General
Guidelines For

Handling 
Injuries

1. Take charge of the situation at once.

2. Send someone reliable to notify the doctor telling him exactly where the injured will be found.

3. See how badly the victim is hurt. Specially note / do the following
   * Is he breathing regularly?
   * Is he losing blood? If so, from where?
   * Cut or rip the clothing from the injured part so as to prevent any pressure over the bleeding points as soon as possible.
   * Be careful not to hurt any affected part of the injured body.
   * Always look carefully for signs of burns or shock

4. Keep the victim lying down, his head level with chest. Don’t let him/her sit up. Calm him down and make him comfortable.

5. Avoid all unnecessary movements, specially if a fracture is suspected.

6. Keep yourself calm and composed. Do what must be done as promptly as possible. Avoid all confusion. Ensure that spectators do not surround the injured

7.  If there is serious bleeding: If the blood is dark in colour and flowing continually, it means a large vein has been cut. Put pressure over it. If the blood is coming in spurts and bright red, an artery is involved. Try pressing constantly over the cut. If this fails to stop the bleeding, apply a tourniquet. A tourniquet is flat band that can be made out of a necktie, belt, joining of stockings, or handkerchief. Tie a single knot, than put a small stick over the knot, and then tie two more knots. Gently twist the stick until the band is tight enough to stop the flow of blood. Do not twist beyond this point. Leave the tourniquet in place until the doctor comes. But if it is likely to be more than half an hour, loosen the tourniquet every twenty minutes for a few seconds, and then tight it again. Be sure to remember the exact time when the tourniquet was applied.

Artificial
Respiration

Why To Give : We all may face a situation where the knowledge of Artificial Respiration becomes a handy tool in saving the life of a friend, relative or even a stranger. Its need arises whenever there is a stoppage of natural breathing in a person due to certain accidents and/or illnesses even though other body conditions permit life.  In such cases a First-Aider must give artificial respiration to the victim until the person is capable of breathing for himself. Thus, artificial respiration is the means of causing air to flow into and from the lungs of a person who has stopped breathing.

When To Give:  The normal process of breathing may stop as a result of:

	Drowning
	Choking
	Electric Shock
	Severe accident
	Poisoning by gas such as carbon monoxide
	Living under condition of inadequate supply of oxygen as in a tightly closed room
	An overdose of sleep-producing drugs.

Watch the chest of the victim for movements of breathing. If no movement is seen, you must begin artificial respiration at once. 

How To Give:  There are several ways to give artificial respiration The American Red Cross teaches three methods:

	The mouth-to-mouth or mouth-to-nose method
	The chest pressure-arm lift (Silvester) method
	The back pressure-arm lift
	(Holger Nielsen) method

The best is the mouth-to-mouth method  because it is very easy to learn and practice and can be used on persons of all ages and, above all, promises more success for alone rescuer. Many people who have only seen a demonstration of this breathing technique on television, or read about it in some book or newspaper have been able to save a life.

Mouth-to-Mouth Method

Its steps are as follows:

	Check the mouth of the victim  for any foreign matter. If there    is any, wipe it out with your  fingers or a cloth wrapped around  your fingers.
	Place the victim on his back, tilt the head backward so that   his/her chin points sharply upward.
	Grasp the victim’s lower jaw at the angles and lift upward, or insert your thumb between his teeth, grasp the rim of his lower jaw, and lift upward. The actions of   tilting the head and jutting the jaw should open a passageway for air, for they move the base of the victim’s tongue away from  the back of his throat, a position the tongue often takes when a person is unconscious.
	Now begin giving artificial respiration.  With one hand, close the victim’s nostrils. Then open your mouth as wide as possible and make an airtight seal over the victim’s mouth, so that all your breath will pass into his/her mouth.  If his teeth are clenched, you may still use this method, since the air will penetrate between the teeth.  As an alternative, you may use the mouth-to-nose method by closing the victim’s mouth and placing your mouth over the victim’s nose and then blowing into it.
	Artificial respiration and chest compression should be done simultaneously. Chest compression is based on the assumption that cardiac compression allows the heart to maintain a pump function by sequential filling and emptying of its chambers, with competent valves maintaining forward direction of flow. The palm of one hand is placed over the lower sternum (right between the nipples), with the heel of the other resting on the dorsum of the lower hand. The sternum is depressed, with the arms remaining straight, at a rate of approximately 80-100 per minute. Sufficient force is applied to depress the sternum 3-5 centimeters, and relaxation is abrupt.
	The rate at which breathing (ventilation) and compression is to be done would depend whether one or two persons are there to resuscitate the patient. When two persons are performing the resuscitation and the patient is an adult, blow vigorously at the rate of 10-12 breaths per minute, i.e once every fifth chest compression. If only one, then twice in succession of every 15 chest compression If the victim  is a child, place your mouth over both his mouth and nose and blow gently at about 20 breath per minute.
	Continue with 2 breaths and 15 pumps alternatively till the help arrives.

Taking Care of
A Shocked  Person

What is Shock ?. Shock is an extremely serious condition due to sudden failure of blood circulation. It is seen in such conditions as sudden heart attacks and stokes. It also frequently follows some serious injury such as burn, fracture, or deeply penetrating wound of chest or abdomen

It Signs : In a person under shock, his skin becomes pale, cold, and clammy. The eyes are dull and listless. The pulse is weak and rapid, and the victim may feel nauseated and began to vomit. Breathing becomes irregular and shallow.

What
Should You Do

Since shock is a serious condition, take the patient immediately to a doctor. If it is not possible, send a SOS to a doctor. In the mean time: Keep the patient quiet and lying down and make him/her as comfortable as possible. Disturb him/her as little as possible.

	Keep him/her warm: If he/she lying on a cold or wet surface, try to put a blanket or newspaper under him. Cover him/her to keep warm. Use anything that may be handy at that moment
	Never give liquids: If he is conscious and the arrival of the doctor is likely to be delayed, give him/her only warm drink if asked. Give only a teaspoonful at a time and never more than a cup if he/she is very thirsty. If he has an abdominal injury, do not give anything by mouth.
	Encourage him/her: Don’t let the victim see his injuries. This may only increase his/her fear and may further add to his shock. Tell him repeatedly that he will be alright and his/her best chance for making a quick recovery is to rest calmly until the doctor arrives

 Taking Care of
 Wounds

Abrasions or Scraping of the skin: As may occur from falling on a street. These “brush burn” injuries are prone to infection. Therefore, gently wash the area with soap and warm water, removing the entire dirt on the surface. Cover the area preferably with a sterile bandage. If sterile bandage is not available, dip a strip of clean cloth in spirit or alcohol, or in petrol as the last resort.

Incised wounds: They are cuts caused by a knife, broken glass, razor blades etc. These wounds bleed freely because many blood vessels in the skin have been cut. Rub ice on the wound to stop bleeding. If no stitching is required, dress the wound with some anti-septic cream or powder before taking the victim to the doctor.

Taking Care of
Burns

Burns are among the leading causes of accidental home deaths and injuries. Burns are classified according to depth or degree:

First Degree:  the skin is reddened

Second Degree: blisters develop

Third Degree: Deep destruction, meaning thereby that  the underlying cells that continually form new skin are destroyed.

The First Aid Measures

	Douse the fire as soon as possible.
	Dip the burnt area in cold water or gently rub ice over it.
	Clean the burnt area and cover it with a clean and light piece of cloth.
	Avoid using coloured ointments like Burnol if it is a deep wound.
	Don’t try to puncture the blisters, if any.
	Get tetanus shot at the earliest.
	Keep the burnt portion elevated
	Remove all rings, bracelets, wristwatch, bangles and tight clothes that may restrict blood flow.
	If the burns are severe, seek medical help at once.

Taking Care of
Dog Bite

Dog is a faithful animal so long it does not go mad. It is a tragedy if it does. But the greater tragedy would be if the victim of  the dog bite, particularly of the mad dog, is not properly attended and given anti-rabid vaccine. 

The
First Aid Measures

As a first-aider, take the following measures in case of a dog bite:

	Immediately flush and wash the wound and the adjoining areas with plenty of soap and water preferably under a running tap for at least five minutes. If soap is not available, simple flushing of wounds with plenty of water should be done.
	After cleansing, irrigate the wound(s) with either alcohol, tincture, or 0.01% aqueous solution of iodine or povidone (Trade Name: Betadine) for inactivation of rabies virus.
	Ensure that dog bite wounds are not stitched immediately.  If stitching is necessary, it should be done preferably after 24-48 hours of the bite.
	Consult your health care provider for antibiotics, anti-tetanus, and anti-rabies vaccination.
	If possible, watch the dog for ten days from the day of bite. If it shows symptoms of rabies, see to it that it is put to sleep very humanely.   If it is alive and healthy at the end of 10 days, the dog possibly does not have the rabies virus.

Taking Care of
Poisoning 

Oral poisoning is one of those emergencies that need immediate first aid. The following products in home may sometimes cause  accidental poisoning:

	Medicines, such as aspirin and laxatives
	Cleaning and polishing agents, such as bleaches, solvents, and waxes
	Pesticides such as ant and cockroach powders or sprays
	Petroleum distillate products, such as kerosene or lighter fluid

Prevention is better than Cure: Accidental poisoning can be prevented simply by good house-keeping, giving special attention to ensure that: 

	The poisonous products are stored in such a way that they are outside the reach of  children.
	Toxic products are kept only in their original containers with their names clearly readable.

What
You Can Do

Poisoning cases are not only complex but they also need immediate cure. Being a layman, the first aider can and should do very little. He/she can, however, ensure that:

Save the poison and its container.  It will substantially help the doctor to find out the suitable antidote.

The victim is taken to the fresh air and He/she is not surrounded by his relatives and friends.

The victim is taken to the emergency service of the nearest hospital at the earliest possible. In the meantime, the victim is protected against the quackery of friends and relatives.

The patient is not given anything by mouth if he is unconscious, nor should he/she be made to vomit forcibly.

In skin poisoning, remove the contaminated clothing from the body of the victim and thoroughly wash the affected part(s) with soap and water.

In eye poisoning, rinse the eyes with a steady stream of tap water for several minutes.

YOUR
FIRST AID KIT
AND MEDICINE CHEST

Every home with children should have a FIRST AID KIT and a HOME MEDICINE CHEST for emergencies.  Here are some suggestions for making them:

 Your FIRST AID KIT should have:

Sterile gauge 3”x 3” in packages. Adhesive tape One tube of burn ointment Spirit Rubbing Alcohol Tourniquet Bandage Scissors Antiseptics: Tincture of Iodine Hydrogen Peroxide, Boric Acid Mercurochrome, Merthiolate Antiseptic cream. Splinter forceps (Tweezers) Roller bandage 1” and 2” wide Sterile absorbent cotton Triangular Red Cross bandage (36” square) made of any cloth   Triangular Red Cross bandage (36” square) made of any cloth Band-Aid strips Roll of adhesive tape

 

Your HOME MEDICINE CHEST Should Have: Aspirin tablets for relief of pain Bicarbonate of soda or similar medicine for upset stomach Medicine prescribed by your doctor for diarrhea and cough Ointment for burns and bite A mouthwash An eyewash An oral and rectal thermometer   Keep It Neat and Safe: The Home Medicine Chest should be safe and neat and must be outside the reach of small children.  Even pills like aspirin, which are safe if taken in proper amounts, can be poisonous if taken in great quantities. A solution containing a small percentage of an antiseptic may be mild enough to put on the skin but poisonous if swallowed. Periodic Weeding: It is  very important to go through your medicine chest every 3-4 months to weed out the old medicines that have reached their expiry dates. Some medicines, like Tincture of Iodine becomes very strong if it remains stored for a long time. The alcohol in it evaporates and what remains is the concentrated iodine strong enough to burn the skin. They may not have any expiry date, still they must be thrown if lying in the chest for a very long time. Read the Label: All medicines should be carefully labeled, and the label must be read before the medicine is given. When Buying Medicines Ensure the Following: Buy what your doctor has prescribed and not what the chemist has. Avoid chemist’s advice. If for any reason, the prescribed medicine is not available, check up with your doctor about the one that is available. Tally the names of the medicines dispensed and prescribed. Check Expiry date Insist on the bill for the medicines bought. It is advisable to go through the Insert of the medicines provided with most medicines to educate yourself.   CAUTION Never commit the folly of giving a medicine to anybody that was prescribed for somebody else. Don’t ever assume the role of a doctor.