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Germs are harboured in the mouths of all animals and humans. Bites from sharp,
pointed teeth cause deep puncture wounds that carry germs deep into the tissues. Human
bites also crush the tissues. Serious wounds require hospital treatment. Any bite in which
the skin is broken requires immediate first aid, followed by medical attention. These
wounds are very susceptible to infection.

Œ
 !"
3 Ñash the wound thoroughly with soap and warm water.
3 Êat dry and cover with an adhesive dressing or a small sterile dressing.
3 Advise the casualty to see their own medical practitioner.

Œ
  # $

3 èontrol bleeding by applying direct pressure and raising the injured part.
3 èover the wound with a sterile dressing or clean pad bandaged in place.
3 The casualty should be taken or sent to hospital.

" %

Bee, wasp and hornet stings are usually more painful and alarming than
dangerous. An initial sharp pain is followed by mild swelling and soreness, which can be
relieved by first aid. However, some people are allergic to these poisons, and can rapidly
develop anaphylactic shock, a very serious condition. Multiple stings can have a dangerous
cumulative effect. Stings in the mouth or throat, causing swelling which may obstruct the
airway, should be taken very seriously.

Œ
 %& '

3 ?emove the sting, if still present, with tweezers.

3 Apply a cold compress to relieve pain and minimise swelling.
3 Advise the casualty to see their own medical practitioner if pain and swelling
persist or increase over the following 24 to 48 hours.

Œ
 %& &

3 Give the casualty ice to suck to minimise swelling.

 3 èontact the emergency service, reassuring the casualty until help arrives.

( )*+ 

Sea creatures can cause various injuries. Jellyfish, Êortuguese man-of-war, corals
and sea anemones can cause stings. Their venom is contained in stinging cells
(nematocysts) that stick to the victim͛s skin, and this is released when the cell
ruptures. The spines of sea urchins or weever fish may puncture the skin, if trodden on,
and become embedded in the foot, usually causing a painful local reaction, though
serious general effects are rare. In some parts of the world, sever degrees of poisoning
can occur, giving rise to sever allergic reaction (anaphylactic shock), or paralysis of the
chest muscle. These cases, rarely, may be fatal.

Œ
 %

3 Êour alcohol or household vinegar over the injury for several minutes to
incapacitate stinging cells that have not yet ruptured.
3 Apply to the wound a paste of equal parts of sodium bicarbonate (baking soda)
and water.
3 must a dry powder such as talcum powder or meat tenderiser over the skin
around the injury so that remaining cells stick together.
3 In case of severe injuries or a serious generalised reaction, contact the
emergency service.

Œ
 " # $

3 Êlace the injured part in water as hot as the casualty can bear for at least 30
minutes, topping up the water as it cools, and taking care not to scald the
casualty.
3 The casualty should be taken or sent to hospital, where any spines remaining in
the skin can be removed.

'

A snake bite is often not a serious injury, but can be very frightening. It is vital to
reassure the casualty, as the spread of venom by be delayed if the casualty keeps still
and calm. The snake, or a note of its appearance, should be kept, so that that correct
 anti-venom can be given, if necessary. The police should be notified if an escaped snake
remains at large.

Œ
 '

3 åay the casualty down, telling them to keep calm and still.
3 Ñash the wound thoroughly with soap and water, if possible.
3 Secure and support the injured part. èontact the emergency service.

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èuts or tears in tissue (lacerations), scrapes (abrasions), and puncture wounds can be
caused by bites or other injuries. Ñounds that are not caused by bites and are not extensive
usually heal rapidly without any problems. However, some wounds can cause extensive blood
loss. In some wounds, deeper structures, such as nerves, tendons, or blood vessels, are also
injured. Other wounds can become infected. A piece of foreign material (such as a splinter,
glass, or a clothing fragment) can also remain hidden inside a puncture wound.
Shallow cuts to most areas of the skin rarely bleed much and often stop bleeding on
their own. èuts to the hand and scalp as well as cuts to arteries and larger veins often bleed
vigorously.
Infection can develop when a wound is contaminated with dirt and bacteria. Although
any wound can become infected, infection is particularly likely in deep scrapes, which grind dirt
into the skin, and in puncture wounds, which introduce contamination deep under the skin.
Also, wounds that contain foreign material almost always become infected. The longer a wound
remains contaminated, the more likely it is that infection will develop.
Ñounds can be painful at first, but usually the pain lessens after the first day. If a cut
affects a nerve or tendon, the person may be unable to move the body part fully. Some nerve
injuries cause weakness or paralysis, loss of sensation, or numbness. If foreign material remains
inside a puncture wound, usually the part of the wound near the material is painful when
touched.
Êain that worsens a day or more after the injury is often the first sign of infection. åater,
an infected wound becomes red and swollen and may ooze pus. A fever may develop.

Œ $

The first step in treating a cut is to stop the bleeding. Visible bleeding can almost
always be stopped by firmly compressing the bleeding area with a finger or hand for at least
 * minutes. Ñhenever possible, the bleeding part is elevated above the level of the heart-for
example, by raising a limb. Because tourniquets shut off all blood flow to a body part and
deprive it of oxygen, they are used only for very severe injuries (such as combat casualties).
To prevent infection, dirt and particles are removed and the wound is washed.
åarge, visible particles are picked off. Smaller dirt and particles that cannot be seen are
removed by washing with mild soap and tap water. mirt and particles that remain after
washing often can be removed with a more highly pressured stream of warm tap water.
Harsher agents, such as alcohol, iodine, and peroxide, are not recommended. These
solutions can damage tissue, impairing the capacity to heal. Scrubbing is required to clean
deep scrapes. If a wound is very small, it can be kept closed with certain commercially
available tapes. Stitches may be needed for deep or large cuts. After cleaning and, if
necessary, closing the wound, antibiotic ointment and a bandage are applied.

Œ Medical assistance is needed under the following circumstances:

3 If a cut is longer than about 1/3 inch (¾ centimeter), is on the face, appears deep, or
has edges that separate
3 If bleeding does not stop on its own or within several minutes after pressure is
applied
3 If there are symptoms of a nerve or tendon injury, such as loss of sensation, loss of
movement, or numbness
3 If a scrape is deep or has dirt and particles that are difficult to remove
3 If there is a puncture wound, particularly if foreign material in the wound is likely
3 If the person has not had a tetanus vaccination within the past * years.
3 All wounds, whether treated at home or by health care practitioners, should be
observed for symptoms of infection during the first several days after treatment. If
any symptoms of infection develop, medical assistance should be sought within
several hours. Most small wounds heal within a few days.

+ 
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Severe internal bleeding is a potentially life-threatening condition. Ñhile the
blood may not be obvious it is still lost from the circulatory system and the casualty is
therefore very likely to go into shock. Internal bleeding may also cause a build-up of
pressure that, in areas such as the skull or around the heart, can cause serious
problems, loss of consciousness and, if untreated, lead to death.
Œ )$%
Internal bleeding can be very difficult to identify. It is not unusual for Internal
bleeding to happen slowly, with signs and symptoms showing up days after an accident.
It can happen to any part of the body but the richness of the blood supply in the
stomach, around the organs such as the liver and the spleen and in the bowel make
these sites particularly vulnerable.
Internal bleeding is also likely to accompany some broken bones. The thigh bone
protects the femoral artery and if broken may pierce it, causing a large and life-
threatening bleed.
Œ %$*!
3 The person is known to have had an accident (not necessarily in the immediate past)
3 Signs and symptoms of shock
3 Bruising
3 Boarding - this most commonly occurs where there is bleeding into the stomach
area; the quantity of blood combined with the tissues swelling result in a rigidity to
the tissues
3 Swelling
3 Bleeding from body orifices
3 If there is any combination of these signs and symptoms, suspect internal bleeding.
Œ $

3 Treat for shock. Keep the casualty warm. Êlace him in a comfortable position,
preferably lying down with the legs slightly raised. ?eassure him. Treat any external
bleeding or bleeding from orifices.
3 èall for an ambulance as soon as possible and explain what has happened.
3 Monitor and record the person's pulse and breathing rates. This information will be
useful for the medical staff in determining the extent of the injury.
3 If the casualty becomes unconscious, place in the recovery position and monitor
airway and breathing. Be prepared to resuscitate if necessary.
Œ (% "!))$%
Internal bleeding can happen in any part of the body but the stomach, the liver,
spleen and intestines are particularly vulnerable because they have a rich blood supply.
Internal bleeding can be very difficult to identify and signs and symptoms may not arise
until several days after an accident has occurred.
  
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0

c1

cosebleeds are common. Most often they are a nuisance and not a true medical
problem. But they can be both.Among children and young adults, nosebleeds usually originate
from the septum, just inside the nose. The septum separates your nasal chambers.
In middle-aged and older adults, nosebleeds can begin from the septum, but they may
also begin deeper in the nose's interior. This latter origin of nosebleed is much less common. It
may be caused by hardened arteries or high blood pressure. These nosebleeds begin
spontaneously and are often difficult to stop. They require a specialist's help.

'")$2
Œ  !%& $  .$ By remaining upright, you reduce blood pressure in the
veins of your nose. This discourages further bleeding. Sitting forward will help you avoid
swallowing blood, which can irritate your stomach.
Œ "&*  Use your thumb and index finger to pinch your nostrils shut. Breathe
through your mouth. èontinue to pinch for five to 10 minutes. This maneuver sends
pressure to the bleeding point on the nasal septum and often stops the flow of blood.
Œ
 !/ )$%  )$% & !!$- don't pick or blow your nose and
don't bend down until several hours after the bleeding episode. Keep your head higher
than the level of your heart.
Œ  )$% "" - blow out forcefully to clear your nose of blood clots and spray
both sides of your nose with a decongestant nasal spray containing oxymetazoline
(Afrin, others). Êinch your nose in the technique described above and call your doctor.
Œ '$""$*2
Œ The bleeding lasts for more than 20 minutes
Œ The nosebleed follows an accident, a fall or an injury to your head, including a punch in
the face that may have broken your nose
Œ , )$
If you experience frequent nosebleeds, make an appointment with your doctor. You
may need a blood vessel cauterized. èautery is a technique in which the blood vessel is
burned with electric current, silver nitrate or a laser. Sometimes your doctor may pack
your nose with special gauze or an inflatable latex balloon to put pressure on the blood
vessel and stop the bleeding.

Also call your doctor if you are experiencing nasal bleeding and are taking blood
thinners, such as aspirin or warfarin (èoumadin). Your doctor may advise adjusting your
medication intake.Using supplemental oxygen administered with a nasal tube (cannula)
may increase your risk of nosebleeds. Apply a water-based lubricant to your nostrils and
increase the humidity in your home to help relieve nasal bleeding.

 
 c

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Œ èheck the person's airway (open if necessary); check breathing and circulation. If
necessary, begin rescue breathing, èÊ?, or bleeding control.
Œ Try to calm and reassure the person as much as possible. Amputation is painful and
extremely frightening.
Œ èontrol bleeding by applying direct pressure to the wound, by elevating the injured
area, and, if necessary, by using pressure point bleeding control. If the bleeding
continues, recheck the source of the bleeding and reapply direct pressure, with help
from someone who is not fatigued. If the person is suffering from life-threatening
bleeding, a constriction bandage or tourniquet will be easier to use than compression of
pressure points.
Œ Save any severed body parts and ensure that they stay with the patient. ?emove
contaminating material if possible, and gently rinse the body part if the cut end is
contaminated with dirt. Ñrap the severed part in a clean, damp cloth, place it in a
sealed plastic bag and immerse the bag in cold water (ice water if available). mo cOT
directly immerse the part in water and do cOT put the severed part directly on ice. mo
cOT use dry ice as this will cause frostbite and injury to the part. If cold water is not
available, keep the part away from heat as much as possible. Save it for the medical
team, or take it to the hospital. èooling the severed part will keep it viable for about 18
hours. Ñithout cooling, it will only remain useable for about 4 to 6 hours.
Œ Take steps to prevent shock. åay the person flat, raise the feet about 12 inches, and
cover the person with a coat or blanket. mo cOT place the person in this position if a
head, neck, back, or leg injury is suspected or if it makes the victim uncomfortable.
Œ Once the bleeding at the site of the amputation is under control, examine the person for
other signs of injury that require emergency treatment. Treat fractures, additional cuts,
and other injuries appropriately.
Œ Stay with the person until medical help arrives.

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2
3 mo cOT forget that saving the victim's life is more important than saving a body part.
3 mo cOT overlook other, less obvious, injuries.
3 mo cOT attempt to push any part back into place.
3 mo cOT decide that a body part is too small to save.
3 mo cOT place a tourniquet, unless the bleeding is life threatening, as the entire limb
may be placed in jeopardy.
3 mo cOT raise false hopes of reattachment
  
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3

Asthma attacks cause the muscles of the air passages to go into spasm, making it very difficult
for the asthmatic to breath, particularly to exhale. Attacks may be triggered by an allergy or by
stress; for example, being involved in an accident. Sometimes the cause of the attacks for a
particular suffer is never identified. There is evidence to suggest that asthma appears to be in
increasing in frequency, or at least in diagnosis.

Œ



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An asthma attack should not be underestimated. Ñhile the preventive treatments
are very effective, and the drugs to relieve attacks usually work very well, left untreated, a
serious attack can be fatal. The strain of a serious asthma attack can cause the breathing to
stop or the heart to cease beating. You should be prepared to resuscitate.

3 ?eassure the victim as this will have a positive effect on his breathing.
3 Help the victim into a sitting position, leaning slightly forward, as most of people
with asthma find this an easier position for breathing.
3 If the victim has a medication, enable him to use it. Inhalers are the main form of
treatment.
3 If this is the first attack, the medication does not work within * minutes, or the
victim is in severe distress, then call an ambulance. Help the victim to take the
medication every *-10 minutes.
3 If the attack eases and the person finds it easier to breathe, he will not need
immediate medical attention but should advise a doctor of the attack. A person will
often be very tired following an attack so it is best to ensure that he is accompanied
home to rest.
Œ 1c c  
 
3 History of condition (although some people may not realize that they are asthmatic
and the first attack may be a sever one)
3 mifficulty in breathing, particularly breathing out
3 Ñheezing or otherwise noisy breathing
3 Inability to speak
3 Êale skin and potential blueness. Êarticularly around the lips, caused by lack of
oxygen
3 mistress. mizziness, and confusion as it becomes harder to get oxygen into the body
3 Unconsciousness and then breathing stopping
 c1cc30

Known asthmatics are usually prescribed an inhaler, a device that administers a
measured dose of drugs inhaled directly into the lungs, where it will have a near-instant effect.
Young children may find it hard to use ordinary aerosol inhaler and will need a spacer instead.
Medication is put into the end of the spacer and the child breathes normally to take this in.
èhildren under the age of four will usually require a face mask to use with the spacer as
they cannot coordinate their breathing to inhale the drugs. If a member of your family is an
asthmatic, make sure that everyone understands the importance of knowing where the inhaler
is and that there is always enough medication in the house.

1 
 c+




èhildren are constantly bumping and bruising themselves. All it takes is one fall too
hard, and your child just might end up with a broken bone. One out of five people has
a fracture at some point of time in their lives, and the maximum of these fractures occur
during childhood. Here are some first aid tips, which you should memorise, just to be on
the safe side.

3."* 4" !5

The pain is less intensive in a sprain than in a fracture, but never make the mistake of
underestimating your child's pain. It takes a doctor to differentiate between the two,
which is why the same kind of first aid is administered in both cases.

#&$"5

A dislocation is when the bone has come out from the socket. This also results in acute
pain, swelling, an inability to carry any weight and an inability to move the injured limb.
The first aid administered in case of a dislocation is also the same.

" .'$2

3" 

A hairline fracture is just when the bone gets a è?AèK that goes through it. Such
fracture still cause immense pain, but at least chances of an operation are less.

+! $" 
A compound fracture is one in which the bone completely breaks apart pops out
through the skin. Ouch! This is the worst kind, and it may result in loss of blood as well.

If your child has had a bad fall, and you feel it may be a fracture, you should call a
doctor, preferably an orthopedic surgeon, immediately. Here's what you can do by way
of administering first aid.

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The first step to be taken is to immobilise the limb. It should not be moved at all. Use
any handy material to immobilise the limb. You could use a magazine or newspaper for
support, and make a sling with the help of some cloth, a rope or shoelaces.

0%" 

If your child has fractured his leg, carefully straighten it out. èall for an ambulance and in
the meantime, secure the leg so it doesn't move. Apply two splints, one on the inner leg
from the foot to the inner thigh, and the other, on the outside, from the foot to the
armpit. Secure the splints well. mo cOT move your child until his leg has been
completely immobilised. You could even tie both legs together for added support.

3$" 

The hand should be moved to a 90-degree angle and kept close to the chest. It should
be immobilised in this position. Move the hand as gently as possible, and if the pain is
too intense, do not move it at all.

$%

If your child is bleeding, you should treat the bleeding first. Stop the bleeding by first
cleaning it carefully with an antiseptic, and then by applying a sterile dressing. mo not
bandage tightly over the injury site. Apply a clean dressing gently over the wound.

)

Keep +
in mind, as a first aid treatment for all fractures, sprains and dislocations.
?Iè stands for ?est, Ice, èompression and levation.
 
Give plenty of rest to the immobilsed limb. Move it as little as possible so that there is
no strain.

"
Apply ice to the injured area. co heat treatment or massage should be given. Use an ice
pack or wrap up some ice cubes in a damp towel and apply it to the injured area. You
could also use anything frozen such as a packet of frozen peas.

mo not massage the injured area, and don't apply any ointments like Iodex.

+!
Ñrap up the injured area with a crepe bandage if possible, or use any clean, fresh cloth
available. Ñrap it as tight as is comfortable. However, ask the doctor before bandaging
the area. This will relieve the pain somewhat.

/
The injured limb should preferably be raised above the level of the heart. This could be
done with the help of a pillow while sleeping.

3 
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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:

 $%) 
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, with swelling, and 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.
 "$$%) 
Ñhen 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 and the skin takes on an intensely reddened, splotchy appearance.
Second-degree burns produce severe pain and swelling.

If the second-degree burn is no larger than 3 inches (7.6 centimeters) 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.
 ) - including first-degree burns and second-degree burns limited to an area no
larger than 3 inches (7.6 centimeters) in diameter, take the following action:

> +&)  Hold the burned area under cool (not cold) running water for 10 or 1* minutes
or until the pain subsides. If this is impractical, immerse the burn in cool water or cool it with
cold compresses. èooling the burn reduces swelling by conducting heat away from the skin.
mon't put ice on the burn.

> +/&) .&% 6)$% mon't use fluffy cotton, or other material that
may get lint in the wound. Ñrap the gauze loosely to avoid putting pressure on burned skin.
Bandaging keeps air off the burn, reduces pain and protects blistered skin.

>
'/&" !/ These include aspirin, ibuprofen (Advil, Motrin,

others), naproxen (Aleve) or acetaminophen (Tylenol, others). Use caution when giving aspirin
to children or teenagers. Though aspirin is approved for use in children older than age 2,
children and teenagers recovering from chickenpox or flu-like symptoms should never take
aspirin. Talk to your doctor if you have concerns.

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. Ñatch 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 Ͷ doing so may
cause more extensive pigmentation changes. Use sunscreen on the area for at least a year.

+ 

> 4 " Êutting ice directly on a burn can cause a burn victim's body to become too cold
and cause further damage to the wound.

> 4!!*) &)  This could cause infection.

> 4)') Broken blisters are more vulnerable to infection.


&$$%) 
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. mifficulty inhaling and exhaling, carbon monoxide poisoning, or
other toxic effects may occur if smoke inhalation accompanies the burn.

() - call 911 or emergency medical help. Until an emergency unit arrives, follow
these steps:

1. 4/) $"&% However, do make sure the victim is no longer in contact

with smoldering materials or exposed to smoke or heat.
 2. 4%/) "$. moing so could cause a drop in body
temperature (hypothermia) and deterioration of blood pressure and circulation (shock).
3. +&"'%"" 7)&%-" %&%/8 If there is no breathing
or other sign of circulation, begin èÊ?.
4.
/&) $)$*!! ?aise above heart level, when possible.
*. +/&&)  Use a cool, moist, sterile bandage; clean, moist cloth; or moist
towels.
1 & Burns are susceptible to tetanus. moctors recommend you get a tetanus
shot every 10 years. If your last shot was more than five years ago, your doctor may
recommend a tetanus shot booster.

 +3c1

$+&'%7$ -%#$)8

1. Stand behind the victim and place your arms around him. Make a fist and place it
against the victim͛s abdomen, thumb side in, between the navel and the breastbone.
2. Hold the fist with your other hand, and push upward and inward, four times quickly.
3. For victims who are pregnant or obese, place your arms around the chest and your
hands over the middle of the breastbone. Give four quick chest thrust.
4. A victim who is lying down should be rolled over onto his or her back. Êlace your hands
on the abdomen and push in the same direction on the body that you would if the
victim were standing (inward, and toward the upper body).
*. If you are not successful, open the mouth by lifting the jaw and tongue, and look for the
swallowed object. p





 
, sweep it out with your little finger.
cote:   




 

 





 











6. If the victim does not begin to breathe after the object has been removed from the air
passages, use mouth to mouth resuscitation.
7. èall for help, and repeat these steps until the object is dislodged and the victim is
breathing normally.

$+&'%7 %+&$8

1. Kneel next to the child who should be lying on his or her back.
2. Êosition the heel of one hand on the child͛s abdomen between the navel and the
breastbone. meliver six to ten thrust inward and toward the upper body.
3. If this doesn͛t work, open the mouth by lifting the jaw and tongue, and look for the
swallowed object. p





 
, sweep it out with your little finger.
cote:   




 

 





 











 4. If the victim does not begin to breathe after the object has been removed from the air
passages, use mouth to mouth resuscitation.
*. èall for help, and repeat these steps until the object is dislodged and the victim is
breathing normally.

$+&'%78

1. Hold the infant along your forearm, face down, so that the head is lower than the feet.
2. meliver five rapid blows to the back, between the shoulder blades, with the heel of your
hand.
3. If this doesn͛t work, turn the baby over and, using two fingers, give four quick thrusts to
the chest.


 +c9 0 cc 
 

+/ 2
- sudden, violent, irregular movement of a limb or the body
- caused by involuntary contraction of the muscles
- associated with brain disorders such as epilepsy, presence of certain toxins or other
agents in the blood, or fever in children.

èonvulsioin is:
- sudden, violent, irregular movement of a limb or the body
- caused by involuntary contraction of the muscles
- associated with brain disorders such as epilepsy, presence of certain toxins or other
agents in the blood, or fever in children.

$

* åay patient on ground in safe area.

* èlear all objects away from the victim and place something soft under his head.
* mo not place anything between his teeth or in his mouth.
* åoosen tight clothing, particularly round the neck.
* mo not give the victim any liquids.
* Stay calm and keep the victim comfortable until help arrives.

* åay patient on ground in safe area.

* èlear all objects away from the victim and place something soft under his head.
* mo not place anything between his teeth or in his mouth.
* åoosen tight clothing, particularly round the neck.
* mo not give the victim any liquids.
* Stay calm and keep the victim comfortable until help arrives.
  c


66


+3

mizziness may be a symptom of something dangerous and should always be discussed with a
doctor.

At home, it is recommended for the patient to do the following:

ë Get plenty to drink, have regular meals, and get plenty of rest.
ë Standing up more slowly may help dizziness associated with position changes.
ë ?eassurance can help an anxious person who feels dizzy.
ë Make your home safe for a chronically dizzy person.
ë Banisters, a walker or cane, and tub mats are safety measures that may help avoid injury
to the patient.
ë Secure rugs and carpeting to avoid falls.
ë A doctor can recommend resources for a professional home-safety consultant visit.

0 c
c1
ë Fainting occurs due to decreased blood supply to brain
ë A fainting spell is usually very brief
ë It may or may not havemedicalsignificance

++ 

± Anxiety
± motional upset
± Stress
± Severe pain
± Skipping meals
± Standing up too fast
± Standing for a long time in a crowd
± Some medications
± miabetes
± Blood Êressure
± *!

Before fainting, a person may experience the following:

 ± causea
± Giddiness
± xcessive sweating
± mimvision
± ?apid heart beat or palpitations




± Fainting is a medical emergency, till proven otherwise

± Ñhen a person feels faint-
Make them sit down or lie down
± If sitting, position head between knees
± Ñhen a person faints, position him on his back
± èheck to see if airways are clear
± ?estorebloodflowby
åoosening clothing/belts/collars
± levate feet above head level
± Êatient should become normal within a minute
± If not, seek medical help
± èheck if breathing/pulse is normal
± If not, do+$! * "7+8

/

± Ñhensymptomsappear, lie down

± Try do avoid stress andanxiety
± èarefully evaluate your medications
± Take care of underlying medical condition

 #cc1


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mrowning is the leading cause of injury-related death among children ages 1 to 4 -- and the
second-leading cause of death in children 14 and under. Young kids are especially at risk
because they're curious, fast, and attracted to water but are not yet able to understand how
dangerous it is. The good news is that a few safety precautions can prevent most drownings. If
your child is the victim of a near-drowning, this fast-action rescue plan can prevent a tragedy.


%"*

Your first priority is to get a drowning child out of the water as quickly as possible. If she isn't
breathing, place her on her back on a firm surface. Immediately begin rescue breathing, below,
and have someone call for help. mon't assume it's too late to save a child's life -- even if she's
unresponsive, continue performing èÊ? and do not stop until medical professionals take over.


!* "&$4.*-

gently tilt her head back with one hand, and lift her chin with the other. Êut your ear to the
child's mouth and nose, and look, listen, and feel for signs that she is breathing.

:* "&$$4))&%;

 $%2 Êlace your mouth over infant's nose and lips and give two breaths, each
lasting about 1½ seconds. åook for the chest to rise and fall. +&$$$2 Êinch child's
nose and seal your lips over her mouth. Give two slow, full breaths (1½ to 2 seconds each). Ñait
for the chest to rise and fall before giving the second breath.

<&"&-

check for a pulse (see number 4). &"&$4- try again. ?etilt the head, lift the
child's chin, and repeat the breaths.

=+&"'! 

Êut two fingers on your child's neck to the side of the Adam's apple (for infants, feel inside the
arm between the elbow and shoulder). Ñait five seconds. If there is a pulse, give one breath
every three seconds. èheck for a pulse every minute, and continue rescue breathing until the
child is breathing on her own or help arrives.

>* "4$! 

 $%2 Imagine a line between the child's nipples, and place two fingers just
below its centerpoint. Apply five half-inch chest compressions in about three seconds. After five
compressions, seal your lips over your child's mouth and nose and give one breath. +&$
$$2 Use the heel of your hand (both hands for a teenager or adult) to apply five quick
one-inch chest compressions to the middle of the breastbone (just above where the ribs come
together) in about three seconds. After five compressions, pinch your child's nose, seal your lips
over his mouth, and give one full breath. %2 èontinue the cycle of five chest compressions
followed by a breath for one minute, then check for a pulse. ?epeat cycle until you find a pulse
or help arrives and takes over.

cote: These instructions are not a substitute for èÊ? training, which all parents and caretakers
should have.

c
c 

Before we get into some of the injuries that can occur in the ear, let͛s go over the three c V ?s
in ear firstaid care. Ñhen you͛re helping someone with an ear injury, make sure you:

± cever put anything inside a damaged ear.

± cever try to stop the bleeding. This is one case when bleeding is encouraged. If you try
to stop it, the blood can back up and seep into the inner ear. Stuffing cotton balls in the
ear to clot fluids is a definite no-no!
± cever shake, jiggle, or thump a person͛s head to restore hearing. èontrary to what you
might see in cartoons, people are not pinball machines.
± èontrary to popular belief, swimmer͛s ear that uncomfortable, swollen feeling with the
accompanying swishing sound does not come from too much water in the ear or from
eardrum damage caused by too much swimming. It͛s an inflammation or infection of the
outer ear canal. Swimmer͛s ear can be caused by bacteria, or, like athlete͛s foot, it can
also be a fungus.
± The main symptom of swimmer͛s ear is pain, with possible swelling, redness, and
itchiness. Over time, the ear can become clogged, resulting in a loss of hearing. There
can also be a drainage of pus from the ear.
± You should make an appointment with your doctor; in the meantime, there are a few
things you can do to ease the pain of swimmer͛s ear:
± Êlace a heating pad (set to medium) on the ear to help ease the soreness.
± Sit up as much as possible, even propping yourself up in bed with pillows. This allows
blood to drain away from the ears so there͛s less stuffiness.
± mrink lots of water and juice. åiquids not only help flush away infection, but the act of
swallowing helps clear your ear canals.
± èhew gum. èhewing a piece of gum or food (and yawning) also helps clear the ear canals
and ease the pain.
 ± Take an over-the-counter anti-inflammatory medication such as Motrin or Advil.
Tylenol, too, will help control the pain.

Although it sounds crazy, an insect buzzing around your head can fly into your ear and become
stuck. And insects are only one of the many foreign objects that can enter the ear and cause
damage. Many children also have the delightful habit of testing out their nimble fingers and
dexterity on tiny toys, jacks, beads, food, or coins and putting them compactly and
complacently in their ears.

Here͛s a step-by-step guide to removing foreign objects from the ear:

± If the object is a live insect, put a drop or two of mineral oil, baby oil, or vegetable oil in
the ear canal. The oil will kill the insect.
± If you can clearly see the object in the person͛s ear, remove it carefully with a pair of
tweezers, but only if the object is near the surface.
± If you cannot see the object clearly or if it͛s lodged in the ear canal, tilt the sufferer͛s
head to the same side as the injured ear.
± Gently shake his or her head in this position.

If this doesn͛t work, leave the victim alone. Attempting to remove a deep or embedded object
can damage the ear. èall for professional help.

ven if you get the foreign object out of the ear, you should seek medical help. Ñith an
otoscope (an instrument that magnifies the eardrum), a professional can determine whether all
the material has been removed.

 c
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3."* $"$.&"& $5

The following signs should be a red flag that the noise around you is too loud:

± If you have to shout to be heard above the noise.

± If you can't understand someone who is speaking to you from less than 2 feet away.
± If a person standing near you can hear sounds from your stereo headset while it is on
your head.

3."!/$ "$&%5

$ "* ?!  This step is especially important for people who work in noisy
places and who go to and from work in noisy city traffic. Special earmuffs that protect your ears
are available for people who work in noisy environments (such as around heavy machinery).
You can also reduce your exposure to noise by choosing quiet leisure activities rather than noisy
ones.

/!&&).%! %.&* '.* .)?!$%

 misposable foam earplugs cost about $2 a pair and are available in drugstores. These
earplugs, which can quiet up to 2* dB of sound, can mean the difference between a dangerous
and a safe level of noise. You should always wear ear plugs when riding snowmobiles or
motorcycles, attending concerts, when using power tools, lawn mowers or leaf blowers, or
when traveling in loud motorized vehicles.

 $))%$ "&$.' ?ubber mats can be put

under noisy kitchen appliances, computer printers and typewriters to cut down on noise.
èurtains and carpeting also help reduce indoor noise. Storm windows or double-pane windows
can reduce the amount of outside noise that enters the home or workplace.

4 /*"&& Try to keep television sets, stereos and

headsets low in volume. åoudness is a habit that can be broken.

4*$.  .$.&& $ For example, don't turn up the

volume on your car radio or headset to drown out traffic noise or turn up the television volume
while vacuuming.

3/* &%"&"'$ Êersons at risk for hearing loss should have their hearing tested
every year. You are at risk if you are regularly exposed to loud noise at work or play.



c 


Knowing what to do for an eye emergency can save valuable time and possibly prevent vision
loss. Here are some instructions for basic eye injury first aid.

!$

± Ñear eye protection for all hazardous activities and sports-at school, home, and on the
job.
± Stock a first aid kit with a rigid eye shield and commercial eyewash before an eye injury
happens.
± c
assume that any eye injury is harmless. Ñhen in doubt, see a doctor
immediately.

+&" &
*
In all cases of eye contact with chemicals:

Immediately flush the eye with water or any other drinkable liquid. Hold the eye under a faucet
or shower, or pour water into the eye using a clean container. Keep the eye open and as wide
as possible while flushing. èontinue flushing for at least 1* minutes.

± c
use an eyecup.

± If a contact lens is in the eye, begin flushing over the lens immediately. This may wash
away the lens.
± c
bandage the eye.
± Seek immediate medical treatment after flushing.
± !"'&
*
± c
rub the eye
± Try to let tears wash the speck out or use an eyewash.
± Try lifting the upper eyelid outward and down over the lower lid.
± If the speck does not wash out, keep the eye closed, bandage it lightly, and see a doctor.
± .&
*
± Apply a cold compress without putting pressure on the eye. èrushed ice in a plastic bag
can be taped to the forehead to rest gently on the injured eye.
± In cases of pain, reduced vision, or discoloration (black eye), seek emergency medical
care. Any of these symptoms could mean internal eye damage.
± + $ " &
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± c
wash out the eye with water or any other liquid.
± c
try to remove an object that is stuck in the eye.
± èover the eye with a rigid shield without applying pressure. The bottom half of a paper
cup can be used.

See a doctor at once.

@ 3
 c
+ c


ceck and spine injuries are very serious injuries that can lead to paralysis and even death. If you
are in a first aid situation where the victim has possible neck and/or spine injuries be very
careful. In serious cases the spinal cord could be severed resulting in paralysis. The extent of
paralysis will depend upon the height of the spinal injury. The closer to the neck, the more
extensive the paralysis.

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± èheck if the victim's head or neck look deformed or in an odd position.

± èheck if the victim is feeling pain in the neck or across the spine.
± èheck if the victim is feeling numbness, tingling or weakness in legs, arms or other body
parts. These are a clear sign of spinal injury.
± èheck for paralysis by actually pinching extremities such as finger and toes to check that
the victim has feeling in those body parts. Ask the victim to squeeze your hand, move
his feet, etc. If the victim is able to perform these operations then there is probably no
spinal injury.
± If there is the slightest chance of spinal injury, take all precautions and assume the
worst.



± Send for medical assistance as soon as possible.

± mo not move the victim in any way and restrict the victim from moving himself. ven if
the victim is in the water, try to stabilize the neck and back without moving the victim. If
there is time wait for the medical assistance to arrive and let them take over. If this is
not possible immobilize the neck and back using any tools that you might have to your
disposal. Keep the head from making any rolling, sideways or up and down movement.
± èheck constantly for vital signs and signs of shock. Keep the victim warm.

3

0
 

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± If someone has a cardiac arrest or &"', there are only a few minutes to act
before it is too late. It is vital to know what to do beforehand.
± To perform èÊ? (cardiopulmonary resuscitation) and artificial respiration (mouth to
mouth resuscitation) effectively, training and frequent practice on resuscitation
dummies are essential.
± First aid courses are offered all over the country at night schools or by voluntary
organisations such as St John Ambulance or The ?ed èross.

3."* &/%&"'5

If the person is unconscious:

 ± are they breathing? åook at the patient's chest to see if it is rising and falling.
± do they have a pulse? Êlace two fingers on one or other side of the person's voice box in
their throat to feel if they have a carotid pulse.
± If the patient has a pulse but is not breathing:
± could it be because of suffocation? Feel inside the mouth with a finger to see if there is
anything blocking it or the windpipe and remove any food or other objects. Êrovided
that dentures are not broken, it is better not to remove them.
± call for help immediately, stating that the casualty is not breathing, and provide
resuscitation (see below) until the patient begins to breathe or the ambulance arrives.

&)&%! -&!&&$"$"

Ñhat help is needed?

± If possible, raise the legs up 12 to 18 inches to allow more blood to flow towards the
heart
± Immediately place the palm of your hand flat on the patient's chest just over the lower
part of the sternum (breast bone) and press your hand in a pumping motion once or
twice by using the other hand. This may make the heart beat again.
± If these actions do not restore a pulse or if the subject doesn't begin to breathe again:
± call for help, stating that the casualty is having a cardiac arrest but stay with the patient.
± find out if any one else present knows èÊ?.
± provide artificial respiration immediately (see below).
± begin èÊ? immediately (see below).
± How to give artificial respiration
± Tilt the head back and lift up the chin.
± Êinch the nostrils shut with two fingers to prevent leakage of air.
± Take a deep breath and seal your own mouth over the person's mouth.
± Breathe slowly into the person's mouth - it should take about two seconds to
adequately inflate the chest.
± mo this twice.
± èheck to see if the chest rises as you breathe into the patient.
± If it does, enough air is being blown in.
± If there is resistance, try to hold the head back further and lift the chin again.
± ?epeat this procedure until help arrives or the person starts breathing again.
± How do I perform èÊ? (cardiopulmonary resuscitation)?
± See if there is breathing. If not, start artificial respiration as described above. èhecking
for a pulse in the neck (carotid artery) may waste valuable time if the rescuer is
inexperienced in this check. The procedure is:
 ± place your fingers in the groove between the windpipe and the muscles of the side of
the neck. Êress backwards here to check for a pulse.
± If there is no pulse, or if you are unsure, then proceed without delay thus:
± look at the person's chest and find the 'upside-down V' shaped notch that is made by
the lower edge of the ribcage. Êlace your middle finger in this notch and then place your
index finger beside it, resting on the breastbone. Take the heel of your other hand and
slide it down the breastbone until it is touching this index finger. The heel of your hand
should now be positioned on the middle of the lower half of the breastbone.
± now place the heel of your other hand on top of the first. Keep your fingers off the
chest, by locking them together. Your pressure should be applied through the heels of
the hands only.
± keep your elbows straight, and bring your body weight over your hands to make it easier
to press down.
± press down firmly and quickly to achieve a downwards movement of 4 to *cm, then
relax and repeat the compression.
± do this 1* times, then give artificial respiration twice, and continue this 1*:2 procedure
until help arrives.
± aim for a rate of compression of about 100 per minute. You can help your timing and
counting by saying out loud 'one and two and three and four ...' etc.
± Artificial respiration and èÊ? should both be performed at the same time

If possible, get someone else to help - one person to perform artificial respiration and the other
to perform èÊ?. (This is not easily done without prior practice and it is well worth attending
sessions on èÊ? training to become familiar with the technique.)

The ratio of chest compressions to breaths is 1*:2 for both one-person and two-person èÊ?.

èontinue until the ambulance arrives or the patient gets a pulse and starts to breathe again.

If the pulse returns and breathing begins but the person remains unconscious, roll them gently
onto their side into the recovery position. This way mucus or vomit can get out of the mouth
and will not obstruct the patient's breathing. It also prevents the tongue from falling back and
blocking the air passage.

Make sure the patient continues breathing and has a pulse until the ambulance arrives

If you succeed in resuscitating the person who has been taken ill, he or she may be confused
and alarmed by all the commotion. Keep the patient warm and calm by quietly, but clearly,
telling them what has happened.
Again, it needs to be emphasised that the only way to provide proper first aid and resuscitation
is through learning the technique, then regular practice and guidance.

3


0

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Heat exhaustion is one of the heat-related syndromes, which range in severity from mild heat
cramps to heat exhaustion to potentially life-threatening heatstroke.

Signs and symptoms of heat exhaustion often begin suddenly, sometimes after excessive
exercise, heavy perspiration, and inadequate fluid or salt intake. Signs and symptoms resemble
those of shock and may include:

± Feeling faint or dizzy

± causea
± Heavy sweating
± ?apid, weak heartbeat
± åow blood pressure
± èool, moist, pale skin
± åow-grade fever
± Heat cramps
± Headache
± Fatigue
± mark-colored urine

*  !"&?& 2

± Get the person out of the sun and into a shady or air-conditioned location.
± åay the person down and elevate the legs and feet slightly.
± åoosen or remove the person's clothing.
± Have the person drink cool water or other nonalcoholic beverage without caffeine.
± èool the person by spraying or sponging him or her with cool water and fanning.
± Monitor the person carefully. Heat exhaustion can quickly become heatstroke.
± If fever greater than 102 F (38.9 è), fainting, confusion or seizures occur, call 911 or
emergency medical help.

 c
+
c 
The mainstay of treatment for finger infections is antibiotics and proper wound care. The
proper wound care varies for each of the different infections. This can range from a simple
incision and drainage of the wound to an extensive surgical exploration of the wound to
remove as much infected material as possible.

Some of the infections can be treated as an outpatient, but several will require inpatient
treatment and intravenous antibiotics. Because the organisms that cause these infections are
similar, many of the same types of antibiotics may be used.

± *"&2 Often the wound may be treated with wound care alone. If a collection of
pus is present, it will need to be drained. This may be done in several different ways.
èommonly a scalpel is used to make a simple incision over the collection of pus to allow
drainage. Or the scalpel may be inserted along the edge of the nail to allow drainage. If
the infection is large, a part of the nail may be removed. If this procedure is required,
the doctor will inject a local anesthetic at the base of the finger that will provide for a
pain-free procedure. Most often, you will be placed on an oral antibiotic. You will then
be instructed how to take care of the wound at home. (See paronychia)
± 2 Often incision and drainage is required because the infection develops within the
multiple compartments of the fingertip pad. Usually an incision will be made on one or
both sides of the fingertip. The doctor will then insert an instrument into the wound and
break up the compartments to aid in the drainage. Sometimes a piece of rubber tubing
or gauze will be placed into the wound to aid the initial drainage. The wound may also
be flushed out with a sterile solution to remove as much debris as possible. These
infections will require antibiotics. The wound will then require specific home care as
prescribed by your doctor.
± 3!".&.2 Antiviral drugs such as acyclovir (Zovirax) may shorten theduration of
illness. Êain medication is often needed. The wound must be properly protected to
prevent a secondary bacterial infection and to prevent you from infecting other sites on
your body or other people. Incision and drainage are not indicated and, if done, may
actually delay healing.
± + 2 This infection is superficial, and oral antibiotics are sufficient. If the area is
extensive or your immune system is weakened, then you may be treated in the hospital
with intravenous antibiotics.
± ?*/2 This is a surgical emergency and will require rapid treatment,
hospital admission, and early treatment with intravenous antibiotics. Usually the area
will need to be surgically opened and all debris and infected material removed. Because
of the intricate nature of the fingers and hands, a hand surgeon will usually perform this
procedure. After surgery, several days of intravenous antibiotics will be required
followed by a course of oral antibiotics.
 ± !!""2 Much like flexor tenosynovitis, this can require emergency care.
If the infection is mild, then only oral antibiotics will be needed. If more severe, a hand
surgeon should evaluate the wound and intravenous antibiotics begun. Often these
wounds will require incision and drainage followed by a course of antibiotics.





± Stroke is also called 'èerebrovascular Accident'

± It is an acute neurological injury
± It may be due to blood clot (ischemic) or bleeding (hemorrhagic)
± åeads to stoppage of blood supply to a part of brain
± Oxygen supply is decreased
± This initiates 'ischemic cascade'-causes brain cell death/damage
± This results in a cerebral stroke

+ A'

± High Blood Êressure

± miabetes
± èigarette smoking
± Heart misease

 *!

± cumbness/weakness of an arm/leg/face/one side of body

± Sudden confusion in speaking/understanding speech
± Impaired vision in one or both eyes
± Sudden headache
± åoss of balance/co-ordination
± mizziness




± If you suspect stroke, call emergency medical help

± ?eassure the patient
± åay the patient down with head and shoulders slightly elevated
± If patient is not breathing well do a èÊ?
± Êlace the patient on the left side if breathing/not responsive
± Keep the chin slightly extended
 !
/$

± cever give a suspected stroke victim anything to eat/drink

± mo not permit the victim to move

/

± mo regular checkups for BÊ

± at food with less salt
± xercise regularly
± at a balanced, healthy diet
± Take the BÊ pills regularly