1. bleeding
2. choking
3. burns
4. shock
5. allergic reactions
6. bites & stings
7. poisoning
8. food poisoning
9. fractures, dislocations, & spinal injuries
10. responding to emergencies: procedure for cpr

responding to emergencies: providing first aid

• emergency situations require quick responses.
• the first step in any emergency is to assess the situation.
• people trained to handle emergencies can be reached by dialing the emergency phone number (usually nine-one-one).
• while they wait for help to arrive, alert bystanders can take steps to help the injured or reduce the risk in dangerous situations.
• sometimes, the quick response of a knowledgeable bystander may save lives.
• it's important to take appropriate precautions to protect yourself when providing aid in an emergency situation.

1. bleeding

precautions

when dealing with another person's blood or body fluids, always wear gloves if possible, and don't expose cuts or scratches to another person's blood. wash your hands with soap and water after exposure.

for severe bleeding

• position victim lying down with head lower than body unless there is significant bleeding from the head or face. if the victim has a head or face injury, keep the head higher than the body.
• apply pressure, using a bandage or clean cloth. use your hand, if no other material is available.
• when bleeding stops, wrap the area in clean cloth or a bandage and tie or tape it in place.
• if bleeding starts again, apply pressure and add more bandages. if bleeding is difficult to control, also apply pressure at major arterial pressure points.
• seek medical attention.

for cuts and scrapes

• apply pressure until bleeding stops, using a clean cloth or your hand.
• if bleeding continues after applying pressure for 10-20 minutes, seek medical attention.
• after bleeding has stopped, wash area with soap and water and cover with a clean cloth or bandage.
• watch area for signs of infection, such as redness, swelling, pain or tenderness, and oozing of fluid from area. seek medical attention for treatment of infection.
• the victim may need a tetanus shot

for bruises

• bleeding occurs beneath the skin in a bruise, so there is no need for a dressing.
• apply an ice pack for 30-60 minutes at a time for one to two days.
• seek medical care if there is a continual headache or pain in the bruised area.

for puncture wounds

• apply pressure to stop any bleeding. (puncture wounds usually don't bleed very much).
• seek medical attention.

for nose bleeds

• have person with a nosebleed sit or stand upright and not lean head back.
• pinch nose for 10 minutes.
• if bleeding lasts much longer, seek medical attention.

2. choking

recognize the signs of choking

• ask if the person can speak.
• people who can speak can probably manage without your help, but do not leave them until they are completely recovered; the food or object might shift to where they cannot cough it out and they will need your help. if they are coughing, their skin color will be okay, indicating that they are getting oxygen into their lungs.
• however, if the cough is a gasping cough and the person's skin color is turning pale or blue, she or he is probably choking.
• the universal signal that a person is choking is raising the hands to the neck.

if a choking person is conscious

• see if you can see the object in the mouth and sweep it out with your finger.
• if you cannot see anything or easily remove it, apply the heimlich maneuver: stand behind the person. wrap your arms around his or her waist. bend the victim slightly forward. place your fist above the victim's navel area. place your other hand over your fist and press quick and hard in an upward direction on the victim's abdomen. keep doing these upward abdominal thrusts until the object is dislodged.
• once the object is dislodged, you may need to provide cpr.

if a choking person is unconscious

• place an unconscious choking victim on her or his back.
• kneel over the person so you are facing the victim. place your hands at the base of the victim's rib cage and provide five quick upward abdominal thrusts.
• repeat until the object is dislodged.
• once the object is dislodged, you may need to provide cpr.

if you are choking

if you are the choking victim, use these steps to help yourself:

• place your fist above your navel.
• grasp the fist with your other hand.
• thrust upward with your hand and fist.

if someone is hyperventilating

hyperventilation is caused by breathing too deeply, too fast. hands and feet tingle, and dizziness and lightheadedness may occur.

• have a person who is hyperventilating breathe slowly into a paper sack.

3. burns

degrees of burns

burns may be caused by fire, sun, chemicals, electricity, hot objects or fluids. there are three levels of burns:

first-degree burns: the top layer of skin is burned and becomes red, and there is some swelling and pain. these burns can be treated at home unless a large part of the body is involved. mild sunburn is an example of a first-degree burn.

second-degree burns: two layers of skin are burned, and there are blisters, severe pain and swelling. if the burned area is small, no more than two or three inches in diameter, it can be treated at home.

third-degree burns: all layers of skin are burned. some muscle and even bone may be burned. the skin looks either black or dry white. if the nerves are damaged, there is no pain. this level of burn is an emergency and requires immediate medical attention.

home treatment for minor burns

• if the skin is not broken, pour cool water over the area for 20 minutes. cover burned area with a clean bandage.
• take acetaminophen (tylenol) for pain.

treatment for severe burns

• remove victim from the area of danger.
• perform cpr if needed.
• manage shock.
• remove any smoldering clothing to stop further burning.
• cover burned area with cool cloths.
• don't use creams or ice.
• seek immediate medical treatment.

treatment for chemical burns

• rinse skin with water for 20 minutes; if pain continues, continue rinsing.
• wrap the area in a clean, dry cloth.
• remove any clothes or jewelry that may have been contaminated by the chemical.
• seek medical attention if an area more than two or three inches wide has been burned by the chemical or if face, hands, feet, major joints, buttocks or groin area has been burned.
• if chemical touches the eye: rinse the eye with warm water for 20 minutes. cover it with a loose, damp dressing. seek medical attention.

4. shock

when someone is in shock, the blood flow to the organs is greatly decreased. the blood pressure drops, and the body organs do not receive the oxygen and other essentials required for life. if shock is untreated, the victim will die.

symptoms of shock

• skin is pale, cool, clammy.
• person feels lightheaded and faint.
• pulse is weak and fast.
• breathing is slow and shallow.
• eyes stare; pupils may be large.
• person may be confused.
• person may be unconscious.

first aid for shock

call for help.

victim should be lying down with feet higher than head. (lay victim on her or his side if the victim is vomiting or bleeding from mouth, so blood or vomitus is less likely to go into the lungs.)

keep victim warm.

check for injuries and provide first aid as needed for other conditions.

loosen any tight clothes that might restrict blood flow.

5. allergic reactions

allergic reactions may be caused by food, insect stings or medications; they can develop at any time. people may become allergic to something at any time, even if they were not allergic to it in the past. allergic reactions can be severe and result in death.

first aid for allergic reactions

• call for help.
• treat for shock.
• use "epi-pen" if victim has one. an epi-pen looks like a large pencil, but is filled with epinephrine [adrenaline]. instructions for use are on the pen. persons who have had allergic reactions in the past may carry an epi-pen with them.

6. first aid for bites and stings

bites and stings carry the risk of allergic reaction, infection and skin tissue injury. human bites may produce infection and may need medical attention. insect bites or stings introduce a venom into the body that often stings and produces a bump and itching at the site of the bite.

• wash area with soap and water.
• apply antibiotic cream and bandage.
• symptoms of infection include redness, swelling, tenderness and fluid draining from the area.

insect bites

• if the reaction is mild, apply a paste of baking soda and water, wet cloths or ice.
• stinger may be removed with tweezers; hydrocortisone cream or calamine lotion may be applied to decrease itching and inflammation.
• seek medical attention for signs of infection or severe allergic reaction.
• if the reaction is severe, seek medical attention immediately. severe reactions produce the following symptoms: difficulty breathing, swelling of tongue, hives (red welts on the skin)

spider bites

spider bites from black widow or brown recluse spiders may produce nausea, fever, pain and local skin reactions.

• keep the bitten area still and hanging downward.
• apply ice.
• seek medical attention.

animal bites

bites from dogs, cats, raccoons and other animals that may carry rabies must be evaluated.

• if there is any suspicion of rabies, seek medical attention.
• bites may also require tetanus shots.

snake bites

venom reactions from snake bites require immediate medical attention if any of the following symptoms occur:

swelling lips, tongue, throat, eyes coughing, wheezing, difficulty breathing numbness and cramping hives slurred speech nausea and vomiting anxiety, confusion, unconsciousness

tick bites

tick bites carry the risk of bacterial infection, such as lyme disease, which can cause the brain to swell. look for a circular skin eruption. if the tick is crawling on skin or clothing, brush if off to remove. don't crush it between your fingers; crush it between rocks or drop it in a fire. if the tick has bitten and is holding on, don't pull if off. cover it with any type of oil to loosen its grip, then remove all parts with tweezers. wash the area with soap and water, and watch for two weeks for signs of illness. prevent future exposures by using tick spray, wearing tight fitting clothing and doing frequent tick checks.

7. poisoning

a poison is any substance that gets into the body and interferes with normal body functioning. poisons can enter the body by being swallowed, breathed in, injected with a needle or absorbed through the skin. examples of poisons include pesticides, chemicals, medications, some plants, any non-food item that is taken in too large amounts (even vitamins).

preventing poisoning

• keep medicines and dangerous substances out of reach of young children.
• practice safe handling of chemicals and other toxic substances.

recognizing possible poisoning

even if you don't see someone actually swallowing something, if they are acting ill, think about poisoning. look for:

• open medicine bottle
• spilled chemical
• burns around the mouth and lips
• breath that smells like chemicals
• burns, stains, odors on or near the person
• vomiting
• difficulty breathing
• other unexpected symptom

getting help for poisoning

different steps are taken for different kinds of poisoning. in some cases, it is good for the victim to vomit out the poison; in other cases, it is more dangerous to have the victim vomit.

• know how to contact the poison control center for your area; call the poison control center to find out what to do.
• tell the center about the symptoms of the patient and what you've found out-the name of the chemical or medication.
• if you know what the person has been poisoned with (for example, a household cleaner), read the label to see if it has instructions on what to do.
• if the victim is alert, have her or him drink some water or milk to slow the absorption of what was swallowed.
• if you are told to try to get the person to vomit, then give syrup of ipecac according to directions. if you don't have this syrup, add three teaspoons of salt to a glass of water and have the victim drink it. if you don't have anything to give the victim to cause vomiting, stick your finger into the victim's mouth to cause vomiting.

8. food poisoning

food poisoning occurs from unwashed or improperly handled food. it usually occurs one to six hours after eating. symptoms, which last about twelve hours, include:

• abdominal cramps and pain
• vomiting
• diarrhea

severe food poisoning

some food poisoning may be fatal. an example is botulism from bacteria growing in food, usually home-canned food or canned foods in damaged cans. do not eat food from a can that has a bulging lid. the lids on canned food prepared at home or purchased from the grocery store should be completely flat. a bulging top indicates there is a gas inside the can and the food is poisoned.

seek immediate medical attention for severe food poisoning. symptoms of severe food poisoning include:

• headache
• blurred vision
• muscle weakness
• paralysis
• nausea, vomiting, constipation

9. first aid for major emergencies

fractures

• recognizing a fracture
  • symptom of broken bones appear immediately and include:
    • tenderness and swelling
    • loss of strength
    • pain that increases with movement
    • inability to move or bear weight
    • grating noise
    • deformity
    • muscle spasms
• precautions
  • move the victim as little as possible, or not at all if there is a chance the spine or neck has been injured.
• control bleeding by applying pressure; if a bone is protruding through the skin, apply gentle pressure to stop the bleeding, but don't try to push the bone back in place.
• cover wounds.
• first aid: immobilize the injured part by using a splint or a sling.
  • the purpose of a splint is to keep the broken bone from moving or bearing weight. a splint can be made by using a stiff object (a stick, a board) and securing it above and below the injury using strips of cloths, belts, bandages, ropes, scarves).
  • splint an injury in the position you found it. don't attempt to straighten or set a broken bone.
  • once splinted, you can elevate the splinted area to decrease swelling and bleeding.
  • the purpose of a sling is to keep the broken bone from moving or bearing weight. broken arms can be supported from slings made from articles of clothing such as a shirt, a belt, a large scarf.
• seek medical aid.

dislocations

• dislocations always cause damage to the displaced joint.
• do not try to put a dislocated joint back into place; this may cause more damage.
• immobilize the joint (using a splint or sling) and seek medical aid.

spinal injuries

• recognizing spinal cord injuries
  • may have loss of use in limbs-arms and legs may feel heavy and stiff.
  • may have loss of feeling below injured site or may have a burning or tingling sensation in the limbs.
  • may say, "i feel like i've been cut in half."
  • if there is a head injury or the victim is found unconscious, assume that a fracture of the neck is possible. do not move the victim until the neck is immobilized with a collar (a folded newspaper or rolled towel can create an improvised collar).
  • keep the whole body straight while moving (log roll).
• precautions
  • damage to the spinal cord can cause permanent paralysis or painful conditions.
• first aid
  • leave the person in the position in which you found her or him, even if it looks uncomfortable.
  • tell person not to move or not her or his head-you can support the head without moving the person by firmly placing your hands over the ears-your purpose is to keep the head still to prevent further damage to the spinal cord.
  • call 911 - reassure that help is on the way.
  • manage shock-keep the person warm.
• special situations:
  • not breathing-if the person is not breathing, begin cpr.
    • you will need to turn the person onto her or his back to start cpr.
      • use the "log roll" procedure to turn person as a unit-this is easier if you have several people to help-keep the person straight, with head, trunk and toes in a straight line at all times.
      • you may have to tilt their head back a little to open the airway to get air into the lungs.
• in immediate danger (fire, explosion...)
  • keeping the person as straight as possible, carry her or him to safety and place the person in the same position in which you found her or him.
  • if you have helpers, use the log-roll procedure to turn, lift and carry the person as straight as you can manage-"straight as a log." the weight is easier to bear if you lift and roll the person in toward your chest with your arms under and around her or him.

10. recognizing and responding to emergencies (includes cpr)

recognizing an emergency and responding promptly and correctly can save lives. each year thousands of lives are saved because someone, often a stranger, has taken the time to become trained in recognizing and dealing with cardiopulmonary emergencies.

performing cardio-pulmonary resuscitation. steps to take

review up-date: october 2007 (updates are italicized)

content source: american heart association

initial medical review: 2000, dr. j. willers, vanderbilt university school of medicine, department of pediatrics. most recent review: 2007, dr. walt larimore, department of family medicine, university of colorado health sciences center.

• check for danger: to you, the victim, others in the area. for example: is there gunfire or potential for explosion?
• check for response: shake the victim gently and shout. if the victim is conscious, reassure him or her that help is on the way. if the victim does not respond he/she may be unconscious.
• call 911. if there are other people around, yell out to them, "call 911!" rescuers should phone 911 for unresponsive adults before beginning cpr.
• see if an aed (automatic electronic defibrillator) is nearby. if there are other people around, yell out to them, "find an aed!"

exceptions: provide cpr first for adult victims of submersion, trauma and drug intoxication.

if the victim is conscious:

• check for other injuries.

if the victim is unconscious:

• check airway: clear any loose material in the mouth.
• check for breathing. check for breathing for 5-10 seconds. bend your head near the victim's face, look for the chest to rise and fall; feel with your face and listen for breath sounds. if victim is breathing: check for other injuries and stabilize position.

if the victim is not breathing:

• begin rescue breathing: position victim on his or her back, kneel by his or her side and place one hand on the forehead and the other under the chin. tilt head back and lift chin to better open the airway. seal nose by pinching with your fingers, cover mouth with your mouth, and give two full breaths. the victim's chest will rise if you are getting enough air to him or her.

if the breaths do not go in, re-tilt the head and try again. if the breaths still do not go in the victim has an obstructed airway and needs abdominal thrusts. to perform abdominal thrusts:

• straddle the victim's abdomen facing the victim.
• place the heel of your hand between the rib cage and the umbilicus.
• place one hand on top of the other hand and give 5 quick upward thrusts.
• sweep the victim's mouth with your finger to remove any object. finger sweep in children only if you can see the object.
• give two breaths. if unsuccessful, repeat until breaths go in.

 

if there is any response, such as a pulse, normal breathing, coughing, or movement in response to the two rescue breaths:

• continue rescue breathing: breathe once about every 5 to 6 seconds. breathe full breaths for an adult, large enough to make the victim's chest rise and fall. keep breathing into the victim until he or she starts breathing on his or her own or until medical help arrives. check for the pulse every two minutes to make sure it is still there.

if there is no sign of a repsponse, such as no pulse, no breathing, no coughing, or no movement in response to the two rescue breaths:

·        begin cpr.

cpr for victims 8 years or older:

• start heart compressions by placing your hands in the center of the victim's chest between the nipples-one hand on top of the other hand. use the palms of your hands to compress the chest down about two inches; push down on the chest 30 times, then give two more breaths.
• compress the chest 30 times, then give two breaths, and repeat this cycle over and over until the victim responds or medical help arrives or your are completely exhausted.
• do the compressions fast enough to deliver 100 compressions per minute. the compression-to-ventilation ration of 30 compressions to 2 breaths for cpr applies for one or two rescuers.
• the chest must be allowed to return to its normal position completely after each compression to allow the heart to fill with blood.
• remember that every interruption in compressions stops the blood flow.
• the compression-to-breath ratio is maintained at 30 compressions to two breaths, and each breath should last just one second.
• if there are two rescuers present, one can do compressions and the other breathing.
• if there is heavy bleeding, you will need to apply pressure to stop the bleeding or the cpr may not help. you will also need to protect the person from shock by keeping her or him warm with feet elevated.
• continue cpr until aed arrives, victim awakens, or emergency personnel arrive.

note: chest compression only cpr is recommended only when the rescuer is unwilling or unable to perform mouth-to-mouth rescue breathing.

cpr (for victims under 8 years old)

• if you are alone with child (under age 8 years), give one minute of cpr before calling 911.
• give one full breath followed by 5 chest compressions; repeat over and over, fast enough to give 20 breaths and 100 compressions a minute.
• use the heel of one hand for chest compressions.
• press down about 1 inch.

References:

Learn more about cpr and the value of additional training through the american heart association.

Learn about and become part of the chain of survival.

This website uses a short video clip to demonstrate the use of cpr.