EMERGENCY FIRST AID |
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EMERGENCY FIRST AID
Accidents cause 150,000 lives to be lost each year in the USA alone -- the fourth leading cause of deaths. In infants, children, and adolescent males, accidents are the leading cause of death. In addition, 70 million or more Americans are injured seriously enough to require medical care. The number self-treated is even higher.
More than half of these can probably be prevented with simple, common-sense precautions such as:
1. Wear seat belts in the car.
2. Teach children proper safety habits.
3. Practice safety at home.
4. Follow fire prevention warnings.
5. Keep all medicines in a safe place away from the reach of children.
6. Keep children away from all power tools.
7. Teach bicycle safety, including wearing protective headgear.
8. Teach every child how to competently swim.
9. Wear life jackets in boats.
10. Heed weather reports when planning outdoor activity.
This section is not an all-inclusive check-list, but instead covers the most frequent, most serious, and most preventable accidents.
FIRST-AID SUPPLIES
Keep first-aid supplies readily available. Carry a set in the car and have another at home in your medical supply cabinet or shelf. Campers, hikers, bikers, and anyone who expects to spend time in a remote and unpopulated area should carry a portable first-aid kit. Carry a first-aid kit wrapped in a waterproof cover on all boats. These supplies should be checked periodically and replenished promptly. Specific items that should be on hand include:
A pair of tweezers
A roll of absorbent cotton
A roll of adhesive bandage tape, 1 inch wide
A tightly covered bottle of hydrogen peroxide
Adhesive bandages in assorted sizes, including 4-inch-square compress pads
Airtight packages of hand-cleansing disposable towels (optional)
An antiseptic spray or cream
Antidiarrheal medication
Antihistamine tablets
Containers of ipecac syrup and activated charcoal
Cotton-tipped applicators
Elastic bandages 2 and 3 inches wide
Fever thermometer
Paper tissues
Precut triangular bandages of various sizes for slings, splints, and bandages
Safety pins
Several medium-sized boards to use as splints for an arm or leg
Sharp scissors
Sterile gauze pads
Tongue depressors
Two rolls of gauze, 1 inch and 2 inches wide In addition, these items should be carried at all times in a car or boat:
A clean, folded sheet
A flashlight with fresh batteries
A folded lightweight blanket (sometimes called a "space" blanket)
A large waterproof cover (tarpaulin)
A tightly capped plastic bottle of water
Flares If a person is hypersensitive to bee or insect stings, he or she also should have a kit containing a syringe of adrenaline, an antihistamine, and a hypodermic needle. These insect-sting kits must be prescribed by and used under the instruction and direction of a physician. Wear a Medic-Alert bracelet or necklace if you have diabetes, heart disease, serious allergies, or take special medicines. For information on how to obtain one, call collect in USA: 209-634-4917.
NOTE
Take a cardiopulmonary (CPR) course through the Red Cross or
American Heart Association. This will prepare you to administer
CPR if it is ever needed.
ANAPHYLAXIS (Severe allergic reaction)
DESCRIPTION
Itching, rash, hives, runny nose, wheezing, paleness, cold sweats, low blood pressure, coma, and cardiac arrest.
TREATMENT
If Victim is Unconscious, Not Breathing:
1. Yell for help. Don't leave victim.
2. Begin mouth-to-mouth breathing immediately.
3. If there is no heartbeat, give external cardiac massage.
4. Have someone call O (operator) or 911 (emergency) for an ambulance or medical help.
5. Don't stop cardiopulmonary resuscitation (CPR) until help arrives.
If Victim is Unconscious and Breathing:
1. Dial O (operator) or 911 (emergency) for an ambulance or emergency medical help.
2. If you can't get help immediately, take patient to nearest emergency room or other facility with adequate equipment and personnel to care for medical emergencies.
BLEEDING
DESCRIPTION
Bleeding caused by any serious injury should be treated in an emergency facility. There is usually a lot of bright-red blood pumping from an injured artery, or darker blood if a large vein has been injured.
TREATMENT
1. Call for ambulance or take to emergency room. In the meantime render first aid yourself.
2. Cover entire injured area with cloth or bare hands if no cloth is available.
3. Apply strong pressure directly on injured area for 10 minutes while awaiting ambulance or transporting to emergency room.
4. If direct pressure doesn't control brisk
bleeding and emergency assistance will not be available within 5 minutes, use a tourniquet as a last resort to prevent death from bleeding. Make a tourniquet from a length of cloth or similar material. Wrap and tie the tourniquet around extremity above the wound. Place a stick or other rigid object between the cloth and the extremity. Twist the rigid object several times until tight pressure has been applied and bleeding stops. Note how long the tourniquet is in place so emergency medical personnel will know.
BURNS
DESCRIPTION
First- and second-degree burns are not usually life-threatening. First-degree burns cause only red skin and mild swelling. Second-degree burns cause blisters, pain, and oozing. Third-degree burns can be life-threatening if extensive. Skin turns white or appears charred.
TREATMENT
For First- and Second-Degree Burns:
1. Put the flames out as quickly as possible.
2. Apply lotion to cool first-degree burns. However, if marked swelling develops, seek emergency care.
3. Immerse small second- or third-degree burn areas (as from hot-grease splatters) in cold water for 10 minutes to reduce pain and swelling.
4. Keep the burn area clean. Soak in a tub or use warm compresses once a day. You may add 2 tablespoons of powdered detergent to the tub to help soak off crusting areas. Use plain water for compresses.
5. Prop the burn area higher than the rest of the body, if possible.
6. Use dressings on the burned area, if you wish.
For Third-Degree Burns:
1. Don't use ice to "relieve" pain!
2. Keep patient lying flat and lightly covered to prevent shock.
3. Remove clothes and jewelry unless they are sticking to burned skin.
4. Take to emergency room.
SPECIAL INSTRUCTIONS:
1. Electrical Burns--Turn off the source of electricity, if possible. If not, use a non-conductive material, such as a board or wooden chair, to pull the victim away from the electrical source. Don't use your bare hands. If the victim is not breathing, begin mouth-to-mouth breathing.
2. Chemical Burns of the Eye or Skin--Hold the victim's head or other burned area beneath a faucet. Turn on cool water at medium pressure. Rinse for at least 15 minutes, directing the water away from the unaffected area.
3. For Burns of Large Areas--Prepare a solution for the victim to drink on the way to the emergency room. Mix 1 quart of water with "%} teaspoon of salt and "%} teaspoon of baking soda. This may help prevent kidney failure.
CHOKING
DESCRIPTION
Clutching at throat. Gagging or gasping for air. Sudden collapse without previous illness. Unable to speak. Breathing labored and wheezing if breathing is possible at all.
TREATMENT
1. Stand behind child, bend child forward and give 3 or 4 sharp blows to back between shoulder blades.
2. If this doesn't dislodge obstruction, perform the Heimlich Maneuver as follows:
HEIMLICH MANEUVER
1. Stand behind child, place both arms around his upper abdomen and grasp your wrists halfway between bottom of ribs and waistline, just above navel.
2. Give 3 or 4 quick forceful squeezes, pushing in and up.
FRACTURES AND DISLOCATIONS
DESCRIPTION
Extreme pain and tenderness in any injured area; change in appearance of injured part, such as swelling, protruding bone, or blood under skin. Extremity, such as finger, arm or leg, may be bent out of normal alignment.
TREATMENT
1. Immobilize any injured area and keep movement to minimum. For obvious fractures of fingers, wrists, arms, legs, ankles, or feet, improvise a splint from stiff rolled-up paper, scrap wood, or metal.
2. Attach splint firmly to injured extremity with strips of cloth, twine, or similar material to prevent movement.
3. If leg, back, or neck is severely injured and possibly fractured or dislocated, keep patient warm and still until ambulance arrives. DON'T MOVE THE VICTIM.
CARDIOPULMONARY RESUSCITATION
DESCRIPTION
To maintain life, everyone needs a constant supply of oxygen to survive--permanent brain damage can result after only 3 minutes without oxygen. If your child is unconscious and not breathing, you may be able to save his life by taking over his breathing and blood circulation. Cardiopulmonary resuscitation (CPR) is
the term used to describe the techniques used to revive someone who is unconscious and not breathing. It is always worth starting cardiopulmonary resuscitation; keep going until a doctor arrives or your child starts to breathe again on his own.
TREATMENT
1. Yell for help. Don't leave victim.
2. Begin mouth-to-mouth breathing immediately.
3. If there is no heartbeat, give external cardiac massage.
4. Have someone call O (operator) or 911 (emergency) for an ambulance or medical help.
5. Don't stop cardiopulmonary resuscitation (CPR) until help arrives.
AIRWAY
The airway consists of the passages between your child's mouth and nose and his lungs. If your child is unconscious, particularly if he is lying face upward, breathing may be difficult. Air may not be able to get through to his lungs because: the tongue has fallen back and blocked the windpipe; the head has tilted forward, narrowing the top of the windpipe; fluid or vomit has collected at the back of the throat and is unable to drain. Keep your fingers and hand away from the soft tissues under your child's chin and along his neck.
1. Lay your child on a firm surface. Place one hand on the child's forehead and one hand under the back of his neck. Tilt the head back. The neck and head are in the right position when you can see straight down the nostrils.
2. Place two fingers of one hand on your child's chin, and lift the jaw up so the chin juts forward. The tongue will come forward with the jaw, thus opening the airway.
OPENING THE AIRWAY FOR BABIES AND SMALL CHILDREN
Babies have very short necks and soft windpipes, and if you tilt the head back too far, you can easily block the airway.
1. Lay your child on a firm surface. Place one hand on the child's forehead, and press very gently to tilt his head slightly.
2. Support the jaw by placing two fingers of the other hand on the bony part of the chin. Check breathing.
CLEARING THE AIRWAY
If your child is not breathing after you have tilted his head back, take a look inside his mouth to see if there is something blocking the airway.
1. Turn your child's head to one side. Quickly, but carefully, run your index finger around the inside of his mouth. Remove anything you find.
2. Be very careful not to push anything farther down his throat.
IMPORTANT
With a young baby, don't put your finger in the baby's mouth unless you can see the foreign body clearly and you are sure there is no risk of pushing it down his throat. It's better to hold the baby upside down and slap the baby's back. If the child is still not breathing, immediately begin mouth-to-mouth resuscitation (see below).
CHECKING BREATHING
If the child is unconscious, before you do anything else, MAKE SURE HE IS BREATHING. OPEN THE AIRWAY.
1. With his head tilted back, place your ear as near to his mouth and nose as possible, and look along his chest at the same time.
2. If he is breathing, you will see his chest moving, and you will hear and feel his breath against your face.
3. If he is not breathing, try to clear the airway.
IMPORTANT
If your child is breathing, even slightly, leave him alone. Do not try to give him mouth-to-mouth resuscitation to try to increase the breathing rate. Just put him in a comfortable position, lying on his abdomen with head and face turned so air can enter mouth and nose.
MOUTH-TO-MOUTH RESUSCITATION
Start this whenever you find your child. If he is in the water, start mouth-to-mouth resuscitation there. If for any reason you can't put your mouth over your child's mouth, close off his mouth and breathe into his nose. If he is very small, it may be easier to place your mouth over his mouth and nose together. If the infant or child is not breathing, it is also likely that the heart is not beating. Begin cardiopulmonary resuscitation immediately and never stop until professional help arrives. At the same time that another person at the scene begins external chest compression (see below), begin mouth-to-mouth resuscitation as follows:
1. Tilt the child's head back to open the airway. If necessary clear the airway.
2. Support the child's jaw with one hand. Be careful not to rest your hand on his neck because you can close off the windpipe. Pinch your child's nostrils shut with two fingers of the other hand.
3. Take a deep breath. Open your mouth wide, and seal your lips around the child's mouth.
4. Breathe gently, but firmly, into his mouth. Blow from your lungs, not just your mouth, until you see the unconscious patient's chest rise. Look along the child's chest--you should see the chest fall again if you have been successful.
NOTE
If the chest has not risen, check to see if:
The head is in the correct position. You should be able to see straight down his nostrils.
You are pinching the nostrils shut and your mouth is forming an airtight seal around his mouth.
Try again; if you're still unsuccessful, give him back slaps.
5. Repeat the breathing procedure 3 more times, as quickly as possible. Wait for the chest to fall between each breath. Then check your child's heartbeat.
6. If your child's heart is beating, continue rescue breathing at a rate of 15 to 20 breaths per minute until he can breathe by himself. Wait for the ambulance.
7. If your child's heart is not beating, continue external chest compression (also called external cardiac massage). See below for instructions.
MOUTH-TO-MOUTH FOR INFANTS AND SMALL CHILDREN
The basic breathing techniques are the same. However, take the baby's smaller size into account when giving mouth-to-mouth resuscitation. The gap between the nose and mouth is small, so you may find it easier to place your mouth over the mouth and
nose together. You'll only have to breathe a small amount of air into the lungs, at a slightly faster rate of 20 breaths per minute; don't breathe too hard.
1. Lay the child on his back. Tap the soles of his feet to make sure he really is unconscious. If there is no reaction, tilt his head back slightly by pressing on his forehead and supporting his chin with your fingers. Do not tilt the head too far.
2. Slide one hand under his back to support him and keep his head back. Put your mouth over his mouth and nose together. Breathe out gently until his chest rises.
Repeat 3 more times, as quickly as possible, then check heartbeat.
NOTE
If you cannot inflate the lungs, check and see if the airway is open. If you still cannot force air in, hold him upside down and give him back slaps.
EXTERNAL CHEST COMPRESSION
Use this technique in conjunction with mouth-to-mouth resuscitation when a child is unconscious and not breathing and his heart is not beating. Chest compression is important because if the heart is not beating, the oxygen you breathe into your child will not get to the body tissues. Permanent brain damage can occur after only 3 minutes without oxygen.
HOW TO CHECK FOR THE HEARTBEAT
Check the pulse in the carotid arteries--the arteries that supply blood to the brain.
1. Find the front of the child's windpipe and slide the pads of three fingers across into the groove between it and the large muscle in the neck, just below the jaw and in line with the ear lobe.
2. Feel for about 5 seconds. If you can't feel anything, the heart has probably stopped beating.
3. If the child's heart has stopped beating, lay the child on a hard surface, and kneel beside him facing his chest. Find his breastbone (the bone that runs down the center of his chest). Feel for the top in the groove between the two collarbones at
the top of your child's chest; then find the center of the breastbone.
4. Place the heel of one hand over the lower half of the breastbone. Position yourself so your shoulders are directly over the child's breastbone. Depress it 1 to 1--1/2 inches (2.5 to 3.5 cm); then release the pressure.
5. Complete 5 compressions at a rate of about 80 to 100 compressions per minute (count "1-and-2-and-" as you go). Someone else should be administering mouth-to-mouth resuscitation simultaneously.
EXTERNAL CHEST COMPRESSION FOR BABIES AND SMALL CHILDREN
The sequence of steps for giving chest compression to babies and small children under age 2 is the same as for large children, but you must use less pressure.
UNCONSCIOUSNESS
DESCRIPTION
Unconsciousness may occur from many causes such as high fever, head injury, epilepsy, an adverse reaction to too much insulin in diabetes, an adverse reaction to many other medications, syncopal or simple fainting episodes--and others.
Unconsciousness is always an emergency. Yell for help and call for an ambulance. DON'T EVER LEAVE AN UNCONSCIOUS CHILD.
Render CPR as described above if the child is not breathing or has no heartbeat.
DEALING WITH AN UNCONSCIOUS INFANT
The procedure for treating an unconscious baby is the same as for an older child, except you should tap his feet to establish whether he is unconscious. He is unconscious if there is no response. When opening the airway, don't tilt a baby's head back as far as for an older child. Blow gently into the mouth when giving mouth-to-mouth. Apply only gentle pressure when giving external chest compression.
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