First Things to Do in an Emergency
Persons who become suddenly sick or injured do not have labels on them telling what the trouble is and what help should be given. So any person available to render aid has to evaluate the victim's condition and decide what to do. Let us suppose that you are the person who must give emergency care to someone suddenly taken sick or injured.
Don't waste time in bemoaning your lack of training. Do the best you can.
If other people are around, you may ask yourself, Am I the best qualified to give aid? If not, then let the better qualified person take charge and follow his instructions. But unless you know that someone else can render better emergency care than you can, take over and tell the others what to do without thought of hurting feelings. If someone else tries to replace you, question his qualifications. As long as you are in charge, do not let the others disregard your instructions. Use a firm voice, and ask for the help you need.
A. Keep Calm. Even though you feel nervous and unprepared, put on the act of being calm and deliberate. The discipline will actually help you to think clearly and will help the victim, if conscious, to avoid psychological panic that might throw him into shock. Keeping calm also inspires the confidence of those who are helping you, and thus your cooperative effort will be more beneficial to the victim.
B. If the emergency consists of a sudden illness, try to get in touch with a doctor at once. Send someone else to phone while you continue caring for the victim. Have this person describe the victim's condition
and ask for advice on what to do until the doctor arrives.
C. When poison has been swallowed, obtain some clue as to the kind of poison taken. If the container is available, the label may mention what antidote is effective. If you live in a city area, have the telephone operator put you in touch with the city's poison control center or have a doctor do this for you. If no qualified help is available, then turn to Poisoning in the alphabetical listing in the main part of this chapter and read first the general instructions and then the specific instruction. Transfer the victim to a hospital emergency room as soon as possible, calling the hospital first so that personnel may be prepared.
D. When the victim has been burned, see under Burns in the alphabetical listing of the main part of this chapter.
E. In case of an accident, it may be more important to have someone call an ambulance than to phone a doctor. Ambulance crews are trained in first aid. If you are in an isolated area where no ambulance is near, call for a policeman or a sheriff.
F. Don't be in a hurry to move an injured person unless it is essential for his safety. First, try to determine the nature of the problem. In some serious illnesses and injuries, moving the victim without proper equipment or before first aid is rendered may cause death. Do not allow the injured person to sit up, much less to stand or try to walk .
G. When a person is not breathing, begin giving artificial respiration at once. This is of first priority, for one may die within three or four minutes without air. Mouth-to-mouth breathing, in which you force your own breath into the patient's mouth and thus into his lungs (while holding his nostrils closed), is the simplest and most effective method of artificial respiration. Take care not to move the position of the head, if there is the possibility of a broken neck. (See Respiration, Artificial.)
H. Check for bleeding next. The simplest way to control continuing loss of large amounts of blood from an injured part is to place a sterile dressing or clean cloth right into the wound and exert firm, continuous pressure. (See
Hemorrhage.)
I. When the victim is unconscious, care for him as best you can right where you are until conditions are favorable for moving him. Make sure that he continues to breathe, either naturally or by artificial respiration. Don't try to rouse an unconscious person. Don't try to give him fluids by mouth. Remove loose objects such as false teeth so that these will not interfere with his breathing. Keep him covered to conserve body heat. (See Unconsciousness.)
J. Look for evidences of fractured bones. The most serious possibility here is that of a broken neck or broken back. (See Fractures.) In case of compound fracture, one with a broken bone protruding through the skin, protect the wound from further infection. Also stabilize the injured part (possibly with a splint) before patient is transported.
K. General care of the waiting victim. While waiting for instructions from a doctor or while waiting for the ambulance to arrive, also follow these principles of general care:
1. Don't give the victim any form of alcoholic drink.
2. Loosen tight clothing which may constrict the victim's neck or waist.
3. Conserve body heat by covering the victim with a blanket or with coats. Do not overheat, and be careful not to burn the skin of an unconscious person by the use of heating devices.
4. When the victim vomits, turn his head gently to the right or to the left so as to avoid the danger of his choking on the vomitus. For an unconscious person, failure here could result in death.
L. When the time comes to move the victim, great care must be taken not to change the relative position of the parts of his body. His body should be kept straight and horizontal, not lifted into a semi-upright position and not allowed to sag, jackknife, or twist. If the victim must be moved from where his body rests on the highway, for instance, he can be slid lengthwise on a blanket. The blanket for this purpose can be placed under the victim by rolling him gently to one side while half of the blanket is tucked under him. Then, by rolling him to the opposite side, the tucked portion of the blanket may be straightened out.
Another proper way of transporting an injured or very sick person is by the use of an improvised stretcher made from two poles placed through the arms of two jackets, the jacket arms having first been turned wrong side out, and the jackets buttoned or zipped up.
Another proper way to move an injured person is by the cooperative effort of four persons who lift and move the victim. Three take, their position on one side of the victim, one at his shoulder, one at his hip, and one at his knees. If one side is injured, they work from the uninjured side. The fourth person is located at the victim's head and his one responsibility is to lift the head in unison with the other three persons so that the head does not change position in relation to the victim's shoulders.
by Harold Shryock M.D.
