A person falls to the ground, unconscious, clutching his heart. A diner begins choking on a piece of steak, her face slowly turning blue. In such emergencies, many of us would know what to do: Perform CPR on the man, and the Heimlich maneuver on the woman. These emergency medical procedures have been around for decades — CPR was developed in 1960, the Heimlich Maneuver in 1974 — and are often taught in schools, workplaces and community settings [sources: American Heart Association, Radel].
But would you know what to do if someone was overdosing or if you were bitten by a venomous snake? Or if you were shot? Hopefully you'll never be in one of these terrifying situations. But it helps to know what to do. Some of the procedures we're about to mention can be done by most people armed with information. Others should not be attempted even if the person who did the procedure lived to tell the tale. In any case, this information presented should not be considered medical advice.
Hollywood loves emergency tracheotomies. One was performed with a pen on Eric Stoltz's character in 1997's "Anaconda," and another using a straw on Franka Potente's character in 2000's "The Princess and the Warrior" [source: Cruikshank, et al.]. While the thought of cutting someone's throat isn't appealing, a tracheotomy is probably one of the easier emergency medical procedures for novices to perform.
A tracheotomy is necessary when someone can't breathe due to a throat obstruction. You can ascertain whether this is happening if the person isn't breathing or making any sounds, such as coughing or gasping. Before performing an emergency tracheotomy, first try the Heimlich maneuverthree times to see if you can dislodge the object. If that doesn't work, and the person has lost consciousness, take a razor blade or knife and make a 1/2-inch (13-millimeter) horizontal cut, 1/2-inch deep, into the person's throat, in between the Adam's apple and Cricoid cartilage, another bump that lies about 1 inch (25 millimeters) below the Adam's apple [source: Bissell].
Stick your finger inside the slit to open it up, then insert a tube into the hole roughly 1/2- to 1-inch deep. The tube can be a straw, a ballpoint pen sans the ink-filled tube, or stiff paper rolled into a tubular shape. Once the tube is in, breathe into it twice and then pause five seconds. Now begin alternating one breath with a five-second rest. If you've done the procedure properly, the person's chest should rise and he should regain consciousness [source: Bissell]. But still call 911.
The stories are horrific, yet captivating. In 2003, young climber Aron Ralston cut off his right forearm to escape from Utah's Bluejohn Canyon. Ralston had been trapped there for six days after an 800-pound (360-kilogram) boulder shifted and crushed his hand, pinning him to the canyon wall. Dehydrated and hypothermic, the emergency amputation was the only way to survive the accident [source: Benoist].
Seven years later, Jonathan Metz went into his basement to repair his furnace. While working, his arm got stuck. Metz was trapped two days when he began smelling rotting flesh. Fearing for his life, he began amputating his arm to free himself. He had most of the procedure completed when firefighters arrived and broke open the furnace. Metz's arm sort of dropped off as the furnace was demolished [source: Eaton-Robb].
Such emergency amputations, while rare, are more common than you might think. Here's what to do if you're unfortunate enough to find yourself in a similar situation [source: Howcast].
- Break the bones in the limb. This may be possible with leverage.
- Put a tourniquet on the limb several inches above where you'll be cutting so you don't bleed to death. You can use a belt, piece of cloth, rope, etc.
- Cut or saw through your skin and muscles first. The tendons will be the most difficult to sever; if you have pliers on hand, it might be easier to twist and snap them.
- Sever the arteries and nerves last; the nerves will be the most painful.
- Bandage the stump and immediately seek medical attention.
Mexico's Inés Ramírez Pérez had seven healthy children, but her eighth was stillborn. In 2000, at age 40, pregnant again, she labored unsuccessfully for 12 hours to bring her ninth child into the world. Panic-stricken — her town only had one phone, and her hubby was partying at the local cantina — she sent one of her kids to purchase a sharp knife. While he was gone, she threw back two cups of mezcal, an alcoholic drink, to numb the pain [source: The Unnecesarean].
Pérez used the knife to make a light incision across her abdomen, then traced the incision over and over, sinking in a little deeper each time. Eventually she pushed aside her internal organs, reached inside her uterus and pulled out a healthy baby boy. Then she wrapped a sweater around the wound and sent her son to find help.
Several hours later, a local health worker found Pérez and the baby, then stitched her wound shut with a needle and thread. Eventually she was treated at a hospital, where she remained for 10 days. Miraculously, she had no infections and no serious harm was done to her internal organs. Doctors think part of her success was due to the fact that she gave birth in a traditional sitting position, so her uterus was against her abdominal wall, rather than her intestines [source: The Unnecesarean].
Pérez was the first woman known to have survived a self-inflicted Caesarean. But a 2013 study later found 22 other cases of self-inflicted Caesareans. Mothers took this action either to kill the child, save the child or due to mental illness. Surprisingly, despite the peril associated with such an action, many of the women survived. In fact, the study authors think the number of cases of self-Caesareans is probably higher [source: Szabó and Brockington]. Still, this procedure is definitely best left to medical professionals.
Drug overdoses are the leading cause of death by injury in America; 44 people die every day from prescription drug overdoses, mainly opioids [source: U.S. Department of Health & Human Services]. One relatively easy way to save lives is to administer naloxone when someone has overdosed.
Naloxone, commonly known by its trademarked name Narcan, is a medication that can reverse an opioid or heroin overdose. (Note: Naloxone does not work for overdoses of cocaine, alcohol or speed). A prescription drug used by medical professionals for decades, Narcan is now available to the general public over the counter. Laws regarding its sale vary by locale [sources: Stop Overdose, Smith].
Narcan comes in two forms: a nasal spray and an injection. If you have the spray on hand, place the atomizer on the tip of the (needleless) syringe and pop in the cartridge of Narcan. Tilt the person's head back, then spray half of the dose in each nostril. If the person isn't breathing, or his breathing is shallow, perform rescue breathing (mouth-to-mouth resuscitation) until the Narcan kicks in. (Instructions for rescue breathing at this link.) It should take three to five minutes. If the person hasn't revived by then, administer another dose and continue with the rescue breathing [source: Harm Reduction Coalition].
With injectable Narcan, take a syringe with an intramuscular needle (1 to 1-1/2 inches or 2.5 to 4 centimeters) and draw up 1 cc of Narcan into the syringe. Inject it straight into a large muscle such as the quadriceps or shoulder. If the person doesn't revive in two or three minutes, administer a second dose, always performing rescue breathing in between. In both situations, if the person doesn't revive after the second dose, professional help is needed [source: Harm Reduction Coalition].
Whether or not you have Narcan on hand, you should still call 911 when someone is overdosing.
Treating a Snake Bite
In 2015, a very pregnant Jacklyn Caramazza was panic-stricken when her 4-year-old son stepped on a baby rattlesnake that was coiled in the middle of a bike trail. Her son's ankle quickly began to swell and turn purple, so Caramazza sucked at the wound and spit out some venom. Her son survived, but Caramazza was chided because the venom she sucked out might have harmed her or her unborn baby [source: CBS News, Web MD].
For decades, and maybe longer, people were told that if they were bitten by a poisonous snake, they should suck the venom out of the wound immediately to enhance their chances of survival. Today, medical experts say that's a myth. And they actively discourage the practice, which can contaminate the wound or harm nerves and blood vessels in the process. Plus, you typically can't suck out all that much venom anyway. Far better to race to the nearest medical facility which will have anti-venom medication on hand [source: CBS News, Web MD].
If you're more than an hour from a hospital, wrap a bandage 2-4 inches (5-10 centimeters) above the wound to slow the spread of the venom. However do not make the bandage too tight or it will cut off blood flow. Also, do not take any pain medication which may thin the blood. (Tylenol would be OK but no ibuprofen or aspirin.) Then try to get to a hospital as soon as possible [source: Wild Backpacker].
Setting a Bone
Breaking a bone is not uncommon. If you're on a hiking trip and a companion breaks a bone, splint the area for stability, then seek medical attention. Don't try to reset the bone yourself, which could cause further injury. However, if you're days from civilization or there is a serious problem (the break is causing extensive bleeding or pressure on an artery; or fingers and toes are numb, indicating nerve pressure), here's how to set a bone:
First, apply traction. When a bone breaks, the surrounding muscles generally contract, which often pulls the bones out of alignment. So if your buddy broke his lower leg, get a good grip on his foot and slowly, firmly, pull it toward you for several seconds. Make sure you're pulling in the same plane as the broken bone. That is, pull the bone in a straight, even motion, not at an angle. And don't jerk while pulling. When it appears the bone is in place, keep a firm grip while someone else splints the bone in place. (Ideally, the splinter will be a third party, not your injured friend.) Then you can gently release your grip [source: Hubbard].
To splint a bone, use something rigid, like sticks, board, or rolled up blankets, to put on either side of the injured body part. Make sure the splint extends beyond the body part. Tie the splint to the body part with rope, a belt or other material. Make sure it's not too tight to cut off circulation [source: Medline Plus].
With all of the mass shootings in America and around the world, it may seem like bullet removal might be something you have to face some day. But the first thing to know is this: Do not remove a bullet! In the vast majority of cases, trying to do this will create more damage than leaving it wherever it's embedded until medical help arrives. A bullet may have lodged itself in an artery, for example, and actually be plugging the hole and preventing the victim from bleeding out. Bullets also may break into pieces once inside the body, and if that happens it can be nearly impossible to find all of the scattered bits [source: Hubbard].
The best treatment for someone who has been shot is to check the person's circulation, then airway, then breathing (CAB). This may seem counterintuitive — shouldn't the person be breathing first? No. In emergency situations where medical attention isn't a quick ambulance drive away, it's most important to stop any serious bleeding first by applying direct pressure to the wound and elevating the affected area. Then you can move on to making sure the person's airway is clear and, finally, that she's breathing. If she's not, it's time to begin CPR [source: Hubbard]. FYI: The trained medical personnel who eventually treat the shooting victim may also elect to leave the bullet or its fragments in the person's body.
Stitching a Wound
Sewing shut a wound may be one of the easier medical procedures to perform for novices. If you're tapped for the job, first check out the wound site and flush the area with a lot of clean water. This will help wash away any foreign objects in the wound, plus dilute any bacteria present. This will help prevent infection. If you do see any objects inside — gravel, bits of wood or metal — gently remove them [source: Off the Grid News].
Then get out your first aid kit. Doctors use a wide variety of needles and suture threads when they're stitching a wound, depending on body location and other factors. The actual stitch used also varies. (No, you cannot use an ordinary sewing needle and thread — they're not strong enough). After sterilizing the needle, pierce the skin at a 90 degree angle, starting at the center of the wound and stitch outward. Twisting the wrist will ensure that the suture thread follows the curve of the needle. Leave about 1/8 of an inch (2 millimeters) between stitches. Keep in mind that skin is thick; you'll have to push the needle quite firmly. When you're finished, knot the thread and clean the area again, then bandage it to help avoid infection. The bandage should be changed twice a day [sources: Off the Grid News, Forsch].
Removing a Parasitic Worm
Have any rough patches inside your mouth? If so, beware. Jon Allen, a biology professor at the College of William & Mary, felt a rough patch at the back of his mouth in December 2012. The patch disappeared and reappeared for several months, always in the back of his throat where he could feel it with his tongue but not see what, exactly, it was. Or even touch it. Then the patch moved under his lip, in the membrane lining his mouth. As a specialist in invertebrates, Allen immediately realized it was some kind of parasitic worm [sources: McClain, Moye].
Allen went to an oral surgeon to have it removed, but the surgeon deemed it merely skin discoloration. However, Allen knew it was a worm. So early the next morning, after taking his young son to the bathroom, Allen grabbed a pair of No. 5 super-fine-tip forceps and pulled out the worm. His wife aimed a flashlight at the medicine cabinet mirror so he was able to see well enough to operate on himself. The worm was 3/4-inch (2 centimeters) long and was later identified as the nematode Gongylonema pulchrum, a parasitic genus typically found in livestock. Allen is only the 13th American and 60th person in the world known to have this worm. But now researchers think it might be much more common, but simply misdiagnosed [sources: McClain, Moye].
Normally, if you have a parasitic worm in your body, you should get a prescription for some anti-nematode medication [source: Veronese]. But just in case your doctor doesn't believe you and won't prescribe it, now you know you can pull it out yourself.
Performing a Self-biopsy
The story had people riveted: Dr. Jerri Nielsen was one of 41 researchers stationed at the remote Amundsen-Scott South Pole Research Station in 1999 when she found a lump in her breast. It was winter there, and the extreme temperatures made an evacuation impossible. Nielsen was the only physician in the group, so she coached one colleague, a welder, on how to conduct a biopsy; he practiced by sticking a needle into various fruits and vegetables. Eventually the co-worker aspirated tissue from her breast, which was then prepared on a slide by another colleague. An image of the slide and its contents was sent back to the U.S. for analysis via satellite transmission [sources: Hevesi, Taub and Parsi].
Unfortunately, Nielsen did, indeed, have cancer. Chemotherapy equipment was air-dropped to her, and she began administering chemo to herself. By October, weak and confused by the combination of the chemotherapy and the South Pole's harsh weather, Nielsen was airlifted in a daring rescue. She survived, and in 2001 wrote the book "Ice Bound: A Doctor's Incredible Battle for Survival at the South Pole," with Maryanne Vollers. In 2005, unfortunately, Nielsen's cancer recurred; she died in 2009 at the age of 57 [source: Hevesi].
While Nielsen was able to coach a non-medical colleague on conducting a biopsy, this is one procedure that you'll probably never have to do to yourself — unless you happen to be stuck at the South Pole in the dead of winter. Then you might need to consult with a doctor via telemedicine for the correct method.
HowStuffWorks celebrates Dr. René Favaloro, whose coronary bypass technique is still being used worldwide after fifty years to save lives.
Author's Note: 10 Emergency Medical Procedures That Can Be Done on the Fly
I have never performed an emergency medical procedure on myself or anyone else, unless you count pulling out a sliver. Strangely (and grossly), both my husband and one of my brothers each removed a cyst from themselves with a penknife. Ick! My husband's was in the middle of his forehead — double ick! (Thank goodness I did not know him then.) Anyway, I can't imagine doing any of these 10 procedures with the possible exception of administering Narcan. The two most unthinkable for me would be the self-amputation and worm removal. Worms gross me out so much, I might be able to cut off one of my limbs sooner than remove a parasitic worm through my mouth. I just made myself really queasy ...
More Great Links
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- Moye, David. "Jonathan P. Allen Pulled A Worm From His Cheek With Forceps." Huffington Post. Oct. 16, 2013. (May 11, 2016) http://www.huffingtonpost.com/2013/10/16/jonathan-d-allen-worm_n_4109733.html
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