First Aid Overview

Assessing the victim is the first step in administering first aid. Before you can know what type of care you need to give, you must first determine exactly what is wrong with the patient. Follow these steps to assess the victim:

Assessing a Conscious Victim:

1. Approach victim, and tell victim not to move. Identify yourself, and ask if you can help.
   
   
2. If victim says "yes," ask what happened, whether victim is having trouble breathing, and if and where they have pain. Based on responses, determine if EMS should be called. If unsure, call for EMS. If victim is choking, see Choking.
   
   
3. Check victim's head, neck, arms, legs, chest, and stomach for injuries. Look for bleeding, bruising, swelling, or other obvious injury. Feel as best you can for any bumps or irregularities on the arms or legs, but DO NOT touch or move any area that is painful. Be sure to tell the victim what you are going to do before you do it.
   
   

   Check the victim’s arms and legs for any irregularities, but do not touch any area that is causing the victim pain.

4. If you suspect a neck or back injury, DO NOT move victim or allow victim to move (see Back or Neck Injury). If no back or neck injury suspected, have victim rest in a position that is comfortable for them. If victim is bleeding, control bleeding (see Bleeding).
   
   
5. Monitor victim's breathing, and stay with them until EMS arrives.

Assessing an Unconscious Victim:

1. Approach victim, gently tap victim's shoulder, and ask if they are OK. If victim responds, go to the steps for a conscious victim.
   
   
2. If no response and victim is an adult, call for EMS. If victim is a child, give care (see ABCs) for one minute before calling for EMS. If someone else is near, have them call for EMS.
   
   
3. Check airway, breathing, and circulation (see ABCs).
   
   
4. Check and care for bleeding (see Bleeding).
   
   
5. If back or neck injury suspected, see Back or Neck Injury. If no back or neck injury suspected, put victim in Recovery Position:
   
   

   The first step in placing the victim in Recovery Position is to place victim’s far arm above their head.

   
   -Extend the victim's arm that is farther from you above the victim's head.
   
   -Position the victim's other arm across the chest.
   
   -Bend the victim's nearer leg at the knee.
   
   -Support back of victim's head with one hand and push on victim's knee with other as you roll victim away from you onto their side.
   
   -If victim vomits, wear glove and use your fingers to clear victim's mouth. DO NOT place fingers into mouth if victim is having a seizure.
   ­
   
6. Monitor breathing, observe for shock (see Shock), and wait for EMS.

To learn more about first aid and emergency care, see:

• How CPR Works
• How Emergency Rooms Work

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If a victim is unconscious, your first priority is to check that their Airway is open, that they are Breathing, and that they have a pulse or other signs of Circulation, such as movement, groaning, or coughing -- these are the ABCs of emergency first-aid.

Check that the airway is open, the victim is breathing and that there are signs of circulation. ­

Check Airway

1. If victim is facedown, gently roll victim onto their back. Place one hand on the back of victim's neck and other on hip, and gently roll victim over onto back. If back or neck injury suspected, enlist aid of others to keep victim's head, neck, and back aligned as you roll victim over.

   Ask others for help if you cannot roll the victim over by yourself.

2. Open victim's airway using head-tilt (even if you suspect back or neck injury):
   

   Use a head-tilt to open the airway.

   -Kneel by victim's side, place one of your hands on victim's forehead, and gently tilt victim's head back.
   
   -Place fingers of your other hand on bony part of victim's chin -- not on throat.
   
   -Gently lift chin straight up without closing mouth.

Check for Breathing and Circulation

1. With victim's airway open, look, listen, and feel for breathing for 5-10 seconds by placing your cheek near victim's mouth and watching for chest to rise and fall.

   Check for signs of breathing.

2. Check for signs of circulation, such as movement, groaning, or coughing.
   
   
3. If victim is not breathing but has signs of circulation, go to rescue breathing. If victim is not breathing and has no signs of circulation, go to CPR.

Rescue Breathing

If adult stops breathing but still has signs of circulation, call for EMS, then begin Rescue Breathing.

If child or infant stops breathing but has signs of circulation, perform Rescue Breathing for 2 minutes before calling for EMS. Then resume Rescue Breathing.

Emergency Treatment, Infant:

Cover the infants nose and mouth with your mouth and give two short puffs.

1. Place your mouth over infant's nose and mouth.
   
   
2. Give 2 gentle puffs.
   
   
3. If no exchange of air, reposition infant's head and retry.
   
   
4. Look, listen, and feel for breathing and circulation (see ABCs) for no more than 10 seconds.
   
   
5. If victim remains unconscious and:
   ­
   -if there are signs of circulation but no breathing, continue giving 1 breath every 5 seconds for child and 1 gentle puff every 3 seconds for infant.
   
   -if there is no breathing or signs of circulation, go to CPR.

Emergency Treatment, Child or Adult:

Look, listen and feel for breathing.

1. Pinch victim's nose closed with your fingers, and place your mouth over their mouth.
   
   
2. Give 2 full, slow breaths, each lasting 1 to 1.5 seconds.
   
   
3. After each breath, pull your mouth away and allow victim's lungs to deflate.
   
   
4. If no exchange of air, reposition victim's head and retry.
   
   
5. Look, listen, and feel for breathing and circulation (see ABCs) for no more than 10 seconds.
   
   
6. If victim remains unconscious and:
   
   -if there are signs of circulation but no breathing, continue giving 1 breath every 5 seconds for adult
   
   -if there is no breathing or signs of circulation, go to CPR.

To learn more about first aid and emergency care, see:

• How CPR Works
• How Emergency Rooms Work

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If an adult is not breathing and has no signs of circulation, call for EMS if this has not already been done. Then begin CPR.

If a child or infant is not breathing and has no signs of circulation, give CPR for 2 minutes before calling EMS (if this has not already been done). Then resume CPR.

Child or Adult:

1. Place your hand on the breastbone midway between the nipples.
   
   
2. Use the heel of just one hand for a child, and place other hand on child's forehead. For adult, place other hand on top of hand that is positioned on breastbone.

   Place your hand on the breastbone midway between the nipples.

3. Align your shoulder(s) above your hand(s) and straighten your elbow(s), using the weight of your upper body to do chest compression.

   Use the weight of your upper body to help you compress.

4. Perform 30 compressions at a rate of 100 per minute. Count aloud at a steady and fast pace to achieve this rate.
   
   -Child: Use one hand to give chest compressions, compressing the chest 1-1.5 inches each time.
   -Adult: Use both hands to give chest compressions, compressing the chest 1.5-2 inches each time.
   
   
5. With victim's head tilted back, pinch victim's nose, place your mouth over victim's mouth, and give 2 breaths for an adult or child.
   
   
6. Repeat Steps 4-5 five times. This should take about 2 minutes.
   
   
7. Recheck for signs of circulation and breathing. If victim does not have signs of circulation and does not begin breathing, continue CPR until the victim's signs of circulation and breathing return or until EMS arrives.

Infant:

1. Place two of your fingers on the breastbone just below the nipple line.

   Use only two fingers when utilizing CPR with an infant.

2. Place your other hand on the infant's forehead to keep the head tilted back and the airway open.
   
   
3. Using your two fingers, give 30 chest compressions, compressing the chest about .5 to 1 inch each time.

   Keep one hand on the infant's forehead to keep the airway open.

4. With the infant's head tilted back, cover the infant's mouth and nose with your mouth and give two gentle breaths.
   
   
5. Repeat Steps 3-4 about four more times, which should take about 2 minutes.
   
   
6. Recheck for signs of circulation and breathing. If infant does not have signs of circulation and does not begin breathing, continue CPR until EMS arrives.

To learn more about first aid and emergency care, see:

• How CPR Works
• How Emergency Rooms Work
• How Your Lungs Work
  

Allergic reactions can be mild, but severe allergies that cause anaphylaxis may require first aid.

Causes: A rapid, severe allergic reaction, or anaphylaxis, may occur when a person who is extremely sensitive to a particular substance, such as insect venom, comes in contact with it.

Symptoms: May include swollen lips, tongue, or ears; uneasiness or agitation; red face; hives; prickling and itching in throat and skin; throbbing or ringing in ears; sneezing; coughing; breathing difficulty; nausea or vomiting; dizziness; loss of bowel or bladder control; convulsions; weak, rapid pulse; cold, clammy skin; unrespon­siveness. Without immediate med­ical treatment, victim may die.

Emergency Treatment

1. Call for EMS at the first sign of allergic reaction.
   
   
2. Monitor ABCs (see ABCs).
   
   
3. Help a responsive victim use their emergency epinephrine kit.
   
   
4. Have victim lie down, and cover them lightly with a blanket. If shortness of breath occurs, have victim sit up.

To learn more about first aid and emergency care, see:

• How Allergies Work
• How to Live With Allergies
• Herbal Remedies for Allergies
• Home Remedies for Allergies
  

First aid for back and neck injuries can significantly prevent a patience from suffering paralysis or loss of movement.

Causes: Any severe blow, fall, or other accident may result in injury to the neck, back, or spinal cord.

Symptoms: Unconsciousness, breathing difficulty, pain, swelling, loss of sensation, or paralysis

Emergency Treatment

1. Seek medical assistance immediately. Call for EMS.
   
   Until EMS arrives:
   
   
2. DO NOT move victim unless absolutely necessary to save victim's life.
   
   
3. DO NOT bend or twist victim's neck or body. Careful handling is extremely important.
   
   
4. Check victim's breathing. If breathing stops, open airway (see ABCs) and begin rescue breathing (see rescue breathing). If victim must be moved to perform rescue breathing or to clean mouth of vomit, enlist help to keep victim's head, torso, and legs in straight line as you turn victim.
   
   
5. Maintain position in which victim was found, even if neck or back is bent, and immobilize head, neck, shoulders, and torso:
   
   -Roll up towels, blankets, jackets, or clothing, and place around head, neck, shoulders, and torso.
   

   Never move the victim

   -If victim is lying on their back or side, slide thin roll of cloth behind neck without moving head or neck.
   

   Keep rolls of cloth in pl­ace with heavy items or your hands.

   -Keep rolls of material in place with your hands or by surrounding with heavy books, rocks, or bricks.
   
   
6. Monitor victim's airway and breathing until EMS arrives.

To learn more about first aid and emergency care, see:

• How Emergency Rooms Work
• How CPR Works
• How MRI Work

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A bee sting generally causes local pain, irritation, and swelling. In a susceptible victim, however, a bee sting can lead to a serious allergic reaction, called anaphylaxis, within minutes.

Symptoms of Allergic Reaction: Swollen lips, tongue, or ears; uneasiness or agitation; red face; hives; prickling and itching throat and skin; throbbing or ring­ing in ears; sneezing; coughing; breathing difficulty; nausea or vom­iting; dizziness; loss of bladder or bowel control; convulsions; weak, rapid pulse; cold, clammy, pale skin; unresponsiveness. If vic­tim shows any of these symptoms, call for EMS, and see allergic reaction.

Treatment for Sting Without Allergic Reaction:

1. Carefully remove stinger by flicking it with your thumb and forefinger or scraping it out with the edge of a credit card. DO NOT squeeze stinger.
   
   
2. Wash area gently with soap and water.
   
   
3. Apply ice pack wrapped in clean cloth to area of sting.
   
   
4. Place stung area lower than level of heart to slow spread of venom.

Bites -- Animal or Human

Any bite that penetrates skin can introduce infectious organisms into the victim's bloodstream.

Symptoms: Bleeding, teeth marks or torn skin, redness, swelling, pain

Emergency Treatment

1. Call for EMS or transport victim to emergency room.
   
   Until medical assistance is available:
   
   
2. If bleeding is severe, see bleeding,external. Otherwise you can allow punctures to bleed to help remove bacteria.
   
   
3. Wash puncture wound with soap and water, and rinse for 10 min­utes. DO NOT clean a severely bleeding wound.
   
   
4. Apply sterile dressing or clean cloth, and secure with bandage.
   
   
5. If bite is from an unknown ani­mal, call animal control or police, so animal can be caught and examined for rabies. DO NOT attempt to catch animal yourself.
   
   
6. Observe for shock (see shock).

To learn more about first aid and emergency care, see:

• How Allergies Work
• Home Remedies for Bites and Stings
• Herbal Remedies for Bites and Stings

First aid for a bleeding victim is crucial. If you can slow or stop blood loss until the paramedics arrive, the patient's chances of surviving increase dramatically.

Causes: Various injuries, such as scrapes, cuts, puncture wounds, or amputations, can cause external bleeding. If an object is impaled in the skin, see impaled object.

Emergency Treatment:

1. Seek immediate medical attention for severe bleeding, cuts that are more than skin deep, cuts with ragged edges, cuts with deeply embedded dirt, impaled objects, or amputations. Call for EMS or transport victim to emergency room.
   
   Until medical assistance is available:
   

2. Control bleeding with direct pressure:
   
   -Cover wound with sterile dressing or clean cloth, diaper, or sanitary napkin.
   
   -Place your gloved hand over dressing, and press firmly.
   
   -Continue pressure until bleeding stops.
   
   -DO NOT remove dressing. If soaked through, add more material, and continue pressure.
   
   -If no broken bone suspected, elevate wound higher than level of heart. DO NOT move limb if you think it is broken.
   
   

   ­ Elevate area above the heart if it does not appear broken.

3. If bleeding does not slow after 5 minutes of direct pressure, have victim lie down, continue direct pressure on wound, and apply pressure to pressure point between wound and heart:
   
   -For wounds on arms, press on brachial artery: Use your fingers to apply pressure to inner side of victim's upper arm, between elbow and shoulder, in groove between muscles.
   
   -For wounds on legs, press on femoral artery in groin: Use heel of hand to apply pressure at middle of crease where thigh meets groin.
   
   -Release pressure point as soon as bleeding stops.
   
   
4. Once bleeding is controlled, secure original dressings with bandage.
   
   
5. Observe for shock (see shock).
   
   
6. To Recover Amputated Part: Wrap amputated part with dry gauze; DO NOT immerse in water or other liquid. Put wrapped appendage in sealed plastic bag or container. Place bag or container atop bed of ice -- DO NOT submerge. Send with victim, or transport immediately to emergency room.

Pressure Points

Causes: Can occur after direct blow or crushing injury to chest, abdomen, or torso or can result from disease-related damage to an internal organ, as in a bleeding ulcer

Symptoms: Bright red blood coughed up; bright or dark red blood in vomit; vomit that looks like coffee grounds; bright red blood or dark tar-like substance in feces; rigid, swollen, or bruised abdomen; weak, rapid, irregular breathing

Emergency Treatment

1. Check victim's breathing. If breathing stops, see rescue breathing.

   Check victim's breathing and watch for shock while waiting for EMS.

2. Seek medical assistance immediately. Call for EMS.
   
   Until EMS arrives:
   
   
3. Keep victim lying down on their side or sitting up if more comfortable for victim, and cover lightly with blanket.
   
   
4. Observe for shock (see shock).
   
   
5. DO NOT give food or drink.

To learn more about first aid and emergency care, see:

• How Emergency Rooms Work
• How Blood Works

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While some burns can be easily treated in the home, serious burns require immediate medical attention and first aid.

Causes: Contact with intense heat, chemicals, electricity, or radiation (including sunlight)

To apply emergency treatment, you must first determine the degree of the burn:

• First degree: red or discolored skin, mild swelling and pain
  
  
• Second degree: deeper burn, red skin and blistering, more severe swelling and pain
  
  
• Third degree: white or charred (black) skin, skin layers destroyed, lack of pain, bleeding

First- and Second-Degree Burns:

1. DO NOT burst blisters. DO NOT put pressure on burn area. DO NOT use antiseptic sprays, ointments, butter, or other home remedies.
   
   
2. Remove constricting clothing and jewelry.
   
   
3. Immerse burned area in cool (not ice) water for at least 10 minutes. For facial burns, apply clean towels soaked in cold water.
   
   
4. Cover burned area loosely with clean gauze or cloth.
   
   
5. Seek medical attention for burns on the face, genitals, hands, or feet.

Third-Degree, Chemical, or Electrical Burns:

1. Call for EMS
   
   Until EMS arrives:
   
   
2. DO NOT remove shreds of skin or burst blisters. DO NOT apply antiseptic spray, ointment, butter, or other home remedies. DO NOT remove adhered particles of clothing, but be sure all clothing is extinguished.
   
   
3. Remove constricting clothing and jewelry.
   
   
4. If burn is from a chemical, remove contaminated clothing and place victim under shower of cool water for at least 5 minutes.
   
   
5. Check airway, breathing, and circulation (see ABCs). If breathing stops, see rescue breathing. If no signs of circulation, see CPR.
   
   
6. Cool burned area with clean, cool water. However, do not cool more than 20 percent of an adult's body or 10 percent of a child's body at a time, due to the risk of hypothermia or shock.
   
   
7. Cover burned area lightly with sterile nonadhesive dressing or clean, dry towel.
   
   
8. Elevate burned area higher than level of heart. If burn is on face, keep victim sitting up.
   
   
9. Observe for shock (see shock).

To learn more about first aid and emergency care, see:

• Home Remedies for Burns
• How to Treat Burns With Aromatherapy
• Herbal Remedies for Burns

Chest pains can be the sign of a heart attack, and the following first aid measures should be immediately taken.

Symptoms: Pain or pressure in chest that can radiate to arms, back, neck, or jaw; sweating; dizziness; shortness of breath; changes in skin color; nausea

Emergency Treatment:

1. Have victim stop activity and sit in comfortable position.
   
   
2. Ask victim if you can help, if they have ever had this problem before, or if they are on medication for this problem.
   
   
3. Assist victim with medication if victim asks for it. Help victim take prescribed doses, but DO NOT suggest any medication to victim. Note what and how much medication victim took.
   
   
4. If pain lasts more than 5 minutes, goes away and comes back, or gets worse, call for EMS.
   
   
5. Stay with victim until EMS arrives. If victim becomes unconscious, check signs of circulation and breathing (see ABCs). See rescue breathing if victim is not breathing but has signs of circulation; see CPR if no signs of circulation or breathing.

To learn more about first aid and emergency care, see:

• How Your Heart Works
• Home Remedies for Heart Disease
• Herbal Remedies for Arteriosclerosis

While we all know the Heimlich maneuver is the prescribed first aid for a choking victim, if a patient is unconscious you need to take extra care. Follow these steps for administering first aid for someone who is choking.

Symptoms: Inability to breathe, speak, or cry out. If choking continues, victim becomes blue, convulsive, limp, and unconscious.

Infant, Conscious:

1. Observe breathing difficulties. If infant is coughing forcefully, help the infant sit up, and monitor breathing.
   
   
2. If infant can no longer cry, cough, or breathe, lay infant facedown on your forearm, with your hand on bony portion of infant's jaw to support head. Keep infant's head lower than torso and support your arm on your thigh.­

   If infant can no longer cry, cough, or breathe, lay the infant facedown on your forearm. Deliver five blows to the back between shoulder blades.

3. Use heel of other hand to deliver 5 forceful back blows between infant's shoulder blades.

   If infant is not responding, use 2 fingers to deliver 5 chest thrusts to middle of breastbone just below level of nipples.

4. If back blows fail to dislodge object, turn infant over: With infant still lying facedown on your forearm, lay your other forearm on infant's back. Gently turn infant over so that infant now rests faceup on your other forearm. Support infant's head with your hand, keeping head lower than torso.
   
   
5. Use 2 fingers to deliver 5 chest thrusts to middle of breastbone just below level of nipples.
   
   
6. Repeat steps 2-5 until object is expelled and infant starts to breathe or until infant becomes unconscious (go to Infant, Unconscious).
   
   
7. Once infant expels object and starts to breathe, have infant checked by doctor.

Infant, Unconscious:

1. Shout "Help," and have someone call for EMS.
   
   
2. Place infant on a flat surface and start CPR (see CPR).
   

   Place an unconscious infant on a hard surface.

3. Look inside the mouth when you open it to give breaths and remove any object, if seen.

4. Only if object is visible, use a hooking action with your pinky to remove it.

   Look for anything lodged in the airway. Use only your pinky to remove it.

Child or Adult, Conscious:

1. Ask victim, "Are you choking?" If victim can speak or is coughing or breathing, stay with victim and encourage them to keep coughing.
   
   
2. If victim cannot speak, cough, or breathe, state you can help them, and send someone to call for EMS as you perform the Heimlich maneuver:
   

   Begin the Heimlich maneuver while you wait for EMS.

3. Stand behind victim, with one foot between victim's feet for balance, and wrap your arms around victim's waist.
   
   
4. Make a fist with one hand. Place thumb side of fist against victim's stomach just above navel and well below lowest part of breastbone.
5. Grasp your fist with your other hand.
   
   
6. Press into victim's stomach with quick upward thrusts until object is expelled. Each thrust should be a separate attempt to get object out.
   
   
7. Repeat thrusts until EMS arrives, object is dislodged, or victim becomes unconscious (see Child or Adult, Unconscious).

Continue the Heimlich maneuver until EMS arrives or victim can breathe again.

Child or Adult, Unconscious:

1. Ease victim faceup onto floor, making sure victim's head does not strike floor.
   
   
2. Shout "Help!" Have someone call for EMS.
   
   
3. Start CPR (see CPR).
   

   Begin CPR if victim is not breathing.

   
   

   Continue CPR until help arrives.

4. Look inside the mouth when you open it to give breaths and remove any object, if seen.
   
   
   

Check to see if there is anything in the victim's airway and remove it.

To learn more about first aid and emergency care, see:

• How Your Lungs Work
• How CPR Works
• How Emergency Rooms Work

Because the eyes are so delicate, eye injuries can be especially difficult to deal with. The following instructions will help you administer first aid to a patient with an eye injury.

Causes: The eye can be injured by a chemical, foreign object, or direct blow.

Symptoms: Pain, redness, bleeding, tearing, sensitivity to light, swelling, and discoloration of area around eye.

Emergency Treatment

Impaled Object:

1. Call for EMS.
   
   
2. DO NOT allow victim to touch or rub eye. DO NOT attempt to remove object.
   
   
3. Cut hole in thick dressing or folded cloth. Place over BOTH eyes, with impaled object sticking out through hole.

   Use thick cloth or dressing and cut a hole for affected eye.

4. Position paper cup over injured eye and impaled object. DO NOT touch eye or impaled object.

   Put paper cup over affected eye.

5. Secure cup in place with bandage or scarf that covers BOTH eyes.
   
   
6. Keep victim still, and observe for shock (see shock).

Chemical in Eye:

1. Call for EMS.
   
   
2. DO NOT let victim rub or close eye.
   
   
3. Flood affected eye with clean, warm running water for at least 20 minutes.
   
   -­With gloved hands, hold eyelid open and pour water slowly over eyeball at inner corner, allowing water to run out of eye from outer corner. DO NOT allow water to run into unaffected eye.
   
   -Have victim roll eyeball as much as possible as you wash out eye.
   
   
4. DO NOT bandage eye.
   
   
5. Keep victim still, monitor victim's breathing (see ABCs), and observe for shock (see shock).

Foreign Object in Eye:

1. DO NOT allow victim to rub eye.
   
   
2. Gently pull upper eyelid outward and down over lower eyelid, and hold. This causes tears to flow, which may wash out foreign object.
   
   
3. If tears do not remove particle, cover both eyes and seek medical attention immediately.

Cut on Eyeball or Eyelid:

1. Eyeball: Cover both eyes with clean gauze or cloth; secure with bandage. DO NOT apply pressure or allow victim to touch eye. Eyelid: Control bleeding by gently pressing lid against bone surrounding eye.
   
   
2. Seek medical attention.

Black Eye:

1. Apply ice-cold compress, ice pack wrapped in thin towel, or ice cubes tied into cloth. If victim is wearing contact lenses, DO NOT attempt to remove them; allow medical professional to do so.
   
   
2. Seek medical attention.

To learn more about first aid and emergency care, see:

• How Vision Works
• How to Care for Your Eyes
• Home Remedies for Puffy Eyes

Fever is generally a symptom of infection or heat exposure.

Symptoms: Elevated temperature, pulse, and breathing rate; chills or hot flashes; flushed skin; headache, achiness. With high fever, seizure may occur.

Emergency Treatment

1. In most cases, fever is not seri­ous but can signal a serious prob­­­lem. The general rule: If fever is 103 degreesF or higher, lasts more than 72 hours, or recurs, contact a doctor within 24 hours.
   
   
2. DO NOT give medications unless directed by doctor. Give acetaminophen, NOT aspirin, to a child.
   
   
3. Until a doctor is contacted, have victim undress, then sponge victim's body with lukewarm water for 20 minutes.
   
   
4. Dry victim, and dress them in comfortably warm clothing.
   
   
5. Continue to take victim's temperature, and repeat these steps if necessary until fever is reduced or doctor is contacted.
   
   
6. Give plenty of cool water and other cold or frozen fluids to drink.
   

To learn more about first aid and emergency care, see:

• Home Remedies for Fevers
• Herbal Remedies for Fevers
• How to Treat a Child's Fever

A fracture is a break or crack in a bone that can be caused by an accident, fall, or blow. Symptoms include a snapping sound as bone breaks, bone protruding from skin, detectable deformity of bone, abnormal movement of bone, grating sensation during movement, pain and tenderness, difficulty in moving or using the affected part, swelling, and discoloration.

A sprain refers to stretched or torn tendons, ligaments, and blood vessels around a joint and can be caused by an accident, fall, or blow. Symptoms of a sprain include pain, tender­ness, swelling, and discoloration in the joint area.

A muscle strain refers to stretched or torn muscle. It can be caused by excessive physical effort or improper posture during activity. Symptoms include pain, stiffness, and possibly swelling in the affected area.
It is sometimes difficult to tell the difference between a fracture and a sprain or strain until an X-ray has been performed. If you cannot tell, treat it as a fracture.

Fracture:

1. SEEK MEDICAL ATTENTION IMMEDIATELY. Call for EMS, or transport victim to emergency room after immobilizing affected area. Wait for EMS and DO NOT attempt to transport victim if you suspect head, back, or neck injury; if there's a visible deformity of bone; or if the victim cannot be splinted or transported without causing more pain.
   
   
2. Suspect back or neck injury if victim is unconscious or has head injury, neck pain, or tingling in arms or legs. If neck or back injury suspected, DO NOT move victim unless necessary to save victim's life. See back or neck injury.
   
   
3. Immobilize and support affected bone in position found. DO NOT try to push protruding bone back into body or let victim move or use affected area.
   
   
4. Control any bleeding through direct pressure, but DO NOT elevate affected area. See bleeding,external.
   
   
5. If bone is protruding, cover with clean cloth once bleeding is controlled.
   
   
6. Observe for shock (see shock). DO NOT give victim anything to eat or drink.
   
   
7. Immobilize injured area, and, if no open wound present, apply ice pack wrapped in clean cloth.

   Apply ice pack to affected area and cover with cloth.

Immobilizing Fractured Bone:

1. Check for sensation, warmth, and color of toes or fingers below suspected break.
   
   
2. Place padded splint under area of suspected break:
   

   Use belts or neckties to bind splint to arm but do not bind on top of the break.

   -Use board, rolled newspaper or maga­zines, broomstick, or rolled blanket for splint.
   
   -Wrap splint in cloth or towels for padding.
   
   -Bind splint to limb using neckties, cloth, belts, or rope. DO NOT bind directly over break.
   
   
3. Recheck often for sensation, warmth, and coloring. If fingers or toes turn blue or swell, loosen binding.
   
   
4. For arm or shoulder injury, place splinted arm in sling, with hand above elbow level. Bind arm to victim's body by wrapping towel or cloth over sling and around upper arm and chest; tie towel or cloth under victim's opposite arm.

   Create a sling for arm injuries using whatever cloth you can find.

Sprain or Strain:

1. Have victim rest, with affected area elevated.

   Keep the affected area elevated and the victim at rest.

2. Apply cold compress or ice pack wrapped in cloth to affected area.

   Use an ice pack or cold compress to combat pain and swelling.

3. If pain or swelling continue for more than 2 days, consult doctor.

To learn more about first aid and emergency care, see:

• Home Remedies for Foot Pain
• Herbal Remedies for Muscle Pain
• Aromatherapy Muscle Pain Relief

In mild cases, frostbite can be treated by simply warming the infected area. Serious cases of frostbite, however, require immediate first aid.

Causes: Frostbite is freezing of skin and possibly underlying tissues. It is caused by exposure to cold, wet conditions and most often affects the face, ears, hands, and feet.

Symptoms: White or yellowish-gray areas of skin, burning or itching sensations, reddened and swollen skin, skin hard to the touch, glossy appearance to the skin, blisters, pain, numbness.

1. Seek medical attention immediately. Call for EMS, or transport victim to emergency room.
   
   Until medical assistance is available:
   
   
2. DO NOT rub or massage affected area. DO NOT rewarm with hot water or high heat from fireplace or stove. DO NOT allow victim to walk on or use frostbitten digits. DO NOT break blisters. DO NOT allow frostbitten area to touch exposed skin.
   
   
3. Warm affected areas by placing them against victim's body or your body, using gloves, clothing, or blankets to keep frostbitten area from directly touching any exposed skin.
   
   
4. Get victim indoors, remove wet clothes, and take off any clothes or jewelry on affected area.
   
   
5. Check for hypothermia (see hypothermia).
   
   
6. Immerse frostbitten area in lukewarm (102-106 degreesF), not hot, water. If lukewarm water is not available, cover area with warm towels or blankets. Take area out of water, or remove coverings, once skin becomes flushed.
   
   
7. Place clean cloth between affected toes or fingers if possible, but do not force digits apart if skin sticks together.

   Keep frostbitten skin seperated.

8. Give victim warm, nonalcoholic, noncaffeinated beverages, and make sure victim is kept warm.

To learn more about first aid and emergency care, see:

• How to Treat Frostbite
• How Emergency Rooms Work

Head injuries can seem minor at first, but can sometimes prove to be much more sever later. This is why correct first aid for head injuries is paramount.

Symptoms: Lump, cut, bruise, or dent in scalp; pain; unconscious-ness; drowsiness; confusion; blood or fluid draining from nose, ear, or mouth; vomiting; convulsions; dis-coloration under eyes; unequal pupils; breathing or speech difficulty; paralysis; restlessness.

Emergency Treatment

1. Call for EMS for all but minor cuts and scrapes. Suspect back or neck injury if victim cannot move limbs or digits or has neck or back pain. (See back or neck injury.)
   
   
2. Monitor airway, breathing, and signs of circulation (see ABCs), and check for shock (see shock).
   
   
3. Keep victim lying down. DO NOT move victim or allow victim to move. DO NOT give victim anything to eat or drink.
   
   
4. Control bleeding (see bleeding,external) but DO NOT press on dent in skull, remove impaled object, (see impaled object), or clean deep scalp wounds. Clean only minor wounds with soap and water.

To learn more about first aid and emergency care, see:

• How Emergency Rooms Work
• Home Remedies for Headaches
• Herbal Remedies for Headaches

There are two main types of heat emergencies that require first aid:

Heat Exhaustion: Heat exhaustion can result from exposure to hot, humid environments. Symptoms include moist, pale, clammy skin; heavy sweating; normal or below-normal body temperature; weakness; dizziness; headache; nausea; vomiting; muscle cramps; fainting. Left untreated, it may progress to heatstroke.

Heatstroke: Heatstroke is a life-threatening emergency marked by an extremely high body temperature that results from overexposure to heat. Symptoms include a high body temperature, possibly above 106 degrees Fahrenheit; red, hot, dry skin; lack of sweating; constricted pupils; rapid pulse (more than 100 beats per minute); confusion or unconsciousness. WITHOUT IMMEDIATE MEDICAL ATTENTION, VICTIM MAY DIE.

Heat Exhaustion

1. Move victim into shade or to cooler area.
   
   
2. Loosen victim's clothing, and have victim rest with feet up.
   
   
3. Use fan or air conditioning to cool victim.
   
   
4. Apply wet towels or ice packs wrapped in cloth to skin.
   
   
5. Give victim sips of cold water or a sports drink -- 1/2 glass every 15 minutes for 1 hour. Stop offering drink if victim vomits, and call for EMS.
   
   
6. Call for EMS if victim does not improve within 1/2 hour or refuses drink.

Heatstroke:

1. Call for EMS.
   
   
2. Undress victim.
   
   
3. Have victim lie down. If victim vomits, roll them onto their side, and be sure their airway is clear.
   
   
4. Wrap victim in cool, wet towels, and place ice packs wrapped in cloth in areas of abundant blood supply -- neck, armpits, groin.
   
   
5. Observe for shock (see shock) and monitor ABCs (see ABCs).
   

To learn more about first aid and emergency care, see:

• What Causes Heat Stroke?
• How Emergency Rooms Work
  

Hypothermia occurs when the body's core temperature drops dangerously low. It can result from prolonged exposure to cold, especially when it's wet or windy. Left untreated, it can be fatal.

Symptoms: Cool skin, shivering, numbness, change in level of con­sciousness, slurred speech

Emergency Treatment

1. Move victim to warmer area or out of wind. If victim is unconscious, call for EMS, and check breathing. If breathing stops, see rescue breathing.
   
   
2. Have victim rest.
   
   
3. Remove wet clothing.
   
   
4. Wrap victim in dry blankets or clothing.
   
   
5. If victim is conscious and able to drink, give warm, nonalcoholic, noncaffeinated liquid.
   
   
6. If victim does not improve within a few minutes or worsens, call for EMS. Monitor ABCs (see ABCs) until EMS arrives.

To learn more about first aid and emergency care, see:

• How CPR Works
• How Emergency Rooms Work
  

An impaled object can be a scary and lie threatening occurrance. Follow these steps to help the victim of an impaled object:

Emergency Treatment

1. Seek medical assistance immediately. Call for EMS.
   
   Until EMS arrives:
   
   
2. DO NOT move or remove impaled object. DO NOT remove victim who is impaled on stationary object unless victim's life is in immediate danger; if you must remove victim from life-threatening situation, do so gently, then control bleeding (see bleeding,external).
   
   
3. Check victim for shock (see shock).
   
   
4. Cut or tear away clothing from around wound without moving object. If object is long, help victim into most comfortable position.

   Tear away clothes from around the object.

5. Wrap bulky dressing around object, and anchor it with bandages or strips of cloth to keep it from moving.

   Use heavy wrappings to keep the object from moving.

6. Keep victim from moving.
   

To learn more about first aid and emergency care, see:

• How CPR Works
• How Emergency Rooms Work
  

There are many different types of mouth injuries. Follow these steps to administer first aid to the victim of a mouth injury:

Emergency Treatment

1. Check for more serious head injuries (see head injury).
   
   
2. Have the victim sit with their head tilted forward to allow blood to drain.
   
   
3. Control bleeding:
   
   -Lip: Place a rolled dressing between the lip and the gum. Hold a second dressing against the outside lip.
   
   -Tongue: Press both sides of tongue with gauze or clean cloth without obstructing victim's breathing.
   
   -Gums and roof of mouth: Use direct pressure with gauze or clean cloth.
   
   -Tooth: Place direct pressure on tooth or socket with gauze or clean cloth, or have victim bite down on gauze or cloth placed on tooth or socket.
   
   
4. DO NOT repeatedly rinse the mouth because this may prevent clotting.
   
   DO NOT let the victim swallow blood because this may cause vomiting.
   
   
5. If bleeding does not stop or wound requires further care, transport victim to emergency room or dentist's office.
   
   
6. If tooth has been broken or knocked out, remove knocked-out tooth or fragments, submerge them in milk, and transport them with victim.
   

To learn more about first aid and emergency care, see:

• How CPR Works
• How Emergency Rooms Work
  

A person can be poisoned from a number of sources in a variety of ways. Because the cause may be unclear, proper first aid is essential.

Causes: Poison can enter the body by inhalation, ingestion, absorption, or injection. The most common sources of poisoning include cleaning supplies; cosmetics; plants; medications, such as analgesics; gases and vapors, such as gasoline; and pesticides.

Symptoms: Depending on the poison, signs may include rapid or difficult breathing; ringing in the ears; nausea; overexcitement; unconsciousness; burns on lips, mouth, and tongue; abdominal pain; vomiting; bloody vomit; abnormal skin color; seizures.

Emergency Treatment

1. Check breathing. If it has stopped, see rescue breathing.
   
   
2. Look for container from ingested substance, and try to determine what and how much victim swallowed and when.
   
   
3. If victim is unconscious, call for EMS. If victim is conscious, call Poison Control Center at 800-222-1222. Be pre­pared to read label on container to emergency personnel and to indicate how much was swallowed and when.

   Have the bottle of poison handy when calling for help.

4. Follow instructions from emergency personnel. DO NOT give anything to eat or drink. DO NOT give antidotes or induce vomiting unless directed to do so by emergency personnel.
   
   Until EMS arrives:
   
   
5. Place victim in Recovery Position. If victim vomits, clean out mouth.
   
   
6. Give container from ingested substance to EMS.

To learn more about first aid and emergency care, see:

• How CPR Works
• How Emergency Rooms Work
  

A seizure may occur because of a disturbance in the electrical activity in the brain. This disturbance can be the result of a head injury, epilepsy, poisoning, electric shock, drug withdrawal, a brain tumor, a bite from a poisonous insect or snake, or a high fever (especially in young children).

Symptoms: Short cry; rigid muscles; jerky, twitching movements; temporary lack of breathing; eyes rolled upward; bluish color in the face and lips; drooling or foaming at the mouth; possible loss of bladder and bowel control; unresponsiveness; confusion and sleepiness following seizure

Emergency Treatment

1. Ease victim to floor, and lay them on their side.
   
   
2. Remove any objects that victim may strike, or move victim away from hazardous areas, but DO NOT interfere with movements or restrain victim.
   
   
3. DO NOT try to open victim's mouth. DO NOT put fingers or objects in victim's mouth.
   
   
4. Stay with victim until seizure ends.
   
   
5. When seizure is over, keep victim lying on their side.
   
   
6. Check breathing. If breathing stops, see rescue breathing.
   
   
7. DO NOT give victim anything to eat or drink.
   
   
8. If you do not know whether victim has a history of seizures, if the seizure lasts more than 5 minutes, or if victim has more than one seizure, call for EMS. If you know victim has history of seizures and current seizure is not unusual, ceases within 5 minutes, and is not followed by additional seizures, transport victim to emergency room.
   
   
9. If seizure is caused by high fever, sponge victim's body with luke­warm water before transporting. DO NOT place victim in water.
   

To learn more about first aid and emergency care, see:

• How CPR Works
• How Emergency Rooms Work
  

Shock is a life-threatening condition in which the body's vital functions are threatened due to lack of sufficient blood or oxygen flow to the tissues. Shock is one of the primary consequences you are trying to avoid when administering first aid.

Symptoms: Pale or bluish skin, lips, and fingernails; moist, clammy skin; weakness; weak, rapid pulse (more than 100 beats per minute); increased breathing rate; irregular breathing; restlessness, anxiety; thirst; vomiting; dull look in eyes; dilated pupils; unresponsiveness; blotchy or streaked skin; possible unconsciousness in severe conditions.

Emergency Treatment

1. Make certain victim's airway is open, using head-tilt chinlift to open airway, even if back, neck, or head injury is suspected (see ABCs).
   
   
2. Seek medical assistance immediately. Call for EMS.
   
   Until EMS arrives:
   
   
3. If back, neck, or head injury suspected, DO NOT move victim (see back or neck injury). If no back, neck, or head injury suspected, lay victim faceup and elevate feet about 12 inches. DO NOT place victim in position that is uncomfortable.

   Move the victim to a comfortable position only if there's no back or neck injury.

4. Loosen any tight clothing.
   
   
5. Look for injuries, and control any bleeding (see bleeding,external).
   
   
6. Cover victim lightly with blanket.
   
   
7. DO NOT give victim anything to eat or drink. If victim vomits, roll the victim onto their side and clean out victim's mouth.
   
   
8. Put an unresponsive victim or a stroke victim in the Recovery Position.
   

To learn more about first aid and emergency care, see:

• How CPR Works
• How Emergency Rooms Work

ABOUT THE AUTHOR:

Linda Mutchner RN, BSN, CRNI, OCN: has been a CPR Instructor for over 25 years and first aid instructor for over 20 years, educating new parents, life guards, teachers, and other health care professionals. Linda also has been a nurse for over 32 years, and is certified in infusion and oncology nursing. Linda is co-owner of a company that teaches CPR, first aid, IV, safety, HIPPA, OSHA, and oncology training.