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SECTION I ORDER OF PRIORITY IN AN EMERGENCY In EVERY emergency situation, there is a logical order to be followed. First, it is important to carefully assess the scene of an emergency BEFORE any further steps are taken. The purpose of this assessment is to assure it is safe to provide first aid care. For example, an unconscious victim might be lying on a live power line. If a rescuer were to touch the victim before the power could be shut off, the rescuer would become a victim as well! Always be sure it is safe before you attempt to help a victim! Once you determine it is safe for you to help a victim, you should immediately determine if the victim is threatened by life threatening conditions. Begin by checking to see if the victim is responsive. If the victim is prone, kneel and ask, " ARE YOU OK?" If there is no response, you must immediately do a PRIMARY SURVEY which is intended to identify life-threatening conditions! First, if there are bystanders on the scene, summon someone to your side to provide assistance. If the victim is on his stomach, first place the victim's arm closest to you above his head. Then turn him over by placing one hand on the victim's hip and the other hand at the victim's shoulder. Turn the body in a smooth, even straight line so as to not cause further injury in the event of existing spinal cord injury. With the victim now on his back, OPEN THE VICTIM'S AIRWAY by placing the heel of your hand on the victim's forehead and the tips of your fingers under the bony part of the jaw. Push down on the forehead while lifting up the chin until the jaw is pointing straight up. Now place your ear over the victim's mouth and LOOK, LISTEN & FEEL for breathing for 3 to 5 seconds. LOOK at the chest to see if it is rising, LISTEN for sounds of breathing and FEEL for air coming from the victim. If the victim is not breathing, RESCUE BREATHING is required immediately! ***************************************************************** IMPORTANT WHILE THIS TUTORIAL IDENTIFIES LIFE THREATENING CONDITIONS REQUIRING RESCUE BREATHING OR CPR, THESE SKILLS REQUIRE INTENSIVE CLASSROOM SKILL DEVELOPMENT AND PRACTICE AND CANNOT BE EFFECTIVELY PRESENTED OR TAUGHT IN THIS TUTORIAL. THE AUTHOR STRONGLY ENCOURAGES EVERYONE TO ENROLL IN A CPR COURSE ***************************************************************** Rescue breathing will provide vital oxygen to a victim who cannot breath on their own. After giving a victim two breaths, the pulse is checked at the Carotid Artery to ascertain if the victim has a heartbeat. This artery is located on the side of the neck and is located by first positioning the fingers on the victim's Adam's Apple, then sliding the fingers down into the soft groove on the side of the neck. The pulse is checked for 5 to 10 seconds. If the victim has a heartbeat, but is not breathing, RESCUE BREATHING is required. If the victim is NOT breathing AND does not have a HEARTBEAT, CPR is required without delay! These initial steps of checking the AIRWAY, BREATHING and CIRCULATION (pulse), together with a check for major BLEEDING, constitute THE PRIMARY SURVEY, which looks for life-threatening conditions! AFTER the PRIMARY SURVEY is completed, and life threatening conditions identified, a bystander should be dispatched to call EMERGENCY MEDICAL SERVICES (911 or other emergency number in your community) while a suitably-trained rescuer begins appropriate emergency treatment! In every instance where first aid is to be provided, it is important to always ask a conscious victim for permission to help them. If a victim is unconscious, it is presumed they have provided consent for you to assist them. SECTION II OBSTRUCTIONS IN THE AIRWAY [NOTE: Emergency treatment of airway obstructions is taught as part of CPR training and only through classroom practice can the necessary skills be mastered. The mechanics of handling airway obstructions are presented in this tutorial for background insight only] If an individual is choking - but can speak or cough forcibly-there is an exchange of air (although it might be diminished) and you should encourage the victim to continue coughing while you just stand by! On the other hand, if a victim is choking, but CANNOT speak or cough, an airway obstruction exists which must be treated immediately! The treatment for an obstructed airway in a conscious victim involves the HEIMLICH MANEUVER which is performed as follows: STAND BEHIND THE VICTIM WRAP YOUR ARMS AROUND THE VICTIM'S WAIST MAKE A FIST WITH ONE HAND AND PLACE THE THUMB SIDE OF THE FIST AGAINST THE VICTIM'S ABDOMEN, JUST ABOVE THE NAVEL AND WELL BELOW THE LOWER TIP OF THE BREASTBONE GRASP YOUR FIST WITH YOUR OTHER HAND WITH ELBOWS OUT, PRESS YOUR FIST INTO THE VICTIM'S ABDOMEN WITH QUICK, UPWARD THRUSTS EACH THRUST IS A DISTINCT, SEPARATE ATTEMPT TO DISLODGE THE FOREIGN OBJECT REPEAT THRUSTS UNTIL FOREIGN OBJECT IS CLEARED OR VICTIM BECOMES UNCONSCIOUS Emergency treatment of airway obstructions in an unconscious victim is taught in CPR classes. SECTION III HEART ATTACK Heart attacks are among the leading cause of death in the United States. A heart attack happens when one or more of the blood vessels that supply blood to the heart become blocked. When this occurs, cells in the heart begin to die when they cannot get blood for vital nourishment. If a large part of the heart is deprived of blood, the heart stops beating and the victim suffers CARDIAC ARREST! When a victim's heart stops beating, they require CARDIOPULMONARY RESUSCITATION (CPR) which provides vital oxygen through rescue breathing and which maintains circulation through chest compressions. PROPER TRAINING IS REQUIRED TO PERFORM CPR, HOWEVER ANY HEART ATTACK CAN LEAD TO CARDIAC ARREST AND IT IS THEREFORE VITAL FOR FIRST AIDERS TO BE ABLE TO RECOGNIZE THE EARLY WARNING SIGNS OF A HEART ATTACK SO THE VICTIM CAN RECEIVE PROMPT PROFESSIONAL ATTENTION! A heart attack victim whose heart is still beating has a much better chance of survival than a victim whose heart has stopped! Most heart attack victims who die succumb within 2 hours after having their heart attack. Many of these victims could be saved if bystanders recognize the symptoms of a heart attack and get the victim to a hospital quickly! Indeed, many victims of heart attacks think they are experiencing HEARTBURN or other minor discomfort when in fact their life is in jeopardy! The most significant sign of a heart attack is chest pain. The victim may describe it as pressure, a feeling of tightness in the chest, aching, crushing, fullness or tightness, constricting or heavy pain. The pain may be located in the center of the chest although it is not uncommon for the pain to radiate to one or both shoulders or arms or to the neck, jaw or back. In addition to pain, victims may experience sweating, nausea or shortness of breath. Many victims deny they may be having a heart attack. Others may have their condition worsened by fear of dying. With all victims of heart attacks - and with all victims receiving first aid for any condition - it is important for the rescuer to constantly reassure the victim and keep them as calm and relaxed as possible. The psychological value of reassurance is as important in first aid as any treatments! FIRST AID FOR A HEART ATTACK 1. Recognize the signs & symptoms of a heart attack 2. Comfort & reassure the victim 3. Have the victim stop whatever they were doing and sit or lie in a comfortable position 4. Summon emergency medical help quickly 5. If the victim become unconscious, be prepared to perform CPR [IF YOU ARE TRAINED] All of us can reduce the risk of heart attack by controlling high blood pressure, limiting cholesterol in the diet, watching weight, exercising,giving up smoking and minimizing stress. SECTION IV BLEEDING Major bleeding may be a life-threatening condition requiring immediate attention. Bleeding may be external or internal. Bleeding may be from an ARTERY, a major blood vessel which carries oxygen-rich blood from the heart throughout the body. It may be from a VEIN, which carries blood back to the heart to be oxygenated or bleeding may be from a CAPILLARY, the smallest of our body's blood vessels. ARTERIAL bleeding is characterized by spurts with each beat of the heart, is bright red in color (although blood darkens when it meets the air) and is usually severe and hard to control. ARTERIAL bleeding requires immediate attention! VENUS bleeding is characterized by a steady flow and the blood is dark, almost maroon in shade. Venus bleeding is easier to control than Arterial bleeding. CAPILLARY bleeding is usually slow, oozing in nature and this type of bleeding usually has a higher risk of infection than other types of bleeding. FIRST AID FOR BLEEDING IS INTENDED TO: l. STOP THE BLEEDING 2. PREVENT INFECTION 3. PREVENT SHOCK HOW TO CONTROL BLEEDING: 1. APPLY DIRECT PRESSURE ON THE WOUND. USE A DRESSING, IF AVAILABLE. IF A DRESSING IS NOT AVAILABLE, USE A RAG, TOWEL, PIECE OF CLOTHING OR YOUR HAND ALONE. ONCE PRESSURE IS APPLIED, KEEP IT IN PLACE. IF DRESSINGS BECOME SOAKED WITH BLOOD, APPLY NEW DRESSINGS OVER THE OLD DRESSINGS. THE LESS A BLEEDING WOUND IS DISTURBED, THE EASIER IT WILL BE TO STOP THE BLEEDING! 2. IF BLEEDING CONTINUES, AND YOU DO NOT SUSPECT A FRACTURE, ELEVATE THE WOUND ABOVE THE LEVEL OF THE HEART AND CONTINUE TO APPLY DIRECT PRESSURE. 3. IF THE BLEEDING STILL CANNOT BE CONTROLLED, THE NEXT STEP IS TO APPLY PRESSURE AT A PRESSURE POINT. FOR WOUNDS OF THE ARMS OR HANDS, PRESSURE POINTS ARE LOCATED ON THE INSIDE OF THE WRIST ( RADIAL ARTERY-WHERE A PULSE IS CHECKED) OR ON THE INSIDE OF THE UPPER ARM (BRACHIAL ARTERY). FOR WOUNDS OF THE LEGS, THE PRESSURE POINT IS AT THE CREASE IN THE GROIN (FEMORAL ARTERY). STEPS 1 AND 2 SHOULD BE CONTINUED WITH USE OF THE PRESSURE POINTS. 4. THE FINAL STEP TO CONTROL BLEEDING IS TO APPLY A PRESSURE BANDAGE OVER THE WOUND. NOTE THE DISTINCTION BETWEEN A DRESSING AND A BANDAGE. A DRESSING MAY BE A GAUZE SQUARE APPLIED DIRECTLY TO A WOUND, WHILE A BANDAGE, SUCH AS ROLL GAUZE, IS USED TO HOLD A DRESSING IN PLACE. PRESSURE SHOULD BE USED IN APPLYING THE BANDAGE. AFTER THE BANDAGE IS IN PLACE, IT IS IMPORTANT TO CHECK THE PULSE TO MAKE SURE CIRCULATION IS NOT INTERRUPTED. A SLOW PULSE RATE, OR BLUISH FINGERTIPS OR TOES, SIGNAL A BANDAGE MAY BE IMPEDING CIRCULATION. SIGNS AND SYMPTOMS OF INTERNAL BLEEDING ARE: * BRUISED,SWOLLEN, TENDER OR RIGID ABDOMEN * BRUISES ON CHEST OR SIGNS OF FRACTURED RIBS * BLOOD IN VOMIT * WOUNDS THAT HAVE PENETRATED THE CHEST OR ABDOMEN * BLEEDING FROM THE RECTUM OR VAGINA * FRACTURES OF THE PELVIS * ABNORMAL PULSE AND DIFFICULTY BREATHING * COOL, MOIST SKIN FIRST AID IN THE FIELD FOR INTERNAL BLEEDING IS LIMITED. IF THE INJURY APPEARS TO BE A SIMPLE BRUISE,APPLY COLD PACKS TO SLOW BLEEDING, RELIEVE PAIN AND REDUCE SWELLING. IF YOU SUSPECT MORE SEVERE INTERNAL BLEEDING, CAREFULLY MONITOR THE PATIENT AND BE PREPARED TO ADMINISTER CPR IF REQUIRED (AND YOU ARE TRAINED TO DO SO). YOU SHOULD ALSO REASSURE THE VICTIM, CONTROL EXTERNAL BLEEDING,CARE FOR SHOCK (COVERED IN NEXT SECTION), LOOSEN TIGHT-FITTING CLOTHING AND PLACE VICTIM ON SIDE SO FLUIDS CAN DRAIN FROM THE MOUTH. SECTION V SHOCK SHOCK IS COMMON WITH MANY INJURIES, REGARDLESS OF THEIR SEVERITY. THE FIRST HOUR AFTER AN INJURY IS MOST IMPORTANT BECAUSE IT IS DURING THIS PERIOD THAT SYMPTOMS OF SHOCK APPEAR. IF SHOCK IS NOT TREATED, IT CAN PROGRESS TO CAUSE DEATH! SHOCK IS FAILURE OF THE CARDIOVASCULAR SYSTEM TO KEEP ADEQUATE BLOOD CIRCULATING TO THE VITAL ORGANS OF THE BODY, NAMELY THE HEART, LUNGS AND BRAIN. ANY TYPE OF INJURY CAN CAUSE SHOCK. SIGNS AND SYMPTOMS OF SHOCK INCLUDE: CONFUSED BEHAVIOR, VERY FAST OR VERY SLOW PULSE RATE, VERY FAST OR VERY SLOW BREATHING, TREMBLING AND WEAKNESS IN THE ARMS OR LEGS, COOL AND MOIST SKIN, PALE OR BLUISH SKIN, LIPS AND FINGERNAILS AND ENLARGED PUPILS. TREATMENT FOR SHOCK: A GOOD RULE TO FOLLOW IS TO ANTICIPATE THAT SHOCK WILL FOLLOW AN INJURY AND TAKE MEASURES TO PREVENT IT BEFORE IT HAPPENS! Putting a victim in a lying-down position improves circulation. If the victim is not suspected of having head or neck injuries, or leg fractures, elevate the legs. If you suspect head or neck injuries, keep the victim lying flat. If the victim vomits, turn on their side. If victim is experiencing trouble breathing, place them in a semi-reclining position. Maintain the victim's body teperature, but do not overheat. SECTION VI BURNS The severity of a burn depends upon its size, depth and location. Burns are most severe when located on the face, neck, hands, feet and genitals; when they are spread over large parts of the body ort when they are combined with other injuries. Burns result in pain, infection and shock. They are most serious when the victims are very young or very old. First degree burns are the least severe. They are characterized by redness or discoloration, mild swelling and pain. Overexposure to the sun is a common cause of first degree burns. Second degree burns are more serious. They are deeper than first degree burns, look red or mottled and have blisters. They may also involve loss of fluids through the damaged skin. Second degree burns are usually the most painful because nerve ending are usually intact, despite severe tissue damage. Third degree burns are the deepest. They may look white or charred, extend through all skin layers. Victims of third degree burns may have severe pain -- or no pain at all if the nerve endings are destroyed. FIRST AID FOR BURNS; FIRST DEGREE FLUSH WITH COOL RUNNING WATER,APPLY MOIST DRESSINGS & BANDAGE LOOSELY SECOND DEGREE APPLY DRY DRESSINGS AND BANDAGE LOOSELY. DO NOT USE WATER AS IT MAY INCREASE RISK OF SHOCK THIRD DEGREE SAME TREATMENT AS SECOND DEGREE ALL VICTIMS OF SERIOUS BURNS SHOULD SEEK PROFESSIONAL HELP QUICKLY1 Burns may also be caused by chemicals. In these cases, it is important to remove clothing on which chemicals have spilled and flush the affected area with copious amounts of water for 15 to 30 minutes. SECTION VII EYE INJURIES Be extremely careful and gentle when treating eye injuries. Floating objects in the eye which can be visualized may be flushed from the eye with water. If the object cannot be removed in this manner, the victim should seek medical attention. Never attempt to remove objects imbedded in the eye! First Aid care for these injuries consists of bandaging BOTH eyes and seeking professional care promptly! An inverted paper cup covered with a bandage is appropriate for serious eye injuries while the victim is transported to the hospital. For chemical burns of the eye, wash the eye with copious amounts of water for 15 to 30 minutes. Then wrap a bandage around both eyes and seek professional help. Eyes are delicate and sight is precious! Prompt professional attention to eye injuries is required to preserve sight! SECTION VIII NOSE INJURIES Severe nosebleed can be most frightening. It can also lead to shock if enough blood is lost! Many cases of nosebleed can be controlled simply by having the victim sit down, pinch the nostrils shut and lean forward (to prevent blood from running into the throat). Once the bleeding has been stopped, talking, walking and blowing the nose may disturn blood clots and allow the bleeding to resume. If it is suspected that the victim has suffered head, neck or back injuries DO NOT attempt to control the blood flow as they may cause increased pressure on injured tissue. All uncontrolled nosebleeds require prompt medical attention! SECTION IX ANIMAL BITES Animal bites carry a high risk of infection, therefore require professional attention promptly.Infection may develop hours, or days, after an animal bite. Signs and symptoms of infection are pain & tenderness at the wound site, redness, heat, swelling, pus at the wound site red streaks in the skin around the wound and possible swollen glands closest to the wound. First aid care for animal bites includes washing the wound well with soap and water, if there is no heavy bleeding. Then cover the wound and seek professional attention. A serious wound should be cleaned only by trained medical personnel. SECTION X INSECT BITES Insect bites and stings can be life-threatening to people with severe allergy to the insect's venom! Signs and symptoms of allergic reaction include pain, swelling of the throat, redness or discoloration at the site of the bite, itching, hives, decreased consciousness and difficult or noisy breathing. First aid calls for being alert for signs of allergic reaction or shock and seeking medical attention as quickly as possible for these victims! If a stinger remains in the victim, you may try to remove it carefully with a tweezers or by scraping with the edge of a credit card. Be careful not to squeeze the stinger as this will inject more venom. Once a stinger has been removed, the would should be washed well with soap and water. Cold compresses will help relieve pain and swelling. The stung area should be kept lower than the heart to slow circulation of the venom. REMEMBER, IN ALL CASES OF INSECT BITES, WATCH FOR SIGNS OF ALLERGIC REACTION AND IF THEY APPEAR, SEEK PROFESSIONAL MEDICAL ATTENTION WITHOUT DELAY! SECTION XI FRACTURES,SPRAINS,STRAINS & DISLOCATIONS Fractures, sprains, strains and dislocations may be hard for the lay person to tell apart. For this reason, first aid treatment of any of these conditions is handled as though the injury was a fracture. Signs and symptoms of the above conditions may include a "grating" sensation of bones rubbing together, pain, tenderrness, swelling, bruising and an inability to move the injured part. First Aid for any of these conditions consists of: * Control bleeding, if present. * Care for shock. * Splint affected area to prevent further movement, but do so only if possible without causing further pain to victim. * Cold packs may help reduce pain and swelling. Victims with traumatic injuries, such as those caused by automobile accidents, falls etc. should not be moved except by trained rescue workers. Head, neck and back injuries are serious and require special care for movement and transport of victims with these conditions. In exceptional circumstances, such as when a victim is at risk of further injury unless moved, the victim's head and neck should be stabilized and the body moved with minimal flexing of the head, neck or spinal cord. All victims with fractures,dislocations, sprains and strains require professional medical attention. XII POISONING Over a million cases of poisoning occur in the United States each year, most involving young children. Obviously, then, PREVENTION of poisoning should be the concern of every parent with young children. ALL substances likely to cause poinsoning should be kept away from inquiring youngsters! Since various poisons cause different symptoms, and because treatments vary depending upon the substance injested, the first step in the event of poisoning is to call the local POISON CONTROL CENTER! DO NOT WAIT FOR SYMPTOMS TO OCCUR! IDENTIFY THE NATURE OF THE POISON AND RECEIVE SPECIFIC CARE INSTRUCTIONS FROM THE PROFESSIONAL STAFF AT THE CENTER! All poisoning victims need to be monitored carefully for signs of shock or impaired consciousness. Every household should keep ACTIVATED CHARCOAL & SYRUP OF IPECAC on hand for possible use in poisoning emergencies, however they should not be administered unless instructed by the Poison Control Center staff. XIII DIABETIC EMERGENCIES Sugar is required in the body for nourishment. Insulin is a hormone that helps the body use the sugar. When the body does not produce enough Insulin, body cells do not get the needed nourishment and diabetes results. People with this condition take Insulin to keep their diabetes under control. Diabetics are subject to two very different types of emergencies: 1. INSULIN REACTION (OR INSULIN SHOCK) This condition occurs when there is TOO MUCH INSULIN in the body. This condition rapidly reduces the level of sugar in the blood and brain cells suffer. Insulin reaction can be caused by taking too much medication, by failing to eat, by heavy exercise and by emotional factors. SIGNS & SYMPTOMS Fast breathing, fast pulse, dizziness, weakness, change in the level of consciousness,vision difficulties, sweating, headache, numb hands or feet, and hunger. 2. DIABETIC COMA This condition occurs when there is TOO MUCH SUGAR and too little INSULIN in the blood and body cells do not get enough nourishment. Diabetic coma can be caused by eating too much sugar, by not taking prescribed medications, by stress and by infection. SIGNS AND SYMPTOMS Diabetic coma develops more slowly than Insulin shock, sometimes over a period of days. Signs and symptoms include drowsiness, confusion,deep and fast breathing, thirst, dehydration, fever, a change in the level of consciousness and a peculiar sweet or fruity-smelling breath. FIRST AID FOR INSULIN REACTION AND DIABETIC COMA Looking for the signs and symptoms listed above will help to distinguish the two diabetic emergencies. In addition, if the patient is conscious, you can ask two very important questions which will help determine the nature of the problem: 1. ASK "HAVE YOU EATEN TODAY?" Someone who has eaten,but has not taken prescribed medication may be in a diabetic coma. 2. ASK "HAVE YOU TAKEN YOUR MEDICATION TODAY?" Someone who has not eaten, but did not take their medication may be having an Insulin reaction. DISTINGUISHING BETWEEN THE TWO TYPES OF DIABETIC EMERGENCIES CAN BE DIFFICULT. (Always look for an identifying bracelet which may reveal a person's condition) OF THE TWO CONDITIONS, INSULIN SHOCK IS A TRUE EMERGENCY WHICH REQUIRES PROMPT ACTION! A PERSON IN INSULIN SHOCK NEEDS SUGAR, QUICKLY! IF THE PERSON IS CONSCIOUS, GIVE SUGAR IN ANY FORM: CANDY, FRUIT JUICE OR A SOFT DRINK! SUGAR GIVEN TO A PERSON IN INSULIN SHOCK CAN BE LIFE-SAVING! IF THE PERSON IS SUFFERING FROM DIABETIC COMA, THE SUGAR WILL NOT CAUSE THEM FURTHER HARM. Monitor victims carefully. Seek professional help. SECTION XIV STROKE Stroke occurs when the blood flow to the brain is interrupted long enough to cause damage. This may be caused by a clot formed in an artery in the brain or carried to the brain in the bloodstream, a ruptured artery in the brain or by compression of an artery in the brain, as found with brain tumors. First aid consists primarily of recognizing signs and symptoms and seeking professional attention. SIGNS AND SYMPTOMS OF A STROKE INCLUDE: * WEAKNESS AND NUMBNESS OF THE FACE, ARM, OR LEG, OFTEN ON ONE SIDE OF THE BODY ONLY. * DIZZINESS * CONFUSION * HEADACHE * RINGING IN THE EARS * A CHANGE OF MOOD * DIFFICULTY SPEAKING * UNCONSCIOUSNESS * PUPILS OF UNEVEN SIZE * DIFFICULTY IN BREATHING & SWALLOWING * LOSS OF BOWEL AND BLADDER CONTROL IF YOU SUSPECT A PERSON IS HAVING A STROKE, HAVE THEM STOP WHATEVER THEY ARE DOING AND REST. PROMPTLY OBTAIN PROFESSIONAL HELP. REASSURE THE VICTIM AND KEEP THEM COMFORTABLE. DO NOT GIVE ANYTHING BY MOUTH. IF THE VICTIM VOMITS, ALLOW FOR FLUIDS TO DRAIN FROM THE MOUTH. OBSERVE CAREFULLY WHILE AWAITING PROFESSIONAL HELP AND, IF TRAINED TO DO SO, MONITOR THE AIRWAY, BREATHING AND CIRCULATION AND BE PREPARED TO ADMINISTER RESCUE BREATHING OR CPR, IF REQUIRED! SECTION XV SEIZURES Seizures are fairly common occurances, but are very misunderstood! Seizures, per se, are not a specific condition. Rather, they may be caused by many different types of conditions such as insulin shock, high fevers, viral infections of the brain, head injuries or drug reactions. When seizures recur with no identifiable cause, the person is said to have epilepsy. SIGNS AND SYMPTOMS Many individuals have a warning AURA (or sensation) before the onset of a seizure. Many times, a person about to have a seizure will physically move themselves from danger (as from the edge of a train platform) before the seizure begins. Seizures can range from mild to severe. Mild seizures may take place and end in a matter of seconds. Severe seizures may involve uncontrollable muscle spasms, rigidity, loss of consciousness, loss of bladder and bowel control, and in some cases, breathing that stops temporarily. Many epileptics carry cards or bracelets which identify their condition. FIRST AID Summon professional help. Prevent the person from injuring themselves by moving furniture or equipment. DO NOT ATTEMPT TO RESTRAIN A PERSON SUFFERING A SEIZURE AND DO NOT PUT ANYTHING IN THEIR MOUTH! Loosen clothing. If they vomit, turn on their side to allow fluids to drain. Stay with the person until they are fully conscious. If trained, administer rescue breathing or CPR, if required. SECTION XVI HEAT EMERGENCIES There are three types of heat emergencies you may be required to treat. 1. HEAT STROKE This is the most serious type of heat emergency. It is LIFE-THREATENING and requires IMMEDIATE and AGGRESSIVE treatment! Heat stroke occurs when the body's heat regulating mechanism fails.The body temperature rises so high that brain damage --and death-- may result unless the body is cooled quickly. SIGNS & SYMPTOMS The victim's skin is HOT, RED and usually DRY. Pupils are very small. The body temperature is VERY HIGH, sometimes as high as 105 degrees. FIRST AID Remember, Heat Stroke is a life-threatening emergency and requires prompt action! Summon professional help. Get the victim into a cool place. COOL THE VICTIM AS QUICKLY AS POSSIBLE IN ANY MANNER! Place the victim into a bathtub of cool water, wrap in wet sheets, place in an air conditioned room. Do not give victim anything by mouth. Treat for shock. 2. HEAT EXHAUSTION Heat exhaustion is less dangerous than heat stroke. It is caused by fluid loss which in turn causes blood flow to decrease in vital organs, resulting in a form of shock. SIGNS AND SYMPTOMS COOL, PALE AND MOIST skin, heavy sweating, dilated pupils (wide), headache, nausea, dizziness and vomiting. Body temperature will be near normal. FIRST AID Get the victim out of the heat and into a cool place. Place in the shock position, lying on the back with feet raised. Remove or loosen clothing. Cool by fanning or applying cold packs or wet towels or sheets. If conscious, give water to drink every 15 minutes. 3. HEAT CRAMPS Heat cramps are muscular pain and spasms due to heavy exertion. They usually involve the abdominal muscles or legs. It is generally thought this condition is caused by loss of water and salt through sweating. FIRST AID Get victim to a cool place. If they can tolerate it, give one-half glass of water every 15 minutes. Heat cramps can usually be avoided by increasing fluid intake when active in hot weather. SECTION XVII COLD EMERGENCIES HYPOTHERMIA SIGNS & SYMPTOMS Signs and symptoms of this dangerous condition which can become life-threatening are: shivering, dizziness, numbness, confusion, weakness, impaired judgement, impaired vision and drowsiness. Hypothermia victims pass through 5 stages, with each stage more serious and leading to death! STAGE 1 SHIVERING STAGE 2 APATHY STAGE 3 LOSS OF CONSCIOUSNESS STAGE 4 DECREASING PULSE AND BREATHING RATE STAGE 5 DEATH FIRST AID Seek professional help. Get victim out of the cold and into dry clothing. Warm the body SLOWLY! Give nothing to eat or drink unless victim is FULLY CONSCIOUS! If trained, monitor airway, breathing & circulation. ***************************************************************** END OF FIRST AID TUTORIAL