teenage son for the strenuous tasks. He's a strong 16-year-old boy." jbiston@sph.com.sg Types of osteoporosis Primary osteoporosis There are two primary kinds of osteoporosis, type I and type II: Type I osteoporosis, or postmenopausal osteoporosis, generally develops in women after menopause when the amount of oestrogen greatly decreases. As a result there is an increase in the resorption of bones, or a loss of substance in the bones. This can lead to fractures of the hip, wrist, or forearm, caused by falls or minor accidents. Type II osteoporosis, also known as age-related or senile osteoporosis, usually happens after the age of 70 and affects women twice as much as men. It often leads to hip and vertebral, or spinal, fractures. Secondary osteoporosis This is caused by other conditions such as hormonal imbalances, diseases, use of steroid and certain kinds of medication. Singapore General Hospital's Dr Manju Chandran said that about 15 to 20 per cent of women and 40 to 50 per cent of men with osteoporosis suffer from this secondary condition. |
Wednesday, 24 September 2008
Photos uploaded.
Monday, 12 May 2008
Monday, 14 April 2008
The Human Heart (Circulatory System)
- It is the central organ of the cardiovascular system
- It is a hollow, muscular organ that contracts at regular intervals, forcing blood through the circulatory system
- It is cone-shaped
- It is about the size of a clenched fist
- It lies between the lungs and behind the sternum
- It is tilted slightly towards the left
- It is enclosed within a protective membrane known as pericardium whose task is to maintain lubrication of the heart to reduce friction during beating of the heart
- The right side of the heart pumps blood (Darker shade of red) from the body into the lungs (Deoxygenated Blood)
- The left side of the heart pumps blood (Brighter shade of red) from the lungs to the rest of the body (Oxygenated Blood)
- The left side of the heart is thicker than the right side of the heart
- The left side of the heart is 5 times more powerful than the right side of the heart
- Veins in the body contains deoxygenated blood
- Arteries in the body contains oxygenated blood
- Veins in the heart contains oxygenated blood
- Arteries in the heart contains deoxygenated blood
I will divide the heart into the Left and Right portions. From the Left, it comprises of aorta, left atrium and left ventricle. From the Right, it is made up of pulmonary trunk, right atrium and right ventricle.
The Right Atrium receives De-Oxygenated Blood from the body via the Superior and Inferior Vena Cava. The blood is then pumped into the Right Ventricle via the Tricuspid Valve. It will flow through the Pulmonary Semi-Lunar Valve into the Pulmonary Artery. The deoxygenated blood will be carried by the pulmonary artery to the lungs to be replenish with Oxygen via Gas Exchange. Oxygenated Blood are brought back to the heart by Left and Right Pulmonary Veins into the Left Atrium. The blood goes through the Mitral Valve (aka Bicuspid Valve) into the Left Ventricle. It will then pass through the Aortic Semi-Lunar Valve into the Aorta (biggest artery in the body) before it begins the journey throughout the rest of the body through the vast networkof arteries.
The Picture below depicts the route I had written above:-
The Cardiovascular System consists of 2 circuits. They are the "Pulmonary Circuit" and "Systemic Circuit". The pulmonary circuit carries blood to and from the lungs. The systemic circuit transports the blood to and from the body.
The above picture shows another diagram of the heart. This picture is extracted from Wikipedia, the free online encyclopedia.
Thursday, 14 February 2008
Recovery Position
Two main risk factors are present when an unconscious or semi-conscious person is lying facing upwards. It can lead to suffocation of the person.
- The person's tongue can fall backwards and obstructs the airway due to loss of muscular control.
- Fluids like blood, vomit or saliva can collect at the back of the person's throat thereby creating the possibility of drowning the person.
As well as obstructing the airway, fluid which collects in the back of the throat can also flow down into the lungs via the trachea (windpipe). Stomach acid will then be able to attack the inner lining of the lungs and cause a condition known as aspiration pneumonia (AP).
***AP develops due to the entrance of foreign material (including food, saliva or nasal secretions) that enters the bronchii. Depending on the acidity of the foreign material, a chemical reaction can occur and presence of bacteria may add to the inflammation***
The main purpose of teaching recovery position in lifesaving is such that the victim can lie down comfortably and breath on their own while the rescuer can maintain a watchful eye for any changes that is shown by the victim.
A good recovery position in my opinion comprises of:
- Ensure victim's airway is open at all times (head-tilt-chin-lift position)
- Ensure victim's mouth is downwards (facilitate in draining of blood and saliva)
- Ensure chest and stomach does not lay flat on the ground surface (easier to breath)
- Ensure victim's arm and knee are locked to maintain stability
- Rescuer is able to maintain visual contact of the victim while checking for signs of circulation every 5 min
For pregnant victims, they should always rest on her left side as lying on her right side may cause the uterus to compress the Inferior Vena Cava thereby making death a possibility!
For victims with torso wounds, it is recommended to place the wounds closest to the ground to minimize the possibility of blood going into the lungs causing a condition known as asphyxiation.
***Asphyxia is a condition of severely deficient supply of oxygen to the body***
Sunday, 10 February 2008
DR ABC
DR ABC
A simple mnemonic is used to aid the memory of the clinical approach to the unconscious victim and CPR. DR ABC, which stands for Danger, Response, Airway, Breathing and Circulation. Complex mnemonic can reach up to complicated levels such as DR AcBCDEEEFG! I will explore this in a later stage.
Early CPR is essential to the prevention of brain damage during cardiac arrest and increases the chance of survival. It maintains blood flow and perfusion to the brain, buying time until AED and/or professional help (paramedics) arrives. On average, about 5% - 10% of people who receives CPR survive.
ABC is designed to remind first aiders and lifesavers of the correct procedure (including the order) in which to deal with a non-breathing victim.
A --- Airway
If the victim's airway is blocked, oxygen cannot reach the lungs and so cannot be transported around the body via the blood. Ensuring a clear airway is the first step. The common causes of airway blockage are tongue and vomit.
In order to open the airway, a method called head-tilt-chin-lift technique is applied. This way, the tongue will be lifted upwards thereby opening up the airway.
B --- Breathing
Next, the victim will be assessed for breathing. Common findings during assessment of breathing may include normal breathing, noisy breathing, gasping or coughing. The next step is based on these. If all seems well, the victim will be placed into the Recovery Position. If absence of breathing is determined, the lifesaver will commence to give 2 rescue breaths. Administering Rescue Breathing is a possibility here.
C --- Circulation
Once oxygen can be delivered to the lungs by a clear airway and efficient breathing, there needs to be a circulation to deliver it to the rest of the body. This can be assessed by doing a pulse check on the carotid artery (neck).
In short, if a victim is determined by absence of pulse and breathing, CPR will be administered. If a victim is not breathing but pulse is present, Rescue Breathing will be administered.
DR ABC
The most commonly taught mnemonic is DR ABC where the D and R stand for Danger and Response. This is to protect yourself before attempting to help others and also to ascertain that the victim is unresponsive before attempting to aid them.
ABCD
- D stands for Defibrillation. --This is quite an essential part of CPR. The arrival of AED. A machine which is able to aid in defibrillating the heart thus making the survival rate from cardiac arrest higher.
The 3 Es here can stand for:
- Environment -- only after assessing ABCD does the lifesaver deal with environmentally-related symptoms or conditions such as cold and lightning.
- Escaping Air -- Checking for air escaping such as through a sucking chest wound, which could lead to a collapsed lung.
- Expose and Examine -- This is predominantly for paramedics where it is important to remove clothing and other obstructions in order to assess wounds.
The F can stand for:
- Fundus -- relating to pregnancy, a reminder for paramedics to check if a female is pregnant and how far progressed she is.
- Family -- the paramedics have to deal with the witnesses and the family as they can give precious information about the accident or the health of the victim.
The G stands for:
- Go Quickly! -- A reminder to ensure all assessments and on-scene treatments are completed with speed, in order to get the victim to the hospital as soon as possible.
- The small 'c' stands for cervical spine. -- This is a reminder to be aware of potential neck injuries to a victim, as opening the airway may cause further damage (tilting of the head). If suspected neck injuries, a cervical collar has to be put on to the victim's neck and using Jaw Thrust to open the airway.
There are 5 ways whereby a lifesaver can stop giving CPR.
- Effective, spontaneous circulation and ventilation are restored.
- Resuscitation is transferred to another trained person.
- Paramedics arrive to take over.
- You are too exhausted and tired to continue
- Continued resuscitation will place lives of others at risk.
Saturday, 9 February 2008
Introduction to CPR
The information below are taken from Wikipedia :-
What is CPR?
Cardio-Pulmonary Resuscitation (CPR) is an emergency medical procedure for a victim of cardiac arrest and/or respiratory arrest. CPR can be performed by doctors, paramedics and even lay persons. It comprises for chest compressions (artificial blood circulation) and lung ventilation (artificial respiration). It is usually combined with Automated External Defibrillator (AED) to restart the victim's heart beat.
As said above, CPR is unlikely to restart the heart alone. However its purpose is to maintain a flow of oxygenated blood to the vital organs like the brain and heart, thereby delaying tissue death and extending the brief window of opportunity for a successful resuscitation without the onset of brain damage. Defibrillation and advanced life support (ALS) are usually needed to restart the heart. Hence, the bottom line is to request an ambulance to the scene fast when a victim is suspected of cardiac arrest.
A brief history of CPR
CPR was first attempted during the 18th Century. The range of methods to stimulate the body are:
- Warming the victim
- Removing swallowed or aspirated water by positioning the victim's head lower than feet
- Applying manual pressure to the abdomen
- Respirations in to the victim's mouth, either using a bellows or with a mouth-to-mouth method
- Tickling the victim's throat
- 'Stimulating' the victim by such means as rectal and oral fumigation with tobacco smoke.
- Bloodletting (withdrawal of blood from victim in a bid to reduce blood pressure)
Past variations of CPR include the Silvester Method and Holger-Nielson Method.
Silvester Method
The victim is laid on their back and their arms are raised above their head to aid inhalation and then pressed against their chest to aid exhalation. This procedure is repeated 16 times per min.
Holger-Neilson Technique
The victim is laid on their front, with their head to the side and a process of lifting their arms and pressing on their back was utilized. This is essentially the Silvester Method with the patient flipped over.
Cardiac Arrest
This is the medical term for the condition in which the victim's heart has stopped. CPR is used to oxygenate the blood and to allow the oxygenated blood to flow to the vital organs. The brain may sustain damage after blood flow has been stopped for about 4 minutes. Irreversible damage will be done after 7 minutes. Therefore CPR has to be performed as soon as possible! Effective CPR enables enough oxygen to reach the brain to delay brain death and allows the heart to remain responsive to defibrillation attempts.
Respiratory Arrest
If the victim has a pulse but is not breathing, this is called respiratory arrest. Rescue breathing has to be effected as soon as possible in order not to let the pulse stop.
Chain of Survival
CPR is part of the Chain of Survival. This includes Early Access (to Emergency Medical Services), Early CPR, Early Defibrillation, and Early Advanced Care.
In conclusion, CPR is a practical skill where students are given professional instruction followed up by regular practice on a resuscitation manikin to gain and maintain full competency.