First Aid

V

Fainting, Seizures, and Coma

Fainting, a sudden, temporary loss of consciousness, occurs when the brain does not receive enough blood. Just before fainting, a person’s skin may appear pale and clammy or sweaty. To restore blood flow to the brain, a first-aid provider should elevate the unconscious person’s feet or position the individual’s head below the level of the heart. The victim’s airway and breathing should be closely monitored. A fainting victim must also be kept warm to prevent shock. If the victim does not fully recover after five minutes, medical help should be requested.

Seizures, sudden brief episodes of intense neurological activity, may result from a variety of causes, including epilepsy, a neurological disorder, and head injuries. First aid for seizures consists of protecting the victim from accidental injury during the seizure. The first-aid provider should not put any objects in a seizing person’s mouth or try to hold the tongue. If the victim has medical identification indicating epilepsy, an ambulance need not be called unless the person experiences multiple seizures or one seizure lasts more than five minutes. Otherwise, once the seizure stops, question the person about the need for a hospital evaluation. If no medical identification exists the first-aid provider should request medical assistance.

A deep state of unconsciousness due to illness or injury is known as a coma. Comatose individuals cannot be awakened. Heart failure, stroke, epilepsy, diabetes, or traumatic brain injury can cause comas and a medical alert tag on the victim may identify a possible cause of the coma. If the person is breathing, first aid is limited to providing comfort until medical assistance arrives. If the victim is not breathing, the first-aid provider should administer mouth-to-mouth or mask-to-mouth resuscitation.

VI

Poisoning and Drug Overdose

A poisonous substance introduced into the body through the mouth or nose causes symptoms such as nausea, cramps, and vomiting. Poisons include toxic medications, herbicides, insecticides, rodenticides, household disinfectants, and noxious gases.

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In a case of poisoning, the first-aid provider should remove the victim from a toxic environment, then contact the poison control center listed in most United States phone books. If the number is unavailable, the provider should call a physician or hospital emergency department. If possible, the provider should try to identify the poison, either by questioning the victim or searching for suspicious containers. Containers of many poisonous substances list the antidote, or remedy, on the label. Burns or stains on the skin or a characteristic odor on the breath may also help the first-aid provider recognize the poison.

Unless instructed to do so by the poison control center, the first-aid provider should never give a poisoning victim anything to eat or drink. Vomiting should not be induced unless the poison control center recommends it. If the victim vomits, the first-aid provider should turn the individual on the side and clear the airway. Before clearing the victim’s mouth of any obstructions, however, the provider should first put on clean first-aid gloves or wrap a cloth around his or her fingers. If the person who ingested the poison is unconscious, the airway, breathing, and circulation should be checked and CPR started if necessary.

A drug overdose occurs when an individual takes too large a dose of a drug or takes a dose that is stronger than the person can tolerate. A drug overdose can be difficult to diagnose because the signs and symptoms vary widely and often mimic other illnesses or injuries. Symptoms of a drug overdose include unusually dilated or contracted pupils, vomiting, difficulty in breathing, hallucinations, and in severe cases unconsciousness and slow, deep breathing. If an overdose is not treated, the individual may die. Victims of overdose should be taken immediately to a hospital emergency room.

VII

Burns

A burn is an injury to the skin caused by exposure to fire, hot liquids or metals, radiation, chemicals, electricity, or the sun’s ultraviolet rays. Burns are classified according to the depth of tissue damage and extent of the burn. A first-degree, or superficial, burn, which involves only the surface of the skin, is characterized by reddening. A second-degree burn extends beneath skin surface and causes blistering and severe pain while a third-degree, or full-thickness, burn causes charring and destruction of the cell-producing layer of skin. The severity of a burn depends also on the area involved, expressed as a percentage of the total body surface area. Severe burns cause shock and loss of body fluids. A person suffering third-degree burns over more than 10 percent of body surface area should be hospitalized as soon as possible.

First aid for burns involves removing the source of the burn as soon as possible. The burn should be cooled immediately with cold water. A clean, cold wet towel or dressing can be placed on less serious burns to ease pain and protect the burn from contamination. Continuously bathe chemical burns with running water for at least 20 minutes to dilute the substance. Any powder should be carefully brushed off with gloved or protected hands before washing. Wet dressings or ointments should never be used for burns. Instead, the first-aid provider should gently apply dry, sterile dressings held in place by bandages and seek immediate medical attention.

VIII

Electric Shock

Contact with electrical current is potentially fatal. Electricity passing through the body can cause injury to the skin and internal organs. If electricity passes through the heart, the heart muscle may be damaged and the heart’s rhythm interrupted, leading to cardiac arrest. The signs and symptoms of electric shock include tingling, burns on the skin where the current entered or exited, muscle pain, headache, loss of consciousness, irregular breathing or lack of breathing, and cardiac arrest. The severity of the injury depends on the strength of the electric current and the path the current takes through the body. The person providing first aid to a victim of electric shock should not touch the individual’s body until the source of the shock is turned off. Because of the potential for internal injuries, victims of electrical injury should not be moved unless they are in immediate danger. The first-aid provider should monitor the victim for symptoms of shock. If the victim has stopped breathing and has no pulse, CPR should be performed after the airway, breathing, and circulation have been checked. When the victim’s vital signs are stable, the site of the burn should be treated using the same methods used for other burns.

IX

Animal Bites and Stings

Animals such as snakes, dogs, cats, small rodents like squirrels, certain insects, and spiders may bite humans with dangerous consequences. Many snakebites are caused by nonvenomous (nonpoisonous) snakes and do not require treatment beyond cleaning the wound. Bites inflicted by venomous snakes require immediate first-aid measures. The victim should be taken as soon as possible to the nearest emergency medical facility. In the interim, the first-aid provider should not cut the area around the bite, attempt to suck out the venom, or apply ice to the wound. The focus of first aid should be to prevent the venom from spreading rapidly through the individual’s bloodstream. The victim should be kept quiet to avoid stimulating circulation of the venom. In addition, the bite area should be kept at a lower level than the rest of the body. The wound should be washed thoroughly with soap and water, blotted dry, and loosely covered with a sterile dressing.

Bites from other animals should be thoroughly washed, treated with an antibiotic ointment, and bandaged. The victim should seek medical attention if the bite is severe, if rabies (an infectious viral disease) is suspected, or if the bite becomes infected. Bites from other humans are particularly prone to serious bacterial infection and should be treated by a medical professional. Victims of any animal or human bite whose immunizations are not current may need a shot for tetanus, an often fatal infectious disease affecting the muscles of the neck and jaw.

Biting insects include fleas, mosquitoes, bedbugs, lice, chiggers, and gnats. Bites from these insects should be washed to prevent infection, and cold compresses or topical medications applied to alleviate itching and pain. Bites from some species of ticks can cause serious illnesses including lyme disease and Rocky Mountain spotted fever. When a tick bites a person, it may attach itself to the body by burrowing into the skin. As a result, a tick should be removed by carefully pulling it straight out with tweezers so as not to leave its head behind. The tick should not be squeezed when it is removed. Bites from most spiders can be treated like those of other biting insects. Bites from black widow spiders and other poisonous spiders require medical help. They are treated similarly to poisonous snakebites.

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