First Aid

Dr. Mehmet nan General Surgeon

First Aid
First Aid is exactly as the term implies, the first aid given for an injury. It is not intended as a long-term solution to a problem, nor does it replace treatment provided by trained medical personnel.

Before attempting to administer First Aid, you need to perform an initial assessment which should include: Safety (yours and the victims), Mechanism of the injury (how did it happen), Medical information devices (Medic Alert tags or bracelets), Number of casualties (if more than one person involved), Bystanders (those that might be able to help you).
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 Always avoid contact with blood or other body fluids. Use latex gloves whenever possible. If administering mouth-to-mouth resuscitation, use a face shield, following instructions on the packet.

In an emergency, you should follow these priorities:

Check that you are not placing yourself in danger by providing first aid. If you become injured you will not be able to help others! Check to see if the person is conscious. If conscious and they are breathing, stay with the victim while sending somebody else to call for help.
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 Check to see if the person is breathing. If you are alone, call 122 first if possible before starting rescue breathing. Check for a pulse. If no pulse found begin CPR if you know the technique. Check for bleeding. Immediately stop bleeding by applied direct pressure before you worry about any fancy bandages. Check for neck and spinal injuries, injuries on the head. You should never move the victim unless its absolutely necessary. If the person is unconscious do not attempt to give them fluids.
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 Do not become involved in using treatment methods beyond your skill. Recognize the limits of your competence. Only perform First Aid procedures that are within your scope of knowledge and skills Always stay calm and do not ever give up. Continue to provide aid to the victim until help arrives!

First Things First

Always perform first aid in the following order: Restore Breathing: A person becomes brain dead in 3-6 minutes if breathing is not restored. Stop Severe Bleeding: Without blood, oxygen can not get to the vital organs of a persons body. Treat Shock: A victims mind and body must work together in order to be healthy. Never overlook shock situations, be they mental or physical. Call advanced medical help immediately: Always realize that you are providing a stop-gap function to an injured person. Always obtain trained medical assistance as soon as possible. It also is good first aid practice to have even minor wounds checked when expert medical assistance is available.
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CPR IN THREE SIMPLE STEPS 1. CALL

Check the victim for unresponsiveness If the person is not responsive and not breathing or not breathing normally. Call 112 and return to the victim. In most locations the emergency dispatcher can assist you with CPR instructions

2. PUMP
If the victim is still not breathing normally, coughing or moving, begin chest compressions. Push down in the center of the chest 2 inches 30 times. Pump hard and fast at the rate of at least 100/minute, faster than once per second.

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3. BLOW
Tilt the head back and lift the chin. Pinch nose and cover the mouth with yours and blow until you see the chest rise. Give 2 breaths. Each breath should take 1 second

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4.Repeat chest compressions.Do 30 more chest compressions just like you did the first time.

5. Repeat rescue breaths. Give 2 more breaths just like you did in step 3 (unless you're skipping the rescue breaths).

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After 2 minutes of chest compressions and rescue breaths, stop compressions and recheck victim for breathing. If the victim is still not breathing, continue CPR starting with chest compressions. Repeat the process, checking for breathing every 2 minutes (5 cycles or so), until help arrives. If the victim wakes up, you can stop CPR.

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Eksternal Automated Defibrillator

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First Aid Kit

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Adhesive tapes

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Band-aid

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Cotton-tiped swaps

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Disposable latex or synthetic gloves

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Gauze pads and roller gauze

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Scissors, tweezers and a needle

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Triangular bandage

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Turkey baster

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EpiPen

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Anaphylaxis: First aid

A life-threatening allergic reaction (anaphylaxis) can cause shock, a sudden drop in blood pressure and trouble breathing. In people who have an allergy, anaphylaxis can occur minutes after exposure to a specific allergy-causing substance (allergen). In some cases, there may be a delayed reaction or anaphylaxis may occur without an apparent trigger.
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If you're with someone having an allergic reaction with signs of anaphylaxis: Immediately call your local medical emergency number. Ask the person if he or she is carrying an epinephrine auto injector to treat an allergic attack (for example, EpiPen, Twinject). If the person says he or she needs to use an auto injector, ask whether you should help inject the medication. This is usually done by pressing the auto injector against the person's thigh. Have the person lie still on his or her back. Loosen tight clothing and cover the person with a blanket. Don't give the person anything to drink. If there's vomiting or bleeding from the mouth, turn the person on his or her side to prevent choking. If there are no signs of breathing, coughing or movements, begin CPR. Do uninterrupted chest presses about 100 every minute until paramedics arrive.
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 Get emergency treatment even if symptoms start to improve. After anaphylaxis, it's possible for symptoms to recur. Monitoring in a hospital setting for several hours is usually necessary. If you're with someone having signs of anaphylaxis, don't wait to see whether symptoms get better. Seek emergency treatment right away. In severe cases, untreated anaphylaxis can lead to death within half an hour. An antihistamine pill, such as diphenhydramine (Benadryl), isn't sufficient to treat anaphylaxis. These medications can help relieve allergy symptoms, but work too slowly in a severe reaction.

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Signs and symptoms of anaphylaxis include:

Skin reactions including hives, itching, and flushed or pale skin Swelling of the face, eyes, lips or throat Constriction of the airways, leading to wheezing and trouble breathing A weak and rapid pulse Nausea, vomiting or diarrhea Dizziness, fainting or unconsciousness
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Some common anaphylaxis triggers include:

Medications Foods such as peanuts, tree nuts, fish and shellfish Insect stings from bees, yellow jackets, wasps, hornets and fire ants

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 Yellow jacket

hornets

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 Fire Ants

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 If you've had any kind of severe allergic reaction in the past, ask your doctor if you should be prescribed an epinephrine auto injector to carry with you.

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Fever: First aid

Fever is a sign of a variety of medical conditions, including infection. Your normal temperature may differ slightly from the average body temperature of 37 C. For young children and infants, even slightly elevated temperatures may indicate a serious infection. In newborns, either a subnormal temperature or a fever may be a sign of serious illness. For adults, a fever usually isn't dangerous until it reaches 39.4 C or higher. Don't treat fevers below 38.9 C with any medications unless your doctor tells you to. If you have a fever of 38.9 C or higher, your doctor may suggest taking an over-the-counter medication, such as acetaminophen (Paracetamol, Tylenol, others) or ibuprofen
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 Adults also may use aspirin, Don't give aspirin to children. It may trigger a rare, but potentially fatal, disorder known as Reye's syndrome. Also, don't give ibuprofen to infants younger than 6 months of age.

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How to take a temperature

Mercury glass thermometer Digital Thermometer

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Digital thermometer

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Rectally (for infants)

To take your child's temperature rectally: Place a dab of petroleum jelly or other lubricant on the bulb. Lay your child on his or her stomach. Carefully insert the bulb one-half inch to one inch into the rectum. Hold the bulb and child still for three minutes. To avoid injury, don't let go of the thermometer while it's inside your child. Remove the thermometer and read the temperature as recommended by the manufacturer. Taking a rectal temperature is also an option for older adults when taking an oral temperature is not possible. A rectal temperature reading is generally 1 degree Fahrenheit (about 0.5 degree Celsius) higher than an oral reading.
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Orally
To take your temperature orally: Place the bulb under your tongue Close your mouth for the recommended amount of time, usually three minutes

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Under the arm (axillary)

Although it's not the most accurate way to take a temperature, you can also use an oral thermometer for an armpit reading: Place the thermometer under your arm with your arm down. Hold your arms across your chest. Wait five minutes or as recommended by your thermometer's manufacturer. Remove the thermometer and read the temperature. To take your child's axillary temperature, have the child sit in your lap, facing to the side. Place the thermometer under your child's near arm, which should be against your chest. An axillary reading is generally 1 degree Fahrenheit (about 0.5 degree Celsius) lower than an oral reading.
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Get medical help for a fever if:

A baby younger than 3 months has a rectal temperature of 38 C or higher, even if your baby doesn't have other signs or symptoms A baby older than 3 months has a temperature of 38.9 C or higher A newborn has a lower than normal temperature 36.1 C rectally A child younger than age 2 has a fever longer than one day, or a child age 2 or older has a fever longer than three days An adult has a temperature of more than 39.4 C or has had a fever for more than three days
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Call your doctor immediately if your child has a fever after being left in a hot car or if a child or adult has any of these signs or symptoms with a fever:

A severe headache Severe swelling of the throat Unusual skin rash Unusual eye sensitivity to bright light A stiff neck and pain when the head is bent forward Mental confusion Persistent vomiting Difficulty breathing or chest pain Extreme listlessness or irritability Abdominal pain or pain when urinating Other unexplained symptoms
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Puncture wounds: First aid

A puncture wound doesn't usually cause excessive bleeding. Often the wound seems to close almost instantly. BUT,,, a puncture wound such as from stepping on a nail can be dangerous because of the risk of infection. The object that caused the wound may carry spores of tetanus or other bacteria, especially if the object has been exposed to the soil. Puncture wounds resulting from human or animal bites, including those of domestic dogs and cats, may be especially prone to infection. Puncture wounds on the foot also are more vulnerable to infection
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 If the bite was deep enough to draw blood and the bleeding persists, seek medical attention.

Otherwise, follow these steps:

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Stop the bleeding. Minor cuts and scrapes usually stop bleeding on their own. If they don't, apply gentle pressure with a clean cloth or bandage. Clean the wound. Rinse the wound well with clear water. Use tweezers cleaned with alcohol to remove small, superficial particles. If debris still remains in the wound, see your doctor. Thorough wound cleaning reduces the risk of tetanus. To clean the area around the wound, use soap and a clean cloth. Apply an antibiotic. After you clean the wound, apply a thin layer of an antibiotic cream or ointment to help keep the surface moist. These products don't make the wound heal faster, but they can discourage infection and allow your body to close the wound more efficiently. Certain ingredients in some ointments can cause a mild rash in some people. If a rash appears, stop using the ointment.
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 Cover the wound. Exposure to air speeds healing, but bandages can help keep the wound clean and keep harmful bacteria out. Change the dressing. Do so at least daily or whenever it becomes wet or dirty. If you're allergic to the adhesive used in most bandages, switch to adhesive-free dressings or sterile gauze and hypoallergenic paper tape, which don't cause allergic reactions. These supplies are generally available at pharmacies. Watch for signs of infection. See your doctor if the wound doesn't heal or if you notice any redness, drainage, warmth or swelling.
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 If the puncture is deep, is in your foot, is contaminated or is the result of an animal or human bite, see your doctor. He or she will evaluate the wound, clean it and, if necessary, close it. If you haven't had a tetanus shot within five years, your doctor may recommend a booster within 48 hours of the injury. If an animal especially a stray dog or a wild animal inflicted the wound, you may have been exposed to rabies. Your doctor may give you antibiotics and suggest initiation of a rabies vaccination series. Report such incidents to county public health officials. If the bite is from someone's pet, it's important to contact the pet owner to confirm the animal's rabies immunization status. If unknown, the animal should be confined for 10 days of observation by a veterinarian.
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Blisters: First aid

Common causes of blisters include friction and burns. If the blister isn't too painful, try to keep it intact. Unbroken skin over a blister provides a natural barrier to bacteria and decreases the risk of infection. Cover a small blister with an adhesive bandage, and cover a large one with a porous, plasticcoated gauze pad that absorbs moisture and allows the wound to breathe.
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 Don't puncture a blister unless it's painful or prevents you from walking or using one of your hands. If you have diabetes or poor circulation, call your doctor before considering the self-care measures below

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To relieve blister-related pain, drain the fluid while leaving the overlying skin intact.

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Here's how:
Wash your hands and the blister with soap and warm water. Swab the blister with polivinil-iodine or rubbing alcohol. Sterilize a clean, sharp needle by wiping it with rubbing alcohol. Use the needle to puncture the blister. Aim for several spots near the blister's edge. Let the fluid drain, but leave the overlying skin in place. Apply an antibiotic ointment to the blister and cover with a bandage or gauze pad. Cut away all the dead skin after several days, using tweezers and scissors sterilized with rubbing alcohol. Apply more ointment and a bandage.
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 Call your doctor if you see signs of infection around a blister pus, redness, increasing pain or warm skin.

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To prevent a blister
Use gloves, socks, a bandage or similar protective covering over the area being rubbed. Special athletic socks are available that have extra padding in critical areas.

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Shoe-shopping tips Remember the following when you shop for shoes:
Shop during the middle of the day. Your feet swell throughout the day, so a late-day fitting will probably give you the best fit. Wear the same socks you'll wear when walking, or bring them with you to the store. Measure your feet. Shoe sizes change throughout adulthood. Measure both feet and try on both shoes. If your feet differ in size, buy the larger size. Go for flexible, but supportive, shoes with cushioned insoles. Leave toe room. Be sure that you can comfortably wiggle your toes
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Bruise: First aid

A bruise forms when a blow breaks blood vessels near your skin's surface, allowing a small amount of blood to leak into the tissues under your skin. The trapped blood appears as a black-and-blue mark
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Enhance bruise healing with these simple techniques:

Elevate the injured area. Apply ice or a cold pack several times a day for a day or two after the injury. Rest the bruised area, if possible.

Consider acetaminophen or ibuprofen for pain relief and to reduce swelling.

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See your doctor if

You have unusually large or painful bruises particularly if your bruises seem to develop for no known reasons. You begin to bruise easily. You're experiencing abnormal bleeding elsewhere, such as from your nose or gums, or you notice blood in your eyes, stool or urine. You have no history of bruising, but suddenly experience bruises. These signs and symptoms may indicate a more serious problem, such as a blood-clotting problem or blood-related disease. Bruises accompanied by persistent pain or headache also may indicate a more serious underlying illness and require medical attention.
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Cuts and scrapes: First aid

Proper care is essential to avoid infection or other complications

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These guidelines can help you care for simple wounds:

Stop the bleeding. Minor cuts and scrapes usually stop bleeding on their own. If they don't, apply gentle pressure with a clean cloth or bandage. Hold the pressure continuously for 20 to 30 minutes and if possible elevate the wound. Don't keep checking to see if the bleeding has stopped because this may damage or dislodge the clot that's forming and cause bleeding to resume. If blood spurts or continues flowing after continuous pressure, seek medical assistance. Clean the wound. Rinse out the wound with clear water. Soap can irritate the wound, so try to keep it out of the actual wound. If dirt or debris remains in the wound after washing, use tweezers cleaned with alcohol to remove the particles. If debris still remains, see your doctor. Thorough cleaning reduces the risk of infection and tetanus. To clean the area around the wound, use soap and a washcloth. There's no need to use hydrogen peroxide, iodine or an iodinecontaining cleanser.
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Apply an antibiotic. After you clean the wound, apply a thin layer of an antibiotic cream or ointment to help keep the surface moist. The products don't make the wound heal faster, but they can discourage infection and help your body's natural healing process. Certain ingredients in some ointments can cause a mild rash in some people. If a rash appears, stop using the ointment. Cover the wound. Bandages can help keep the wound clean and keep harmful bacteria out. After the wound has healed enough to make infection unlikely, exposure to the air will speed wound healing. Change the dressing. Change the dressing at least daily or whenever it becomes wet or dirty. If you're allergic to the adhesive used in most bandages, switch to adhesive-free dressings or sterile gauze held in place with paper tape, gauze roll or a loosely applied elastic bandage. These supplies generally are available at pharmacies.
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Get stitches for deep wounds. A wound that is more than 1/4-inch (6 millimeters) deep or is gaping or jagged edged and has fat or muscle protruding usually requires stitches. Adhesive strips or butterfly tape may hold a minor cut together, but if you can't easily close the wound, see your doctor as soon as possible. Proper closure within a few hours reduces the risk of infection. Watch for signs of infection. See your doctor if the wound isn't healing or you notice any redness, increasing pain, drainage, warmth or swelling. Get a tetanus shot. Doctors recommend you get a tetanus shot every 5 years. If your wound is deep or dirty and your last shot was more than five years ago, your doctor may recommend a tetanus shot booster. Get the booster as soon as possible after the injury.
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Chemical splash in the eye: First aid

1. Flush your eye with water. Use clean, lukewarm tap water for at least 20 minutes, and use whichever of these approaches is quickest: Get into the shower and aim a gentle stream of lukewarm water on your forehead over your affected eye. Or direct the stream on the bridge of your nose if both eyes are affected. Hold your affected eye or eyes open. Put your head down and turn it to the side. Then hold your affected eye open under a gently running faucet. Young children may do best if they lie down in the bathtub or lean back over a sink while you pour a gentle stream of water on the forehead over the affected eye or on the bridge of the nose for both eyes.

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 2. Wash your hands with soap and water. Thoroughly rinse your hands to be sure no chemical or soap is left on them. Your first goal is to get the chemical off the surface of your eye, but then you must remove the chemical from your hands. 3. Remove contact lenses. If they don't come out during the flush, then take them out.

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Caution
Dont rub the eye
Don't rub the eye this may cause further damage. Don't put anything except water or contact lens saline rinse in the eye, and don't use eye drops unless emergency personnel tell you to do so.
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Seek emergency medical assistance

After following the above steps, seek emergency care or, if necessary, call your local emergency number. Take the chemical container or the name of the chemical with you to the emergency department. If readily available, wear sunglasses because your eyes will be sensitive to light.

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f you are working with chemicals

Use protective glasses

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Burns: First aid

To distinguish a minor burn from a serious burn, the first step is to determine the extent of damage to body tissues. The three burn classifications of first-degree burn, second-degree burn and third-degree burn will help you determine emergency care.

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 Burn Classification

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1st-degree burn
The least serious burns are those in which only the outer layer of skin is burned, but not all the way through. The skin is usually red Often there is swelling Pain sometimes is present Treat a first-degree burn as a minor burn unless it involves substantial portions of the hands, feet, face, groin or buttocks, or a major joint, which requires emergency medical attention.

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2nd-degree burn
When the first layer of skin has been burned through and the second layer of skin (dermis) also is burned, the injury is called a second-degree burn. Blisters develop Skin takes on an intensely reddened, splotchy appearance There is severe pain and swelling. If the second-degree burn is no larger than 7-8 cm in diameter, treat it as a minor burn. If the burned area is larger or if the burn is on the hands, feet, face, groin or buttocks, or over a major joint, treat it as a major burn and get medical help immediately.
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For minor burns, including first-degree burns and seconddegree burns limited to an area no larger than 7-8 cm in diameter, take the following action: Cool the burn. Hold the burned area under cool (not cold) running water for 10 or 15 minutes or until the pain subsides. If this is impractical, immerse the burn in cool water or cool it with cold compresses. Cooling the burn reduces swelling by conducting heat away from the skin. Don't put ice on the burn.

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 Cover the burn with a sterile gauze bandage. Don't use fluffy cotton, or other material that may get lint in the wound. Wrap the gauze loosely to avoid putting pressure on burned skin. Bandaging keeps air off the burn, reduces pain and protects blistered skin.

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 Take an over-the-counter pain reliever. These include aspirin, ibuprofen, naproxen or acetaminophen. Use caution when giving aspirin to children or teenagers. Minor burns usually heal without further treatment. They may heal with pigment changes, meaning the healed area may be a different color from the surrounding skin. Watch for signs of infection, such as increased pain, redness, fever, swelling or oozing. If infection develops, seek medical help. Avoid re-injuring or tanning if the burns are less than a year old doing so may cause more extensive pigmentation changes. Use sunscreen on the area for at least a year.
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Caution
Don't use ice. Putting ice directly on a burn can cause a person's body to become too cold and cause further damage to the wound. Don't apply egg whites, butter or ointments to the burn. This could cause infection. Don't break blisters. Broken blisters are more vulnerable to infection.

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3rd-degree burn
The most serious burns involve all layers of the skin and cause permanent tissue damage. Fat, muscle and even bone may be affected. Areas may be charred black or appear dry and white. Difficulty inhaling and exhaling, carbon monoxide poisoning, or other toxic effects may occur if smoke inhalation accompanies the burn.

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For major burns, call emergency help. Until an emergency unit arrives, follow these steps:
Don't remove burned clothing. However, do make sure the victim is no longer in contact with smoldering materials or exposed to smoke or heat. Don't immerse large severe burns in cold water. Doing so could cause a drop in body temperature (hypothermia) and deterioration of blood pressure and circulation (shock). Check for signs of circulation (breathing, coughing or movement). If there is no breathing or other sign of circulation, begin CPR.
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 Elevate the burned body part or parts. Raise above heart level, when possible. Cover the area of the burn. Use a cool, moist, sterile bandage; clean, moist cloth; or moist cloth towels. Get a tetanus shot. Burns are susceptible to tetanus
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Chemical burns: First aid

If a chemical burns the skin, follow these steps: Remove the cause of the burn by first brushing any remaining dry chemical and then rinsing the chemical off the skin surface with cool, gently running water for 10 to 20 minutes or more. Remove clothing or jewelry that has been contaminated by the chemical. Wrap the burned area loosely with a dry, sterile dressing (if available) or a clean cloth. Rewash the burned area for several more minutes if the person experiences increased burning after the initial washing. Take an over-the-counter pain reliever if needed for pain. Get a tetanus shot. All burns are susceptible to tetanus.
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Seek emergency medical assistance if:

The person shows signs of shock, such as fainting, pale complexion or breathing in a notably shallow manner The chemical burn penetrated through the first layer of skin, and the resulting second-degree burn covers an area more than 7 cm. in diameter The chemical burn occurred on the eye, hands, feet, face, groin or buttocks, or over a major joint The person has pain that cannot be controlled with overthe-counter pain relievers If you're unsure whether a substance is toxic, call the poison control center at 0800 3147900 or 0312 4337001. If you seek emergency assistance, take the chemical container or a complete description of the substance with you for identification.
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Electrical burns: First aid

An electrical burn may appear minor or not show on the skin at all, but the damage can extend deep into the tissues beneath your skin. If a strong electrical current passes through your body, internal damage, such as a heart rhythm disturbance or cardiac arrest, can occur. Sometimes the jolt associated with the electrical burn can cause you to be thrown or to fall, resulting in fractures or other associated injuries. Call your local emergency number for assistance if the person who has been burned is in pain, is confused, or is experiencing changes in his or her breathing, heartbeat or consciousness
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While helping someone with an electrical burn and waiting for medical help, follow these steps:
Look first. Don't touch. The person may still be in contact with the electrical source. Touching the person may pass the current through you. Turn off the source of electricity if possible. If not, move the source away from both you and the injured person using a dry, nonconducting object made of cardboard, plastic or wood. Check for signs of circulation (breathing, coughing or movement). If absent, begin cardiopulmonary resuscitation (CPR) immediately. Prevent shock. Lay the person down with the head slightly lower than the trunk, if possible, and the legs elevated. Cover the affected areas. If the person is breathing, cover any burned areas with a sterile gauze bandage, if available, or a clean cloth. Don't use a blanket or towel, because loose fibers can stick to the burns.
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Sunburn: First aid

Signs and symptoms of sunburn usually appear within a few hours of exposure, bringing pain, redness, swelling and occasional blistering. Because exposure often affects a large area of your skin, sunburn can cause headache, fever and fatigue.

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If you have a sunburn

Take a cool bath or shower. You can also apply a clean towel dampened with cool water. Apply an aloe vera or moisturizing lotion several times a day. Leave blisters intact to speed healing and avoid infection. If they burst on their own, apply an antibacterial ointment on the open areas.
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 If needed, take an over-the-counter pain reliever such as aspirin, ibuprofen, naproxen or acetaminophen. Don't use petroleum jelly, butter, egg whites or other home remedies on your sunburn. They can prevent or delay healing. If your sunburn begins to blister or if you experience immediate complications, such as rash, itching or fever, see your doctor

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Frostbite: First aid

When exposed to very cold temperatures, skin and underlying tissues may freeze, resulting in frostbite. The areas most likely to be affected by frostbite are your hands, feet, nose and ears. If your skin looks white or grayish-yellow, is very cold and has a hard or waxy feel, you may have frostbite. Your skin may also itch, burn or feel numb. Severe or deep frostbite can cause blistering and hardening. As the area thaws, the flesh becomes red and painful. Gradually warming the affected skin is key to treating frostbite
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Protect your skin from further exposure.

If you're outside, warm frostbitten hands by tucking them into your armpits. Protect your face, nose or ears by covering the area with dry, gloved hands. Don't rub the affected area and never rub snow on frostbitten skin.
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 Get out of the cold. Once you're indoors, remove wet clothes. Gradually warm frostbitten areas. Put frostbitten hands or feet in warm water 40 to 42 C. Wrap or cover other areas in a warm blanket. Don't use direct heat, such as a stove, heat lamp, fireplace or heating pad, because these can cause burns before you feel them on your numb skin. Don't walk on frostbitten feet or toes if possible. This further damages the tissue. If there's any chance the affected areas will freeze again, don't thaw them. If they're already thawed, wrap them up so that they don't become frozen again. Get emergency medical help. If numbness or sustained pain remains during warming or if blisters develop, seek medical attention. 88

Chest pain: First aid

Causes of chest pain can vary from minor problems, such as indigestion or stress, to serious medical emergencies, such as a heart attack or pulmonary embolism. The specific cause of chest pain is often difficult to interpret. Finding the cause of your chest pain can be challenging, especially if you've never had symptoms in the past. Even doctors may have a difficult time deciding if chest pain is a sign of a heart attack or something less serious, such as indigestion. If you have unexplained chest pain lasting more than a few minutes, you should seek emergency medical assistance rather than trying to diagnose the cause yourself. As with other sudden, unexplained pains, chest pain may be a signal for you to get medical help.

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Important reasons of chest pain

Heart attack Angina Pulmonary embolism Aortic dissection Pneumonia with pleurisy

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Other causes of chest pain include:

Strained chest muscles from overuse or excessive coughing Chest muscle bruising from minor injury Short-term, sudden anxiety with rapid breathing Peptic ulcer disease Pain from the digestive tract, such as esophageal reflux, peptic ulcer pain or gallbladder pain that may feel similar to heart attack symptoms Chest wall pain, costochondritis
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Heart attack
A heart attack occurs when an artery that supplies oxygen to your heart muscle becomes blocked. A heart attack may cause chest pain that lasts 15 minutes or longer. But a heart attack can also be silent and produce no signs or symptoms. Many people who experience a heart attack have warning symptoms hours, days or weeks in advance. The earliest warning sign of an attack may be ongoing episodes of chest pain that start when you're physically active, but are relieved by rest.
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Heart attack

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Someone having a heart attack may experience any or all of the following: Uncomfortable pressure, fullness or squeezing pain in the center of the chest lasting more than a few minutes Pain spreading to the shoulders, neck or arms Lightheadedness, fainting, sweating, nausea or shortness of breath

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If you or someone else may be having a heart attack:

Call emergency medical assistance. Don't "tough out" the symptoms of a heart attack for more than five minutes. If you don't have access to emergency medical services, have someone, such as a neighbor or friend, drive you to the nearest hospital. Drive yourself only as a last resort, if there are absolutely no other options. Driving yourself puts you and others at risk if your condition suddenly worsens. Chew a regular-strength aspirin. Aspirin reduces blood clotting, which can help blood flow through a narrowed artery that's caused a heart attack. However, don't take aspirin if you are allergic to aspirin, have bleeding problems or take another blood-thinning medication, or if your doctor previously told you not to do so. Take nitroglycerin, if prescribed. If you think you're having a heart attack and your doctor has previously prescribed nitroglycerin for you, take it as directed. Don't take anyone else's nitroglycerin. Begin CPR on the person having a heart attack, if directed. If the person suspected of having a heart attack is 95 unconscious,

Angina
Angina is a type of chest pain or discomfort caused by reduced blood flow to your heart muscle. Angina may be stable or unstable: Stable angina persistent, recurring chest pain that usually occurs with exertion Unstable angina sudden, new chest pain, or a change in the pattern of previously stable angina, that may signal an impending heart attack Angina is relatively common, but can be hard to distinguish from other types of chest pain, such as the pain or discomfort of indigestion.
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Angina signs and symptoms may include: 1

Anxiety and sweating Chest pain or discomfort Nausea Fatigue Shortness of breath Anxiety Sweating Dizziness
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Angina signs and symptoms may include:2

Pain in your arms, neck, jaw, shoulder or back accompanying chest pain

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 The severity, duration and type of angina can vary. If you have new or changing chest pain, these new or different symptoms may signal a more dangerous form of angina (unstable angina) or a heart attack. If your angina gets worse or changes, becoming unstable, seek medical attention immediately.

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Pulmonary embolism
Pulmonary embolism occurs when a clot usually from the veins of your leg or pelvis lodges in a pulmonary artery of your lung. The lung tissue served by the artery doesn't get enough blood flow, causing tissue death. This makes it more difficult for your lungs to provide oxygen to the rest of your body.
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Pulmonary embolism

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Signs and symp. of pulmonary embolism may include: Sudden, sharp chest pain often accompanied by shortness of breath Sudden, unexplained shortness of breath, even without pain Cough that may produce blood-streaked sputum Rapid heartbeat associated with shortness of breath Fainting Severe anxiety Unexplained sweating Pulmonary embolism can be life-threatening. As with a suspected heart attack, call emergency medical assistance immediately
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Aortic dissection
An aortic dissection is a serious condition in which a tear develops in the inner layer of the aorta, the large blood vessel branching off the heart. Blood surges through this tear into the middle layer of the aorta, causing the inner and middle layers to separate (dissect). If the bloodfilled channel ruptures through the outside aortic wall, aortic dissection is usually fatal. If you think aortic dissection is the cause of your chest pain, seek emergency medical assistance immediately.
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Aortic dissection

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Typical signs and symptoms of aortic dissection include:

Sudden severe chest or upper back pain, often described as a tearing, ripping or shearing sensation, that radiates to the neck or down the back Loss of consciousness (fainting) Shortness of breath Sudden difficulty speaking, loss of vision, weakness, or paralysis of one side of your body, such as having a stroke Sweating Weak pulse in one arm compared with the other
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Pneumonia with pleurisy

Frequent signs and symptoms of pneumonia are chest pain accompanied by chills, fever and a cough that may produce bloody or foul-smelling sputum. When pneumonia occurs with an inflammation of the membranes that surround the lung (pleura), you may have considerable chest discomfort when taking a breath or coughing. This condition is called pleurisy. One sign of pleurisy is that the pain is usually relieved temporarily by holding your breath or putting pressure on the painful area of your chest. This isn't usually true of a heart attack. If you've recently been diagnosed with pneumonia and then start having symptoms of pleurisy, contact your doctor or seek immediate medical attention to determine the cause of your chest pain. Pleurisy alone isn't a medical emergency, but you shouldn't try to make the diagnosis yourself.
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107

Chest wall pain

One of the most common varieties of harmless chest pain is chest wall pain. One kind of chest wall pain is costochondritis. It causes pain and tenderness in and around the cartilage that connects your ribs to your breastbone (sternum). In costochondritis, pressing on a few points along the edge of your sternum often results in considerable tenderness in those small areas. If the pressure of a finger causes similar chest pain, it's unlikely that a serious condition, such as a heart attack, is the cause of your chest pain.
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costochondritis

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Other causes of chest pain include:

Strained chest muscles from overuse or excessive coughing Chest muscle bruising from minor injury Short-term, sudden anxiety with rapid breathing Peptic ulcer disease Pain from the digestive tract, such as esophageal reflux, peptic ulcer pain or gallbladder pain that may feel similar to heart attack symptoms
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Stroke: First aid

A stroke occurs when there's bleeding into your brain or when normal blood flow to your brain is blocked. Within minutes of being deprived of essential nutrients, brain cells start dying a process that may continue over the next several hours. Seek immediate medical assistance. A stroke is a true emergency. The sooner treatment is given, the more likely it is that damage can be minimized. Every moment counts.
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In the event of a possible stroke, use FAST to help remember warning signs. Face. Does the face droop on one side trying to smile? Arms. Is one arm lower when trying to raise both arms? Speech. Can a simple sentence be repeated? Is speech slurred or strange? Time. During a stroke every minute counts. If you observe any of these signs, call your local emergency number immediately
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113

 intracerebral bleeding

Cerebral embolism

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Other signs and symptoms of a stroke include:

Weakness or numbness on one side of your body including either leg Dimness, blurring or loss of vision, particularly in one eye Severe headache Unexplained dizziness, unsteadiness or a sudden fall, especially if accompanied by any of the other signs or symptoms
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Risk factors for stroke include

High blood pressure Previous stroke Smoking Diabetes Heart disease. Age

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Fainting: First aid

Fainting occurs when the blood supply to your brain is momentarily inadequate, causing you to lose consciousness. This loss of consciousness is usually brief. Fainting can have no medical significance, or the cause can be a serious disorder. Therefore, treat loss of consciousness as a medical emergency until the signs and symptoms are relieved and the cause is known. Discuss recurrent fainting spells with your doctor.
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If you feel faint

Lie down or sit down. To reduce the chance of fainting again, don't get up too quickly. Place your head between your knees if you sit down. If someone else faints Position the person on his or her back. If the person is breathing, restore blood flow to the brain by raising the person's legs above heart level about 12 inches (30 centimeters) if possible. Loosen belts, collars or other constrictive clothing. To reduce the chance of fainting again, don't get the person up too quickly

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119

If the person doesn't regain consciousness within one minute, call your local emergency number. Check the person's airway to be sure it's clear. Watch for vomiting. Check for signs of circulation (breathing, coughing or movement). If absent, begin CPR. Call your local emergency number. Continue CPR until help arrives or the person responds and begins to breathe. If the person was injured in a fall associated with a faint, treat any bumps, bruises or cuts appropriately. Control bleeding with direct pressure
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Electrical shock: First aid

The danger from an electrical shock depends on the type of current, how high the voltage is, how the current traveled through the body, the person's overall health and how quickly the person is treated

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Call your local emergency number immediately if any of these signs or symptoms occur:

Cardiac arrest Heart rhythm problems (arrhythmias) Respiratory failure Muscle pain and contractions Burns Seizures Numbness and tingling Unconsciousness
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While waiting for medical help, follow these steps:

Look first. Don't touch. The person may still be in contact with the electrical source. Touching the person may pass the current through you. Turn off the source of electricity, if possible. If not, move the source away from you and the person, using a nonconducting object made of cardboard, plastic or wood. Check for signs of circulation (breathing, coughing or movement). If absent, begin cardiopulmonary resuscitation (CPR) immediately. Prevent shock. Lay the person down and, if possible, position the head slightly lower than the trunk, with the legs elevated. After coming into contact with electricity, the person should see a doctor to check for internal injuries, even if he or she has no obvious signs or symptoms.
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Caution
Don't touch the person with your bare hands if he or she is still in contact with the electrical current. Don't get near high-voltage wires until the power is turned off. Stay at least 20 feet away farther if wires are jumping and sparking. Don't move a person with an electrical injury unless the person is in immediate danger.

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Food-borne illness: First aid

All foods naturally contain small amounts of bacteria. But poor handling of food, improper cooking or inadequate storage can result in bacteria multiplying in large enough numbers to cause illness. Parasites, viruses, toxins and chemicals also can contaminate food and cause illness. Signs and symptoms of food poisoning vary with the source of contamination, and whether you're dehydrated or have low blood pressure
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Semptoms generally include:

Diarrhea, Abdominal pain Nausea, Vomiting (sometimes) Dehydration (sometimes) With significant dehydration, you might feel: Lightheaded or faint, especially on standing, a rapid heartbeat
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Whether you become ill after eating contaminated food depends on the organism, the amount of exposure, your age and your health. High-risk groups include:

Older adults. As you get older, your immune system may not respond as quickly and as effectively to infectious organisms as when you were younger. Infants and young children. Their immune systems haven't fully developed. People with chronic diseases. Having a chronic condition, such as DM or AIDS, or receiving chemotherapy or radiation therapy for cancer reduces your immune response.
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If you develop food poisoning:

Rest and drink plenty of liquids. Don't use anti-diarrheal medications because they may slow elimination of bacteria from your system. Foodborne illness often improves on its own within 48 hours. Call your doctor if you feel ill for longer than two or three days or if blood appears in your stools.
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Call for emergency medical assistance if:

You have severe symptoms, such as watery diarrhea that turns very bloody within 24 hours. You belong to a high-risk group. You suspect botulism poisoning. Botulism is a potentially fatal food poisoning that results from the ingestion of a toxin formed by certain spores in food. Botulism toxin is most often found in home-canned foods, especially green beans and tomatoes. Signs and symptoms of botulism usually begin 12 to 36 hours after eating the contaminated food and may include headache, blurred vision, muscle weakness and eventual paralysis. Some people also have nausea and vomiting, constipation, urinary retention, difficulty breathing, and dry mouth. These signs and symptoms require immediate medical attention.
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Botulism toxin is most often found in home-canned foods

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Gastroenteritis: First aid

Gastroenteritis is an inflammation of your stomach and intestines. Common causes are: Viruses. Food or water contaminated by bacteria or parasites. Reaction to a new food. Young children may develop signs and symptoms for this reason. Infants who are breast-fed may even react to a change in their mothers' diets. Side effect from medications.
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Characteristic signs and symptoms include:

Nausea or vomiting Diarrhea Abdominal cramps Bloating Low-grade fever (sometimes) Depending on the cause of the inflammation, symptoms may last from one day to longer than a week.
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If you suspect gastroenteritis in yourself:

Stop eating and drinking for a few hours to let your stomach settle. Drink plenty of liquids, such as a sports drink or water, to prevent dehydration. If you have trouble tolerating liquids, take them in frequent sips. Make sure that you're urinating normally, and that your urine is light and clear and not dark. Infrequent passage of dark urine is a sign of dehydration. Dizziness or lightheadedness also are signs of dehydration. Ease back into eating. Gradually begin to eat bland, easy-todigest foods, such as soda crackers, toast, bananas, rice and chicken. Stop eating if your nausea returns. Avoid milk and dairy products, caffeine, alcohol, nicotine, and fatty or highly seasoned foods for a few days. Consider acetaminophen for relief of discomfort, unless you have liver disease. Get plenty of rest. The illness and dehydration can make you weak and tired 133

Get medical help if:

Vomiting persists for more than two days Diarrhea persists for longer than several days Diarrhea turns bloody Fever is 38.3 C or higher Lightheadedness or fainting occurs with standing Confusion develops Worrisome abdominal pain develops

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If you suspect gastroenteritis in your child:

Allow your child to rest. When your child's vomiting stops, begin to offer small amounts of an oral rehydration solution, such as Pedialyte or Infalyte. Don't use only water. In children with gastroenteritis won't adequately replace lost fluids and electrolitis. Also avoid apple juice and milk, which can make diarrhea worse. Gradually introduce bland, easy-to-digest foods, such as toast, rice, bananas and potatoes. Avoid giving your child dairy products and sugary foods, such as ice cream, sodas and candy. These can make diarrhea worse. Consider acetaminophen for relief of discomfort, unless your child has liver disease. Don't give your child aspirin. If you have a sick infant, let your baby's stomach rest for 30 to 60 minutes, then offer small amounts of liquid. If you're breastfeeding, let your baby nurse. If your baby is bottle-fed, offer a small amount of an oral rehydration formula (Pedialyte, Infalyte) or regular formula.
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Get medical help if your child:

Becomes unusually drowsy. Vomits blood. Has bloody diarrhea. Shows signs of dehydration, such as dry mouth and skin, marked thirst, sunken eyes, or crying without tears. In an infant, be alert to the soft spot on the top of the head becoming sunken and to diapers that remain dry for more than eight hours. Is younger than age 2 and has a fever for longer than one day or is age 2 or older and has a fever for longer than three days.
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Poisoning: First aid

Signs and symptoms of poisoning: Burns or redness around the mouth and lips, from drinking certain poisons. Breath that smells like chemicals, such as gasoline or paint thinner. Burns, stains and odors on the person, on his or her clothing, or on the furniture, floor, rugs or other objects in the surrounding area Empty medication bottles or scattered pills Vomiting, difficulty breathing, sleepiness, confusion or other unexpected signs
137

Signs of poisoning

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Call your local emergency number immediately if the person is:

Drowsy or unconscious Having difficulty breathing or has stopped breathing Uncontrollably restless or agitated Having seizures If the person seems stable and has no symptoms, but you suspect poisoning, call your regional poison control center. Provide information about the person's symptoms, the person's age and weight, and any information you have about the poison, such as amount and how long since the person was exposed to it. It helps to have the pill bottle or poison container on hand when you call.

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What to do while waiting for help:

If the person has been exposed to poisonous fumes, such as carbon monoxide, get him or her into fresh air immediately. If the person swallowed the poison, remove anything remaining in the mouth. If the poison spilled on the person's clothing, skin or eyes, remove the clothing. Flush the skin or eyes with cool or lukewarm water, such as by using a shower for 20 minutes or until help arrives. Make sure the person is breathing. If not, start rescue breathing and CPR. Take the poison container (or any pill bottles) with you to the hospital.
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 If the suspected poison is a household cleaner or other chemical, read the label and follow instructions for accidental poisoning. If the product is toxic, the label will likely advise you to call the poison control center.Follow treatment directions that are given by the poison control center.

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What NOT to do
Don't give ipecac syrup or do anything to induce vomiting. The American Academy of Pediatrics advises discarding ipecac in the home, saying there's no good evidence of effectiveness and that it can do more harm than good.

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Foreign object in the ear: First aid

A foreign object in the ear can cause pain and hearing loss. Usually you know if an object is stuck in your ear, but small children may not be aware of it. If an object becomes lodged in the ear, follow these steps: Don't probe the ear with a tool. Don't attempt to remove the foreign object by probing with a cotton swab, matchstick or any other tool. To do so is to risk pushing the object farther into the ear and damaging the fragile structures of the middle ear. Try using gravity. Tilt the head to the affected side to try to dislodge the object.

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 Remove the object if possible. If the object is clearly visible, pliable and can be grasped easily with tweezers, gently remove it.

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Try using oil for an insect

If the foreign object is an insect, tilt the person's head so that the ear with the offending insect is upward. Try to float the insect out by pouring mineral oil, olive oil or baby oil into the ear. The oil should be warm but not hot. As you pour the oil, you can ease the entry of the oil by straightening the ear canal. Pull the earlobe gently backward and upward for an adult, backward and downward for a child. The insect should suffocate and may float out in the oil bath. Don't use oil to remove any object other than an insect. Do not use this method if the child has ear tubes in place or if there is any suspicion of a perforation in the eardrum pain, bleeding or discharge from the ear. If these methods fail or the person continues to experience pain in the ear, reduced hearing or a sensation of something lodged in the ear, seek medical assistance.
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Foreign object in the nose: First aid Don't probe at the object with a cotton swab or other tool. Don't try to inhale the object by forcefully breathing in. Instead, breathe through your mouth until the object is removed. Call for emergency medical assistance or go to your local emergency room if these methods fail.

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 Blow out of your nose gently to try to free the object, but don't blow hard or repeatedly. If only one nostril is affected, close the opposite nostril by applying gentle pressure and then blow out gently through the affected nostril.

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 Gently remove the object if it's visible and you can easily grasp it with tweezers. Don't try to remove an object that isn't visible or easily grasped.

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Foreign object in the eye: First aid

If you get a foreign object in your eye: Wash your hands. Try to flush the object out of your eye with clean water or saline solution. Use an eyecup or a small, clean drinking glass positioned with its rim resting on the bone at the base of your eye socket.

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To help someone else:

Wash your hands. Seat the person in a well-lighted area. Gently examine the eye to find the object. Pull the lower lid down and ask the person to look up. Then hold the upper lid while the person looks down. If the object is floating in the tear film on the surface of the eye, try flushing it out with saline solution or clean, lukewarm water.
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Caution
Don't try to remove an object that's embedded in the eyeball. Don't rub the eye. Don't try to remove a large object that makes closing the eye difficult.

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When to call for help Call your local emergency number when:

You can't remove the object. The object is embedded in the eyeball. The person with the object in the eye is experiencing abnormal vision. Pain, redness or the sensation of an object in the eye persists after the object is removed.

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Foreign object in the skin: First aid If a foreign object is projecting from the skin: Wash your hands and clean the area well with soap and water. Squeeze the wound gently to allow bleeding to wash out germs. Wash the area again and pat dry. Apply antibiotic ointment.
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 Use tweezers to remove splinters of wood or fiberglass, small pieces of glass, or other foreign objects. A magnifying glass may help you see the object better.

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If the object is completely embedded in your skin:

Wash your hands and clean the area well with soap and water. Sterilize a clean, sharp needle by wiping it with rubbing alcohol. If rubbing alcohol isn't available, clean the needle with soap and water.

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 Use the needle to break the skin over the object and gently lift the tip of the object out. A magnifying glass may help you see the object better. Use tweezers to remove the object. Squeeze the wound gently to allow bleeding to wash out germs. Wash the area again and pat dry. Apply antibiotic ointment.

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Seek medical help if:

The particle doesn't come out easily. The particle is close to an eye. Check your immunization record to be sure you're current on your tetanus shot (within 5 years unless the wound is deep or dirty). The immunization may be listed as Td, DTaP or Tdap.

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Foreign object inhaled: First aid

If you or your child inhales a foreign object, see your doctor. If an inhaled foreign object causes choking, the American Red Cross recommends the "five-and-five" approach to delivering first aid: Give 5 back blows. First, deliver five back blows between the choking person's shoulder blades with the heel of your hand. Give 5 abdominal thrusts. Perform five abdominal thrusts (also known as the Heimlich maneuver). Alternate between 5 blows and 5 thrusts until the blockage is dislodged. If you're the only rescuer, perform back blows and abdominal thrusts before calling your local emergency number for help. If another person is available, have that person call for help while you perform first aid.
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Back Blow

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 Give 5 abdominal thrusts. Perform five abdominal thrusts (also known as the Heimlich maneuver).

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To perform the Heimlich maneuver on someone else

Stand behind the person. Wrap your arms around the waist. Tip the person forward slightly. Make a fist with one hand. Position it slightly above the person's navel. Grasp the fist with the other hand. Press hard into the abdomen with a quick, upward thrust as if trying to lift the person up. Perform a total of 5 abdominal thrusts, if needed. If the blockage still isn't dislodged, repeat the five-and-five cycle. A modified version of the technique is sometimes taught for use with pregnant or obese people. The rescuer places his or her hand in the center of the chest to compress, rather than in the abdomen.
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Heimlich Maneuver

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To perform the Heimlich maneuver on yourself

If you're alone and choking and you have a landline phone, call your local emergency number immediately. Then, although you'll be unable to effectively deliver back blows to yourself, you can still perform abdominal thrusts to dislodge the item. Place a fist slightly above your navel. Grasp your fist with the other hand and bend over a hard surface a countertop or chair. Shove your fist inward and upward.
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Foreign object swallowed: First aid

If you swallow a foreign object, it will usually pass through your digestive system uneventfully. But some objects can lodge in your esophagus, the tube that connects your throat and stomach. If an object is stuck in your esophagus, you may need to remove it, especially if it is: A pointed object, which should be removed as quickly as possible to avoid further injury to the esophageal lining A tiny watch- or calculator-type button battery, which can rapidly cause nearby tissue injury and should be removed from the esophagus without delay. If a person who has swallowed an object is coughing forcefully, encourage him or her to continue coughing and do not interfere. If a swallowed object blocks the airway and the person's condition worsens (the cough becomes silent or their breathing becomes more difficult), the American Red Cross recommends the "five-and-five" approach to first aid:
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 Give 5 back blows. First, deliver five back blows between the victim's shoulder blades with the heel of your hand. Give 5 abdominal thrusts. Perform five abdominal thrusts (also known as the Heimlich maneuver). Abdominal thrusts may injure infants. Use chest compressions instead. Alternate between 5 back blows and 5 abdominal thrusts until the blockage is dislodged. If you're the only rescuer, perform back blows and abdominal thrusts before calling your local emergency number for help. If another person is available, have that person call for help while you perform first aid. If the person becomes unconscious, help him or her to the ground and begin CPR. With attempted breaths, check the mouth for an object and if visible remove it. Do not perform a "blind finger sweep" because this could push an object farther into the airway.
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Dislocation: First aid

A dislocation is an injury in which the ends of your bones are forced from their normal positions. The cause is usually trauma, such as a blow or fall, but dislocation can be caused by an underlying disease, such as rheumatoid arthritis. Dislocations are common injuries in contact sports, such as football and hockey, and in sports that may involve falls, such as downhill skiing and volleyball. Dislocations may occur in major joints, such as your shoulder, hip, knee, elbow or ankle or in smaller joints, such as your finger, thumb or toe. The injury will temporarily deform and immobilize your joint and may result in sudden and severe pain and swelling. A dislocation requires prompt medical attention to return your bones to their proper positions.
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If you believe you have dislocated a joint:

Don't delay medical care. Get medical help immediately. Don't move the joint. Until you receive help, splint the affected joint into its fixed position. Don't try to move a dislocated joint or force it back into place. This can damage the joint and its surrounding muscles, ligaments, nerves or blood vessels. Put ice on the injured joint. This can help reduce swelling by controlling internal bleeding and the buildup of fluids in and around the injured joint.
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Fractures (broken bones): First aid

A fracture is a broken bone. It requires medical attention. If the broken bone is the result of major trauma or injury, call your local emergency number. Also call for emergency help if: The person is unresponsive, isn't breathing or isn't moving. Begin cardiopulmonary resuscitation (CPR) if there's no respiration or heartbeat. There is heavy bleeding. Even gentle pressure or movement causes pain. The limb or joint appears deformed. The bone has pierced the skin. The extremity of the injured arm or leg, such as a toe or finger, is numb or bluish at the tip. You suspect a bone is broken in the neck, head or back. You suspect a bone is broken in the hip, pelvis or upper leg (for example, the leg and foot turn outward abnormally).
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 Don't move the person except if necessary to avoid further injury. Take these actions immediately while waiting for medical help: Stop any bleeding. Apply pressure to the wound with a sterile bandage, a clean cloth or a clean piece of clothing. Immobilize the injured area. Don't try to realign the bone or push a bone that's sticking out back in. If you've been trained in how to splint and professional help isn't readily available, apply a splint to the area above and below the fracture sites. Padding the splints can help reduce discomfort. Apply ice packs to limit swelling and help relieve pain until emergency personnel arrive. Don't apply ice directly to the skin wrap the ice in a towel, piece of cloth or some other material. Treat for shock. If the person feels faint or is breathing in short, rapid breaths, lay the person down with the head slightly lower than the trunk and, if possible, elevate the legs.
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Head trauma: First aid

Most head trauma involves injuries that are minor and don't require hospitalization. However, call your local emergency number if any of the following signs or symptoms are apparent. Adults

Severe head or facial bleeding Bleeding or fluid leakage from the nose or ears Severe headache Change in level of consciousness for more than a few seconds Black-and-blue discoloration below the eyes or behind the ears Cessation of breathing Confusion Loss of balance Weakness or an inability to use an arm or leg Unequal pupil size Slurred speech Seizures
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Children
Any of the signs or symptoms for adults Persistent crying Refusal to eat Bulging in the soft spot on the front of the head (infants) Repeated vomiting
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If severe head trauma occurs

Keep the person still. Until medical help arrives, keep the injured person lying down and quiet, with the head and shoulders slightly elevated. Don't move the person unless necessary, and avoid moving the person's neck. If the person is wearing a helmet, don't remove it. Stop any bleeding. Apply firm pressure to the wound with sterile gauze or a clean cloth. But don't apply direct pressure to the wound if you suspect a skull fracture. Watch for changes in breathing . If the person shows no signs of circulation (breathing, coughing or movement), begin CPR.
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Spinal injury: First aid

If you suspect a back or neck (spinal) injury, do not move the affected person. Permanent paralysis and other serious complications can result. Assume a person has a spinal injury if: There's evidence of a head injury with an ongoing change in the person's level of consciousness The person complains of severe pain in his or her neck or back The person won't move his or her neck An injury has exerted substantial force on the back or head The person complains of weakness, numbness or paralysis or lacks control of his or her limbs, bladder or bowels The neck or back is twisted or positioned oddly
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If you suspect someone has a spinal injury:

Keep the person still. Place heavy towels on both sides of the neck or hold the head and neck to prevent movement. The goal of first aid for a spinal injury is to keep the person in much the same position as he or she was found. Provide as much first aid as possible without moving the person's head or neck. If the person shows no signs of circulation (breathing, coughing or movement), begin CPR, but do not tilt the head back to open the airway. Use your fingers to gently grasp the jaw and lift it forward. If the person has no pulse, begin chest compressions. If the person is wearing a helmet, don't remove it. If you absolutely must roll the person because he or she is vomiting, choking on blood or in danger of further injury, you need at least one other person. With one of you at the head and another along the side of the injured person, work together to keep the person's head, neck and back aligned while rolling the person onto one side.
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Animal bites: First aid

If an animal bites you or your child, follow these guidelines: For minor wounds. If the bite barely breaks the skin and there's no danger of rabies, treat it as a minor wound. Wash the wound thoroughly with soap and water. Apply an antibiotic cream to prevent infection and cover the bite with a clean bandage. For deep wounds. If the animal bite creates a deep puncture of the skin or the skin is badly torn and bleeding, apply pressure with a clean, dry cloth to stop the bleeding and see your doctor. For infection. If you notice signs of infection, such as swelling, redness, increased pain or oozing, see your doctor immediately.
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 For suspected rabies. If you suspect the bite was caused by an animal that might carry rabies including any wild or domestic animal of unknown immunization status, particularly bats see your doctor immediately.
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 Doctors recommend getting a tetanus shot every 5 years. If your last one was more than five years ago and your wound is deep or dirty, your doctor may recommend a booster. Get the booster as soon as possible after the injury. Domestic pets cause most animal bites. Dogs are more likely to bite than cats. Cat bites, however, are more likely to cause infection because they are usually puncture wounds and can't be thoroughly cleaned. Bites from nonimmunized domestic animals and wild animals carry the risk of rabies. Rabies is more common in bats, raccoons, skunks and foxes than in cats and dogs. Rabbits, squirrels and other rodents rarely carry rabies. The Centers for Disease Control and Prevention recommends that children or adults exposed to bats, or who are sleeping and discover bats present, seek medical advice, even if they don't think they've been bitten. This is because bat bite marks can be hard to see.
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Human bites: First aid

Human bites can be as dangerous as or even more dangerous than animal bites because of the types of bacteria and viruses contained in the human mouth. If someone cuts his or her knuckles on another person's teeth, as might happen in a fight, this is also considered a human bite. If you sustain a human bite that breaks the skin: Stop the bleeding by applying pressure. Wash the wound thoroughly with soap and water. Apply an antibiotic cream to prevent infection. Apply a clean bandage. If the bite is bleeding, apply pressure directly on the wound, using a sterile bandage or clean cloth, until the bleeding stops. Seek emergency medical care. If you haven't had a tetanus shot within five years, your doctor may recommend a booster. In this case you should have the booster within 48 hours of the injury.
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Insect bites and stings: First aid

Signs and symptoms of an insect bite result from the injection of venom or other substances into your skin. The venom sometimes triggers an allergic reaction. The severity of your reaction depends on your sensitivity to the insect venom or substance and whether you've been stung or bitten more than once. Most reactions to insect bites are mild, causing little more than an annoying itching or stinging sensation and mild swelling that disappear within a day or so. A delayed reaction may cause fever, painful joints and swollen glands. You might experience both the immediate and the delayed reactions from the same insect bite or sting. Only a small percentage of people develop severe reactions (anaphylaxis) to insect venom.
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Signs and symptoms of a severe reaction include:

Nausea Facial swelling Difficulty breathing Abdominal pain Deterioration of blood pressure and circulation (shock)

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For mild reactions

Move to a safe area to avoid more stings. Remove the stinger, especially if it's stuck in your skin. This will prevent the release of more venom. Wash area with soap and water. Apply a cold pack or cloth filled with ice to reduce pain and swelling. Apply hydrocortisone cream (0.5 percent or 1 percent), calamine lotion or a baking soda paste with a ratio of 3 teaspoons (15 milliliters) baking soda to 1 teaspoon (5 milliliters) water to the bite or sting several times a day until symptoms subside. Take an antihistamine containing diphenhydramine or chlorpheniramine maleate . Allergic reactions may include mild nausea and intestinal cramps, diarrhea, or swelling larger than 2 inches (5 centimeters) in diameter at the site. See your doctor promptly if you experience any of these signs and symptoms.
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For severe reactions

Severe reactions may progress rapidly. Call emergency medical assistance if the following signs or symptoms occur: Difficulty breathing Swelling of the lips or throat Faintness Dizziness Confusion Rapid heartbeat Hives Nausea, cramps and vomiting
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Take these actions immediately while waiting with an affected person for medical help:
Check for medications that the person might be carrying to treat an allergic attack, such as an auto-injector of epinephrine (for example, EpiPen). Administer the drug as directed Have the person take an antihistamine pill if he or she is able to do so without choking. Do this after administering epinephrine. Have the person lie still on his or her back with feet higher than the head. Loosen tight clothing and cover the person with a blanket. Don't give anything to drink. Turn the person on his or her side to prevent choking if there's vomiting or bleeding from the mouth. Begin CPR if there are no signs of circulation, such as breathing, coughing or movement.
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Spider bites: First aid

Only a few spiders are dangerous to humans. Black widow spider and the brown recluse spider. Both prefer warm climates and dark, dry places where flies are plentiful. They often live in dry, littered, undisturbed areas, such as closets, woodpiles and under sinks. Most presumed spider bites are actually bites from other bugs. If you suspect you have been bitten by one of these spiders, check to see if the spider lives in your area.
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Black widow spider

Although serious, a black widow bite is rarely lethal. You can identify this spider by the red hourglass marking on its belly.

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 The bite feels like a pinprick. You may not even know you've been bitten. At first you may notice slight swelling and faint red marks. Within a few hours, though, intense pain and stiffness begin. Other signs and symptoms include: Chills Fever Nausea and vomiting Severe abdominal pain
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Brown recluse spider

You can identify this spider by the violin-shaped marking on its back. The bite produces a mild stinging, followed by local redness and intense pain within eight hours. A fluid-filled blister forms at the site and then sloughs off to leave a deep, enlarging ulcer. Reactions from a brown recluse spider bite vary from a mild fever and rash to nausea and listlessness. On rare occasions death results, more often in children.

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Brown Recluse Spider

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If bitten by a spider
Try and identify the type of spider that bit you. Clean the site of the spider bite well with soap and water. Apply a cool compress over the spider bite location. If the bite is on an extremity, elevate it. Aspirin or acetaminophen (Tylenol, others) and antihistamines may be used to relieve minor signs and symptoms in adults.
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If bitten by a brown recluse or black widow spider

Cleanse the wound. Use soap and water to clean the wound and skin around the spider bite. Slow the venom's spread. If the spider bite is on an arm or a leg, tie a snug bandage above the bite and elevate the limb to help slow or halt the venom's spread. Ensure that the bandage is not so tight that it cuts off circulation in your arm or leg. Use a cold cloth at the spider bite location. Apply a cloth dampened with cold water or filled with ice. Seek immediate medical attention. Treatment for the bite of a black widow may require an anti-venom medication. Doctors may treat a brown recluse spider bite with various medications
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Snakebites: First aid

Most snakes aren't poisonous. Some exceptions include the rattlesnake, coral snake, water moccasin and copperhead. Their bite can be life-threatening. Of the poisonous snakes , all but the coral snake have slit-like eyes. Their heads are triangular, with a depression, or pit, midway between the eyes and nostrils.
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Other characteristics are unique to certain poisonous snakes:

Rattlesnakes rattle by shaking the rings at the end of their tails. Water moccasins' mouths have a white, cottony lining. Coral snakes have red, yellow and black rings along the length of their bodies.

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Rattlesnakes

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Rattlesnakes teeths

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Water moccasins

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Coral snakes

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Copperhead snake

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 To reduce your risk of snakebite, avoid touching any snake. Instead, back away slowly. Most snakes avoid people if possible and bite only when threatened or surprised. If a snake bites you: Remain calm Immobilize the bitten arm or leg and stay as quiet as possible to keep the poison from spreading through your body Remove jewelry before you start to swell Position yourself, if possible, so that the bite is at or below the level of your heart
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 Cleanse the wound, but don't flush it with water, and cover it with a clean, dry dressing Apply a splint to reduce movement of the affected area, but keep it loose enough so as not to restrict blood flow Don't use a tourniquet or apply ice Don't cut the wound or attempt to remove the venom Don't drink caffeine or alcohol Don't try to capture the snake, but try to remember its color and shape so you can describe it, which will help in your treatment Call immediate medical attention, especially if the area changes color, begins to swell or is painful.
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