10 Basic First Aid Procedures: getting someone through a medical crisis

First aid is the emergency care a sick or injured person gets. In some cases, it may be the only care someone needs, while in others, it may help them until paramedics arrive or they are taken to the hospital

The best way to prepare for these events is to get official first aid training, but until you are able to do so, you can learn some basic life-saving steps

This article will explain the steps of first aid for various emergencies. It will also give first aid examples and explain when further care may be needed.

ABCs of First Aid

When someone is unconscious, or unresponsive, a basic principle of first aid is ABC:

  • Airway: If someone’s not breathing, clear their airway.
  • Breathing: If the airway is clear and they’re still not breathing, provide rescue breathing.
  • Circulation: Perform chest compressions to keep blood circulating, as well as rescue breathing. If the person is breathing but unresponsive, check their pulse. If their heart has stopped, provide chest compressions.

A simpler version of the ABCs is:

  • Awake? If not, try to wake them. If they don’t wake up, make sure someone is calling 911 and move on to B.
  • Breathing? If not, start rescue breathing and chest compressions. If so, move on to C.
  • Continue care: Follow instructions from 911 on, or continue treatment until an ambulance arrives.

Some courses also include D and E:

  • D can stand for disability assessment, deadly bleeding, or automated external defibrillator (AED), which is a device that shocks the heart so it begins beating.1
  • E stands for examination—evaluating the person for signs of injury, bleeding, allergies, or other problems once you know they’re breathing and their heart is beating.

First Aid: CPR and AEDs

Cardiopulmonary resuscitation, or CPR, is one of the most important emergency medical procedures.

If a person is in cardiac arrest, in which their heart is not beating, they could die. Performing CPR or using an AED could save their life.2

AEDs are available in many public areas and businesses. These devices are simplified for use even if you have never been trained.

What to Do

When you suspect someone is in cardiac arrest, follow these steps:3

  • Get someone to call Emergency Number
  • Start chest compressions immediately. Using both hands, push down hard and fast in the center of the chest, allowing the chest to come back up naturally between compressions. Continue until someone with more training has arrived.
  • If you’re trained in CPR, use chest compressions and rescue breathing.
  • Use an AED if available. However, don’t delay chest compressions to find the device. If possible, have someone else look for it instead.

Taking a formal CPR class will help you become familiar with chest compressions, rescue breathing, and AED use.

Bleeding

The color of the blood and how it’s leaving the body can give you a sense of the extent of the injury:

  • Capillaries: Bleeding from capillaries, which are the smallest blood vessels, looks like a trickle and will usually stop on its own.
  • Veins: A consistent blood flow and blood that’s a dark red color is most likely coming from the veins. It can range from mild to severe.
  • Arteries: Arteries are the largest blood vessels and carry a lot of oxygen. If they are injured, bright red blood typically spurts out. Blood can be lost really quickly from this type of bleed.

Almost all bleeding can be controlled. If severe bleeding is allowed to continue, it can lead to shock and eventually death.4

What to Do

While it is important to stop bleeding, remember the ABCs of first aid and check for something more serious first.

Then:5

  • Wash your hands or put on disposable gloves, if possible. This can help protect you from diseases like viral hepatitis and HIV/AIDS.6
  • Rinse the wound with water.
  • Cover the wound with a gauze or cloth (towel, blanket, clothing, whatever’s available).
  • Apply direct pressure to stop the blood flow and encourage clotting, which is when blood naturally thickens to stop blood loss.
  • If possible, elevate the bleeding body part above the heart.
  • Don’t remove the cloth if it becomes soaked through, but add more layers if needed. Removing the first layer will interfere with the clotting process and result in more blood loss.
  • Once bleeding has stopped, apply a clean bandage.

Get medical help if:5

  • The wound is deep
  • The wound has widely separated sides
  • The injury oozes blood after pressure has been applied
  • The injury is from an animal or human bite
  • The injury is a puncture, burn, or electrical injury
  • You suspect arterial bleeding
  • Blood is soaking through bandages
  • Bleeding won’t stop

Make sure someone keeps treating the person during the drive to the hospital or while you wait for an ambulance.

Choking

Choking due to a blockage in the throat is a serious situation that can lead to unconsciousness or even death.7

Signs include:8

  • Gagging, gasping, or wheezing
  • Inability to talk or make noise
  • Turning blue in the face
  • Grabbing at the throat
  • Waving arms
  • Appearing panicked

The Heimlich maneuver is a series of abdominal thrusts that can help dislodge whatever someone may be choking on. It should only be done if someone is truly choking.

Before doing anything, simply ask the person if they are choking. If someone is coughing or talking, they aren’t choking. If they are unresponsive or exhibit any of the above signs, proceed with the Heimlich.

What to Do

To perform the Heimlich maneuver:8

  • Stand behind the person and lean them slightly forward.
  • Put your arms around their waist.
  • Clench your fist and place it between their navel and rib cage.
  • Grab your fist with your other hand.
  • Pull the clenched fist sharply backward and upward under the rib cage in 5 quick thrusts. Repeat until the object is coughed up.

For someone who’s obese or pregnant, perform thrusts around the chest instead of the abdomen.

If someone is unconscious:

  • Place them on their back and kneel over them.
  • Place the heel of your hand slightly above the navel.
  • Place your other hand on top of it.
  • Give quick upward thrusts to dislodge the obstruction.

Note: Methods are different for babies.

Burns

The first step to treating a burn is to stop the burning process.9

Chemicals need to be cleaned off. Electricity needs to be turned off.

Heat needs to be cooled down with running water.

Those with sunburns need to be covered up or go inside.

The severity of a burn is based on its depth and size:10

  • First-degree burn: This affects only the outer layer of skin and causes redness and swelling. It is considered a minor burn.
  • Second-degree burn: This affects two layers of skin and causes blistering, redness, and swelling. It is considered a major burn if it’s more than three inches wide or is on the face, hands, feet, genitals, buttocks, or over a major joint.
  • Third-degree burn: This affects deeper layers of skin and causes white or blackened skin that may be numb. It is always considered a major burn.

What to Do

Major burns need emergency medical attention.10

Call Emergency Number or get someone else to call once the burning process has been stopped.

For other burns, take these first aid steps:

  • Flush the burned area with cool running water for several minutes. Do not use ice.11
  • Apply a light gauze bandage. (You may apply an ointment, like aloe vera, before doing so if the burn is minor.)12
  • Take Motrin (ibuprofen) or Tylenol (acetaminophen) for pain relief, if necessary.
  • Do not break any blisters that may have formed.12

Blisters

Blisters are designed to protect the damaged skin underneath while it heals.

Whether or not it should be treated, and how so, depends on the qualities of the blister and your overall health.

What to Do

If the blister is small, unbroken, and not very painful, it’s best to leave it alone.

Cover it to prevent rubbing that could cause it to swell and possibly burst.

Popping a blister may let in bacteria that could lead to an infection.13

If the blister is large or painful, follow these steps:14

  • Wash your hands and sterilize a needle with alcohol.
  • Make small punctures at the edge of the blister.
  • Gently push the fluid out.
  • Apply antibiotic ointment.
  • Put on a bandage.
  • If possible, take steps to protect the area from further rubbing or pressure.

If the blister broke open on its own:

  • Gently wash with clean water only.
  • Smooth the flap of broken skin over the newly exposed skin, unless it’s dirty, torn, or pus has gathered under it.
  • Apply petroleum jelly.
  • Bandage it.

Change the bandage any time it gets wet. Take it off when you go to bed so the area can air out.

Broken Bone or Fracture

Any injury to your limbs, hands, and feet needs to be treated as a broken bone until an X-ray can confirm what you’re dealing with.

While broken bones or fractures do need medical treatment, they don’t all require an emergency trip to the hospital.

What to Do

Call Emergency Number immediately if:15

  • The person is bleeding profusely, is unresponsive, not breathing, or has numerous injuries
  • You suspect a fracture or other serious injury to the spinal column, head, hip, pelvis, or thigh. In this case, the person should not be moved except by trained medical personnel.
  • A broken bone protrudes from the skin, known as an open or compound fracture
  • The area below an injured joint feels cold and clammy or becomes bluish
  • You can’t immobilize the injury well enough to transport the person

If these don’t apply, use first aid and then go to an urgent care or contact your healthcare provider for guidance.

Steps to take:16

  • Don’t try to straighten the bone.
  • For a limb, use a splint and padding to keep it still and elevate it.
  • Put a cold pack on the injury, with a barrier between it and the skin to prevent tissue damage. If ice is all that’s available, put it in a plastic bag and wrap it in a shirt or towel.
  • Give anti-inflammatory drugs like Advil (ibuprofen) or Aleve (naproxen) for pain.

Research has shown that non-steroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen) and Aleve (naproxen sodium) can slow bone healing. However, short-term NSAID use appears to have little or no effect on healing.17

Sprains

A sprain is an injury to the ligaments, which are connective tissues that hold bones, cartilage, and joints together.

Sprains are generally caused by twisting a joint, which overstretches or tears these tissues. They commonly occur in the ankle and wrist.18

Symptoms of a sprain are similar to those of a broken bone, so an X-ray will likely be used for diagnosis.

What to Do

The first thing to do is make sure the injured person stops any unnecessary activity so they don’t make the injury worse.

Sprains often don’t require emergency treatment.

However, you should get immediate medical care if the injured person has:19

  • Severe pain with movement or touch
  • Ongoing inability to bear weight on the injured joint
  • Increased bruising
  • Numbness or pins-and-needles near the sprain
  • Signs of infection
  • Little or no improvement during the first week

If they don’t, begin first aid:19

  • Keep the limb still.
  • Apply a cold pack.
  • Elevate the injured part if you can do so safely.
  • Use NSAIDs for pain.

See your healthcare provider soon after for further treatment.

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Nosebleeds

The biggest cause of a nosebleed is digital trauma, better known as picking your nose.

Other causes may include:20

  • Dry or hot air
  • High altitudes
  • Chemical fumes that irritate the nasal passage
  • Colds and allergies
  • Blowing your nose hard or often
  • Trauma to the nose
  • Deviated septum, which is crooked nasal cartilage
  • Nasal polyps or tumors, which are non-cancerous or cancerous growths in the nasal passage and sinuses
  • Bleeding disorders, including hemophilia and leukemia
  • High blood pressure
  • Pregnancy
  • Frequent use of nasal sprays, decongestants, and antihistamines
  • NSAIDs
  • Blood thinners such as Coumadin (warfarin)
  • Cocaine and other snorted drugs

Many of these things dry out or damage the delicate nasal membranes in your nostrils, causing them to become crusty and burst when irritated.21

What to Do

First aid for nosebleed includes:22

  • Lean slightly forward, not back.
  • Pinch the nose just below the bridge, high enough that the nostrils aren’t pinched closed.
  • Check after five minutes to see if bleeding has stopped. If not, continue pinching and check after another 10 minutes.
  • You can also apply a cold pack to the bridge of the nose while pinching.

See a healthcare provider if:20

  • You get frequent nosebleeds
  • You have anemia symptoms like weakness, faintness, fatigue, and pale skin
  • You’re taking blood thinners
  • You have a clotting disorder
  • You just started a new medication
  • You also have unusual bruising

A nosebleed needs emergency medical treatment when:20

  • It won’t stop even after more than 15 minutes of direct pressure
  • There is a lot of blood loss
  • You have a hard time breathing
  • You’ve swallowed a lot of blood and vomited it up
  • You’ve had a serious injury or a blow to the head

Frostbite

Frostbite occurs when the body’s tissues freeze deeply in the cold. This is the opposite of a burn, but the damage it does to your skin is almost identical.

What to Do

Treating frostbite is a delicate procedure of gradual warming the affected area.

If at all possible, this should be done by a medical professional.

If that’s not possible, or while awaiting an ambulance, you can begin first aid:23

  • Get out of the cold.
  • Immerse the affected area in warm water (98 to 105 F) for 20 to 30 minutes.
  • Do not rub the affected area.
  • Do not use sources of dry heat, like a heating pad or a fireplace.
  • For fingers and toes, after they’re warm, put clean cotton balls between them.
  • Loosely wrap the area with bandages.
  • Use Tylenol (acetaminophen) or Advil (ibuprofen) for pain.
  • Get medical attention as soon as possible.

For small areas of minor frostbite, you can also warm the area with skin-to-skin contact.

Get emergency treatment if the skin is hard and begins turning white.

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Bee Stings

Bee stings may be painful for some people, but they can also be deadly for those who are allergic to bee venom.

An allergy can develop at any time, so it’s important to always watch for signs of an allergic reaction after a bee sting.

These include:24

  • Swelling away from the area that was stung
  • Flushing
  • Hives, which are raised, large red or skin-colored bumps
  • Itching
  • Signs of anaphylaxis, a life-threatening allergic reaction that can cause hives, swelling, chest pain, confusion, sweating, blue lips and nails, and difficulty breathing

What to Do

Call Emergency Number immediately or get the person to the hospital if any signs of allergy appear.

If the person who was stung has a known allergy to bee stings, use an EpiPen to prevent anaphylaxis.

In someone without a known bee allergy, watch for signs of an allergy while performing first aid:

  • Get the stinger out any way you can to keep it from injecting more venom. The method doesn’t matter. What’s most important is that this is done quickly.
  • Wash the area with soap and water.
  • Use a cold pack to reduce swelling at the site, but don’t apply ice directly to the skin.
  • Use an allergy medication, or antihistamine, like Benadryl to reduce swelling and itching.
  • Use Tylenol (acetaminophen) or Advil (ibuprofen) for pain.

References:

  1. American Red Cross. What is aed?
  2. American Heart Association. Saving lives: why cpr aed training matter.
  3. Charlton NP, Pellegrino JL, Kule A, et al. 2019 american heart association and american red cross focused update for first aid: presyncope: an update to the american heart association and american red cross guidelines for first aidCirculation. 2019;140(24):e931-e938. doi:10.1161/CIR.0000000000000730
  4. AlSabah S, Al Haddad E, AlSaleh F. Stop the bleed campaign: a qualitative study from our experience from the middle eastAnn Med Surg (Lond). 2018;36:67-70. doi:10.1016/j.amsu.2018.10.013
  5. Nemours KidsHealth. First aid: cuts.
  6. MedlinePlus. Bleeding.
  7. Johns Hopkins Medicine. Choking and the heimlich maneuver.
  8. National CPR Foundation. Choking, hypothermia & dehydration.
  9. American Burn Association. Initial first aid treatment for minor burns.
  10. MedlinePlus. Burns.
  11. Hyland EJ, Connolly SM, Fox JA, Harvey JG. Minor burn management: Potions and lotionsAust Prescr. 2015;38(4):124-127. doi:10.18773/austprescr.2015.041
  12. MedlinePlus. Minor burn-aftercare.
  13. Cleveland Clinic. Blisters: caues, treatments — and why you should never pop them.
  14. Michigan Medicine. Blister care.
  15. Nemours KidsHealth. First aid: broken bones.
  16. Nemours TeensHealth. First aid: broken bones.
  17. Wheatley BM, Nappo KE, Christensen DL, Holman AM, Brooks DI, Potter BK. Effect of nsaids on bone healing rates: a meta-analysisJ Am Acad Orthop Surg. 2019;27(7):e330-e336. doi:10.5435/JAAOS-D-17-00727
  18. Cleveland Clinic. Sprains of the ankle, knee, and wrist.
  19. Nemours KidsHealth. First aid: strains and sprains.
  20. Cleveland Clinic. Nosebleed (epistaxis).
  21. Nemours TeensHealth. Nosebleeds.
  22. Beck R, Sorge M, Schneider A, Dietz A. Current approaches to epistaxis treatment in primary and secondary careDtsch Arztebl Int. 2018;115(1-02):12-22. doi:10.3238/arztebl.2018.0012
  23. Nemours KidsHealth. First aid: frostbite.
  24. American College of Allergy, Asthma, & Immunology. Insect sting allergies.
  25. American Red Cross. First aid steps.
  26. American Red Cross. Sof tourniquet.

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Source:

Very Well Health

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