First Aid

First Aid Audio Crash Course™ Complete First Aid Guide for the laymen

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TABLE OF CONTENTS Preface .................................................................................................................................... 1 Chapter 1: Safety Basics........................................................................................................... 5 Injury Prevention ...................................................................................................................... 5 On the Road .............................................................................................................................. 5 Sports Injury Prevention ........................................................................................................... 6 Home Injury Protection ............................................................................................................ 6 Work Injury Protection ............................................................................................................. 7 Scene Safety .............................................................................................................................. 8 Infection Prevention ................................................................................................................. 9 Approach to the Victim ........................................................................................................... 10 Primary and Secondary Survey ............................................................................................... 12 Requesting Help ...................................................................................................................... 14 Medical Alert Information ...................................................................................................... 15 Key Takeaways ........................................................................................................................ 16 Quiz ......................................................................................................................................... 17 Chapter 2: Incident Management .......................................................................................... 21 Auto Accidents ........................................................................................................................ 21 Fire Emergencies ..................................................................................................................... 23 Water Accidents ...................................................................................................................... 26 Electrical Incidents .................................................................................................................. 27 Mass Casualties ....................................................................................................................... 28 Disaster Survival ...................................................................................................................... 29 Flooding or Flash Flooding Situations ..................................................................................... 31 Hurricane Disasters ................................................................................................................. 31

Earthquakes ............................................................................................................................ 32 Volcanos .................................................................................................................................. 33 Wild Fires ................................................................................................................................ 33 Tornadoes ............................................................................................................................... 33 Blizzards .................................................................................................................................. 34 Tsunamis ................................................................................................................................. 35 Survival Situations ................................................................................................................... 35 Treating Shock in the Wilderness ........................................................................................... 36 Treating Stopped Breathing .................................................................................................... 37 Controlling Bleeding................................................................................................................ 38 Fracture and Dislocation Care................................................................................................. 38 Concussion Care ...................................................................................................................... 40 Heat Exhaustion Treatment .................................................................................................... 40 Snake Bites .............................................................................................................................. 40 Treating Hypothermia ............................................................................................................. 41 Key Takeaways ........................................................................................................................ 42 Quiz ......................................................................................................................................... 43 Chapter 3: First Aid Kits ......................................................................................................... 47 Dressings ................................................................................................................................. 47 Cold Compresses and Ice Packs .............................................................................................. 51 Warm Compresses and Heating Packs ................................................................................... 52 Butterfly Bandages .................................................................................................................. 55 Medical Tape ........................................................................................................................... 57 Improvised Slings .................................................................................................................... 59 Aspirin, Ibuprofen, and Acetaminophen ................................................................................ 61 ACE Wraps ............................................................................................................................... 62 Splints ...................................................................................................................................... 64

Key Takeaways ........................................................................................................................ 66 Quiz ......................................................................................................................................... 67 Chapter 4: CPR ....................................................................................................................... 71 CPR for Adults ......................................................................................................................... 71 CPR for Children ...................................................................................................................... 75 CPR in Babies ........................................................................................................................... 76 SIDS Prevention and First Aid ................................................................................................. 77 CPR for Newborns ................................................................................................................... 78 Using an AED ........................................................................................................................... 80 Key Takeaways ........................................................................................................................ 82 Quiz ......................................................................................................................................... 83 Chapter 5: Respiratory Emergencies ...................................................................................... 87 Respiratory System ................................................................................................................. 87 Choking Emergencies .............................................................................................................. 89 Asthma Emergencies............................................................................................................... 91 Croup Emergencies ................................................................................................................. 94 Strangulation/Hanging ............................................................................................................ 95 Inhalation of Fumes ................................................................................................................ 96 Penetrating chest wounds ...................................................................................................... 97 Hyperventilation ..................................................................................................................... 99 Drowning Emergencies ......................................................................................................... 100 Key Takeaways ...................................................................................................................... 103 Quiz ....................................................................................................................................... 104 Chapter 6: Circulation Issues ............................................................................................... 109 The Heart and Blood Vessels ................................................................................................ 109 Severe External Bleeding ...................................................................................................... 111

First Aid for Internal Bleeding ............................................................................................... 112 Nosebleeds............................................................................................................................ 113 Shock ..................................................................................................................................... 115 Impalement ........................................................................................................................... 116 Amputations.......................................................................................................................... 117 Key Takeaways ...................................................................................................................... 119 Quiz ....................................................................................................................................... 120 Chapter 7: Managing the Unconscious or Head-injured Victim ............................................ 124 Mechanisms of Unconsciousness ......................................................................................... 124 Breathing and Circulation in Unconscious Individuals.......................................................... 126 Unconscious Adult First Aid .................................................................................................. 127 Unconsciousness in Children ................................................................................................ 128 Coma in Adults and Children ................................................................................................ 129 Spinal Precautions................................................................................................................. 130 Concussions........................................................................................................................... 131 Concussion Management Protocols ..................................................................................... 132 Other Head Injuries ............................................................................................................... 133 Prevention of Head Injuries .................................................................................................. 135 Key Takeaways ...................................................................................................................... 137 Quiz ....................................................................................................................................... 138 Chapter 8: Wound Care ....................................................................................................... 142 Bruises ................................................................................................................................... 142 Lacerations/Cuts ................................................................................................................... 143 Scrapes and Road Rash ......................................................................................................... 145 Puncture Wounds ................................................................................................................. 147 Eye Injuries ............................................................................................................................ 148

Blisters................................................................................................................................... 149 Crush Injuries ........................................................................................................................ 150 Infected wounds ................................................................................................................... 151 Key Takeaways ...................................................................................................................... 153 Quiz ....................................................................................................................................... 154 Chapter 9: Musculoskeletal Injuries ..................................................................................... 158 The Skeleton and Muscles .................................................................................................... 158 Axial Skeleton ........................................................................................................................ 159 The Appendicular Skeleton ................................................................................................... 160 Spine Injuries......................................................................................................................... 161 Fractures ............................................................................................................................... 162 Facial Injuries ........................................................................................................................ 163 Sprains/Strains ...................................................................................................................... 164 Muscle Cramps...................................................................................................................... 165 Key Takeaways ...................................................................................................................... 167 Quiz ....................................................................................................................................... 168 Chapter 10: Heat and Cold injuries ...................................................................................... 172 Burns ..................................................................................................................................... 172 Frostbite Treatment .............................................................................................................. 177 Hypothermia ......................................................................................................................... 178 Heat Injuries .......................................................................................................................... 179 Key Takeaways ...................................................................................................................... 182 Quiz ....................................................................................................................................... 183 Chapter 11: Foreign Objects and Bites ................................................................................. 187 Splinters ................................................................................................................................ 187 Fishhook Impalement ........................................................................................................... 188

Swallowed Foreign Object .................................................................................................... 188 Eye, Nose, and Ear Foreign Bodies........................................................................................ 189 Insect Bites ............................................................................................................................ 191 Animal Bites .......................................................................................................................... 192 Tick Bites ............................................................................................................................... 192 Snake Bites ............................................................................................................................ 194 Marine Stings ........................................................................................................................ 194 Marine Punctures.................................................................................................................. 195 Key Takeaways ...................................................................................................................... 197 Quiz ....................................................................................................................................... 198 Chapter 12: Medical conditions ........................................................................................... 202 Poisoning ............................................................................................................................... 202 Hyperglycemia ...................................................................................................................... 203 Hypoglycemia ........................................................................................................................ 204 Angina/Heart Attack ............................................................................................................. 206 Stroke .................................................................................................................................... 207 Seizures ................................................................................................................................. 208 Fever ..................................................................................................................................... 209 Meningitis ............................................................................................................................. 211 Fainting ................................................................................................................................. 211 Allergies................................................................................................................................. 211 Migraine Headaches ............................................................................................................. 212 Vomiting/Diarrhea ................................................................................................................ 213 Pain........................................................................................................................................ 214 Emergency Childbirth............................................................................................................ 214 Key Takeaways ...................................................................................................................... 216 Quiz ....................................................................................................................................... 217

Summary ............................................................................................................................. 221 Course Questions and Answers ........................................................................................... 225

PREFACE This course is designed to empower the layperson who might face an emergency in the course of their daily lives so they can feel comfortable handling many common conditions. As a layperson, you might feel afraid to dive in and help in the case of an injury or illness you encounter. With the help of this course, you will have the knowledge and skills to help strangers and loved ones alike who need help. The course isn’t intended to take the place of a medical professional’s advice but will help you participate in an individual’s care before advanced help arrives.

Chapter one covers safety basics. Safety starts with injury prevention, which is something you can influence. Should an injury happen, however, you need to be prepared. This chapter talks about scene safety and infection prevention—things that are paramount when caring for a person in the field. It also talks about what your approach to the victim should be as well as the primary and secondary surveys that should occur when approaching the victim. Part of your job is to check for medical alert information on the victim and to get help when necessary.

These important safety issues are covered in this chapter.

The focus of chapter two is incident management, and covers what you need to do when you are faced with an emergency when no Emergency Medicine Services (EMS) are available. We’ve talked about getting help already; however, you need to know that there are things you can do as a bystander that can make the difference between life and death in an emergency situation.

Auto accidents, water accidents, and fires are possible incidents you may encounter. In rare instances, you might be asked to help in a mass casualty incident. This is where your first aid skills could be very helpful. Finally, you could be in a survival situation while camping or hiking where your knowledge of first aid could save your life or the life of others.

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Chapter three talks about first aid kits. As a first responder to an incident or as part of your home equipment, you should have a first aid kit and should know how to use it. This chapter will cover what’s in a first aid kit and what things you might have handy to deal with an emergency or first aid situation. You should know more than what’s in the kit. You should evaluate your kit, keep it stocked, and know how the items in it can be used in a first aid setting.

The topic of chapter four is cardiopulmonary resuscitation or CPR. Most of what you’ll learn will come directly from the American Red Cross and American Heart Association guidelines for emergency bystanders. They’ve done a lot of work in determining which interventions can truly make a difference in saving the life of a person who has had a cardiopulmonary arrest. The use of the Automatic External Defibrillator is also covered because these are available in public places and can save lives if you know how to use one.

Chapter five examines common respiratory issues. There are several actions that a first responder or bystander can take to help the person with respiratory distress or a respiratory problem. Some emergency situations may be the result of preexisting problems like asthma or croup. Other may be due to the sudden onset of a respiratory problem, such as choking, fume inhalation, penetrating chest wound, or drowning. The common problem of hyperventilation and what to do about it is also covered in this chapter.

The focus of chapter six is circulatory problems. The function of the heart and blood vessels is covered as well as the management of external bleeding, internal bleeding, impalement, and shock. These are situations that a bystander can manage and that can improve the victim’s outcome. Amputations are rare but can be life-threatening if not managed properly by the bystander or first responder.

The care of the unconscious and head-injured victim is the main topic of chapter seven in the course. Unconscious victims can have many different causes for their problem that can be divided into traumatic and non-traumatic causes. The victim may have breathing and circulation problems, which need to be treated. Concussions are extremely common and can

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lead to a brief period of unconsciousness. Head-injured victims are also discussed in the chapter. Finally, we will discuss spinal precautions, which are those actions a first responder can take to protect an unconscious trauma victim from also becoming paralyzed from a neck or back injury.

Chapter eight covers the basics of wound care. There a number of minor injuries that you might be asked to care for, such as bruises, blisters, cuts or lacerations, puncture wounds, scrapes, and “road rash.” Injuries to the eyes can lead to the need for emergency management. The care of crush injuries in the field is covered as well as what you can do in order to identify and treat infected wounds.

The musculoskeletal system and musculoskeletal injuries are the topics of chapter nine. The victim may have spinal injuries, fractures of the face, fractures of the ribs, or fractures of the extremities that may need management in the field. Sprains and strains are common injuries that may not need to be seen by a doctor or hospital and that you can treat at home. Muscle cramps are generally not due to a traumatic injury but, after recognizing this problem, you can decide whether or not to seek further medical attention.

Chapter ten covers the different injuries caused by excessive heat or cold exposure. These can be as simple as sunburns or as complex as severe burns. Exposure to excessive heat can lead to problems like heat cramps, heat exhaustion, and heatstroke. Cold exposure can cause as many problems as heat exposure can, including hypothermia and frostbite. Injuries to the skin and/or eyes can happen because of chemical burns. Electrical burns are a special kind of burn that can cause severe internal health problems because of the special nature of these types of injuries.

The care and management of foreign body injuries, stings, and bites are the topic of chapter eleven. A foreign body can be a splinter or a fishhook. Foreign objects can be swallowed, stuck in the eye, or trapped in the external ear. You may need to apply first aid for insect, tick, or animal bites. Depending on where you live or vacation, you might have to apply first aid to marine stings, snake bites, or marine-related puncture wounds. Each of these is covered in this chapter.

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The focus of chapter twelve is the first aid management of common medical conditions. There are several medical problems you may have to handle, including poisoning situations, low and high blood sugar symptoms, heart attacks or chest pain, and stroke. These are all emergencies where first aid can make a difference. Fever, especially in children, may require emergency management. There are several other medical problems, including the possibility of having to attend to an emergency childbirth, which are also covered in this chapter.

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CHAPTER 1: SAFETY BASICS Safety starts with injury prevention, which is something you can have an impact on. Should an injury happen, however, you need to be prepared. This chapter talks about scene safety and infection prevention. It also talks about what your approach to the victim should be and the primary and secondary surveys that need to happen when approaching the victim. Part of your job is to check for medical alert information on the victim and to get help when necessary.

These important safety issues are covered in this chapter.

INJURY PREVENTION Part of being a good bystander or first responder to an emergency is recognizing that safety in all situations is crucial to reducing injuries and illnesses. There are several aspects to safety that apply to the roadways, sports safety, work safety, and safety in the home. Recognize there are several ways to get injured, especially if you are not careful to follow simple safety tips that apply not only to your life but to the lives of those around you. Let’s take a look at some basic injury prevention tips you should follow.

ON THE ROAD Here are some safety tips you should always be thinking about: A. Wear your safety belt—this saves the most lives of any road safety tip you can follow.

B. Never drive under the influence—this applies to alcohol, illicit drugs, and certain prescription drugs.

C. Be aware of your surroundings—this means driving defensively and never assuming everyone on the road will be following the law or paying attention to the roadway.

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D. Be aware of weather conditions—check your smart phone, the radar, and the news about the current weather conditions and try avoid driving when road conditions are poor.

E. Don’t drive angry—this has the potential to anger other drivers and might get you into a dangerous road rage situation.

SPORTS INJURY PREVENTION A. Wear protective gear appropriate to the sport. This includes items like mouth guards, knee pads, bike helmets, football helmets, eyewear, and protective shoes.

B. Know your limits. If you aren’t well-trained for a sport, take it easy until your muscles and reflexes are adept at doing the sport.

C. Respect concussions and take adequate time to heal after experiencing a concussion.

HOME INJURY PROTECTION A. Buy a fire extinguisher and learn how to use it.

B. Keep children away from fires, hot surfaces, tools, lighters, and medications/drugs.

C. Teach children how to call for help in an emergency.

D. Use appropriate tools and ladders for housework and know your limits.

E. Clear away dead vegetation that could catch fire.

F. Maintain home security with deadbolts, closed garage doors, and security systems.

G. Maintain smoke detectors and check them periodically (or get those that chirp when the batteries are dying).

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WORK INJURY PROTECTION A. Be aware of your surroundings—this applies to all jobs but particularly to those that involve hazards or hazardous work.

B. Use a back brace or lift with correct posture—it also applies to desk work in which good posture can make the difference between back and neck problems and a pain-free job.

C. Take recommended breaks—many injuries happen because a worker is overworked, tired, and burned out. Taking breaks can help you be more alert and will reduce your injury risk.

D. Don’t take shortcuts—use equipment the way it was intended and take the proper precautions when using tools and machinery.

E. Know where the emergency exits are in the workplace—should a fire or other emergency take place, you should know the fastest way out.

F. Report any unsafe conditions to a supervisor—as an employee, you know what’s safe and what’s not safe about your job. It’s your duty to do what you can to keep yourself and others safe.

G. Stay sober at your workplace—this sounds obvious; however, three percent of workplace deaths are secondary to alcohol or drug use on the job.

H. Reduce stress on the job—this can lead to concentration difficulties and depression.

Address workplace stress with your coworkers and supervisors.

I. Wear the correct safety equipment—this includes protective eyewear, earplugs, hardhats, face masks, and gloves, if these are indicated for your particular job.

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SCENE SAFETY As the first person or one of the first people to encounter an injury situation, you may want to do what you can to help those that are injured. The problem is that doing so can endanger your life as well. This applies to terrorist/shooter situations, fires, workplace injuries, and motor vehicle accidents. You cannot help someone if you get killed or injured yourself. Let’s take a look at the main reasons why first responders get injured at a scene: A. Body motion injuries—this is the number one reason why people who render first aid get injured. It happens when trying to lift or move the victim at the scene or from rescue efforts that injure the rescuer as well. Don’t try to move a victim without help and pay attention to body mechanics when doing the move. Don’t move a victim unless it is absolutely necessary.

B. Exposure to dangerous substances—this is the second most common injury. It involves exposure to substances like blood or body fluids and from inhalation injuries at the scene of a fire or industrial incident.

C. Falls and trips—in the chaos of an injury incident, it can be easy to get carried away and fall. Stay aware of both the surroundings and the terrain so you don’t become a casualty in the act of trying to rescue someone.

D. Motor vehicle incidents—this involves trying to work on someone while on a roadway where gawkers are not paying attention as they drive by. This especially happens on busy roadways or in situations where you’re trying to help a victim in poorly lit areas. As a pedestrian on a roadway, you will be in danger.

E. Assaults and violence— Victims you are trying to help may become combative or violent while you are trying to help them. Just be aware that these people are scared and sometimes confused so you cannot trust them to be completely calm and cooperative.

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INFECTION PREVENTION Anytime you render aid to a person who is sick or injured, you run the risk of getting an infectious disease from that person. Because many sick individuals have a period of time before they actually show symptoms but can transmit the sickness, you need to be wary, even if the individual doesn’t show obvious symptoms. This applies to a lot of infectious diseases, like strep throat, respiratory infections, and influenza (the “flu”). While you can’t necessarily control your exposure, you can do simple things like washing your hands after touching someone who’s sick. Hand washing is the best prevention for most infectious diseases.

If the person is obviously sick, be wary of symptoms like cough, sneezing, fever, chills, and body aches. This is probably influenza and it would help if you had an annual flu shot, which has the potential to fully protect you from catching it. Vomiting and diarrhea are often due to infectious diseases; it is also possible to get an infection from an open or weeping wound or sore. Again, wash your hands.

Less commonly, exposure to “droplets” from coughing or sneezing can lead to infections from tuberculosis or meningitis. Fortunately, these are relatively rare diseases that happen more commonly in people with a poor immune system. Even so, you should make sure you always have current immunizations. Most people under the age of 30 years have been fully vaccinated as children but you need to keep on getting a Diphtheria-tetanus vaccine every ten years. Some time in your life, it also pays to be immunized against Haemophilus influenza type B (which can cause meningitis) and hepatitis B (which is not a respiratory disease).

When washing your hands, use an alcohol-based gel that you can keep as hand sanitizer in a bag or purse or use soap and water. Wash with soap and water for 15 seconds at a minimum and don’t touch the faucet with your hands after you’ve washed them. Try to wash in between your fingers and up to your wrist while scrubbing your hands.

Bloodborne diseases such as HIV disease (AIDS) and hepatitis B are transmitted when the victim’s blood mixes with your blood or if there is sexual contact with an infected person. You

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can’t get these diseases by doing mouth-to-mouth resuscitation or from exposure to their saliva, sputum, nasal secretions, or vomit. To be safe, though, you should cover any cuts or sores you have that could result in an exchange of blood through the break in your skin. This is good practice, even if you aren’t rendering first aid.

If you have significant contact with the bodily secretions or blood of another person, especially if it is someone you do not know, change your clothing and take a shower to clean your body.

While you can’t really get HIV disease or hepatitis B if there is no contact with your blood, there is still contact with possibly infected fluids causing other diseases. The best way to avoid a hepatitis B infection is to get immunized if it didn’t happen when you were little.

APPROACH TO THE VICTIM There is a saying that the first thing you should do when approaching a person who is unconscious and not breathing is to take your own pulse. This means you first need to collect yourself and calm down or you won’t be of help to anyone. This is especially the case when the victim is one of your family members or when the person is seriously sick or injured. This doesn’t mean you need to act slowly; you just need to think about what you’re doing and try not to be emotionally overcome—at least not until the emergency is over.

Once you have calmed down, your initial approach to a victim is to get an overall impression of what’s going on. Do they look sick? Are they talking and do they make sense? Is their skin a normal pink or skin-color or do they look blue in the extremities or around their mouth? Are they struggling to catch their breath? The person who is talking and not struggling to breathe probably doesn’t need overzealous treatment. On the other hand, the individual who can’t complete a sentence because they are short of breath or who isn’t making sense needs urgent treatment.

If the victim is a child, the fact that they are crying is usually a good sign. Crying children have the respiratory (lung) reserves to allow them to cry. The child who cannot cry because they are too busy breathing is probably sicker than the crying child. Listening for abnormal breathing

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sounds is the first thing you should assess. People with pneumonia, heart failure, asthma, croup, or a foreign body in the airway will have unusual breath sounds you can hear when they breathe. This is a quick way of checking the person’s airway patency and breathing ability.

Next, determine if they have an increased “work of breathing”. Are they sitting up and drooling? Are they breathing shallow and fast? Is their chest heaving when they breathe?

These are signs that the person is using extra energy to breathe and might tire out and stop breathing. You should call for an ambulance when you perceive the work of breathing is increased.

Third, what is their circulation like? Do they have cool hands and feet or do they have a bluish discoloration around their mouth? These are signs that the individual might not have the blood pressure to support their body’s needs. It could be for several different reasons, including blood loss or severe infection, but suffice it to say, it is a sign that an ambulance needs to be called.

If you know how to check a pulse, this can be very helpful in determining if the person is in distress. The pulse or “heart rate” can be detected by placing two fingers over the inside of the wrist on the “thumb side” of the wrist. The “heart beat” can be felt beneath the skin. Tilt the wrist back to feel it better. A normal pulse is between 60 and 100 beats per minute. Measure the number of beats you feel in 30 seconds and multiply what you’ve felt times two. A fast pulse might mean anxiety, but it could mean the person is going into shock or struggling to breath. Figure 1 in your guide shows how to check a radial pulse.

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Figure 1: How to check a radial pulse.

After you have checked the airway, work of breathing, and circulation, think about the person’s mental status. Do they make sense or are they asking the same questions over and over again?

Do they follow simple commands? Is there drooping of one side of the face, an inability to talk, or weakness on one side or the other of the body? These are all signs of an abnormal mental status or possibly a stroke. An individual doesn’t have to be unconscious to have brain problems. A low level of consciousness or confusion is a sign that you probably need to call an ambulance.

PRIMARY AND SECONDARY SURVEY EMTs and paramedics do a primary and secondary survey when encountering a sick or injured person for the first time. This is basically what you should do when deciding if a person is in an emergency situation and is sick or injured.

We’ve already covered the primary survey, which involves the heart function, the work of breathing, the airway or breathing tube function, and the level of consciousness. These are considered the most life-threatening issues you must deal with. A problem with any of these

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things means you should call an ambulance as soon as you can. The person needs more care than you can give them with first aid measures.

The other thing that should be done in the primary survey is to assess for dangerous situations.

For example, if there is toxic gas get out of the area, taking the injured person with you only if it is safe for you to do so. If there is a fire, get out and ask questions later. Once safe, get an idea of what happened to the individual from other bystanders or from the victim themselves.

If the primary survey indicates a problem, you may have to intervene to save the person’s life before the paramedics arrive. We’ll talk about what you can do to help the victim in later chapters. If the person has no problems in the primary survey, you can do a secondary survey.

While awaiting help or deciding if the person really needs help, you need to ask questions and look the person over more carefully. Questions you should ask, whether this is a trauma victim or a sick person, include: A. What happened leading up to the person’s symptoms?

B. What symptoms does the person have?

C. Is the person allergic to anything?

D. Does the person take any particular medications?

E. What health problems has the person had?

F. When did the person last eat anything?

While you are asking these questions, take a few minutes to check the person from head to toe, looking for bleeding, broken bones, open sores, or areas of soreness. If the person has a specific complaint, you can focus on that as part of the secondary survey. Look for bruising or deformities of the chest, abdomen, or extremities.

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REQUESTING HELP At some point, you might decide to ask for help. Years ago, you needed to memorize or look up the number for the ambulance service in your area. Now, most countries have a system in which a three-digit code is used to contact a universal emergency number for fire, rescue, police, and ambulance services. In the US, this number is 911. Upon calling that number, you will reach a dispatcher who will listen to your story and contact the appropriate authorities, including a nearby ambulance crew.

You should know that 911 is universal for the US but not necessarily for other countries you might travel to. If you are fond of traveling, look up the emergency number for that country and write it down or memorize it before you go. Here are some examples: A. Canada—911 B. Great Britain (UK)—999 (Call 55 if it is too dangerous to speak or make a noise) C. Most of Europe—112 D. Australia—000 E. New Zealand—111 F. Japan—110 for police and 119 for ambulance or fire G. Brazil—190 for police, 192 for ambulance, and 193 for fire H. China—110 for police, 120 for ambulance, and 119 for fire I. Hong Kong—999 J. Bahamas—911 or 919 K. India—112 L. Barbados—911

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You should call emergency services anytime you feel as though you cannot handle the person with first aid measures alone. There is no non-emergency number to call for an ambulance or the police department (that are answered routinely) so you need to err on the side of safety and call anytime you think the person needs to go to a hospital urgently.

MEDICAL ALERT INFORMATION If you are rendering first aid to someone you don’t know, it is a good idea to look for a medical ID of some kind. This might be a medical alert bracelet, necklace, or sometimes even a tattoo that has important medical information on it. Figure 2 in your guide shows what a medical alert bracelet looks like. The goal of any type of medical identification is that it contains medical information that can be used by the paramedics and doctors so treatment can be appropriate even if the person cannot speak for themselves.

Figure 2: A medical alert bracelet

The key components of the medical alert jewelry include the person’s name, medical conditions, allergies, and emergency contact information. It can contain a list of their medications if this is important information for doctors to have. You might find that the person is diabetic and their unconsciousness could mean that they have low or high blood sugar. This could ultimately help the paramedics you call to care for the person appropriately sooner than they could have without the bracelet. Usually, the person’s address and social security number are not on the jewelry unless the person has dementia (making the address an important thing to know).

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Figure 3: How to tilt the head back and lift the jaw for mouth-to-mouth resuscitation.

CONTROLLING BLEEDING When taking care of a person who is bleeding, you should first apply direct pressure to the bleeding site with a clean cloth or gauze. Elevate the site so that it is above the level of the heart. After the bleeding is well-controlled, you need to wash it with a disinfectant and put on a bandage dressing. The goal is to stop bleeding and keep the wound clean while you await help.

FRACTURE AND DISLOCATION CARE Fractures can be “open” or “closed.” Figure 4 in your guide shows you what these fractures look like. An open fracture is when you can see the bone or when there is a break in the skin over the injured site. Look for pain, possible deformity, and an inability to use a particular joint or extremity. You may also feel a grating sensation or sound over the fracture site. If you don’t know if it’s fractured, treat it as a fracture anyway. Splint the arm or leg to include the joints

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