Catherine is a mom who has devoted many years to volunteer organizations including 10 years as a mentor to girls through Scouting programs.
CPR/First Aid certification is a requirement for most teachers, caregivers, and community workers. It also raises the value of a babysitter and helps put new parents at ease. The confidence it brings to many can be a burden to others who hope to never put what they've learned into real practice. Why is there such a disparity?
First of all, the technicality of CPR is daunting. How many breaths and compressions? How many repetitions? I just can't seem to remember the ABCs of resuscitation! Others are simply squeamish or afraid. It is important to stay calm, assess the safety of the scene, call for help, and reassure the victim until professional help arrives.
My focus here concerns the most common situations and how to offer aid. This is where we first responders can make a profound difference. Over the years, I have learned both how to recognize signs of distress and how best to treat them. I would like to share them with you.
One of the most common problems here in Southern California through summer and into fall when football season hits the stadiums, is heat stress. For many years, I worked outdoors in temperatures that consistently stayed in the triple digits. It is easy for a situation to go from uncomfortable to life-threatening in a very short period. It is important to recognize the signs of heat stress and not to think of it as simple dehydration. In fact, drinking too much water can dangerously deplete the salts and electrolytes needed for cardiac function.
A person's body temperature can rise to a dangerous level in spite of water consumption. Excess sweating keeps a person cool, but weakness and dizziness can set in, along with headaches and nausea. It is urgent to get the person to a cool spot, loosen clothing, remove shoes and socks, and apply cool cloths to bring body temperature down. Call 911. When skin becomes hot and dry, this is a sign of heat stroke and is a medical emergency.
Heart attack can come without warning. Be aware of changes in behavior. If someone seems uncomfortable, begins to sweat excessively, looks ashen, or has trouble breathing, consider it an emergency and call 911.
Symptoms of a heart attack may include:
- Chest pressure or discomfort that persists continuously for 3-5 minutes.
- Unexplained pain in the upper back, arms, or stomach that spreads to the jaw, neck, or shoulders.
- Damp pale skin
- Shortness of breath
- Excessive sweating
Women may not exhibit the classic crushing chest pain symptoms. Instead, pain may be in the jaw, back, or stomach. Shortness of breath, queasiness, and anxiety are other signs. Women tend to dismiss symptoms as indigestion, hormones, or stress. Be aware and err on the side of caution. Call 911.
In the meantime, have the victim rest and breathe slowly. Try to find out about any existing conditions or prescription medications. Give an aspirin as long as there are no allergies, ulcers, or blood thinner medicines being taken.
As with heart attack, be aware of sudden changes. Older people are especially susceptible and may experience weakness or numbness of the face or limbs often on one side of the body.
FACE: Weakness in the face. Ask the person to smile.
ARMS: Weakness in the limbs. Ask the person to raise both arms.
SPEECH: Slurred speech or trouble enunciating. Ask the person to say a simple sentence.
TIME: Call 911 if any of these responses are abnormal. Early treatment with clot busters may reverse the damage of a stroke.
Falls and Bruising
Common among rough-housing kids and unstable elderly people, be ready to grab the ice. A first aid kit should have instant ice packs that are pressure activated or refillable ice bags with screw tops. These, when applied to injured areas, reduce bruising and swelling and help to control pain. Head injuries need to be watched closely. Dizziness, confusion, or sudden sleepiness require medical evaluation. Call 911.
An abrasion or simple laceration may result in stubborn bleeding. As long as no glass or foreign material is embedded in the skin, the best treatment is direct pressure to the wound with a clean gauze pad. Gloves should be worn when dealing with body fluids.
Once the bleeding has been stopped, gauze bandage can be rolled over the pressure pad and either taped, tied, or tucked in place. Band-aids can also be used for smaller cuts. If bleeding is heavier and direct pressure doesn't slow the flow, apply additional bandages and call 911.
For tooth loss and gum bleeding, direct pressure with rolled gauze works well. It can be chilled on ice to help w pain relief. Tannins in black tea help control gum bleeding as well.
For a bloody nose, have the victim lean slightly forward and apply firm pressure to the upper nostrils for 5-10 min.
Those on blood thinners, mostly the elderly, will bleed profusely even with minor injuries. It the bleeding doesn't stop with direct compression and wrapped ice application, call 911.
In the event that foreign material gets in the eye, try to induce tears by having the victim blink or gently squeeze their eyes shut. Do not rub or apply pressure. If natural tears do not eject the irritant, don't try to remove it. Instead, flush with a sterile saline solution if available until the irritant is dislodged or place an eye bandage over the eye and seek medical care. With any eye injury, a follow-up with a doctor is always a good idea.
Chemical splash requires copious flushing with water and a call to 911.
Insect Stings and Animal Bites
If a bee or wasp should sting, quickly remove the stinger by firmly scraping over the bite with a credit card. This will dislodge the stinger and the source of the poison. Avoid using tweezers as this may force more toxin into the skin. Ice application will reduce pain, and a Benadryl stick can be applied to reduce swelling and itching. Alcohol swabs also work well. New to the market are suction syringes to remove irritating toxins before they cause problems.
Bee stings are extremely serious to a person with an allergy. If the swelling is confined to the area of the sting (left arm if the bite was to left hand) this is a normal reaction. If breathing becomes difficult and swelling or rash extends to areas well beyond the sting, it is considered an emergency requiring swift action. Call 911 and use an epi-pen if one is available.
In the event of an animal bite, wash thoroughly with soap and water then cover with a bandage. Although not always an emergency, saliva carries many germs and can lead to infection. A doctor should be seen as soon as possible. Take a picture or write down a description of the animal and its whereabouts for local animal control. Wild animal bites are very serious due to diseases they can carry. Domestic pets will be checked for vaccination records.
Sunscreen should always be worn and reapplied during prolonged sun exposure. Sunburn, like any other burns, should be cooled. Damp cool cloths can be applied to sore areas, or a soak in a cool tub of water can help. Topical sprays with lidocaine or benzocaine really help with numbing the pain of overly-sensitive skin.
In cases of steam or hot-object contact burns, cool immediately under cool running water or apply a cool compress. Never apply ice or greasy ointments. Aloe Vera and apple cider vinegar have both been shown to reduce pain and itching and promote healing from minor burns where the skin hasn't broken or blistered. Seek immediate medical help for serious and large-scale burns by calling 911.
Strains and Sprains
Sprains are injuries to the ligaments at the joints. Strains are tears to the muscles and tendons. They are slower to heal.
Both need ample rest and respond to the R.I.C.E. treatment.
Rest: Keep immobilized. Avoid movement and exertion. Only splint if necessary ie. in a remote area.
Ice: Apply a cold pack to the injury to reduce swelling and relieve pain. Always use a barrier between the ice and the skin. 15 min on and 15 min off before reapplication.
Compression: Wrap the injury with an ace bandage to give firm yet comfortable support. Do not wrap too tightly.
Elevation: Raise the affected limb to reduce swelling while ensuring that there is proper support underneath. If there is increased pain with elevation, it may be a sign of a more serious injury. Don't force it. Follow up with a doctor.
Call 911. Fractures can be simple, displaced, or compound when they break through the skin. They will all need immediate medical treatment. A simple break to a limb or wrist, for example, can be immobilized by slinging, splinting, or strapping it to the body over a support pillow and securing it with bandages or laces. Splint supports can be made from magazines, newspapers, and other common items.
Dislocations can be treated this way also until medical help is available. If an injury involves the neck or back, it is best to not move the victim and wait for professional help. These areas are prone to major nerve involvement and require secure transport on a rigid backboard.
Compound fractures that result in skin trauma involve treatment to bleeding also. Apply ice both above and around the break being careful to not contaminate the wound itself.