how to do it

TM

Mind & Body

First Aid & CPR

published by Barnes & Noble

In case of emergency, be prepared.

You never know when youll be confronted by an accident or emergency: they can
happen in the home, at work, or even out in public. To make sure you remain cool
under pressure, learn the fundamentals of first aid, including:
When and how to intervene in a crisis
How to perform CPR, rescue breathing, and the Heimlich maneuver
How to respond to more than 30 different health emergencies

First Aid Basics

First aid skills are techniques that a first responder to
the scene of an injury or illness can use to help an injured
or sick person until medical professionals arrive. First aid
may involve assisting with something as simple as a minor
cut or as complex as performing CPR (cardiopulmonary
resuscitation).

First Aid and the Law

People are sometimes hesitant to provide help during an
emergency for fear of being sued if they do something
wrong. Most states have passed Good Samaritan laws that
protect volunteers who provide first aid from lawsuits, provided the volunteer follows three general guidelines:
Obtain consent before giving first aid: A person has
the right to refuse first aid. Before acting at the scene
of an emergency, identify yourself and tell the victim
that you know first aid. Then ask for permission to help.
Expressed consent: If the victim gives permission,
you may begin first aid.
Implied consent: If the victim is unconscious or
unresponsive and the situation is life-threatening,
you may assume that if the person were able to
respond, he or she would likely have accepted help.
You may then begin first aid.
Dont abandon the victim: Once youve begun first
aid, dont stop until medical assistance arrives or until
youre so exhausted that you cant continue giving care.
Give first aid according to your training: Follow the
practices that youve been taught. Dont try to perform
first aid procedures beyond your skill level.
Good Samaritan laws cant guarantee that you wont be
sued for something you did or didnt do at the scene of an
emergency. But very few Good Samaritans are sued, and
even fewer lose in court.

Duty to Act
If youve been trained in first aid, you have a moral duty to
provide first aid to the victim of an emergency. But in most
states, you are legally compelled to provide care only if:
Its your job: If youre trained to perform first aid as
a part of your job, then you must provide first aid in
an emergency while youre on duty. Nurses, doctors,
policemen, firefighters, and lifeguards all must provide
first aid when on duty.

Youre responsible for the victim: If youre in a

position of responsibility for other people, such as a
teacher or a Boy Scout leader, you must provide care
for those in your charge if theyre injured or ill.
A few states have laws that require any bystander to help
the victim of an emergency to the best of their ability, as
long as doing so doesnt endanger the first aid provider.
Check your states laws to confirm your responsibilities.

First Aid Courses

The best way to learn, and the only way to get certified in
first aid and CPR, is to take a first aid course.
Whats covered: Courses provide extensive training
about what to do in a variety of emergency situations.
Who offers courses: Your local chapter of the
American Red Cross or the American Heart
Association (AHA) offer first aid and CPR courses.
Many fire departments and medical centers do as well.
Length and cost: First aid and CPR courses vary in
length and cost. Contact your local Red Cross or AHA
chapter for further information.
Certification: Youll have to pass a test in both first aid
and CPR to get certified. To remain certified, youll need
to update your knowledge and skills periodically.
This guide serves as a handy quick-reference for some of
the most important first aid and CPR procedures, but it
should not serve as a replacement for the hands-on training
provided by a course.

The First Aid Kit

Though you can give basic first aid and CPR without tools,
a few supplies can make it safer, easier, and more effective.
Its a good idea to assemble a simple first aid kit for your
home, car, boat, workplace, or anywhere else you spend
lots of time. You can find first aid supplies at pharmacies and
medical supply stores.
Sterile gauze bandages:
For covering cuts and
wounds. They come in
various sizes and forms.
You should have 2" 2"
pads, 4" 4" pads, a
large absorbent pad, as
well as roller-type gauze.

Adhesive tape: To hold gauze

bandages or splints in place.
Usually sold in rolls, like Scotch
tape.
Adhesive bandages: To cover
cuts or wounds without the
need for adhesive tape. You
should have large and small
bandages, and they should be
sterile if possible. Latex-free
bandages are best, since
some people are allergic to
latex.
Elastic bandages: To bind and
immobilize fractures and
sprains temporarily, or to
hold splints in place.
Bandage scissors: To cut
bandages to the
appropriate size and to
snip adhesive tape.
Instant cold pack: To provide
immediate source of cold
without the need for
refrigeration.
Waterless hand wash or
moist towelettes: To sanitize
hands and skin after providing
first aid.

an

Protecting Yourself
Blood, or body fluids contaminated with blood, may carry
infectious diseases such as hepatitis or human immunodeficiency virus (HIV). First aid kits should contain medical
exam gloves, CPR mouth shields, and/or other equipment
to limit this risk.
Medical exam gloves:
To protect your hands and
skin from contact with
blood and bodily fluids.
Latex-free gloves are best,
but any rubber gloves are
better than nothing at all.
Mouth shield: To let you perform CPR without any
actual mouth-to-mouth contact. There are two main
types: Pocket Masks (generally used by medical
professionals) and Microshields (more common
among Good Samaritan responders).

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1. Straighten the victims legs and place the arm closest
to you at a right angle to the body. Remove any bulky
items from the victims pockets.

If youre exposed to body fluids in any way, call your healthcare provider as soon as possible for guidance.

What to Do During an Emergency

No two emergencies are exactly the same. But there is a
general plan of response that you should follow in every
emergency situation.

1. Survey the Scene

2. With one hand, lift the arm farthest from you and bring
it across the victims chest. Hold the arm so the back
of the victims hand is against the cheek closest to you.
With your other hand, lift the knee farthest from you so
that the victims far foot rests flat against the ground.

You cant help a victim if you get hurt yourself. Before

providing first aid, always check the scene for dangers
such as:

Fire
Downed power lines
Hazardous chemicals
Unsafe structures
Traffic

Never attempt to enter a dangerous scene. Instead, call 911

and explain the situation. The 911 operator will dispatch the
appropriate public safety workers.

2. Decide Whether to Move the Victim

Assessing Illness or Injury

3. Roll the victim gently toward you, without ever allowing

the victims hand to lose contact with his cheek. The
hip and knee of the victims top leg should both be bent
at right angles. Tilt the head back slightly to keep the
airway open.

In the vast majority of emergencies, you should not move

the victim. Movement can worsen injuries the victim may
already have sustained. However, there are a few scenarios
in which you may need to move a victim:
If the victim is in immediate physical danger
If the victims injury or illness is life-threatening and the
victim is positioned in a way that prevents you from
providing first aid

How to Move a Victim

If you do have to move a victim, follow these guidelines:
Keep the spine and neck straight: Always keep the
neck and spine in a straight line. Never move a victim
sidewaysonly in the direction of the head or feet.
Drag by the collar: If possible, try to pull the victim by
the collar, using your forearms to support the head.
Pull from shoulders or feet: If you cant move the
victim using only his clothes, pull the body from both
feet or both shoulders.

The Recovery Position

The recovery position is a body position that keeps the victims airway unobstructed. It should be used when a person
is injured or ill but breathing normally. It should not be used
if breathing is unstable or if you suspect a spinal injury.

B. If youre alone and the victim is an adult: Call for

help yourself and then continue your assessment.
C. If youre alone and the victim is a child or
infant: Deliver five cycles of CPR before calling 911.
3. Try to open the
airway: A foreign object
or the victims tongue
may be obstructing the
airway. With the victim
on his back, open the
airway by tilting the
head back with one
hand while tilting the
chin upward with the other.
4. Take ten secondsand no longerto check for
normal breathing: Watch to see whether the victims
chest is rising. Put your ear close to the victims mouth
and nose and listen and feel with your cheek for
breathing. Dont mistake gasping for breathing.
A. If the victim is breathing: Put him in the recovery
position and wait for medical help.
B. If theres no sign of breathing: Perform CPR.

If the victim is breathing, assess for illness or injury. Question the victim, question other people at the scene, and
observe the victim. If you observe (or the victim reports) any
of the signs listed below, call 911:

Sudden dizziness or fainting

Decreased level of responsiveness
Shortness of breath or difficulty breathing
Sudden, severe vomiting
Weakness in or loss of use of an extremity
Change in vision
Chest or abdominal pain or pressure
Sudden or severe pain in any body part

You should also palpate (feel) the victims body from head
to toe to check for:

3. Assess the Victim

Assessing an ill or injured person will give you the information you need to begin providing first aid.

Assessing Airway and Breathing

1. Assess consciousness: Approach the victim and ask,
Are you okay?
A. If the victim is able to talk or cough: This means
he has an open airway and is breathing. Skip to
Assessing Illness or Injury below.
B. If the victim does not speak: Check for
responsiveness by tapping or gently shaking his
arm. If the victim responds by talking or coughing,
skip to Assessing Illness or Injury below.
2. If the victim still doesnt respond: Call 911.
A. If someone else is with you: Have that person call
for help while you stay with the victim.

Severe bleeding
Unusual skin color or temperature
Abnormal breathing
Deformities, such as extremities in abnormal positions
Verbal complaint of pain when a body part is touched
Swelling or tenderness in any area
Cuts or scrapes

4. Calling for Help

The most important aspect of first aid is knowing when and
how to summon medical assistance. You should always call
for help when:
The victim is unconscious or unresponsive
You believe that the victims condition is, or could
become, life-threatening
There has been a car accident, fire, or explosion
There are downed electrical wires or a hazardous
substance is present

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2: Vincent & Jennifer Keane/Lucence Photographic (photos 1-2). Illustrations by
Precision Graphics.

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Printed in the United States
Writer: Linda Hepler

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If you believe that the condition is or may be life threatening,
or if you are uncertain what to do, you should always call for
helpeven if the victim refuses first aid.

How to Summon Help

Calling 911 is the most common way to access the emergency response system, though some phone systems have
different contact methods. In some locations, dialing 911
doesnt work, so make sure you know the specific numbers
to call for emergency help from home, work, and anywhere
else you spend considerable time. When you call your local emergency number, be ready to share the following
information:

Chest Compressions

Automated External Defibrillators (AEDs)

Chest compressions circulate blood through the victims

body until the heart begins to beat on its own. Chest compressions for adults and children are performed differently
from those for infants.

An automated external defibrillator (AED) is a machine

that can deliver an electric charge, or defibrillation, that for
certain types of cardiac arrest can shock the heart back
into normal rhythm. Used in combination with CPR, AEDs
greatly increase survival rates.
AEDs can be dangerous to you and to the victim if used
incorrectly. They should be used only by people who have
received the proper training. Most Red Cross and American
Heart Association chapters offer AED training.

Chest Compressions for Adults and Children

1. Place the heel of one hand in the center of the victims
chest, on the sternum (breastbone). Place the heel of
your other hand on top of the first hand. Interlock your
fingers and lift them up, but keep the heel of the hand
against the victims chest. Make sure the heel of your
hand is on the middle of the victims sternum, not on
the bottom end, which is fragile and may break off.

Your name, location, and the telephone number from

which youre calling
Type of emergency (car accident, animal bite, heart
attack, etc.)
Number of persons injured
Condition of victims and treatment received so far.

Choking is the partial or total obstruction of the airway by a

piece of food or other object. First aid for a choking adult is
different from first aid for a choking infant.

First Aid for a Choking Adult

CPR

Rescue Breathing
If the victim is not breathing, its crucial to get air into his
body by giving rescue breaths. Rescue breaths can be given
through a face shield or mask, or directly mouth-to-mouth.
The steps for delivering rescue breaths are:
1. Head tilt: Use a head tilt to make sure the victims
airway is open (see Assess the Victim).
2. Form a seal: If using a face shield or mask, place it
over the victims face, holding the edges of the shield
snugly against the face with the fingers of both hands
to make a tight seal. If providing direct mouth-tomouth, place your mouth over the victims mouth to
make a seal. Pinch closed the nose, using the hand
thats tilting the victims head back.

Respiratory problems can be caused by many different injuries and illnesses. The most common are choking, asthma,
and hyperventilation.

Choking

Dont hang up until the emergency response operator tells

you to do so. You may need to answer further questions or
follow instructions vital to the victims survival.

CPR, short for cardiopulmonary resuscitation, is a technique that keeps blood and oxygen flowing through the
body of a person who isnt breathing and whose heart has
stopped. Immediate CPR applied until medical help arrives
doubles a victims chances of survival.

Respiratory Problems

2. With your body

directly over the
victim and elbows
straight, push down
firmly. Compress the
chest about 1 1/22".
Allow the chest to
return to the normal
position between
compressions but
always keep your
hands in contact
with the victims
chest.
Give compressions at a rate of about 100 per minute
about one and a half compressions per second.

Chest Compressions for Infants

To give chest compressions to an infant, place your middle
and index fingers slightly below the nipple line at the center
of the chest. Push the chest in about 1/23/4".

Ask the victim, Are you choking? If the victim can talk or
cough, the airway is not completely blocked. Encourage
the victim to try to
Signs of Choking
cough out the object.
Coughing or wheezing
If the victim cant talk
Difficulty breathing
or cough, then the air Grasping at the throat
way is blocked. Ask
Bluish color around mouth
the victims permission to administer the
Heimlich maneuver.
1. Stand behind the
victim. Wrap your
arms around the
victims abdomen
(or chest, if the
victim is heavyset or
pregnant).
2. Make a fist and
place it between the
victims sternum and
navel, with the thumb
side facing the victim.
3. With your other hand, grasp the hand thats formed into
a fist. Thrust your hands quickly inward and upward to
expel the object.
If the victim loses consciousness, check his airway and
breathing. If necessary, begin CPR.

First Aid for a Choking Infant

3. Give two rescue breaths: Take a normal breath, then

give a one-second-long rescue breath. Repeat. Watch
for the victims chest to rise with each rescue breath.
4. If the chest does not rise: The breath may not be
getting through the airway. Re-tilt the head and give
two more rescue breaths. If the breaths still arent
going in, give care for choking.
5. If the victim begins breathing: Put him in the
recovery position and wait for medical help.
6. If the victim does not begin breathing: Begin chest
compressions (see below).

Rescue Breaths on Infants

Rescue breathing for infants is identical to that for adults,
except that you should form a seal over both nose and
mouth with your mouth.

Cycles of CPR
After the two initial rescue breaths, CPR should be given
in cycles30 chest compressions followed by two rescue
breaths. Two full cycles of CPR would be:
First cycle: 30 compressions, 2 breaths
Second cycle: 30 compressions, 2 breaths
Continue giving cycles of breathing and compression until
the victim has started to breathe on his own or until medical
help has arrived. If the victim starts breathing at any time,
put him in the recovery position and wait for medical help.

1. Lay infant face down on

your forearm, with your
hand beneath the chest and
fingers supporting the head.
2. Give 35 quick, sharp blows
with the heel of your hand
to the babys back, between
the shoulder blades.
3. If the object is not expelled,
back blows
turn the infant face up
on your other forearm,
keeping the infants head
supported.
4. Give 35 chest thrusts with
two fingers placed in the
center of the chest, a finger
width below the nipple line.
5. Alternate back blows and
chest thrusts
chest thrusts until the
object is expelled. If the infant loses consciousness,
check his airway and breathing. If needed, call 911 and
begin CPR.

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Asthma Attacks

External Bleeding

Asthma is a condition
Signs of an Asthma Attack
in which the airways
Wheezing
in the lungs narrow,
Coughing
making it difficult to
Chest tightness
breathe. Dust, smoke,
and exercise are common triggers for asthma attacks, though attacks may also
occur without an obvious trigger.

Most external bleeding can be stopped by applying direct

pressure to the wound.

1. Assist the victim into a comfortable position.

2. Ask the victim to try to breathe slowly and deeply.
3. Most people with asthma have blue-capped reliever
inhalers that help lessen attacks. If the victim has an
inhaler, help him find and use it.
Most asthma attacks ease after three or four minutes. If the
attack continues past five minutes or the inhaler seems to
have no effect, call 911. If the victim becomes unconscious,
check his airway and breathing. If necessary, begin CPR.

Hyperventilation
Hyperventilation is overly fast and deep breathing, often brought about
by anxiety or panic.

Signs of Hyperventilation
Fast or deep breathing
Lightheadedness
Tingling in the hands

1. Reassure the victim.

2. Lead the victim to a quiet place, if possible.
3. Ask the victim to concentrate on breathing with his
abdominal muscles and to breathe in through the nose
and slowly out through the mouth. Breathe along with
the victim to help slow his breathing down.
Do not have the victim breathe into a paper bag.

Anaphylactic Shock
Anaphylactic shock
Signs of Anaphylactic Shock
is a severe, life-threat Itching skin, eyes, or nose
ening allergic reaction.
Congestion and sneezing
Common triggers may
Hives (red skin rash)
include insect stings,
Difficulty breathing
medications, and cer Swollen face and tongue
tain foods, such as
shellfish or peanuts.
If you suspect anaphylactic shock, call 911 immediately.
Assist the victim into the position of greatest comfort and
try to determine what caused the allergic reaction. If the
victim loses consciousness, monitor his airway and breathing and be ready to perform CPR.

Auto-Injectors
Some people who know they have severe allergies carry an
auto-injector, a device that injects a substance called epinephrine, which relieves allergic reactions. Auto-injectors
are often referred to by the brand name EpiPen .
If the victim has an auto-injector, you may have to help
him use it. The injection is given in the side of the thigh. Follow the instructions on the wrapper.

Bleeding
Bleeding occurs when blood vessels, which circulate blood
throughout the body, are ruptured in an injury. If the injury
breaks the skin, external bleeding occurs. If the skin isnt
broken, internal bleeding occurs, in which blood from
broken blood vessels pools within the body. Both types of
bleeding can result in shock.
When providing first aid for a bleeding person, wear
gloves if possible.

1. Apply direct pressure to the wound using your fingers

or palm. If available, use a sterile gauze dressing folded
in half or fourths. If you dont have a clean dressing, a
handkerchief, scarf, T-shirt, or other clean cloth will do.
2. Unless you believe there has been a fracture, lift the
injured limb above the level of the heart to limit blood
loss (see Skeletal Injuries for more on fractures).
3. If blood soaks through the dressing, put another
dressing on top of the first and apply increased
pressure.
4. If the bleeding slows, clean the wound and surrounding
area with running water or alcohol-free wipes. Pat dry
and cover with gauze or an adhesive bandage.
5. If the bleeding does not slow, call 911. Continue to
apply pressure to the wound until medical help arrives.
6. If the victim has lost a lot of blood and is dizzy or
confused, or if he has clammy skin and is breathing
rapidly, treat him for shock.

Nosebleeds
1. Place the victim in a seated position with his head
tilted slightly forward and ask him to breathe through
his mouth. This will prevent blood from obstructing the
airway or running down the back of the throat.
2. Using a gloved hand, pinch the nostrils together. If the
victim is able to do this himself, allow him to do so.
3. Check to see whether the bleeding has stopped after
ten minutes. If not, continue pinching for ten minutes,
and then, if necessary, ten minutes more.
4. If the bleeding stops, advise the victim to rest for a few
hours and to avoid blowing his nose, spitting, coughing,
or sniffing during this time.
5. If the bleeding doesnt stop, transport the victim to a
medical center.

Internal Bleeding

Signs of Internal Bleeding

Internal bleeding can be

Bruising
minor (mild bruises) or
Pain
severe (bleeding organs).
Swollen or tender area
If you believe that the internal bleeding is severe,
call 911 immediately. If you suspect that the internal bleeding is due to a bone injury, treat the bone injury (see Skeletal
Injuries) and summon medical assistance.

Shock
Shock is a life-threatSigns of Shock
ening condition that oc Confusion or dizziness
curs when a persons
Change in responsiveness
circulatory system is
Cool, clammy, pale skin
unable to supply the
Nausea, vomiting, or thirst
body with oxygen. The
most common cause of shock is blood loss, though it can
also be caused by a heart attack, burns, or fluid loss from
vomiting or diarrhea.
Symptoms of shock may appear suddenly or slowly, which
makes it difficult to spot. Any time a victim has severe fluid
loss, burns, or heart trouble, look out for signs of shock.
1. If a victim appears to be in shock, call 911.
2. Search for and treat the cause of the shock, if you are
not already aware of it.
3. Help the victim to lie on his back.
4. Elevate the legs about 12 inches from the floor. Be very
careful doing this if there are possible fractures.
5. Cover the victim with a coat or blanket to help maintain
body temperature. Loosen any tight clothing that might
restrict blood flow.
6. If the victim vomits, make sure he can still breathe and
put him in the recovery position.
7. If the victim becomes unconscious, check for airway
and breathing. If there is no breathing, begin CPR.

Heat and Cold Ailments

Extremely hot or cold temperatures can cause medical
problems, especially if the victim is exposed to such condition for a long period of time. Temperature-related injuries
often have a gradual onset but then progress rapidly to an
emergency-level situation.

Cold-Related Ailments
The two most common cold injuries are frostbite and hypothermia.

Frostbite
Frostbite is the freezing
Signs of Frostbite
of skin tissues. It occurs
White or gray waxy skin
when skin is exposed to
Numb or tingling skin
freezing temperatures (or
Severe frostbite: less
near-freezing with a wind
pain and hard skin
chill) for an extended period of time. Severe frostbite can result in tissue death, called gangrene.
Frostbite victims should receive immediate medical attention as soon as possible. Meanwhile, provide the following first aid:
1.
2.
3.
4.

Move the victim to a warm area.

Remove any wet clothing.
Remove any clothing or jewelry around the frostbite.
Dont warm the frostbitten area unless medical
facilities are inaccessible.
5. Elevate the frostbitten area to reduce swelling.
If you must re-warm the frostbitten area, immerse the body
part in lukewarm water. If immersion is impossible, cover
with lukewarm towels. Pat dry and cover in light gauze to
protect against rubbing.

Hypothermia
Hypothermia is a drop
Signs of Hypothermia
in a persons body tem Lowered responsiveness
perature after long expo Unnatuarlly cool skin
sure to cold air or water.
Violent shivering
If the victim is elderly or
an infant, call 911 immediately. If victim is young and fit and the symptoms are not
extreme, provide first aid and wait a few minutes to determine whether medical attention is required.
1. Move the victim quickly to a warm place.
2. Remove any wet clothing. Cover the victim with dry
clothing, a blanket, or even newspapers.
3. If the victim can swallow, give warm liquids to drink.
4. If youre at all unsure of the victims condition,
transport him to a medical care facility or call 911.

Heat-Related Ailments
The most common heat-related illnesses are sunburn, heat
exhaustion, and heat stroke.

Sunburn
Sunburn is caused by excessive
Signs of Sunburn
exposure to sunlight or to the rays
Red skin
from a sunlamp in a tanning salon.
Pain
Certain medicines make people
Blistering
more susceptible to sunburn. If
youre on medication, check
whether it has any side effects related to sun exposure.
1. Move the sunburned person into the shade or indoors.
Provide cool water to drink.
2. Sponge the affected skin with cold water or soak the
affected areas in cold water for 1015 minutes.
3. If no blistering develops, soothe the skin with calamine
lotion. If blistering develops, get medical assistance.

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Heat Exhaustion
Heat exhaustion results
when a person loses too
much water and salt as a
result of excessive sweating. It can be caused by
overexertion, hot weather, or illness.

Signs of Heat Exhaustion

Sweating, clammy skin

Headache
Dizziness and confusion
Nausea or cramps

1. Move the victim to a cool place, and have him lie down
and elevate his legs.
2. Provide plenty of cool water to drink. If possible, add
salt to the water at a ratio of one teaspoon per quart.
3. Transport the victim to a medical center, even if he
seems to have recovered.
4. If the victims condition deteriorates, put him in the
recovery position and monitor breathing. Be ready to
provide CPR if necessary.

Heat Stroke
Heat stroke occurs when
the body can no longer
cool itself. It can stem
from prolonged heat exhaustion, fever, or heat
exposure. The goal of
heat stroke first aid is to
lower the victims body
temperature.

Signs of Heat Stroke

Dry, red, hot skin

Absence of sweating
High fever
Vomiting
Rapid, shallow breathing
Seizures
Unresponsiveness

1. Call 911.
2. Move the victim to a cool place.
3. Wrap the victim in a cool, wet sheet, or sponge with
cool water and/or place ice packs against his neck. If
no water or ice is available, fan the victim.
4. If possible, monitor the victims body temperature with
the goal of reducing it to at least 100.4F (38C).
5. If the victims body temperature falls to target level,
replace the wet blanket with a dry one and put the
victim into the recovery position.
6. Monitor body temperature and breathing. If the victims
body temperature rises, return to cooling the body. If
the victim loses consciousness, check his breathing
and, if necessary, begin CPR.

Head, Neck, and Spinal Injuries

Head, neck, and spinal injuries are most often caused by
falls, car crashes, diving accidents, or blows to the head,
neck, or chest.

Head Injuries
Head injuries range from concussions that cause brief
impairment of consciousness to grave, life-threatening injuries. Any serious head injury should be treated also as an
injury to the spine or neck.

Concussion
Concussion occurs when the
brain is shaken by an impact. To provide first aid for a
concussion:

Signs of Concussion
Brief impairment of
consciousness
Nausea or dizziness
Memory loss

1. Monitor the victims vital

signs and responsiveness.
2. Do not leave the victim to his own care, even if
he seems to have recovered. Make sure a person
responsible for the victim remains near him at all times.
3. Advise the victim to go to the hospital if a headache,
nausea, or drowsiness develops.

Serious Head Wounds

First Aid for Open (Compound) Fractures

The most common serious head wounds are skull fractures

and cerebral compressions, in which internal bleeding puts
pressure on the brain.

Cover the open wound with a loose, sterile dressing.

Check for signs of shock.
Build up pads around and over the wound and bone.
Never put direct pressure on a protruding bone.
Keep the victim still until medical help arrives. If the
victim has to be transported to the emergency room,
bandage as you would a closed fracture.

Skull Fracture

Cerebral Compression
Symptoms

Falling responsiveness
Head wound or bruising
Soft scalp depression
Bruising around eyes
Blood from nose or ear
Asymmetry of head
or face

Falling responsiveness
Drowsiness
Intense headache
Fever or flushed skin
Unequal pupil size
Paralysis on one side of
the body

Treatment
Call 911. If the victim is
conscious, keep him comfortable but keep his head
and neck motionless. If
the victim is unconscious,
monitor breathing until
medical help arrives.

Call 911. If the victim is

conscious, lay him down
with his head and neck
stabilized. If there is bleeding, control with pressure
around (not directly on)
the wound. If the victim
is unconscious, monitor
breathing until medical
help arrives.

Spinal Injuries
If you suspect a neck
or spinal injury, dont
move the victim unless absolutely necessary.

Signs of Spinal Injury

Injury to head, neck, or back
Lack of feeling in extremities
Paralysis

1. Lay the victim flat and advise him not to move.

2. Call 911.
3. Kneel behind the victims head. Grasp both sides of the
head to stabilize it in line with the neck and spine.
If you must turn the victim to keep the airway open, roll him
while supporting the head, neck, and trunk. Moving a victim
with a spinal injury is an absolute last resort and should be
done only if the need is dire.

Skeletal Injuries

A dislocation occurs
Signs of Dislocation
when a bone pops out
Searing pain
of its normal position
Inability to move the area
at a joint. Dislocations
Swelling and discoloration
occur most often in
Awkward bending
the shoulder, jaw, and
fingers, though they
can occur at any joint. As a first responder, your goal is
to immobilize the injury and get the victim to the hospital.
Never attempt to snap a dislocation back into place.
1. Call for medical help. Watch for signs of shock.
2. Keep the injured area immobilized.
3. Support the injured area with a sling secured with a
bandage wrapped around an uninjured body part.
4. Check bandages every ten minutes to make sure they
arent cutting off circulation.

Strains, Sprains, and Tears

Other injuries that can occur to the ligaments, muscles,
and tendons include strains, sprains, and tears. They have
symptoms much like those for closed fractures.
1. If the pain is severe, call for medical help.
2. If not, immobilize the area with elastic bandaging. Try
to reduce pain and swelling with ice and elevation.
3. If pain persists, call for medical help or transport the
victim to the hospital.

Burns
Heat, chemicals, and electricity can all cause burns.
Though minor burns may only need first aid care, major
burns need professional medical attention.

Major and Minor Burns

Skeletal injuries can involve bones, joints, or muscles. Bones

can be fractured or dislocated from their correct position in
a joint, while soft tissue such as muscles and ligaments may
suffer strains, sprains, or tears.

Bone Fractures
Bone fractures can be
closed, meaning that the
skin is left intact, or open,
meaning that the broken
bone has punctured the
skin. Open fractures are also

Dislocations

Signs of Fracture
Loss of function
Pain, swelling, bruising
called compound fractures.

First Aid for Closed Fractures

1. Ask the victim to keep still.
2. If there is significant bruising, or the fracture is of a
large bone, call 911. Check for signs of shock.
3. Bandage the broken bone to an uninjured part of the
body. If an arm is broken, bandage against the torso;
if a leg is broken, bandage to the uninjured leg. The ties
on the bandage should be on the uninjured side.
4. If bandaging the broken bone causes pain, stop
immediately and call 911. If the victim feels coldness or
tingling in his extremities, the bandages are too tight.
5. If possible, place a cold pack or bag of ice on the
injured area. Keep a cloth between the ice and skin.
6. If movement causes the victim pain, call 911. If the
victim can move without pain, transport him to the
closest hospital emergency room.

The classification of a burn as minor or major depends on

the burns depth and the area it covers.
Minor burns include:
All superficial burns, which cause red skin and pain.
Any partial thickness burns that cover an area
smaller than your palm and dont affect the head,
neck, hands, feet, genitals, or respiratory system.
Partial thickness burns cause blistering, swelling,
and blotchiness.
Major burns include:
Any partial thickness burns larger than your palm
or that affect the head, neck, hands, feet, genitals,
or respiratory system.
All full thickness burns, which leave a charred or
white appearance and usually are painless (because
they cause nerve damage).

Thermal Burn First Aid

Thermal burns are caused by fire or other heat sources.
1. If the victims clothing is on fire, help him drop to the
ground and roll around in order to smother any flames.
You can also smother the fire by covering it with a
blanket or coat.
2. Once the fire is out, remove the burned clothing unless
it is stuck to the skin. Remove jewelry over any burn
before swelling occurs.

First Aid & CPR

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3. If the burn is major, or if victims clothes were on fire,
call 911 and treat him for shock. If the victim loses
consciousness, check his airway and breathing. If there
is no breathing, begin CPR.
4. If the burn is minor, immerse the burned area in a sink
or bucket of cool (not cold) water, or cover it with a wet
cloth for ten minutes. If possible, cover the burn loosely
with a dry sterile dressing, but dont tape the dressing.

Chemical Burn First Aid

Chemical burns are caused by contact with harmful chemicals. If there are fumes or spilled chemicals on the scene,
call 911 rather than provide first aid yourself. If the scene
is safe:
1. Summon medical assistance for any chemical burn.
2. If the victim has been burned with a dry chemical,
brush any remaining chemical off of the skin. Be very
careful not to let the chemical touch your own skin.
3. Run water over the burned area for 3060 minutes.
4. Remove jewelry and clothing from the burned area.
5. Put a dry sterile dressing over the burn, if available.

Electrical Burn First Aid

Electrical burns are caused by direct exposure to electricity. For any electrical burn, make sure the source of electricity is no longer present or active before entering the scene,
and call 911. Care for an electrical burn just as you would for
a thermal burn (see above).

Poisoning
Poisons are substances that have a toxic effect on body
tissues. They can range from overdoses of medicine to
household chemicals, industrial gases, or natural plant
substances. The treatment depends on the specific poison.
Poisons are most commonly ingested or inhaled.

Ingested Poisons
An ingested poison can
damage the digestive
tract and, if absorbed
into the bloodstream,
can cause additional
damage to the body.
Never induce vomiting
in a case of ingested
poison.

Signs of Ingested Poison

Burns or redness around
mouth or lips
Breath smells like chemicals
Empty pill bottles
Nausea or vomiting

1. Try to determine what caused the poisoning. Look for a

bottle and ask the victim or his family.
2. If victim is responsive, call the national Poison Control
Center (800.222.1222) and follow directions for care.
3. If victim is unresponsive, call for help, check his airway
and breathing, and provide CPR if needed. Make sure
there are no chemicals on the mouth before performing
CPR.

Inhaled Poisons

Signs of Inhaled Poison

Gases or fumes that may

Headache
cause poisoning include
Confusion or falling
everything from carbon
responsiveness
monoxide (produced by
Dizziness
auto engines and other
Seizures
machines) to the fumes
from household cleaners.
Do not enter a scene where there may be gases or fumes
until youre absolutely sure its safe.
1.
2.
3.
4.

Move the victim to an area free of fumes.

Once away from the fumes, call for medical help.
If the victim vomits, put him in the recovery position.
If the victim becomes unresponsive, check his airway
and breathing. If necessary, begin CPR.

Heart Attack

Bites and Stings

Insect and spider bites and stings can be a painful nuisance,
or, if the victim is allergic, the source of a life-threatening
emergency. Animal and snake bites can also cause lifethreatening situations.

Insect Stings and Bites

The first step when dealing with an insect sting or bite is
to ask whether the victim has an allergy to insect stings. If
yes, call 911 immediately and prepare to provide first aid for
anaphylactic shock. If the victim is not allergic:
1. Remove the stinger by gently scraping it away. Clean
the area with soap and water if possible.
2. Apply a cold pack or ice to the sting site, keeping a
cloth between the skin and the ice.
3. Observe the victim for 30 minutes for signs of an
allergic reaction. At any sign of an allergic reaction, call
911 and treat for anaphylactic shock.
Medical personnel should see any spider bite that causes
symptoms such as sweating, nausea, or stomach cramps.

Animal Bites
Animal bites can cause blood loss, spread disease, and
lead to infection. Notify police about any animal bite.
1. If there are large or multiple wounds, call 911.
2. Stop bleeding with direct pressure to the wound ( see
External Bleeding).
3. If necessary, treat the victim for shock ( see Shock).
4. Wash the wound with soap (if available) and water.
5. If medical assistance is not on its way, transport the
victim to an emergency room as soon as possible.

Snake Bites
Though few snakes in the United States are poisonous, its
always best to be cautious when dealing with a snake bite.
Call 911 and then follow these guidelines while awaiting the
arrival of medical personnel.
1. Wash the bite with soap (if available) and water.
2. Immobilize the bitten body part and gently compress
the part of the limb above the bite with bandages.
3. If the victim loses consciousness, check his airway and
breathing and provide CPR if needed.
Do not slash a snakebite with a knife, try to suck the poison
from the wound, or do anything that prevents blood from
reaching or leaving the site of the wound.

Emergency Medical Issues

A number of medical conditions can appear very suddenly,
demanding first aid care. The most common are fainting,
hypoglycemia, seizure, heart attack, and stroke.

Fainting
Fainting is a brief period of
unconsciousness after which
the victim recovers fully. It can
result from pain, hunger, exhaustion, stress, surprise, or
sudden action after inactivity.

Signs of Fainting
Lightheadedness
Brief loss of
consciousness
Slow pulse

1. If the victim feels faint, advise him to lie down. If the

victim faints while standing up, try to ease his fall.
2. Once the victim is lying down, elevate his feet about 12
inches above the ground.
3. Treat injuries that may have occurred during a fall.
4. When the victim regains consciousness, advise him
to rest. As dizziness subsides, help him to a sitting
position and then gradually to a standing position.
5. If dizziness persists after 15 minutes, transport the
victim to a hospital or medical care facility.

A heart attack is a sudden loss of or drop in

blood supply to the heart,
usually caused by a blockage of one of the hearts
coronary arteries.
1. If you suspect a heart
attack, call 911.
2. Sit the victim in a
comfortable position.
3. If possible, have the
victim slowly chew a
tablet of aspirin.
4. Monitor breathing and
be prepared to give
CPR if necessary.

Signs of Heart Attack

Intense chest pain
Viselike pressure around
the chest
Gasping for air
Sweating
Faintness
Sudden collapse
Ashen skin; blue lips
Women, diabetics, and
the elderly may experience different heart attack
symptoms: a feeling similar
to heartburn or indigestion,
or discomfort in the jaw,
shoulder, abdomen, back
or neck.

Hypoglycemia
Hypoglycemia is a lack
of glucose (sugar) in the
blood. It tends to strike
people who are diabetic.

Signs of Hypoglycemia
Faintness or confusion
Clammy, sweaty skin

1. Provide a quick source of sugar, such as juice, non-diet

soda, or a sugar packet. Many diabetics carry special
glucose tablets for just this purpose.
2. If the victim does not improve within 15 minutes, give
more sugar and call for help. Be prepared to provide
CPR if necessary.
3. If the victim has a seizure, take actions to protect him
(see below).

Seizure
A seizure involves a loss
Signs of Seizure
or impairment of con Loss of consciousness
sciousness and loss of
Convulsive movements
muscle control. Many
Arching of the back
seizures are caused by a
medical condition called
epilepsy, but they can also result from head injuries, hypoglycemia, heat stroke, or poisoning.
1. Protect the victim by moving objects out of his way.
If possible, put a towel or blanket beneath his head to
protect it against impact with the floor.
2. Call for medical help.
3. After the seizure is over, check his airway and
breathing.
If necessary, begin CPR.
4. If the victim is breathing, help him into the recovery
position. Stay with him until help arrives.
Never try to restrain a seizure victim by force or try to pry
open or put anything inside a seizure victims mouth.

Stroke
A stroke occurs when blood flow to the brain is stopped
or impaired by a blood clot or rupture of a blood vessel.
Strokes tend to affect older people or people suffering from
high blood pressure. Speedy medical care is the priority for
any stroke victim.
1. Call 911.
2. If the victim is conscious, lay him down with his head
and shoulders slightly elevated, and rest his head
slightly to the side. The victim may dribble from the
mouth.
3. If the victim becomes unconscious, check his airway
and breathing. If necessary, begin CPR.