Basic First Aid
Accidents happen anywhere and anytime. The first response to an accident is the most important. Often times, first aid given at the scene can improve the victim's chances of survival and a good recovery. The right response is better than an incorrect quick one. Any response, even if it is wrong, is better than none at all.
If the victim is unconscious, perform rescue breathing. (Rescue breathing is explained later on in this section.) If the victim's heart has stopped beating, perform cardiopulmonary recessitation (CPR) if you have been properly trained to do so.
Shock usually accompanies severe injury or emotional upset. The signs are cold and clammy skin, pale face, chills, confusion, frequent nausea or vomiting and shallow breathing. Until emergency help arrives, have the victim lie down with the legs elevated. Keep the victim covered to prevent chilling or loss of body heat. Give non-alcoholic fluids if the victim is able to swallow and has not sustained an abdominal injury.
Until emergency help arrives, try to control any bleeding. If possible, first put on rubber or latex gloves before touching any blood. If these are not available, a clean plastic bag can be used to cover your hands. It is important not to come in contact with blood because of the health risks.
If finger or hand pressure is inadequate to control bleeding, place a thick pad of clean cloth or bandage directly over the wound, and hold in place with a belt, bandage, neckties or cloth strips. Take care not to stop the circulation to the rest of the limb. For injuries where a tie cannot be used, such as to the groin, back, chest, head and neck, place a thick pad of clean cloth or bandage directly over the wound and control the bleeding with finger or hand pressure. If bones are not broken, raise the bleeding part higher than the rest of the body. If the injury is extensive, the victim may go into shock and should be treated for it.
As a last resort, a tourniquet can be applied to stop bleeding. There is a risk of sacrificing a limb to save a life. A tourniquet is a wide band of cloth or other material tightly placed just above the wound to stop all flow of blood. A tourniquet crushes the tissue and can cause permanent damage to nerves and blood vessels. Once in place, a tourniquet must be left there until a physician removes it. The victim must be taken to medical help as soon as possible.
Until medical help arrives, immerse the burned area immediately in tap or cool water or apply clean, cool, moist towels. Do not use ice because it may cause further damage to the burned area. Maintain this treatment until the pain or burning stops. Avoid breaking any blisters that may appear. Do not use ointments, greases or powders.
For more severe burns or chemical burns, keep the victim quiet and treat them for shock. Remove any clothing. If the clothing sticks to the burned area, leave it there. For exposure to chemicals, flush the skin with plenty of water, but only cover the exposed area with a clean bandage if the chemical has caused a burn. If the burn victim is conscious, can swallow and does not have severe mouth burns, give plenty of water or other non-alcoholic liquids to drink. Get the victim to a physician or hospital as soon as possible.
For fractured limbs, take the following precautions until emergency help arrives. Place the injured part in as natural a position as possible without causing discomfort to the patient. If the patient must be moved to a medical facility, protect the injured part from further injury by applying splints long enough to extend well beyond the joints above and below the fracture. Use firm material, such as a board, pole or metal rod, as a splint. Pad the splints with clothing or other soft material o prevent skin injury. Fasten splints with a bandage or cloth at the break and at points along the splint above and below the break. Use a pressure bandage to control any bleeding.
For very serious fractures involving injuries to the body, neck or back, observe the following: Do not move the victim without medical supervision, unless absolutely necessary, and then only if the proper splints have been applied. If a victim with a suspected neck or back injury must be moved, keep the back, head and neck in a straight line, preventing them from being twisted or bent during movement. Use a board or stretcher to support the victim, if available.
Take special care when helping a spinal injury victim. All damage to the spinal cord is permanent, because nerve tissue cannot heal itself. The result of nerve damage is paralysis or death.
Do not move the limbs or body of a victim with a suspected spinal injury unless the accident scene is such that there is imminent danger of further injury or unless it is necessary to establish breathing. The victim's body should be stabilized to prevent any movement of the head, neck or body. Be aware that any movement of a victim with spinal injury may result in paralysis or death.
If the victim must be moved, keep the neck and torso of the body as straight as possible and pull in a direction that keeps the victim's spine in a straight line. Pull the body from the feet or shoulders (using both feet, both shoulders, or both arms pulled over the shoulders). It is also possible to pull the victim by the clothing. Grab the victim by the collar of the shirt and support the victim's head with your forearms while pulling. The clothes drag is preferred because the victim's head s supported while being moved. Do not pull the body sideways.
When providing patient care, it may be necessary to roll the victim over on his or her back to clear an airway or evaluate breathing. When rolling the victim over, the head, neck and torso should be moved together so that no twisting occurs.
When breathing movements stop or lips, tongue and fingernails become blue, a person needs immediate help. When in doubt, apply rescue breathing until medical help arrives. Delay of rescue breathing may cost the victim's life. Start immediately. Seconds can count.
The American Red Cross teaches the following 10 steps to assist an adult who has stopped breathing.
For infants and small children, follow the first five steps listed above. On the sixth step cover the child's mouth and nose in a tight seal and give two small breaths. Check for pulse and call for help. Begin rescue breathing, giving one small breath every three seconds for an infant and one every four seconds for a child.
Choking occurs when food or a foreign object obstructs the throat and interferes with normal breathing. The following steps are advised if the choking victim is unable to speak or cough forcefully.
For adults and children over one year of age:
For infants less than one year old:
Dawna L. Cyr and Steven B. Johnson, Ph.D.
University of Maine