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FIRST AID INSTRUCTIONS William W. Forgey, M.D. Emergency Phone Numbers DIAL 911 or: Paramedics/ Fire______________________________________ Ambulance ______________________________ Poison Center ___________________________________ Personal (Name) _________________________ Doctor___________________________________ Pharmacist/ Allergist _________________________________ Relative/ Friend ___________________________________ ©2005 Sawyer Products P.O. Box 188, Safety Harbor, FL 34695 BASIC FIRST AID TECHNIQUES RAPID ASSESSMENT FOR FIRST AID CARE: PRESSURE WRAP METHOD: These four areas of the body should be surveyed to rapidly assess an injured person. • The pressure wrap in the kit is designed to apply pressure to a serious wound to stop bleeding. HEAD AND NECK: • Place a sterile gauze pad over the wound and apply pressure wrap over gauze pad. • Wrap should be tight enough to stop bleeding, yet allow you to still feel a pulse in the extremity. • No need for tape; wrap is self-adherent. • Check the pupils in the victim’s eyes: normally, they should be reactive to light and equal in size. An unequal, large pupil that does not react to light may mean a severe life-threatening head injury. • Do not leave pressure wrap on for more than 10 minutes without loosening. • If a conscious person complains of neck pain after an accident or trauma, then his neck should be secured. See FIRST AID TECHNIQUES. • In an unconscious person, or in a person with head or neck injury, keep the neck from moving to prevent damage to the spinal cord; this could cause paralysis. • The neck can be made immobile by the following: 1. Hold the victim’s head steady with your hands. 2. Secure the victim’s body before securing the neck. 3. Place a hard surface under the victim’s back and secure head with pressure wrap. CAUTION: A pressure wrap must not obstruct breathing or be around neck. 4. In the field, place large rocks or small logs beside victim’s neck and secure the head with pressure wrap to prevent the neck from moving. CHECKING PULSES Read and familiarize yourself with these aids for any emergency. • Wrist Pulse (Radial Artery) 1. Remain calm. Panic delays effective medical care. 2. Check airway, breathing, and circulation (See CPR). 3. Check for serious bleeding and shock (See Shock section on reverse side). 4. Maintain body core temperature (See Heat and Cold Injuries). 5. Check for other injuries as directed by this guide. 6. Check for medical information (usually found in wallet, on bracelet or neck chain) that describes a medical problem or allergy. • In a neck injury check person for the presence of normal sensation and the ability to move fingers and toes. Do not allow victim to move neck. Head and Neck The hand is supplied by another large artery, therefore injuries to the radial artery do not result in complete loss of blood supply. Radial Artery Treatment: If the victim has good air exchange, DO NOT attempt to remove the object. Encourage coughing. Call for medical help immediately. COMPLETE OBSTRUCTION Recognition: Treatment: DON’TS Unconsciousness can occur in a few minutes followed by cardiopulmonary arrest. Victim cannot speak or nods yes when asked, “Are you choking?” Victim appears dusky in color and panicky because no air is getting to the lungs. • Don’t stick your finger or other object into the victim’s mouth. • Don’t give victim anything to drink until you are sure the object is swallowed or removed. • Don’t interfere if victim is moving air into lungs. • Call for medical help. • If the victim is speaking and moving some air, encourage continued coughing and breathing through nose. • Ask, “Are you choking?” If the victim cannot answer, then full obstruction exists. • Apply the abdominal thrust technique: 1. Get behind victim and place your arms around his abdomen. 2. Make a fist with one hand and place the thumb side of your fist against victim’s abdomen above the navel and below the ribs. 3. Grasp your fist with your other hand. 4. Make quick upward and inward forceful thrusts until the foreign body is expelled or the patient becomes unconscious. DO’s FOR VICTIM WHO BECOMES UNCONSCIOUS: Carotid Artery CHEST AND BACK: • Look for obvious wounds and bruises. • Watch the pattern of breathing. The chest wall should rise and fall evenly on both sides of the lungs. Femoral Artery • Groin Pulse (Femoral Arteries) • Feel the chest wall for deformities and pain. • Check for back injuries but do not move the victim who is unconscious or who has back pain. Located just below the abdomen next to the genital region. The femoral arteries are easily felt in the midline. • 3. Attempt rescue breathing. If unsuccessful, reposition the head and try again. • 2. Open mouth and sweep deeply with a hooked finger in an attempt to remove foreign body. • 4. If air will not go in, kneel astride the victim’s thighs, place the heel of one hand on the victim’s, abdomen in the midline slightly above the navel and well below the ribs, and perform up to five abdominal thrusts. • 5. Repeat steps 2 and 4 until foreign body is removed. NOTE: Children are treated the same as adults. AIRWAY OBSTRUCTION IN INFANTS • DON’T attempt to remove obstructing object with fingers since this may push object further back against airway. Lacerations or penetrating wounds to the chest or back can penetrate into the lungs and cause the lung to collapse (pneumothorax). Lung collapse can also be caused by blunt non-penetrating trauma that fractures a rib. • Foot Pulse (Pedal Artery) Pedal Pulse Located on the top (dorsum) of the foot, in the center, in line with the middle two toes. • Rolled up newspaper • Board or stick • Cardboard • Pillow or rolled up sheets For a splint to be useful it must bridge the injury or joint involved in the injury. The pressure wrap can he used to secure the splint. Do not wrap too tightly. Apply wrap in a figure “8” around ankle joint and foot Start on foot first, then wrap ankle. Wrap secures itself. Use board or cardboard. Board should be placed under palm of hand to adequately support wrist. If no board is available, splint wrist with wrap alone as shown in figure. Caution: Check for presence of pulse after applying pressure wrap. 4. Don’t attempt first aid measures beyond your level of skill. Knee MOVING THE INJURED PERSON Apply wrap around knee making sure wrap goes above and below knee joint for adequate support. (Never attempt to straighten injured joint.) A chest or back wound that has air alternately escaping and being sucked into the wound must be closed by use of an airtight seal bandage (See FIRST AID TECHNIQUES). A sucking wound of this sort can be sealed with plastic wrap. Leave any Chest and Back penetrating object in the secure (See FIRST AID TECHNIQUES). If a victim has been impaled by a penetrating object, then attempt to cut object off at base but do not remove object. Removal of penetrating object can result in massive, uncontrollable bleeding. • Repeat if necessary. BASIC CARDIOPULMONARY RESUSCITATION – CPR WHEN TO PERFORM CPR – FOR UNCONSCIOUS PERSON ONLY #5a. #5b. ABDOMEN AND PELVIS: • Feel the abdomen with your hands; any pain elicited could indicate potential organ injury. • Check for obvious wounds or bruises. A bruise could indicate serious organ injury. • Rock the hips slightly; the presence of pain could mean a hip fracture. • Feel for the presence of femoral (groin) pulses. #6 • Splint a joint injury by wrapping above and below. 10. ONE RESCUER CPR • Splint a long bone injury by securing the joint above and below. SECURING A PENETRATING OBJECT 1. Do not remove object from body. 2. Secure the object so that it cannot move. Pack sterile pads or clean clothes around the object at point of entry. Use the roll of self-adherent wrap to hold pads and object in place. 3. Make sure that wrapping is not so tight as to restrict breathing, or to cause loss of pulse. Redo wrapping if necessary. 4. Continually monitor breathing, pulse and symptoms of shock. 5. Seek medical help immediately. EXTREMITIES: • Check for deformities, wounds, and fractures. • Feel the skin for indications of shock or fever. • Check for radial (wrist) pulse and pedal (top of the foot) pulse. See FIRST AID TECHNIQUES. • Always check for presence of a pulse in an injured extremity. • In a neck or back injury, check person for the presence of normal sensation and the ability to move fingers and toes. Do not allow victim to move neck. In the amputation of an extremity, finger or toe, apply pressure dressing to help stop bleeding. Place amputated part in plastic bag and keep cold but not on ice. Seek immediate medical help. AIR TIGHT SEAL BANDAGE FOR CHEST WOUNDS 1. Cover wound with sterile pads. 2. Over the pads place plastic or aluminum foil so as to completely stop air leakage while victim exhales forcefully. 3. Secure the plastic or foil using the roll of self-adherent wrap. Hold seal in place until wrap is secure. 4. Loosen wrapping as necessary (one side only) to relieve air pressure build-up or victim discomfort. 5. Continually monitor breathing, seek medical help immediately. INFANT CPR WOUNDS OF EXTREMITIES Wounds of the extremities can involve blood vessels, nerves, or tendons. The wound can be cleaned or irrigated with clean water to remove contaminating dirt. If bleeding involves a blood vessel or appears heavy, apply direct pressure using pressure wrap. Check for a pulse in injured extremity. SEIZURES Seizures are common and usually safely terminate by themselves in less than a minute. The victim may jerk upper and lower extremities in a tonic fashion and turn blue in the face. However, in most instances the seizure will terminate in seconds. After the seizure terminates the victim usually remains unconscious or very lethargic and is confused. This phase clears slowly. Make sure the victim does not aspirate vomitus or mouth contents into their lungs during the seizure. DO NOT attempt to force any object between their teeth during the seizure. Seek medical attention. If the seizure is prolonged it can interfere with respiration. SEEK MEDICAL HELP IMMEDIATELY. 6. #9 Another splint can be made using a board, rolled-up bed sheet or cardboard with the wrap above and below the knee joint. • Always pad splints. 5. 8. 9. Abdomen and Pelvis Leg or Arm 1. 2. 3. 4. 7. WOUNDS OF THE ABDOMEN AND PELVIS Wounds may be superficial or penetrating. A penetrating wound can enter the abdominal cavity and cause further damage. Even a very small wound such as from a knife can be very serious and result in lifethreatening internal bleeding. Cover any abdominal wound; seek medical attention. • Hold infant head slightly down and give five back blows between the shoulder blades. • Turn infant face up and give five chest thrusts with two fingers on the lower half of the sternum (breastbone). Do not give infant abdominal thrusts. WOUNDS OF THE CHEST AND BACK Wrist 5. If the victim’s neck cannot be protected, do not move him. Victim may be able to talk and get some air past the object. There may be wheezes between coughs. Victim is coughing in an attempt to remove the object. • 1. Call 911. Located on each side of the neck just underneath the angle of the jaw. Can be felt using two fingers. Never attempt to feel both sides of the neck arteries at the same time since this could reduce blood to the brain and cause fainting. 3. Don’t give an injured or unconscious victim food or water. 4. A blanket or large, flat object, such as a door, can be used to help transport a victim. Recognition: Injuries to the eye can involve penetration of the eyeball itself or superficial wounds. If a chemical injury occurs (SEE REVERSE SIDE) then immediate flushing with water is critical or sight may be jeopardized. Eye wounds and injuries from foreign objects should be seen by expert medical help. Lightly apply a patch to the eye and seek medical help. • Neck Pulse (Carotid Artery) Ankle 3. To turn an injured person from a face down position onto his back requires a technique of “log rolling” with a person protecting the head and neck, a person in the middle protecting the spine and a person at the hips and upper leg area. • Check carotid pulse on ONE SIDE OF THE NECK ONLY. See FIRST AID TECHNIQUES. Located on the thumb side of the hand, it can be easily felt using two fingers. 2. Don’t move victim until the neck is secured; always protect the neck of an unconscious person. 2. An unconscious or seriously injured victim should not be moved without help unless he is in danger of death, hypothermia, or further injury. PARTIAL OBSTRUCTION An object that is impaled in the head or neck should never be pulled out. Any penetrating object should be left in. Trauma in the face, mouth and nose can result in blood being swallowed or breathed into the airway. A victim with these injuries should be rolled onto his side to prevent blood and vomitus from being inhaled into the airway and causing aspiration. Rolling the victim on his side should be done only when the neck is secured. The following can be used to splint an injured extremity. 1. Securing the neck of an unconscious victim with a head injury is vital. • Recognized by the victim grasping his throat, panicked appearance, and inability to talk. Caused by a foreign object such as food lodged against the vocal cords obstructing the flow of air into the lungs. • Usually occurs during eating and can result in unconsciousness, and cardiopulmonary arrest if not relieved. The scalp, face and neck will bleed profusely when cut. Scalp wounds are best controlled with direct pressure. Lacerations of the face are also controllable with direct pressure. Neck wounds too should be controlled with direct pressure. DO NOT wrap pressure dressing around neck! BUILDING A SPLINT 1. Don’t move an unconscious victim unless the situation is life-threatening. AIRWAY OBSTRUCTION WOUNDS OF THE HEAD AND NECK: 7. Seek medical attention immediately, if needed. DON’TS: It is recommended that the untrained person using this manual receive professional instruction in basic cardiac life support by an official course recognized by the local chapter of the American Heart Association. • Remove dentures, gum or any food from the mouth of an injured person to prevent airway obstruction. SECURING THE HEAD AND NECK BASIC FIRST AID EMERGENCY FIRST AID: DO’s AND DON’TS DO’S: • If person is unconscious a head or neck injury may be present. Use your hands to check for obvious injuries to scalp, head and neck. DO NOT MOVE NECK IN UNCONSCIOUS PERSON. If person is unconscious, secure the neck. See FIRST AID TECHNIQUES. DIFFICULTY BREATHING, CHOKING, BASIC CPR – CARDIOPULMONARY RESUSCITATION CHILD CPR Determine if victim is responsive by loud voice. DO NOT SHAKE VICTIM. Call for help. Dial 911. If there is injury above the collarbone, secure the neck (First Aid Techniques). If no injury is suspected, then lay person on back and clear the airway. Use a single finger in a hook-like fashion to sweep the mouth and back of throat. Avoid pushing any object in the mouth further back. For a suspected injury above collarbone, perform a chin lift without moving head or neck. This is done by one of two methods; (a) place thumb behind lower front teeth and index finger under jaw, lift jaw forward to help open airway. (b) place both hands behind jaw bone at angle of jaw and lift jaws forward to open airway. For a non-injured person push down on the forehead while lifting the chin (the head tilt-chin lift method). DO NOT EXAGGERATE THIS MANEUVER IN INFANTS OR CHILDREN SINCE HYPEREXTENSION MAY FURTHER AIRWAY OBSTRUCTION. LOOK at the victim’s chest for any breathing movements. FEEL for breath on your face. LISTEN for breath. CHECK for presence of (carotid) NECK pulse. If pulse is present but breathing absent, perform mouth to mouth ventilation by pinching the person’s nose and blowing air into mouth maintaining the head and neck position as above. Blow one strong breath every five seconds. THE VICTIM’S CHEST WILL RISE IF TECHNIQUE IS CORRECT. For infants and children try to blow breath every three seconds. For very small infants or newborns, place your entire mouth over their nose and mouth and do not pinch their nose. If neck pulse is not present start CPR. • Give TWO FULL BREATHS immediately. • Note that chest rises with breaths, signifying clear victim airway. • Begin chest compressions over lower half of sternum using the heel of your hand with other hand on top or fingers interlocked. Keep elbows locked so that arms are straight. Shoulders should be directly over victim’s sternum. • Sternum should be depressed 11/2-2 inches at a rate of 80 to 100 compressions per minute. • Every 15 compressions should be followed by two full breaths. • Interrupt CPR only to check neck pulses or for signs of respiration. Use the tips of the first two fingers for compressing chest. Depress chest wall approximately 1/2 - 3/4 inch over sternum. Compression rate should be approximately 100 per minute. Place infant on firm surface so a breath can be delivered every five compressions. In delivering breath, cover infants mouth and nose with your entire mouth. DO NOT PINCH NOSE as with adults. Use the heel of one hand only and compress sternum 11/2 inches per compression. Compression rate is 80-100 per minute. Deliver breath every five compressions and pinch nose during each breath. PITFALLS IN PERFORMING CPR 1. Do not interrupt CPR for more than 10 seconds. 2. Do not move victim until he is stable. 3. Do not compress sternum at extreme lower tip since this may cause a fracture and internal organ damage. 4. Do not bounce up and down on chest wall during compressions. Hands should always maintain contact with chest wall. 5. Do keep shoulders square and directly over sternum. 6. 7. 8. 9. Do lock elbows. Rib fractures may occur even with proper technique. Do make sure that the chest wall RISES with each breath. CPR can be terminated ONLY when (a) a physician assumes responsibility and issues an order to stop (b) a qualified rescuer takes over (c) effective circulation and breathing are restored (d) the rescuer becomes exhausted (e) the victim is transferred to properly trained and designated medical or paramedical professionals. 10. Do not interrupt CPR for more than 10 seconds. BLEEDING AND WOUNDS HEAT RELATED INJURIES BURNS 1. Lay victim down or have victim sit. 2. Remain calm. Panic delays effective care. 3. Control bleeding by applying direct pressure on the wound itself with a clean cloth or sterile bulk dressing. 4. Hold pressure for a minimum of five (5) minutes before removing pad. When bleeding has stopped, apply gauze dressing with the pressure wrap in first aid kit. This pressure wrap will maintain pressure on the wound. If bleeding is not controlled, then apply MORE pressure. Use large bulk dressing and pressure wrap. Seek immediate medical help. You can use the roll of pressure wrap as a compress. 5. Check pulse in injured extremity. No pulse indicates that wrap is too tight, cutting off circulation. Re-apply wrap. 6. Check for signs of shock. (See Shock) 7. An injured person who is out of doors is much more susceptible to hypothermia (dangerously low body temperature). Keep the victim warm and protected from wind and cold. 8. If the victim is alone, he should lie down and use pressure wrap with gauze dressing to control bleeding. 9. SEE FIRST AID TECHNIQUES FOR INSTRUCTIONS ON GAUZE DRESSING AND PRESSURE WRAPPING. Heat Stroke Recognition: Burns can he caused by hot liquids; flame; electricity; chemicals in contact with skin, such as gasoline or paint stripper; compressed gases that are very cold, such as ammonia or propane. Burns are classified as minor, partial thickness, or full thickness. FRACTURES (BROKEN BONES) A broken bone results in pain in the area. The bone may or may not protrude through the skin and may cause a deformity of the involved extremity. 1. Keep victim still and seek medical help immediately. 2. Do not move victim until splint has been applied. See FIRST AID TECHNIQUES. 3. A broken bone of the lower extremities or pelvis can cause shock due to profuse bleeding around the bone. 4. Check for the presence of a pulse in the fractured extremity. 5. In a fracture that does not penetrate the skin, place the extremity in a comfortable position, check for a pulse, and splint. See FIRST AID TECHNIQUES. 6. For a fracture that penetrates the skin, check for a pulse. If present, do not attempt to straighten the extremity, but splint and cover wound with a sterile dressing. If a circulation is decreased compared to the patient’s other side, improve by using gentle traction in line followed by slow straightening. Do not increase pain. Do not use force. 7. Pain on gently rocking the hips may denote a hip or pelvis fracture. 8. If the victim must be moved, splint the extremity as directed and check for the presence of a pulse in the extremity. 9. Follow the instruction for transporting an injured victim, as directed in this manual. Common symptoms of heat stroke include dry hot skin; no perspiration; internal body temperature of greater than 105° F; rapid and difficult to detect pulse; shock. Victim is usually unconscious. Heat stroke is LIFE-THREATENING! It can progress to seizures, cardiac arrest, and death if not treated immediately. Heat stroke can occur in any hot climate, but occurs more frequently in hot and humid climates. Heat Stroke Treatment: PREVENTION OF INFECTIONS 1. Wash hands before touching any wound. 2. Clean wounds and abrasions with clean water and cover with clean or sterile dressing. 3. Try to remove any dirt or gravel from wounds by irrigating with clean water. 4. Apply your first aid ointment and cover with dressing. 5. Keep up to date with tetanus immunizations every ten years. RECOGNITION OF INFECTION Redness occurs naturally around the edges of a healing wound or abrasion. The following first aid tips help you recognize abnormal redness and infection (cellulitis). Cellulitis is manifested by redness and pain that do not improve with time and that extend beyond the wound site. The area may be swollen, tender and warm to touch. Fever may be present. Medical treatment is required. Abscess is a collection of pus in a wound site surrounded by redness and swelling. These are painful and usually require draining for improvement. DO NOT attempt to drain; seek medical help. If the abscess opens spontaneously and drains, cleanse the area and cover with clean, sterile dressing. TREATMENT OF INFECTIONS 1. For most minor cuts and abrasions, simple cleaning with soap and water is sufficient to prevent and treat minor infections. 2. Ointments and creams are of no more benefit than a good daily cleansing of the wound. SHOCK CAUSES OF SHOCK Shock is a condition caused by a lack of blood flow to the organs in the body. This lack of blood flow may occur when blood is being lost from a serious wound or when a person is bleeding internally. Shock can also be caused by a heart attack when the heart cannot effectively pump blood. RECOGNIZING SHOCK The victim feels dizzy when he is standing or sitting; the skin is clammy, cool and sweaty to touch; the pulse is rapid and may be difficult to feel. The victim may be nauseated and vomit; the victim may become unconscious due to lack of blood flow to the brain. Another form of shock is allergic reaction to drugs or bee and wasp venoms. TREATMENT OF SHOCK: SHOCK IS LIFE-THREATENING 1. 2. 3. 4. 5. 6. Lay victim down and keep him warm. DO NOT give anything by mouth. Render care for bleeding or wounds. Check medical alert tags for possible allergies. Seek medical help immediately. Render basic life support CPR if necessary. DO’S AND DON’TS OF BURN TREATMENT: DO apply cold compress to burn caused by hot substance or flame immediately. DO irrigate a chemical burn with water immediately. 1. Call for immediate medical help and move victim out of hot environment. 2. Immediately begin lowering body temperature by spraying with water and using fans and ventilation. 3. Give nothing by mouth. 4. Do not lower body temperature below 101° F. DO apply sterile pad loosely over burn site. Prevention of Heat Stroke: DON’T pack in ice. Avoid excessive exercise or work outdoors in a hot, humid environment. Acclimatize slowly to these adverse conditions if you have to be exposed. Heat stroke may be precipitated by cardiac disease, blood pressure medication, and other medication that interferes with the normal heat control mechanism. Heat Exhaustion Recognition: Headache, nausea, abdominal and leg cramps, increased thirst, and dizziness are associated with heat exhaustion. Internal temperature is usually elevated, but not above 103 degrees F. Skin is sweaty to touch. Victim has usually been exposed to a hot humid environment. Pulse may be rapid. Treatment of Heat Exhaustion 1. Move victim out of hot environment. 2. Have victim sit or lie down. 3. Offer cool drinks of water or sweetened solutions but have victim drink slowly to prevent vomiting. 4. Have victim continue to sip water until he feels better and can sit up without being dizzy. 5. Seek medical help. Prevention of Heat Exhaustion: Avoid excessive hot and humid environments. If you must be outdoors, drink plenty of water or other comparable liquid to maintain adequate hydration. COLD RELATED INJURIES HYPOTHERMIA INFECTIONS POISONINGS AND OVERDOSES This is the number one killer of all outdoor injuries. Hypothermia is a lowering of the internal body temperature due to exposure to cold, wind, rain, or immersion in cold water. The outdoor temperature does not have to be very cold for hypothermia to occur. Hypothermia is more common in moderate climates than in cold climates. Any outdoor injury increases the risk of hypothermia. DO seek medical help. DON’T scrub burn area. DON’T break blisters. DON’T remove clothing adhering to burn. DON’T apply ointment, grease, or medication to burn. MINOR BURN (First Degree Burn) Recognition and Treatment: 1. Skin area is red, minor swelling, pain at site, no blisters. 2. Apply cold compress (NOT ICE) or immerse in cool water for pain relief. 3. Medical treatment is usually not necessary unless burn is caused by chemical, electricity, or cold exposure. 1. Skin is red and blisters are present; pain and swelling are present. 2. Apply cool compress or immerse in cool water for pain relief. 3. Medical treatment is necessary especially if face, hands, feet, or buttocks is involved or if a large portion of body or extremity is involved. 1. Chemical burns result from prolonged skin contact with common chemicals such as gasoline, other hydrocarbons, wet cement, ammonia, acids, and caustics. 2. Burns may be deeper than they appear and pain may be delayed. 3. Flush exposed area with water immediately, and continue flushing for 5-10 minutes. 4. If eyes are involved, immediately flush with water and seek medical help. Do not allow fluids from the injured eye to contact the non-involved eye. Flush for 20 minutes. 5. Remove contaminated clothing. 6. Call 911. Wear proper clothing, seek shelter in adverse weather conditions, KNOW the early recognition signs of hypothermia. Frostbite Recognition: The involved areas are usually hands, feet, and face. A first symptom is pain from the cold, followed by numbness. The frozen area appears waxy white, yellow-white or mottled blue. The area is hard and insensitive. 5. DO NOT give anything by mouth to a person who has had a seizure. SEE SEIZURE TREATMENT. 6. DO NOT induce vomiting unless told to do so by the poison center specialist. 7. DO NOT induce vomiting in the following circumstances: • If victim swallows a caustic substance or acid. • If the victim is unconscious or sleepy. • If the victim has a seizure. — Get victim to fresh air. Avoid breathing fumes. Start resuscitation if victim is not breathing. Poison on Skin — Remove any contaminated clothes. Flush skin with water for ten minutes. Poison in Eye — Flood eye with lukewarm water, away from non-involved eye for 15 minutes. Poison Ingested — Can also occur from space heaters and faulty furnaces. Symptoms are headaches, nausea, vomiting, shortness of breath. Treatment is fresh air immediately. Seek medical help. Call local gas company to investigate problem. Call 911 if a plant eaten is suspected of being poisonous. FOOD POISONING Caused by certain bacteria and microbes ingested from food or in water. Botulism is life-threatening; the other food poisonings generally are not. TYPE CAUSE SYMPTOMS TREATMENT Staphylococcus Exposed food such as chicken, potato or tuna salad and desserts Abdominal pain and vomiting within 6-8 hours. Prevent dehydration with clear fluids. Usually limited to 24 hours. Salmonella and Shigella Contaminated food or water Fever, abdominal pain, diarrhea which may be bloody, dehydration and shock may occur. Symptoms within 8-48 hours of eating contaminated food. Disease is selflimiting and in most cases goes away in a few days. Prevent dehydration with clear fluids. Giardia Contaminated water Abdominal pain, diarrhea which may be bloody. Within 10-30 days. Prevent dehydration with clear fluids. Camphylobacter Contaminated food or water Diarrhea which may last for days. Large fluid losses possible which may cause shock. Self-limiting, may last a few days to a week. Fluids must be replaced. Botulism Nausea, vomiting, weakness, dizziness, blurred vision, drooping eyelids, difficulty swallowing and talking, weakness of neck and upper body muscles, then later lower body muscles. Symptoms begin 12-36 hours after ingestion. Duration may be weeks to months. Most serious of food poisonings, may be lifethreatening. Consult your physician immediately if suspected. Contaminated food Keep syrup of Ipecac available at home. Syrup of Ipecac is used to safely induce vomiting. It is available at pharmacies POISONOUS BITES SNAKE BITES Coral snakes are small, less than 2 ft. and small in diameter. They carry a very potent venom. Look for symptoms or remember the phrase which distinguishes their skin’s color ring patterns from a similar looking nonpoisonous snake: “red on yellow, kill a fellow (poisonous) – red on black, venom lack.” Smoke is toxic and exposure should be avoided. The major toxin in smoke is carbon monoxide, a gas that is lighter than air and results in asphyxiation. Other toxins in smoke can cause burns of the upper airway, choking, and difficulty breathing. A victim of smoke inhalation should seek medical attention immediately; airway obstruction and carbon monoxide poisoning can occur. Eating Poisonous — Plants DO NOT give anything by mouth unless told to do so by medical professional. 1. Compressed gases such as propane and ammonia are extremely cold. Contact with the skin can cause deep burns through freezing of skin and deeper tissue. 2. Pain may be delayed and the involved area is more injured than it appears. 3. Flush area with water and seek medical help immediately. CARBON MONOXIDE POISONING Activated charcoal may also be kept at home as a poison antidote. Only use charcoal on advice of your physician. TREATMENT OF POISONING Burns from Compressed Gas: SMOKE INHALATION The usual adult dose of syrup of Ipecac is one ounce; children’s dose is 1/2 ounce. CALL 911 FIRST. Follow Ipecac with water to help induce vomiting. Vomiting usually occurs in 15-20 minutes. 8. SEEK MEDICAL HELP FOR ANY POISON OR OVERDOSE. Two types of poisonous snakes are found in the U.S., pit vipers and coral snakes. Most common is the pit viper. Rattlesnakes, copperheads, and water moccasins are the three types of pit vipers found in the U.S. Recognition of a pit viper bite would include: two distinctive fang marks or puncture wounds, swelling at bite site, pain at bite site, or beginning of typical reactions. DO NOT pursue a snake for identification. Snakes do not travel far and if pursued will definitely strike again. While first bite might be “dry” (no venom) or limited venom, a second bite might be venomous. Treatment does not require identification. Treatment of Frostbite: Frostbite injuries should be thawed as soon as possible with a rapid rewarming technique, but taking care not to burn the victim. 1. Rapid thawing is best accomplished with warm water, NOT HOTTER than 110 degrees F. At this temperature, the water is very warm to the touch, but not hot enough to burn. 2. Do not open any blisters that appear. 3. Do not rub injured area with snow, ice, or any other object. 4. Thawing requires 30-40 minutes and is complete when involved part is pliable and sensation and color have returned. Pain and blisters may appear after thawing. 5. If hypothermia is present along with frostbite, treat hypothermia first. 6. After thawing, cover area with clean or sterile dressing. Frostbite is a severe burn. Splint and elevate involved extremity. 7. Protect from re-freezing. 8. Seek medical attention. 4. DO NOT give anything by mouth to a victim who is sleepy or who is unconscious. Electrical Burns: 1. Get victim safely away from electrical source without endangering yourself. 2. Apply CPR if victim is not breathing or has no pulse. 3. Electrical burns are much deeper than they appear. 4. Always seek medical help immediately. without prescription. Use only under the direction of your physician or 911. 3. DO call 911 before administering anything by mouth to the victim. If you cannot call 911 immediately and the victim has ingested a caustic substance, lye, or acid, give him water to drink to dilute the substance. FULL THICKNESS BURN (Third Degree Burn) Recognition and First Aid: 1. This very deep burn through the skin involves other tissue beneath the skin. Skin may be charred, white, or mottled. 2. Wrap site in sterile covering; lay victim down. 3. Victim may be in shock. 4. Seek immediate medical help. — 2. DO make note of the product swallowed or inhaled (or the nature of an exposure), the time of ingestion, the amount ingested, the location of the victim, and whether or not the victim is taking any other medications. Poison Inhaled Chemical Burns: Prevention of Hypothermia: 1. DO call 911. PARTIAL THICKNESS BURN (Second Degree Burn) Recognition and First Aid: The victim first begins shivering; the victim then stops shivering and becomes disoriented and confused; the victim may appear apathetic and moody; as hypothermia becomes more severe, the victim may lapse into coma. 1. Move victim into a sheltered area immediately. Get victim out of wind, rain, or cold. 2. Remove any wet clothes and replace with dry clothes or warm blankets. 3. If victim is alert and awake, give warm drinks. 4. Seek medical attention immediately. 5. Warming the body temperature may take a long time in severe hypothermia. Death can occur during rewarming of extreme hypothermia. Handle the victim gently. Poison Ingested (continued) • If victim swallows a petroleum product. Recognition of Hypothermia: Treatment of Hypothermia: DO’S AND DON’TS 6. Do not give alcohol or any drugs. 7. Do not apply a constricting band or tourniquet unless you are experienced in how to apply them properly and safely. 8. Seek medical help quickly. BEE OR WASP STINGS, SPIDER BITES, OTHER INSECT BITES The actual amount of poison from any one bite or sting is usually not in itself life-threatening. Generally people will experience pain and swelling at the bite site, redness and itching which last for hours. People who experience allergic reactions have much greater risk, perhaps life-threatening, and should seek medical advice quickly. BITE OR STING SIGNS OF SEVERE ALLERGIC REACTION ALL POISONOUS SNAKEBITES ARE DANGEROUS Bee, Wasp Hornets, Yellow Jackets They can result in disfigurations and/or deformities, and some people die each year as a result of poisonous bites. Children are especially threatened. • • • • Spiders (Black Widow) • Cramping • Rigidity at shoulder, back, chest or abdomen • Nausea, vomiting, headache, anxiety, hypertension Significant local swelling within 10 minutes. Nausea, weakness, black and blue discoloration, pain at bite site, fang marks. Scorpions • • • • Minimal pain and swelling, symptoms often delayed, complaints of drowsiness, apprehension, nausea, vomiting, or salivation can appear 1-7 hours after bite. FIRST AID: SYMPTOMS: Pit Vipers: (Rattlesnakes, Copperhead, Water Moccasins) Coral Snakes: FIRST AID: 1. 2. 3. 4. Remain calm and reassure victim. Remove victim from risk of a second bite. Decrease movement of affected limb. If available, apply Extractor™ Pump from Sawyer Products as soon after bite as possible. The pump has been proven to remove venom from the bite cavity and is the most effective method of first aid currently available. 5. Do not use ice, cold packs or sprays. Lumpy welts over body Itching palms and feet Headache, nausea, vomiting Breathing difficulties Weakness of bitten arm or leg Pain at site “Roving eye” or hyperactivity in children Abdominal cramps The most effective method currently available is to apply the Extractor™ pump from Sawyer Products as soon as possible. The pump’s suction draws poison back out of the body thus reducing or eliminating the pain and allergic reaction. Antihistamines may be helpful for minor reactions. If Extractor™ pump is not available, remove bee or wasp stingers by scraping the stinger off the skin surface with knife blade. This will reduce the amount of poison in the body – do not pull stinger out with fingers. For serious allergic reactions call 911 or medical help as soon as possible.