First Aid Tips*

Introduction

When someone becomes ill or injured there is usually a short period of time before you can get professional medical assistance. It is that length of time that is most critical to the victim. What you do, or don't do during that period of time can make the difference between life and death. By having some first aid training and knowing cardiopulmonary resuscitation (CPR) you can have a major impact to the successful outcome of a medical emergency. Does your household or place of employment have a well stocked first aid kit? Keep your kit in a location that is well known to other family members or coworkers. Contact the American Heart Assn. or the American Red Cross to obtain information on CPR classes.
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911

When and how to use 9-1-1

9-1-1 is simply a telephone number used for reporting all types of emergencies - police, fire and emergency medical.

9-1-1 makes reporting emergencies fast and easy;

The 3 digit number makes it easy to remember - you no longer waste time looking up the correct number to dial in an emergency!

The 3 digit number makes it fast to dial - dialing 3 numbers is obviously quicker than dialing 7 numbers.

DO NOT program 9-1-1 into speed dials - WHY? 9-1-1 is fast and easy to dial as it is. Placing it in speed dials often
results in "accidental" calls to 9-1-1.

9-1-1 is the correct number to dial no matter where you are.

9-1-1 is the correct number to dial no matter if the emergency you are reporting is for police, fire, or emergency medical services.

9-1-1 is equipped and ready to accept calls from deaf persons utilizing a telecommunications device for the deaf (TDD)

9-1-1 is for emergencies only. If you call 9-1-1 for non-emergency reports, someone with a real emergency might not get through! When away from your home remember 9-1-1 is coin free from a pay telephone.

What is an emergency?

A fire, an automobile accident, a robbery, a burglary, a prowler outside your home, when someone is sick or injured so badly that they need to go to the hospital.

Non-emergency calls should be placed on normal telephone numbers which may be found in the telephone book. Calls on these lines are answered at the same location, by the same dispatchers, but they don't tie up the "special" 9-1-1 lines.

If you need to dial 9-1-1 remember:

Stay calm! Before picking up the phone, take a deep breath and do your best to relax.

Pick up the phone, listen for dial tone, then dial 9-1-1. That's all, just three numbers - 9 - 1 - 1.

When the dispatcher answers, simply state what you need; I need the police, I want to report a fire, I need an ambulance.

The dispatcher will then ask for the address or location of the emergency. This is very important! Do you and other
members of your family/workforce all know your address? If not, let everyone know! Better yet, mark the address by each telephone - that way it will be easy to remember. Do you know what city or township you are located in?

This is important information as well. In addition to knowing your address, it is important that emergency responders can see your house number from the street. The next time you are returning to your home at night, pretend that you are a policeman, firefighter, or paramedic trying to find your house. Can you easily see your house number from the street? If not, you have some work to do. Mark your house number in large, reflective numbers that can easily be seen from the street.

Next, the dispatcher will ask you exactly what is wrong - the "details" of your emergency. This is important information too! Do not become upset that it is "taking too long", or that "they are asking too many questions" remember, while one dispatcher is talking to you on the phone, another dispatcher is putting your call out on radio to the emergency personnel.

Finally, the dispatcher will ask your name and telephone number.

DO NOT hang up until the dispatcher says it is okay to do so. If you are alone or frightened, we'll stay on the phone until help arrives.

For medical emergencies, the dispatcher can transfer you to medically trained personnel who can tell you what to do until the ambulance arrives.
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First Aid Supplies

Here's a checklist you can use for building your own first aid kit.

Nosebleed

A nosebleed is sudden bleeding from one or both nostrils, and may result from a variety of events: a punch in the nose, breathing dry air, allergies, or for no apparent reason. To stop the flow of blood from a common nosebleed, use these steps:

1.    Sit or stand upright to slow the flow of blood in the veins of the nose. Do not tip your head back.

2.    Pinch your nose with your thumb and forefinger for 10 minutes without relieving pressure. Breathe through your mouth during this time.

3.    If the bleeding continues despite these efforts, consult your doctor or call  911.
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Cuts and Scrapes

Small cuts and scrapes usually don't demand a visit to the emergency room of your local hospital, but proper care is necessary to keep infections or other complications from occurring.

When dealing with minor wounds, keep the following guidelines in
mind:

1.    Stop the bleeding by applying pressure using a gauze pad or clean cloth. If the bleeding persists after several
minutes of applying pressure, get immediate medical attention.

2.    Keep the wound clean by washing the area with mild soap and water and removing any dirt. Dry the area
gently with a clean cloth, and cover the wound with a protective bandage. Change the bandage at least once a
day. If the wound becomes tender to the touch and red or oozes fluid, see your doctor.

3.    If your cut is more serious and the bleeding does not stop on its own or the cut is large, deep, or rough on the
edges, try to stop the bleeding by applying pressure directly to the injury using a sterilized gauze pad or clean
cloth. Maintain pressure on the wound until the bleeding stops. Then consult your physician. A tetanus booster
may be required if you haven't had one for a while.
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Severe Bleeding

To stop serious bleeding, follow these steps:

1.    Lay the affected person down. If possible, the person's head should be slightly lower than the trunk of his or her body or the legs should be elevated. This position increases blood flow to the brain. Elevate the site of bleeding, if possible to reduce the blood flow.

2.    Do not attempt to clean the wound.

3.    Apply steady, firm pressure directly to the wound using a sterile bandage, a clean cloth, or your hand. Maintain pressure until the bleeding stops, then wrap the wound with a tight dressing and secure it with adhesive tape.  Most bleeding can be controlled this way. Call for emergency help immediately.

4.    If the bleeding continues and seeps through the bandage, add more absorbent material. Do not remove the first bandage.

5.    If the bleeding does not stop, apply pressure to the major artery that delivers blood to the area of the injury    (see Major Arterial Pressure Points).

6.    When the bleeding has stopped, immobilize the injured portion of the body. You can use another part of the body, such as a leg or torso, to immobilize the area. Leave the bandages in place and take the person for
immediate medical attention or call for emergency help.
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Shock

A variety of symptoms appear in a person experiencing shock:

1. The skin may appear pale or gray, and is cool and clammy to the touch.

2. The heartbeat is weak and rapid, and breathing is slow and shallow. The blood pressure is reduced.

3. The eyes lack shine and seem to stare. Sometimes the pupils are dilated.

4. The person may be conscious or unconscious. If conscious, the person may faint or be very weak or confused.   On the other hand, shock sometimes causes a person to become overly excited and anxious.

Even if a person seems normal after an injury, take precautions and treat the person for shock by following these steps:

1. Get the person to lie down on his or her back and elevate the feet higher than the person's head. Keep the person from moving unnecessarily.
          
2. Keep the person warm and comfortable. Loosen tight clothing and cover the person with a blanket. Do not give the person anything to drink.           

3. If the person is vomiting or bleeding from the mouth, place the person on his or her side to prevent choking.

4. Treat any injuries appropriately (bleeding, broken bones, etc.).

5. Summon emergency medical assistance immediately.
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Burns

Burns can be caused by fire, the sun, chemicals, heated objects or fluids, and electricity. They can be minor problems or life-threatening emergencies. Distinguishing a minor burn from a more serious burn involves determining the degree of damage to the tissues of the body. If you are not sure how serious the burn is, seek emergency medical help.

First-degree burns are those in which only the outer layer of skin is burned. The skin is usually red and some swelling and pain may occur. Unless the burn involves large portions of the body, it can be treated at home.

Second-degree burns are those in which the first layer of skin has been burned through and the second layer of skin is also burned. In these burns, the skin reddens intensely and blisters develop. Severe pain and swelling also occur. If a second-degree burn is no larger than 2 or 3 inches in diameter, it can be treated at home. If the burn covers a larger area, seek medical attention. You may need a tetanus booster.

Third-degree burns are the most serious and involve all layers of skin. Fat, nerves, muscles, and even bones may be affected. Areas may be charred black or appear a dry white. If nerve damage is substantial, there may be no pain at all. These burns should receive emergency medical attention.

Follow these steps when treating minor burns at home:

1.If the skin is not broken, run cool water over the burn for several minutes.

2.Cover the burn with a sterile bandage or clean cloth.

3.Take aspirin or acetaminophen to relieve any swelling or pain.

Seek emergency treatment immediately for major burns. Until an emergency unit arrives, follow these steps:

1. Remove the person from the source of the burn (fire, electrical current, etc.).

2. If the person is not breathing, begin mouth-to-mouth resuscitation immediately (see Mouth-to-Mouth     Resuscitation).

3. Remove all smoldering clothing to stop further burning.

4. If the person is breathing sufficiently, cover the burned area with a cool, moist, sterile bandage or clean cloth. Do not place any creams, ointments or ice on the burned area or break blisters.

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Seizures

Generalized Tonic-Clonic (Grand Mal):

DO:
Look for medical identification.
Protect from nearby hazards.
Loosen tie of shirt collar.
Protect head from injury.
Turn on side to keep airway clear.
Reassure when consciousness returns.
If single seizure lasted less than five minutes, ask if hospital evaluation is wanted.
If multiple seizures, or if one seizure lasts longer than five minutes, call an ambulance. If person is pregnant, injured or diabetic, call for aid at once.

DON'T DO:
Do not put any hard implement in the mouth.
Do not try to hold tongue. It cannot be swallowed.
Do not try to give liquids during or just after the seizure.
Do not use artificial respiration unless breathing is absent after muscle jerks subside or unless water has been
inhaled.
Do not restrain.
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Poisoning

A poisoning may or may not be obvious. Sometimes the source of a poisoning can be easily identified -- an open bottle of medication or a spilled bottle of household cleaner. Look for these signs if you suspect a poisoning emergency:

1. Burns or redness around the mouth and lips.

2. Breath that smells like chemicals.

3. Burns, stains, and odors on the person, his or her clothing, or on the furniture, floor, rugs, or other objects in the surrounding area.

4. Vomiting, difficulty breathing, or other unexpected symptoms.

If you can find no indication of poisoning, do not treat the person for poisoning, but call for emergency help.

If you believe someone has been poisoned, take the following steps:

1. Some products have instructions on the label specifying what to do if a poisoning occurs. If the product known to be the poison has these instructions, follow them.

2. If the person is alert, give him or her a glass of water or milk to drink. The liquid will slow the rate at which the  poison is absorbed by the body. But if the person is weak, lethargic, unconscious, or having seizures, do not give him or her anything by mouth.

3. If you cannot identify the poison or there are no instructions on the product label, call your local poison control center for instructions. Keep the number near your telephone.

4. Certain poisons should be vomited; others should not. If you do not know the identity of the substance swallowed, do not induce vomiting. Overall, you should not induce vomiting unless directed to by a poison control authority or your physician.

5. If you are told to induce vomiting in the person who has swallowed poison, use syrup of ipecac to do so. An     alternative method to induce vomiting is touching the back of the throat of the person to initiate gagging. If you have no other alternative, have the person drink a glass of warm water containing 1 teaspoon of dried mustard or  3 teaspoons of salt. After the person has vomited, give a glass of water or milk.

6. If the poison has spilled on the person's clothing, skin, or eyes, remove the clothing and flush the skin or eyes with cool or lukewarm water for 20 minutes.

7. Get immediate medical attention. If you have identified the poison, take the container with you.
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Electrical Injuries

Everyone experiences minor electrical shocks from time to time. In some cases, however, even small amounts of electricity can be life-threatening because they can produce unconsciousness, cardiac arrest, and cessation of breathing. Electrical shocks also can produce serious, deep burns and tissue injury, although often even a serious electrical burn appears as only a minor mark on the skin. If you find a person whom you think has been electrocuted, look first--do not touch. He or she may still be in contact with the electrical source, and touching him or her may only pass the current through you.

If possible, turn off the source of electricity. If this is not possible, move the source away from you and the affected person using a non-conducting object made of cardboard, plastic, or wood. Once the person is free of the source of electricity, check the person's breathing and pulse. If either has stopped or seems dangerously slow or shallow, initiate resuscitation immediately (see Cardiopulmonary Resuscitation). If the person is faint or pale or shows other signs of shock (see Recognizing and Treating Shock), lay the person down with the head slightly lower than the trunk of his or her body and the legs elevated. Treat any major burns (see Treating Major Burns) and wait for emergency medical assistance to arrive.
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Diabetes

People suffering from diabetes need to control their blood sugar levels by balancing the amount of sugar in their diet with insulin injections. As a result, many carry hypodermic needles, insulin bottles, medication, card or identity bracelet with them, indicating that they have diabetes.

If a person with diabetes on treatment has missed a meal or taken too much exercise, the concentration of sugar in the blood falls, and unconsciousness can follow. The aim of first aid in this situation is to restore the sugar/insulin balance as soon as possible.

Treatment:
If the patient is conscious and capable of swallowing, immediately give sugar lumps, a sugary drink, chocolate or other sweet food in order to raise the level of sugar in the blood. If the casualty is unconscious but breathing normally, place in the recovery position, and carry out general treatment for unconsciousness  call 911 immediately."
IF VICTIM IS UNCONSCIOUS DO NOT GIVE ANYTHING BY MOUTH.
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Eye Injuries

Impaled Objects
DO NOT ATTEMPT TO REMOVE THE OBJECT. Stabilize the impaled object by placing bulky dressings on each side of the object and then securing the dressings together, or by placing a paper cup over the object and then securing to the face.


Foreign Bodies
Foreign bodies such as dirt, sand, wood or metal chips may cause tearing. Tearing may rid the eye of the foreign body. If the object remains in the eye, have the victim blink several times. If the object still remains in the eye, gently flush the eye with water.
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Heat Related Emergencies

Heat exhaustion occurs when your heart and vascular system do not respond properly to high temperatures. The symptoms of heat exhaustion resemble shock and include faintness, rapid heartbeat, low blood pressure, an ashen appearance, cold clammy skin, and nausea. If you suspect heat exhaustion, get the person out of the sun and into a cool spot. Lay the person down and elevate his or her feet slightly. Loosen or remove most or all of the person's clothing. Give the person cold (not iced) water to drink, with a teaspoon of salt added per quart.

The main indication of heat stroke is a fever of 105 degrees Fahrenheit with hot, dry skin. Other signs include rapid heartbeat, rapid and shallow breathing, either elevated or lowered blood pressure, and confusion or unconsciousness. If you suspect heat stroke, get the person out of the sun and into a cool spot. Cool the person by covering him or her with damp sheets or spraying with water. Direct air onto the person with a fan or a newspaper, and monitor the person's temperature with a thermometer. Stop cooling the person when his or her temperature returns to normal. If breathing ceases, start mouth-to-mouth resuscitation. Heat stroke is an emergency that needs immediate medical attention.
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Cold Related Emergencies

When exposed to very cold temperatures, the skin and underlying tissues may freeze, resulting in frostbite. The areas most likely to be affected are the hands, feet, nose, and ears.

Frostbite is distinguishable by the hard, pale, and cold quality of the skin that has been exposed to the cold. As the area thaws, the flesh becomes red and painful. If your fingers, ears, or other areas are frostbitten, get out of the cold. Warm your hands by tucking them into your armpits; if your nose, ears, or face are frostbitten, warm the area by covering it with dry, gloved hands. Do not rub the affected area. If numbness remains during warming, seek
professional medical care immediately. If you are unable to get immediate emergency assistance, warm severely frostbitten hands or feet in warm--not hot--water. (The water should be between 100 and 105 degrees Fahrenheit).
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Mouth to Mouth Resuscitation

Before you can begin mouth-to-mouth resuscitation, you must be sure the person's airway is clear. If the person does not begin breathing once the airway is clear, perform mouth-to-mouth resuscitation.

To begin mouth-to-mouth resuscitation, position the victim so you can check for breathing by laying the person on his or her back on a flat, firm surface. Place yourself next to the person's neck and shoulders. Extend the person's neck gently, and open the mouth and airway by lifting the chin.

To determine whether the victim is breathing, place your ear above the person's mouth and listen for the sounds of inhaling or exhaling. Feel for air against your cheek and watch for motion in the victim's chest.

If the victim is not breathing, begin mouth-to-mouth resuscitation immediately. Pinch the victim's nostrils closed with your thumb and forefinger. Take a deep breath, and make a seal around the victim's mouth with your mouth. Breathe slowly into the victim's mouth twice, checking to be sure the victim's chest rises each time you breathe. After the second breath, turn your head, listen for air leaving the victim's lungs and watch to see if the chest falls.

Next, check to see if the victim has a pulse. Place two fingers on the victim's carotid artery, just to the side of the Adam's apple, to feel for movement. If the artery is pulsating, continue mouth-to-mouth resuscitation in the same way, blowing a deep breath into the victim every 5 seconds--12 breaths every minute. If the artery is not pulsating, begin cardiopulmonary resuscitation (CPR).

Continue to breathe for the person until he or she breathes on his or her own or until professional medical help arrives.
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Cardiopulmonary Resuscitation

Cardiopulmonary resuscitation (CPR) is used in a range of emergencies, including heart attack, choking, and drowning. In these situations, the person is unconscious and has stopped breathing. Before you begin CPR on anyone, however, you should call for immediate medical assistance. The most effective way to learn CPR is by enrolling in a class sponsored by the American Heart Association or the American Red Cross.

The goal of CPR is to restore circulation. If you are unable to find a pulse in an unconscious person, heart compression is necessary to restore circulation. These compressions must be coordinated with mouth-to-mouth resuscitation: the breathing delivers air to the lungs; heart massage pumps the oxygenated blood to the brain
and other parts of the body.

To begin CPR, place yourself at right angles to the person's chest. Find the base of the breastbone at the center of the chest where the ribs form a V. Position the heel of one hand on the chest immediately above the V; with the other hand, grasp the first hand from above, intertwining the fingers. Shift your weight forward and upward so that your shoulders are over your hands; straighten your arms and lock your elbows.

To begin pumping the heart, shift your weight onto your hands to depress the person's chest 1 and 1/2 to 2 inches. Compress the chest 15 times in a slow, even rhythm. After 15 compressions, breathe for the person twice. Establish a regular rhythm of compressing and breathing, counting aloud. If help does not arrive in 1 minute and a phone is readily available, call for an ambulance immediately--then resume CPR.
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Heimlich Maneuver

The Heimlich Maneuver is the best known method of removing an object from the airway of a person who is choking. You can use it on yourself or someone else. These are the steps:

1. Stand behind the choking person and wrap your arms around his or her waist. Bend the person slightly forward.

2. Make a fist with one hand and place it slightly above the person's navel.

3. Grasp your fist with the other hand and press hard into the abdomen with a quick, upward thrust. Repeat this
    procedure until the object is expelled from the airway.

If you must perform this maneuver on yourself, position your own fist slightly above your navel. Grasp your fist with your other hand and thrust upward into your abdomen until the object is expelled.
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  *Cortlandt Ambulance Corps thanks the ALF Ambulance of Mn. for the first aid tips