Captain Tropic's
Basic First Aid
First Aid is defined as emergency care for a victim of sudden illness or injury until more skillful medical treatment is available. I think it's what the first person does when an injured person is found. My kind of first aid can be as simple as remembering the number to 911, in other words don't freak out. In minor emergencies, first aid can prevent a victim's condition from worsening and provide relief from pain. First aid must be administered as soon as possible. In the case of the critically injured, a few minutes can make the difference between complete recovery and death. Knowing what to do in an emergency is as important as knowing what not to do. Moving a person with a neck injury, for example, can lead to permanent spinal cord injury and paralysis.
In spite of the variety of injuries possible, several principles of first aid apply to all emergencies. The very first step is to call for professional medical help, if that is possible. Establish what dangers may still be present at the scene of the accident or injury before beginning to provide first aid. The victim, if conscious, should be reassured that medical aid has been summoned, and ask for permission to provide any first aid. If we are talking about a family member that last step would be rather stupid, but if you are trying to assist a total stranger it is absolutely necessary. Next, ask any bystanders or the injured person's family or friends about details of the injury or illness. Ask about any care that may have already been given, and about any preexisting conditions such as diabetes or heart trouble. The victim should be checked for a medical bracelet or card that describes special medical conditions. Don't move the victim unless the accident scene becomes unsafe or the victim may suffer further injury.
One method for evaluating a victim's condition is known by the acronym "ABCs", which stands for:
A Airway: is it open and unobstructed?
B Breathing: is the person breathing? Look, listen, and feel for breathing.
C Circulation: is there a pulse? Is the person bleeding externally? Check skin color and temperature for additional indications of circulation problems.
The injured person's head should be kept in a neutral position in line with the body. If you determine there is no skull or spinal cord injury, move the injured person into a more comfortable position. If you suspect it may be necessary position the person on one side so the victim can vomit without choking or obstructing the their airway.
Shock
Before treating specific injuries, protect the victim from shock. Shock occurs when blood pressure drops and the organs do not receive enough blood, depriving them of oxygen. Heart failure, injury, burns, and hemorrhage can cause shock. The symptoms of shock to watch for include, anxiety or restlessness, pale cool clammy skin; a weak but rapid pulse; shallow breathing; bluish lips; and nausea, apathy, and weakness. During the early stages, consciousness is retained, but alertness is diminished. Sudden circulatory failure of the outer extremities, however, affects the brain and causes fainting. These symptoms may not be apparent immediately, as shock can develop several hours after an accident.
First aid for shock includes having the victim lie down, keeping him or her warm but not overheated, stopping any bleeding, and, if the person is not breathing, administering artificial respiration. The victim's feet should be elevated. Because of the danger of abdominal injuries, nothing should be administered by mouth.
Cardiopulmonary Arrest
Cardiopulmonary resuscitation (CPR) is used to restore the heartbeat in a victim whose heart has stopped, a condition known as cardiac arrest or cardiopulmonary Arrest. Symptoms of this extremely life threatening condition may include crushing pain or pressure behind the breastbone; pain in the arms, neck, or shoulder; anxiety and a feeling of impending doom; difficulty breathing; heavy perspiration; weakness; nausea; and loss of consciousness. CPR combines the techniques of artificial respiration with the application of external heart massage to keep blood flowing through the victim's body.
First aid for Cardiopulmonary Arrest: The first-aid provider positions the victim face up on a firm surface and clears the airway of any obstructions. To maintain an open airway, the head is tilted back and the chin lifted forward. The provider then gives the victim two breaths by mouth or mask. If no pulse is detected at the carotid artery (located in groove beside windpipe in the neck), the first-aid provider kneels next to victim, placing the heel of one hand on top of the other over the lower half of the sternum. The provider depresses the chest about 2 inches, forcing blood from the heart through the victim's arteries. When the pressure is released, blood flows into the heart and the cycle is repeated. The first-aid provider applies the pressure in short, rhythmic thrusts about 15 times every ten seconds. This cycle of two breaths followed by 15 chest compressions is repeated until the victim revives or professional medical help arrives. This is hard work and you will need help as soon as possible.
Artificial Respiration / Asphyxiation
Asphyxiation occurs when air cannot reach the lungs, cutting off the supply of oxygen to circulating blood. If left untreated this can cause irreparable damage to the brain. Some of the causes of asphyxiation are drowning, gas poisoning, overdose of narcotics, electrocution, choking, and strangulation. Victims may collapse, be unable to speak or breathe, and have bluish skin. Most people will suffer brain death within 4 to 6 minutes after breathing ceases unless first aid is administered. For victims of asphyxiation, the most practical method of first aid is artificial respiration. In cases of drowning, artificial respiration should be attempted even if the victim appears dead. People submerged in cold water for more than 30 minutes who appeared blue have responded to first-aid efforts and recovered with no brain damage. Artificial respiration is the mouth-to-mouth technique in which the first-aid provider forcefully exhales air into the victim's lungs after the victim stops breathing on their own.
First aid Asphyxiation: The provider tilts the victim's head backward by placing one hand under the victim's chin and lifting while the other hand presses down on the victim's forehead. At this point, the mouth and airway can be checked for foreign objects, which can be removed with the fingers. To begin mouth-to-mouth resuscitation, gently pinch the victim's nostrils together to prevent air from escaping out the nose. Take normal breaths, seal the victim's mouth with a pocket mask or mouth, and exhale into the mouth. When performed properly the victim's chest should rise visibly. The provider then listens for the victim to exhale; if using a pocket mask, it need not be removed. This process is repeated at a rate of about 12 times per minute (one breath every five seconds) for adults and about 20 times per minute for children, using less pressure and volume for children. Once beginning artificial respiration, the first-aid provider should continue until the victim begins to breathe or medical help arrives
Bleeding
The best way to stop bleeding from a medium-sized blood vessel is by applying direct pressure at the site of the wound. This pressure will flatten the injured blood vessel slowing the flow of blood to make clotting possible.
First aid for bleeding: Cover the wound with a clean dressing, elevate the wound, and pressure should be applied over it with the fingers for 5 to 15 minutes, until the bleeding stops. If there is a foreign body in the wound, pressure should be applied to one side, do not remove the object. If bleeding continues, new bandages should be added, but do not remove the saturated one; removing the first bandage may disrupt clots in the process of forming. Once the bleeding has stopped, secure the dressing in place with tape or some other means to minimize chances of renewed bleeding.
Severe Bleeding
The presence of blood over a large area of a person's body does not always indicate severe bleeding. The blood may ooze from multiple small wounds or be smeared, giving the appearance of more blood than is actually present. The rate at which blood is lost from a wound depends on the size and kind of blood vessel ruptured. Bright red, spurting blood indicates injury to an artery while welling or steadily flowing, dark red blood indicates injury to a vein.
Welling or spurting blood is an unmistakable sign of severe bleeding. If a major artery ruptures, a person may bleed to death within a minute. Injuries to veins and minor arteries bleed more slowly but may also be fatal if left unattended. Shock usually results from loss of fluids, such as blood, and must be prevented as soon as the loss of blood has been stopped.
First aid for sever bleeding: To stop the bleeding, apply pressure directly over the wound and, when possible, elevate the bleeding body part. The first-aid provider should use bandages to hold a sterile dressing or clean cloth firmly over the wound. Dressings that become saturated with blood should not be removed but should be reinforced with additional layers.
Bleeding normally stops through the process of coagulation, or clotting of the blood, and methods used to stop hemorrhage depend on slowing the flow of blood sufficiently for a clot to form. The hemorrhage is most effectively stopped by the application of pressure directly over the wound. A tourniquet should never be applied if there is another way to stop the bleeding, as application of a tourniquet increases the likelihood that amputation will be required.
Pressure Points
If an arm or leg wound bleeds rapidly and cannot be controlled by direct pressure, dressings, and bandages, the first-aid provider can apply pressure to the artery at a point adjacent to the wound called the pressure point. Arteries pass close to the skin at these points and can be compressed against underlying bone to stop arterial bleeding. The pressure point for the femoral artery, which supplies blood to the leg, is located on the front center of the leg's hinge, the crease of the groin area where the artery crosses the pelvic bone. The pressure point for the brachial artery, which supplies blood to the arm, is located halfway between the elbow and armpit on the inner side of the arm.
Tourniquet
A tourniquet is a first-aid device used for stopping external bleeding by squeezing the "pressure point" nearest the wound, but lying between the wound and the heart. The use of a tourniquet is dangerous; it should be used only when the bleeding is life threatening and cannot be controlled by any other method.
The device is usually made from a piece of strong bandaging material that is wrapped around the pressure point and twisted by means of a stick. A tourniquet can also be fashioned by the use of a leather belt, or a piece of ½ inch rope. Instead of the stick mentioned above, you can use a large screwdriver. In the absence of familiarity with the pressure points of the body, the tourniquet should be applied to any portion of the injured limb but always between the site of the wound and the heart. Never apply a tourniquet around a victim's neck. Remember application of a tourniquet increases the likelihood that amputation will be required.
Burns
A burn is an injury to the skin caused by exposure to fire, hot liquids or metals, radiation, chemicals, electricity, or the sun's ultraviolet rays. Burns are classified according to the depth of tissue damage and extent of the burn. A first-degree, or superficial, burn, which involves only the surface of the skin, is characterized by reddening. A second-degree burn extends beneath skin surface and causes blistering and severe pain while a third-degree burn causes charring and destruction of the cell-producing layer of skin. The severity of a burn depends also on the area involved, expressed as a percentage of the total body surface area. Severe burnscause shock and loss of body fluids. A person suffering third-degree burns over more than 10 percent of body surface area should be hospitalized as soon as possible.
First aid for burns: Remove the source of the burn as soon as possible. The burn should be cooled immediately with cold clean water. A clean, cold wet towel or dressing can be placed on less serious burns to ease pain and protect the burn from contamination. Continuously bathe chemical burns with running water for at least 20 minutes to dilute the substance. If a chemical powder causes the burn, it should be carefully brushed off with gloved or protected hands before washing. Wet dressings or ointments should never be used for sever burns. Instead, the first-aid provider should gently apply dry, sterile dressings held in place by bandages and seek immediate medical attention.
Heimlich maneuver
In the case of choking, a procedure known as the Heimlich maneuver can be used to clear the windpipe of food or other objects. In this procedure quick upward thrusts are applied to the victim's abdomen to eject the object blocking the windpipe.
The first-aid provider stands behind the victim with both arms around the victim's waist. One fist is placed slightly above the navel and below the rib cage with the thumb against the victim's body. The other hand is used to hold the fist and apply pressure. The abdomen is then pressed quickly inward and upward, forcing air from the lungs to eject the object from the windpipe. If the victim is too large to hold while standing, or becomes unconscious, the maneuver can be accomplished by laying the person down face up and using the heel of one hand in the same manner as above. The person performing the maneuver must be careful not to apply pressure on the rib cage to avoid breaking ribs, especially in children and the elderly. For obese orpregnant choking victims, the provider's hands should be placed over the lower half of the sternum (breastbone) and pressure applied as described above.
Fainting
Fainting, a sudden, temporary loss of consciousness occurs when the brain does not receive enough blood. Just before fainting, a person's skin may appear pale and clammy or sweaty.
First aid for fainting: Restore blood flow to the brain, a first-aid provider should elevate the unconscious person's feet or position the individual's head below the level of the heart. The victim's airway and breathing should be closely monitored. A fainting victim must also be kept warm to prevent shock. If the victim does not fully recover after five minutes, medical help should be requested.
Seizures
Seizures, sudden brief episodes of intense neurological activity, may result from a variety of causes, including epilepsy, a neurological disorder, and head injuries.
First aid for seizures: consists of protecting the victim from accidental injury during the seizure. The first-aid provider should not put any objects in a seizing person's mouth or try to hold the tongue. If the victim has medical identification indicating epilepsy, an ambulance need not be called unless the person experiences multiple seizures or one seizure lasts more than five minutes. Otherwise, once the seizure stops, question the person about the need for a hospital evaluation. If no medicalidentification exists the first-aid provider should request medical assistance.
Coma
A deep state of unconsciousness due to illness or injury is known as a coma. Comatose individuals cannot be awakened. Heart failure, stroke, epilepsy, diabetes, or traumatic brain injury can cause comas and a medical alert tag on the victim may identify a possible cause of the coma.
First aid for coma: If the person is breathing, first aid is limited to providing comfort until medical assistance arrives. If the victim is not breathing, the first-aid provider should administer mouth-to-mouth or mask-to-mouth resuscitation.
Poisoning
One of the mainstays of the treatment of accidental poisoning is the local or regional poison control center. Approximately 85 percent of cases of poisoning are handled in the home after telephone consultation with a center. Poisons include toxic medications, herbicides, insecticides, noxious gases, household disinfectants, and various rat poisons.
First aid for poisoning: In a case of poisoning, the first-aid provider should remove the victim from a toxic environment, then contact the poison control center listed in most United States phone books. If the number is unavailable, the provider should call a physician or hospital emergency department. If possible, the provider should try to identify the poison, either by questioning the victim or searching for suspicious containers. Containers of many poisonous substances list the antidote, or remedy, on the label. Burns or stains on the skin or a characteristic odor on the breath may also help the first-aid provider recognize the poison.
Various treatments counteract the effect of a poison. In most cases the use of dilution is advisable, that is, the ingestion of large quantities of water or milk. In other cases it is advisable to use an emetic, a substance that induces vomiting and rids the stomach of certain poisons. An emetic may act locally, as on the gastric nerves, or systematically on the part of the brain that causes the vomiting. Household emetics, which act locally, include a tablespoon of salt dissolved in warm water or two tablespoons of mustard dissolved in a pint of water.
Emetics must not be given to a person who has swallowed a corrosive poison. An antidote, unlike an emetic, is a remedy that counteracts the effects of a poison chemically, although it may result indirectly in vomiting. An antidote may work against a poison by neutralizing it, rendering it insoluble, absorbing it, isolating it, or producing an opposite physiological effect generally. In any instance of poisoning, it is imperative that remedial treatment be started immediately.
Unless instructed to do so by the poison control center, the first-aid provider should never give a poisoning victim anything to eat or drink. Vomiting should not be induced unless the poison control center recommends it. If the victim vomits, the first-aid provider should turn the individual on the side and clear the airway. Before clearing the victim's mouth of any obstructions, however for self-protection, the provider should first put on clean first-aid gloves or wrap a cloth around his or her fingers. If the person who ingested the poison is unconscious, the airway, breathing, and circulation should be checked and CPR started if necessary.
Drug Overdose
A drug overdose occurs when an individual takes too large a dose of a drug or takes a dose that is stronger than the person can tolerate. A drug overdose can be difficult to diagnose because the signs and symptoms vary widely and often mimic other illnesses or injuries. Symptoms of a drug overdose include unusually dilated or contracted pupils, vomiting, difficulty in breathing, hallucinations, and in severe cases unconsciousness and slow, deep breathing. If an overdose is not treated, the individual may die. Victims of overdose should be taken immediately to a hospital emergency room.
Electric Shock
Contact with electrical current is potentially fatal. Electricity passing through the body can cause injury to the skin and internal organs. If electricity passes through the heart, the heart muscle may be damaged and the heart's rhythm interrupted, leading to cardiac arrest. The signs and symptoms of electric shock include tingling, burns on the skin where the current entered or exited, muscle pain, headache, loss of consciousness, irregular breathing or lack of breathing, and cardiac arrest. The severity of the injury depends on the strength of the electric current and the path the current takes through the body.
First aid for electric shock: The person providing first aid to a victim of electric shock should not touch the individual's body until the source of the shock is turned off. Because of the potential for internal injuries, victims of electrical injury should not be moved unless they are in immediate danger. The first-aid provider should monitor the victim for symptoms of shock. If the victim has stopped breathing and has no pulse, CPR should be performed after the airway, breathing, and circulation have been checked. When the victim's vital signs are stable, the siteof the burn should be treated using the same methods used for other burns.
Animal Bites/Stings
Animals such as snakes, dogs, cats, rodents, certain insects, and spiders may bite humans with dangerous consequences. Many snakebites are caused by non-venomous or nonpoisonous snakes and do not require treatment beyond cleaning the wound. Bites inflicted by venomous snakes require immediate first-aid measures. The victim should be taken as soon as possible to the nearest emergency medical facility. The first-aid provider should not do the following, cut the area around the bite, and attempt to suck out the venom, or apply ice to the wound.
First aid for snake bites: The focus of first aid should be to prevent the venom from spreading rapidly through the individual's bloodstream. The victim should be kept quiet to avoid stimulating circulation of the venom. In addition, the bite area should be kept at a lower level than the rest of the body. The wound should be washed thoroughly with soap and water, blotted dry, and loosely covered with a sterile dressing.
Bites from other animals should be thoroughly washed, treated with an antibiotic ointment, and bandaged. The victim should seek medical attention if the bite is severe, if an animal that is suspected of having rabies inflicted the bite, or if the bite becomes infected. Bites from other humans are particularly prone to serious bacterial infection and should be treated by a medical professional. Victims of any animal or human bite whose immunizations are not current may need a shot for tetanus, an often-fatal infectious disease affecting the muscles of the neck and jaw.
Biting insects include fleas, mosquitoes, bedbugs, lice, chiggers, and gnats to name just a few. Bites from these insects should be washed to prevent infection, and cold compresses or topical medications applied to alleviate itching and pain. Bites from some species of ticks can cause serious illnesses including Lyme disease and Rocky Mountain spotted fever. Carefully checking the body and removing ticks after spending time in wooded areas is currently the most effective form of prevention. Insect repellent can be an effective deterrent. When a tick bites a person, it may attach itself to the body by burrowing into the skin. As a result, a tick should be removed by carefully pulling it straight out with tweezers so as not to leave its head behind. The tick should not be squeezed when it is removed. Bites from most spiders can be treated like those of other biting insects. Bites from black widow spiders, tarantulas, scorpions, and other poisonous spiders require medical help. They are treated similarly to poisonous snakebites.
Head Injuries
Injuries to the head may involve the scalp, skull, or brain. If the victim has a head wound that seriously damages or penetrates the scull, the first-aid provider should not apply pressure to it, as this may damage the brain. The victim's airway should be kept clear from obstructions, such as vomit, which is common in cases of head injury. If the victim has a seizure, a sudden spasm of the body, the head must be protected with cushions to prevent further injury. A physician should evaluate all individuals with head injuries. Bleeding from a head wound often appears to be much worse than it is.
Eye Injuries
Medical attention should be sought for all eye injuries as well. In the case of foreign material in the eye, especially caustic substances, or those that can burn, corrode, or dissolve tissues, the eye should be flushed immediately with a cool, sterile saline solution, if available, or plain tap water for 15 to 30 minutes. Hold the affected eye open during the flushing process. The first-aid provider should never attempt to remove embedded objects from the eye. If there is an embedded object in the eye and flushing with water did not remove it, lightly bandage both eyes this will help immobilize the injured eye by preventing the victim from looking around, reducing the possibility of further damage. Eye injuries are very painful; a tiny grain of sand feels like a bolder!
Nose Injuries
The most common injuries to the nose involve nosebleeds, objects lodged in the nasal passages, and broken nasal bones. The victim of a simple nosebleed should sit down, lean forward, and gently pinch together the soft part of the nose for 15 minutes. A cold compress can also be placed on the bridge of the nose. If material lodged in the nose cannot be forced out by gently blowing the nose, the victim should request medical help. In the case of a broken nose, the first-aid provider should apply a cold compress to the bridge of the nose and seek medical attention.
Sprains and Fractures
A sprain, the painful stretching or tearing of ligaments, occurs when a bone is suddenly wrenched at the joint. A fracture, a break or crack in a bone, is caused by sudden, violent pressure against the bone. Great pain and swelling characterize both a sprain and a fracture, but the inability to move the affected part, a deformed appearance, and pain or tenderness at a specific point usually indicates a fracture. A first-aid provider should treat sprains and fractures in the same way since it can be difficult to diagnose a fracture without an X ray of the affected bone.
Because the slightest movement of the affected part may cause the injured person great pain and increase the damage, no attempt should be made to straighten or move sprained or broken limbs until medical help arrives. If the injured person must be transported to a hospital, rigid splints should be used to immobilize the broken part and adjacent joints or bones. Splints can be improvised from light, smooth boards or folded cardboard and tied to the broken part with wide strips of cloth or improvised material.
If a person is found with the head or body in an unnatural position, a fracture of the spinal column may have occurred. Other signs of a broken spinal column are severe pain in the back or neck and lack of movement of the lower extremities. The first-aid provider should not attempt to straighten or move the injured person's body as this may cause permanent paralysis or death. If the victim must be transported, his or her body should be immobilized by placing it on a flat board. However, moving such a victim should not be attempted without prior training.
Bruising
Bruising is an injury in which tiny blood vessels beneath the skin are ruptured, but the skin itself is not broken. The affected area swells and turns shades of blue, red, and purple as blood from the broken blood vessels seeps into the tissues. During the healing process, the color of a bruise will gradually change to yellow as hemoglobin, the pigment in red blood cells, is broken down and reabsorbed into the bloodstream. When absorption is complete, the bruise disappears without a trace.
First aid for bruising: Applying either ice or a cold wet clothe to the affected area immediately after the injury may reduce discoloration, swelling, and pain. Because they may indicate more serious underlying conditions, three kinds of bruises warrant examination by a physician:
1. Those that are very large and very painful.
2. Those that do not result from contact with hard objects and have no obvious cause.
3. Those that fail to disappear completely within one or two weeks.
A severe black eye may be accompanied by damage to the eyeball and optic nerves, and should receive professional attention if the patient experiences abnormal vision.
Heat Exhaustion
Heat Exhaustion or heat prostration, a condition usually produced by overexertion in hot temperatures. During heavy exertion the body perspires and sweat evaporates to cool the skin and helps prevent the body temperature from rising. Perspiration causes the loss of fluids and salts normally replaced by regularly consuming liquids and food. However, if prolonged, excessive sweating occurs, fluids and salts are not replaced rapidly enough. This causes blood circulation to diminish, affecting the brain, heart, and lungs, and heat exhaustion results.
Symptoms of heat exhaustion include heavy sweating; pale, clammy skin; dilated pupils; a slightly elevated body temperature; and cramps, weakness, dizziness, nausea, vomiting, headache, mental confusion, and sometimes unconsciousness.
First aid for heat exhaustion: Remove the affected person from the source of heat to a cool place, preferably near a fan or air conditioner. Elevate the person's legs to improve blood circulation to the brain; loosen clothing; and cool the body with wet compresses or ice packs, but not an alcoholic rub. Massage the arms and legs if cramping occurs. If the person is responsive to conversation and not nauseated, give electrolyte beverages or water that is slightly salty. If neither of these are immediately available, give cool water alone. However, do not give the person alcohol or caffeine, which interfere with the body's ability to regulate temperature, and do not administer any medication to reduce body temperature. Also, stop the person from cooling too quickly to prevent shock from setting in. A person who experiences heat exhaustion should be checked by a doctor after several hours of rest, and should not engage in strenuous activities for one or two days.
Heatstroke
Heatstroke is the response to extreme heat characterized by high body temperature and disturbance of the sweating mechanism; it is called sunstroke if caused by long exposure to sun. In heatstroke the skin is hot, red, and dry; the pulse is strong and rapid; the victim may be unconscious; and the body temperature is about 106° F or higher. Prior to unconsciousness the person may experience dizziness, fainting, tingling, and mental confusion. If untreated, heatstroke is often fatal, because prolonged fever can cause brain damage, shock, or heart or kidney failure, especially in persons with underlying disease.
Heatstroke is a result of excessive sweating during which the body's salts are depleted. The control of heat regulation by the central nervous system is disturbed, and sweating ceases. This leads to the hot, dry skin characteristic of the condition. Children and the elderly are more susceptible than others because their temperature regulating system is less responsive to change. People suffering from obesity are also at greater risk because their bodies dissipate heat with decreased efficiency.
First aid for heatstroke: First aid must be immediate and consist of measures to bring the temperature below at least 102° F. This is accomplished by rubbing the victim's skin with cold water or alcohol. If a cold bath is available, it should be used, but an ice bath is not advisable. When the body temperature reaches 102° F, cooling should proceed more slowly. If the temperature rises again, cooling procedures should be repeated.
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