Self-Help and Emergency First-Aid

This is a guide for immediate aid for injured or sick people until medical aid arrives. It does not replace professional first-aid or treatment. Burns & Scalds Minor (first degree) Skin reddened. Place burned area in cold water until stinging is relieved. Apply dry dressing if needed. Aspirin or Tylenol for discomfort. Second Degree. Serious Burn Skin is blistered. Place burned area in cold water ( not ice water) or apply clean cloths saturated in ice water to ease pain, & stop burn from continuing to burn additional layers of tissue. Apply protective bandages, and raise the affected area to reduce swelling. Third Degree Burn. Very Serious Skin is charred black. Do not remove particles of burned clothing. Many experience very little pain if the area is small. Raise the burned area above the patients heart. If the burn is on face or upper body, raise and support the upper body.Cover the areas with sterile dressing, or freshly ironed sheets, but use no ointments or salves. Treat for shock, call 911 or get person to the hospital. Second & Third Degree Burns Can Be Life Threatening. Always get help as soon as possible. Chemical Burns To the Eye: Flush the area with large amounts of water for 15 minutes, from the inside corner of the eye, toward the outside, holding the eye open if necessary. Cover with clean dressings. Seek professional help! Injuries to the eyes should always be seen by a professional. For other areas of skin: Flush as above, remove the chemical soaked clothing as soon as possible. Treat as above. See M.D.

Sprains & Strains Gently palpate (feel) the area of sprain. Do any bones feel out of line, is the shape of the limb normal? If the answer to the above is no, continue as for sprain. Ice, elevate, and wrap with ace type elastic wrap. Ice for the first 24-48 hours, then moist heat to aid with absorption of fluid. Tylenol, Advil, or other over-the-counter analgesics for pain. Gently exercise the limb after icing to avoid stiffness. If no improvement within 24 hrs. See your Dr. Potential or Actual Fracture of a Limb Do not give anything to drink by mouth. If the area of injury is misshapen, or bone is coming through the skin, call 911. If you are in a primitive area without help, stabilize with a splint. Splint in the position that the limb is in if possible. Cover exposed bone lightly with a sterile dressing and secure gently above and below injury. Splints can be made from rolled up newspaper, pillows or rolled blankets. If leg injury, the other leg may be used as a splint. Fingers and toes may be splinted by gently securing to the next finger or toe. For large bone fracture, treat for Shock. Elevate the limb above the heart, & Call 911. Bleeding To Stop Bleeding. Place a clean cloth over wound & apply pressure. Raise the body part above the heart until bleeding subsides. Heavy or Arterial Bleeding This severe type of bleeding usually surges or spurts with each beat of the heart. Pressure must be applied to both the injury and pressure to the pulse to that area. For the arm or hand, place the palm side of all four fingers on the inside of the upper arm, about 4 fingers width below the armpit. Using the palm side of all 4 fingers, press firmly to compress the brachial artery and stop the blood loss, and elevate the limb. See the diagram on the last page. Severe Bleeding to the Lower Extremities

As in severe bleeding of the upper extremities, in the lower extremities one will use direct pressure and pressure point at the same time. Elevate the extremity as well, if possible. Pressure points for the lower extremities are located in the groin area; the area where the leg joins the body. *See diagram on the last page for pressure points. Anytime that one encounters a bleeding wound that surges with the heart beat, it is a medical emergency. Get help immediately. Treat for shock. Shock Quickly assess the situation and if possible have someone else call 911 or the local emergency number. Skin pale or bluish, cool, pulse rapid & weak, and patient may be unconscious. Keep the person lying down unless there is a head or chest injury. In that case, raise the head and shoulders. Use pillows, books padded with coats or blankets, etc. Cover the individual with a blanket to keep warm. Check breathing and assess injuries. (Bleeding, broken bones, pain, etc.) Raise the lower extremities unless it will worsen an injury. If help is near do not give fluids If help is known to be unavailable for 1 or more hours, give fluids as described below.. Do not try to force fluids on an unconscious person. If help is delayed as above, and there are no stomach, head, or chest wounds, and the patient is not vomiting, give gatoraid, or a substitute such as 2-4 oz of tepid water mixed with 1\8 tsp. salt and a pinch or two of baking soda every 15 min. Heart Attack Early Warning Pain, pressure, or tightness in the center of the chest, usually near the breast bone. May radiate outwards, to left shoulder and/ or arm. May radiate up the neck, jaw, or teeth. Usually persistent. Patient may begin vomiting, sweating, or may become increasingly short of breath.. Allow patient to lie or sit in a position of comfort. Do not allow the patient to continue working or walking.

Expect denial. Im too young, Im in too good of health, its probably heartburn, etc. If he or she becomes unconscious, check breathing. Give artificial respirations if not breathing. Call for help! If trained in CPR, give CPR. If there is no carotid pulse. (Located on either side of the Adams apple.) Call 911 Choking If coughing or talking, do not attempt to assist, but stay close by. Most choking victims will grasp their throats or look in extreme distress. Ask, are you choking? If the victim cannot speak or cough, tell him, Im going to help you. Stand behind the victim, wrap arms around the waist, make a fist with one hand and place thumb side of fist against middle of the victims abdomen. Grasp fist with your other hand just above the navel. Quickly press fist into and upward into the victims abdomen. Repeat until throat is clear or victim becomes unconscious. Gently lower the person to the floor, straddling the hips, lay the palm of one hand in the same area, just above the navel, place the other hand on top of the first hand. Continue the upward thrusts. Check the mouth every few minutes in case the object is within reach. If so, make a hook of your index finger and try to sweep the object up, and out. Try to give artificial respirations using the jaw thrust. If ineffective, reposition head, open mouth, squeeze nostrils closed and give two deep, even breaths. Watch for the chest to rise, listen and feel for exhaled breath. If the object is coughed up before or after artificial respirations are given, the patient should be seen in the emergency room for possible complications. If the heart stops, and there is no breathing, begin CPR. Brain function ceases after only a few minutes. CPR should only be performed by trained personnel. Call the American Red

Cross, or The American Heart Association for a training location near you. Exposure to Extreme Heat: Emergency Procedure Until Help Arrives Heat Exhaustion: Signs & Symptoms: Profuse Sweating, hot, flushed skin, headache, weakness or confusion. Move to a shaded area, drink cool fluids. Heat Stroke: May-be unconscious, hot, dry, skin. There may be little or no sweating. Increased confusion, headache, nausea/vomiting. For heat stroke, begin cooling immediately as shown below for heat exhaustion. Do not give fluids if there is nausea/vomiting. Treat for shock, have someone call 911 or local emergency number. Heat Exhaustion: Get the patient indoors to an air conditioned room if possible. If not, get to a shaded area. Apply cool water, moist cool cloths, or rubbing alcohol to bare skin. Use fans or air conditioning to begin cooling as soon as possible. If not nauseated or vomiting, give small sips of tap water. Continue as long as necessary to bring down temperature. If the patient does not recover quickly, take to a doctor, or an emergency room. Frosts Bite: Emergency Procedure Until Help Arrives Frozen part will appear glossy white or gray. Skin often feels numb or painful, or has an intense itch. Cover frozen part and provide extra clothing or covering. Take the person indoors & remove wet clothing. Immerse frozen part into warm water 101102 degrees, or wrap gently in sheets and warm blankets. Do not rub. Do not apply heat, heat lamps, hot pads or hot water bottles.Elevate the affected part, and get medical help.

Do not allow victim to drink alcohol or smoke. Hypothermia Get victim to a hospital . Slow, slurred, thick speech. Uncontrollable shivering about 89.6 degrees Blueness & puffiness of skin & face. Skin feels hardened Exhaustion and/or drowsiness Rigid, tense muscles are signs of late hypothermia. Move victim to shelter, remove wet clothing. Cover with warm blankets. Keep him warm and quiet. Do not give alcohol. This will worsen the loss of body heat. Monitor breathing and heart beat. Tilt head back using the jaw thrust to open airway. If no pulse is felt or breathing detected, wait a full minute while continuing to try & find a pulse. Victims of hypothermia often appear dead because of a decreased metabolism, & may take the entire minute to detect a heart beat. Even though the victim may appear dead, do attempt CPR and continue until help arrives or you can no longer physically continue. Moving an Injured Person Call for Help! Move only when there is a clear danger to your-self or the injured person. For example, when theres danger from traffic, drowning, carbon monoxide poisoning, an electric line, fire or other serious hazard. Take time to immobilize (splint) the injured part if possible without endangering yourself or the individual. When possible, have three or four people move the victim. Always support the head, neck, and back. Do not lift head or bend the neck if a fracture of the neck or back is suspected, or if origin of accident is unknown. Log roll as one unit to one side in order to slide a board or blanket beneath the victim. (to log roll: someone support head & neck on both sides. As the patient is turned, support neck and head, turning with the

patients body. Reach over patient, grasp shoulder & hip, and roll the patient toward you on to his side. Someone else can slip the board, etc. underneath the patient. Roll him to his back as a unit. Be careful not to allow the head and neck to turn to either side while turning. Keep the body in a straight line, sliding him in a straight line away from the hazard.In an emergency, a blanket may be used by rolling under the injured party while the body is rolled as one unit to either side. Gently ease to back, one person supporting the head and neck on both sides, and another slowly dragging the injured person away from immediate danger. Call 911.Prepare to administer rescue breathing or CPR if not breathing, or if heart stops. (Other items to be used for stretcher include: A door removed from hinges, a sled, ply board, etc.) Bites Animal: Stop the bleeding. Wash wound with soap & water, and cover. Restrict movement of the affected part. When possible, locate and capture the animal for rabies test. Take patient to the emergency room for evaluation. Insect Bites or Stings Minor: Apply cold packs, calamine, or Benadryl lotion, etc. If it is a bee sting, carefully remove stinger by flicking gently with finger nail. Do not use tweezers as this may empty venom sac into the individual. If you have access to Adolphs unseasoned meat tenderizer, make paste and apply after stinger is removed. (Inactivates poison venom.) Severe: 1. Remove the stinger as instructed above. If victim become short of breath, monitor closely and call for help. Victim may break out with large puffy welts or hives. If accompanied by shortness of breath, this can be life threatening. Apply a constricting band about 2 inches above the bite, closest to the heart, and keep the affected part down. Place cool packs over

the area. Call for help or get him to an emergency room. Usually occurs within 15 minutes in those sensitive to the venom. If victim is known to have severe allergies, ask if he or she has epinephrine on hand, and if so get it and allow him or her to inject it.. Get victim to the hospital. If breathing stops, begin rescue breathing. If heart stops, begin CPR. If you are the person who is allergic, and you know that your reactions are severe, speak with your Dr. Regarding a prescription for epinephrine and or Benadryl. Be sure you carry it with you when youll be out-of -doors. Self Care for Minor Illness or Injury and When to Call the Doctor Appendicitis: Pain in right lower abdomen. Possibly nausea and vomiting, low grade fever, chills, or constipation. Call the doctor immediately.. Until a diagnosis is confirmed do not eat or drink anything, or take laxatives or pain medications. Minor Burns Oozing blistered skin that appears within several hours. Cool quickly in cold water if skin is not broken. Apply a moist dressing. If blisters are forming, apply a dry dressing. If area is large, seek medical help. Earache Pain, discharge from ear, and possible fever. May be hearing loss. In an infant, may be pulling of the ear. Call the doctor immediately. Report fever with or without discharge. Use prescribed antibiotics as ordered; take all of it unless instructed by your doctor not to finish it. Electric Shock Possible unconsciousness, breathing difficulty and heart damage. Blackened burns at point of entry, and muscle spasms Disconnect power source and get help. Cover burns with clean sheets or dressings.

If no breathing begin rescue breathing. Check pulse. If no pulse, begin CPR until help arrives or you can no longer proceed. Eye Something In the Eye Burning, irritated, scratchy, painful eye. Difficulty in opening the eye. Foreign object may be visible. Lay a cotton q-tip on the lid, using thumb and forefinger grasp lashes and roll upward over the swap to expose inner lid and eyeball. Have patient look down, and rinse the lid and eye area with water. If object is embedded in the eye, cover loosely and take patient to an ophthalmologist. Do not try to remove an impaled object from the eye. Head Injury May-be unconscious, vomiting, pale with headache, and sleepy. Pupils may be dilated unevenly. The patient may be confused or combative. Head injury is always a medical emergency. Call for help. Have someone stay with victim. Watch closely for unconsciousness. If no spinal, neck, or back injury, elevate the upper body. If there is bleeding, apply pressure with clean cloth. If breathing or pulse stops, begin CPR. Seizures The individual becomes unconscious, and will fall if standing. Limbs and body stiffen, followed by uncontrolled jerking. 1. Catch the person and gently lower to floor. Move furniture and other obstacles away from the victim, loosen tight clothing, and pad under the head.. You cannot stop the seizure, do not try. Put nothing in mouth. 2. When jerking stops, roll to side to drain saliva from mouth. When he or she awakens there will be confusion and a probable headache. Once fully awake, Tylenol can be given, and is usually followed by sleep. If seizures last more that a minute or two, or this is the first seizure, the victim has ever experienced, call for

help. If they do continue, and the victim begins turning a bluish or gray color, try to give artificial breathing. Call 911 SnakeBite Help Keep Victim Calm Keep bitten area below heart level Do not apply cold to snakebite Do not give aspirin Splint to keep bitten area from moving Seek Medical Help!

Self Care for Minor Illness or Injury Fainting: Temporary loss of consciousness. May experience dizziness, sweating, paleness, or anxiety prior to becoming unconscious. Lay the patient on back, elevate the feet or if conscious, have patient bend over we head level of knees. Assess breathing. If breathing stops, begin mouth to mouth, Call for help. Nose Bleed Blood flowing from nose after blowing, sneezing, picking, illness or injury to the nose. 1. Keep head forward, do not allow patient to blow the nose. Squeeze nostrils closed. If bleeding does not stop, apply a cold compress to nasal area, and then apply pressure. If it doesnt stop, call a Dr. Poisoning Nausea & vomiting, or diarrhea. Sweating, seizures, and unconsciousness. Call local Poison Control. (In Kansas or Missouri, KU Med. Center, or Childrens Mercy Hospitals , Immediately. Report condition, and the identify of the poison if known. Keep samples of the vomitus for evaluation. Follow Instructions. Usually safe to dilute with water if patient is conscious. Shock Can follow any serious illness, trauma, etc. Skin moist and cool, rapid, weak, irregular pulse, and or confusion. If no reason to suspect spinal injury, lay patient on back, and raise both legs above the heart.

Assess breathing and pulse. Check for unseen bleeding. Call for help. Give nothing to drink. Cool cloths to head and neck may be comforting. Cover lightly if skin is cold. Sore Throat Self Care A sore throat is a common complaint and is usually not serious. Discomfort can be mild with only slightly sore, dry and scratchy feeling, or may progress to severe pain. Throat may be red & sore, or swollen, with red tonsils inflamed and coated with pus. Common Causes Cold or flu Allergies Viral or bacterial infection Smoking Dry air, especially during winter months Mononucleosis (Mono) Temporary Relief Salt water gargles 1/2 teaspoon. to a glass of warm water. Do every 1-2 hours when possible. Drink plenty of liquids, warm or cool as your throat allows. (Stay away from dairy products as this thickens secretions and makes it difficult to swallow.) If caused by allergies, an antihistamine and/ or decongestant will lessen discomfort of nose & throat. Nasal sprays should not be used more that 3 days. They can cause an unpleasant rebound effect that may be worse than the original condition if over used.

A cool air humidifier lessens sore throat dryness. Hard candy and lozenges help to keep the throat moist. Sore throat with fever of 100 or more for 2 or 3 days, or a temperature of 101 degrees with sore throat for more than 24 hours should not be treated at home. This could be a serious infection such as strep throat. Strep throat can lead to serious heart problems. If you have a chronic health problem, are pregnant, or are treating small children, always get the advice of a doctor. If in doubt about your condition, contact a physician. Toothache Sensitivity to heat & cold and sweets.Pain, and possible facial swelling. Call dentist. Give aspirin, Ibuprofen, or acetaminophen for pain. Ice pack to jaw for swelling. After dental treatment, contact dentist for fever, continued pain or continued sensitivity. See diagrams for pressure points, and moving injured victims.
If breathing does not begin, pinch victims nose shut and using the jaw thrust, put your mouth over the victims mouth and give two full, slow breaths.(If you have a CPR mask, use it.)

Bleeding, Upper Extremities Elevate the limb. Apply pressure with a cloth and four fingers to site of the injury. If bleeding doesnt stop after a few minutes, use fingers to apply pressure over the pressure point and call 911. If you must move an injured person out of harms way and you do not have help, slide her by the shoulders or ankles. Be sure the body is straight. A blanket would help in moving him or her more smoothly, allowing him to ride the blanket. See below.

To assess an injured victim who is lying face down, reach over and grasp them above and below the injured area to gently turn them to the side, then to the back.

Moving an Injured Victim If you have a choice, do not move the injured victim. If you must for his safety or yours do the following. To place a victim on a back board or blanket: Fold the blanket into several folds, working it very close to and under the body. Reaching over the body, grasp the shoulder or upper back with one hand and the hip with the other. Slowly roll the victim toward you onto his side. Gently roll him to his back and on the board or blanket. Pull him to safety and get help.

A The Heimlich Maneuver for CHOKING INFANTS choking victim can't speak, cry or breathe and needs your help immediately. To help a choking infant: Lay the child down, face up, on a firm surface and kneel or stand at the victim's feet, or hold infant on your lap facing away from you. Place the middle and index fingers of both your hands below his rib cage and above his navel. Press into the victim's upper abdomen with a quick upward thrust; do not squeeze the rib cage. Be very gentle. Repeat until object is expelled. If the Victim has not recovered, proceed with CPR. The Victim should see a physician immediately after rescue. Don't slap the victim's back. (This could make matters worse.)

UNCONSCIOUS VICTIM, OR WHEN RESCUER CAN'T REACH AROUND VICTIM: Place the victim on back. Facing the victim, kneel astride the victim's hips. With one of your hands on top of the other, place the heel of your bottom hand on the upper abdomen below the rib cage and above the navel. Use your body weight to press into the victim's upper abdomen with a quick upward thrust. Repeat until object is expelled. If the Victim has not recovered, proceed with CPR. The Victim should see a physician immediately after rescue. Don't slap the victim's back. (This could make matters worse.)

Heimlich Maneuver for standing, seated, or unconscious victim.

Ask, are you choking? If the victim cannot speak, and is obviously choking tell him Im going to help you. Stand behind victim; wrap your arms around the victims waist. Make a fist and place the thumb side of your fist against the victims upper abdomen, below the rib cage and above the navel. Grasp your fist with your other hand and press into the victims abdomen with a quick upward thrust. Do not squeeze the ribcage; confine the force of the thrust to your hands. Repeat until the object is dislodged, or the victim faints. If unconscious, straddle the victim, place the heel of your hand on the upper abdomen, below ribcage, above navel, and trust upward until object is dislodged. Try to give 2 quick, deep breaths. Continue abdominal thrusts, attempt to give breaths until help arrives or you can no longer physically continue.

The Heimlich Maneuver for CHOKING-Helping Yourself. When you choke, you can't speak or breathe and you need help immediately. Follow these steps to save yourself from choking:

1. Make a fist and place the thumb side of your fist against your upper abdomen, below the ribcage
and above the navel.

2. Grasp your fist with your other hand and press into your upper abdomen with a quick upward thrust. 3. Repeat until object is expelled.
Alternatively, you can lean over a fixed horizontal object (table edge, chair, railing) and press your upper abdomen against the edge to produce a quick upward thrust. Repeat until object is expelled. See the picture on the next page.

See a physician immediately after rescue.

The Heimlich Maneuver for DROWNING "You can't get air into the lungs until you get the water out!" VICTIM LYING ON GROUND

1. Place victim on back. Turn face to one side to allow water to drain from mouth. 2. Facing victim, kneel astride victim's hips. 3. With one of your hands on top of the other, place the heel of your bottom hand on the upper
abdomen below the rib cage and above the navel. until water no longer flows from the mouth.

4. Use your body weight to press into the victim's upper abdomen with a quick upward thrust. Repeat

STANDING IN A POOL OR SHALLOW WATER (Bouyancy of the Water Lightens Victims' Weight)

1. Stand behind the victim and wrap your arms around victim's
waist.

2. Make a fist and place the thumb side of your fist against the
victim's upper abdomen, below the rib cage and above the navel.

3. Grasp your fist with your other hand and press into the

victim's upper abdomen with a quick upward thrust. Do not squeeze the ribcage; confine the force of the thrust to your hands.

4. Repeat until water no longer flows from the mouth.

If the Victim has not recovered, proceed with CPR. The Victim should see a physician immediately after rescue. The Heimlich Maneuver for ASTHMA Perform the Heimlich maneuver on a person with an acute asthma attack who hasn't responded to medication, or is unable to take their medication Follow these steps to help relieve an asthma attack:

1. If you are performing the maneuver on another, wrap your arms around the victim's waist from
behind.

2. Make a fist and place the thumb side of your fist against your (the victim's) upper abdomen, below
the ribcage and above the navel.

3. Grasp your fist with your other hand and press into your (the victim's) upper abdomen with a quick
upward thrust. Do not squeeze the ribcage; confine the force of the thrust to your hands.

4. Repeat if necessary.
Alternatively, you can lean over a fixed horizontal object (table edge, chair, railing) and press your upper abdomen against the edge to produce a quick upward thrust. Repeat if necessary. If the Victim has not recovered, proceed with CPR. The Victim should see a physician immediately after rescue.