Calling for Help
First aid providers should know how/when to access the EMS system, the on-site emergency response plan (ERP), and the Poison Control Center.
Choking occurs when a foreign object becomes lodged in the throat/windpipe, blocking airflow. Look for these choking signs:
- Hands clutched around throat
- Inability to talk
- Difficult or noisy breathing
- Inability to cough forcefully
- Skin, lips or nails turning blue or duskyLoss of consciousness
The Red Cross recommends a "five-and-five" approach to choking:
- First, give five back blows between the person's shoulder blades with the heel of your hand.
- Give five abdominal thrusts (the Heimlich maneuver).
- Alternate between five blows and five thrusts until the blockage is dislodged.
To perform the Heimlich maneuver on another person:
- Stand behind person and wrap your arms
around their waist. Tip person forward slightly.
- Make a fist with one hand and position it
slightly above the person's navel.
- Grasp the fist with your other hand. Press hard
into the abdomen with a quick, upward thrust,
as if trying to lift the person.
If you're the only rescuer, perform back blows/abdominal thrusts before calling 911 or your local emergency number. If another person is available, have them call for help while you perform first aid. If the person becomes unconscious, perform standard CPR.
To perform the Heimlich maneuver on yourself:
Call 911 or your local emergency number immediately, then perform abdominal thrusts.
- Place a fist slightly above your navel.
- Grasp your fist with your other hand and bend over a hard surface (countertop, chair, etc.).
- Shove your fist inward and upward.
Clearing the airway of a pregnant woman or obese person:
- Position your hands a little higher than a normal Heimlich maneuver, at the base of the breastbone, just above where the lowest ribs join.
- Proceed like the Heimlich maneuver, pressing hard into the chest with a quick thrust.
Clearing the airway of an unconscious person:
- Lower the person onto the floor on their back.
- If there's a visible blockage, reach a finger into the mouth and sweep out the cause of the blockage. Be careful not to push the object deeper into the airway.
- Begin CPR if the object remains lodged and the person doesn't respond after you take the above measures. CPR chest compressions may dislodge the object. Recheck the mouth periodically.
Clearing the airway of a choking infant younger than age 1:
- Sit down, rest your forearm on your thigh, and hold infant face down on your forearm.
- Thump the infant gently but firmly five times on the middle of the back using the heel of your hand.
- Hold infant face up on your forearm with the head lower than the torso if the above doesn't clear the blockage. Using two fingers placed at the center of the infant's breastbone, give five quick chest compressions.
- Repeat the back blows and chest compressions if breathing doesn't resume. Call for emergency medical help.
- Begin infant CPR if the airway opens but the infant doesn't resume breathing.
Anaphylaxis (Allergic Reaction)
A life-threatening allergic reaction (anaphylaxis) can cause shock, a sudden drop in blood pressure and trouble breathing. Common food-based anaphylaxis triggers include peanuts, tree nuts, fish, and shellfish.
Signs and symptoms of anaphylaxis include:
- Hives, itching, flushed or pale skin
- Swelling of the face, eyes, lips, throat
- Constriction of the airways, wheezing, trouble breathing
- Weak, rapid pulse
- Nausea, vomiting, diarrhea
- Dizziness, fainting, unconsciousness
If someone is exhibiting signs of anaphylaxis:
- Call 911 or your local emergency number.
- Ask the person if they are carrying an epinephrine autoinjector (e.g. EpiPen®).
- If the person says they need to use an autoinjector, ask whether they need help. This is generally done by pressing the autoinjector against the thigh.
- Have the person lie still on their back.
- Loosen tight clothing and cover the person with a blanket. Don't give them anything to drink.
- If there are no signs of breathing, coughing or movement, begin CPR.
- Get emergency treatment even if symptoms start to improve. After anaphylaxis, it's possible for symptoms to recur.
The least serious burns are those in which only the outer layer of skin is burned, and is usually red, often with swelling and some pain. Treat as a minor burn unless it involves large portions of the hands, feet, face, groin or buttocks, or a major joint.
A second-degree burn involves the first layer and the second layer of skin (dermis) being burned. Blisters develop, skin is intensely red and splotchy, and there is severe pain with swelling.
If the second-degree burn is no larger than 3” in diameter, treat it as a minor burn. If burned area is larger or is on the hands, feet, face, groin or buttocks, or a major joint, treat it as a major burn and get medical help immediately.
For minor burns:
- Cool the burn by holding it under cool (not cold) running water for 10-15 minutes or until pain subsides, or immerse the burn in cool water or cool it with cold compresses. Do not put ice on the burn.
- Cover the burn with a sterile gauze bandage (do not use material that may get lint in the wound). Wrap loosely to avoid putting pressure on burned skin.
- Administer a pain reliever, such as aspirin, ibuprofen, naproxen, or acetaminophen. (Never give aspirin to children.)
The most serious burns involve all skin layers and cause permanent tissue damage, and fat, muscle and bone may be affected. Burned areas may be charred and black or appear dry and white.
For major burns:
- Call 911 or your local emergency number.
- Do not remove burned clothing. Make sure victim is not in contact with smoldering materials or exposed to smoke or heat.
- Do not immerse large severe burns in cold water.
- Check for signs of circulation (breathing, coughing or movement). If there is no breathing or other sign of circulation, begin CPR.
- Elevate the burned area. Raise above heart level when possible.Cover the burned area with a cool, moist, sterile bandage, clean, moist cloth, or moist cloth towels.
Cuts and Scrapes
1. Stop the bleeding
If minor cuts and scrapes do not stop bleeding on their own, apply gentle pressure with a clean cloth or bandage. Hold pressure continuously for 20 to 30 minutes and elevate the wound if possible. If wound does not stop bleeding after applying continuous pressure, seek medical assistance.
2. Clean the wound
Rinse wound with clear water. Soap can irritate the wound, so try to keep it out of the actual wound. If dirt or debris remains after washing, use tweezers cleaned with alcohol to remove particles. If debris still remains, see a doctor. Do not use hydrogen peroxide or iodine.
3. Apply an antibiotic
After cleaning, apply a thin layer of antibiotic ointment (e.g. Neosporin®) to help retain moisture.
4. Cover the wound
Bandages can help keep the wound clean. Change dressing daily or whenever it becomes wet or dirty. After the wound heals enough to make infection unlikely, air exposure will speed healing.
5. Get stitches for deep wounds
A wound that is greater than ¼” deep or is gaping or jagged usually requires stitches.
6. Watch for signs of infection
Signs of infection include redness, increasing pain, drainage, warmth or swelling. See a doctor.
7.Get a tetanus shot
If the wound is severe or dirty and/or previous tetanus shot was more than five years ago, a doctor may recommend a tetanus shot booster.
A sprain or strain is known as a soft-tissue injury, and application of cold to the affected area is generally recommended. Place a barrier, such as a thin towel, to the affected area, and apply a plastic bag filled with ice and water (ice alone can be too cold and cause discomfort or skin damage). Limit cold application to 20 minutes, or to the amount of time the injured person is comfortable with, whichever is less.
To be safe, assume any injury to a limb may include a broken bone. Do not try to move or straighten an injured extremity.
FIRST AID KITS
Keep at least one well-stocked first aid kit on site in an easy-to-retrieve location.
- First-aid manual
- Adhesive tape
- Antibiotic ointment
- Antiseptic towelettes
- Bandages, including elastic wrap (e.g. ACE™) and assorted strips (e.g. Band-Aid® Brand)
- Instant cold packs
- Cotton balls and swabs
- Disposable latex or synthetic gloves
- Gauze pads and rolls
- Petroleum jelly
- Safety pins
- Scissors and tweezers
- Soap or instant hand sanitizer
- Sterile eyewash, (e.g. saline solution)
- Activated charcoal (use only if instructed by poison control)
- Aloe vera gel
- Antihistamine (e.g. Benadryl®)
- Aspirin and non-aspirin pain relievers (never give aspirin to children)
- Hydrocortisone cream
- Syringe, medicine cup or spoon
- American Red Cross: www.redcross.org
- Mayo Clinic: http://www.mayoclinic.org/first-aid
- American Heart Association: www.heart.org