COMMON INJURIES AND HOW TO TREAT THEM

BLOOD LOSS & LARGE CUTS If a person loses a large amount of blood, the heart will speed up to keep the blood pressure high enough to transport the blood - and thus, oxygen - to muscles and organs. If the wound stays untreated, meaning you either a) keep losing blood or b) have no way of replacing the blood you lost (because you lost too much for the body to recover itself or by getting a transfusion), the heart will continue to speed up until it loses its rhythm or fails entirely. It is likely that a person passes out; as hinted at before, low blood pressure will result in lack of oxygen in organs - which includes the brain, obviously. A word on the placement of wounds: The most life threatening wounds would be injuries of the abdomen (you can bleed out into your belly with no outward wound!) or when major arteries are damaged (the carotis at the side of the neck, the aorta though you would have to damage the spine for that, etc) or organs that hold a great deal of blood, prime example for this being the spleen. If blood is getting into the abdomen, the belly will become hard. Also, you will usually find evidence of violence, like bruises, on the outside. You can find the approximate amount of blood a person has if you know their weight and calculate how much 8% of it are. With blood loss, there is also a high probability of shock. First Aid: 1. Injured person should lie down or at least sit. They might pass out and fall, injuring themselves, and it is easier for the heart if it doesnt have to pump the blood so far up. 2. If an extremity is wounded, hold it up! Also put pressure on the arteries leading up to it (for an arm, that would be a bit further down from the arm pit), however, dont tie it off unless its unavoidable. That can cause blood clots (which can lead to strokes, thromboses and other nasty things. Also the extremity will be cut off oxygen and die.). If you cant avoid it at all, note down the time you tied the limb off and make sure the information gets to the EMTs/hospital/doctors. 3. Only administer shock position (more on that later) if you are sure there is no bleeding in the abdomen. As shock position requires holding up of the legs, that would result in sending more blood to the wound. 4. Obviously you need to bandage the wound. A quick

graphic:

Its in German, but you dont really need to read the words to understand, I believe. Obviously, you dont do that if the wound is on the neck. In that case, you need to put pressure on it but not bandage it. HEAD TRAUMA Head trauma is a result of blunt force to the head, either caused intentionally (you will find more on this in the section about unconsciousness & knocking someone out) or by accident. Indicators for a head trauma are: a) Bruises or bleeding wounds on the head b) Differently sized pupils which might not widen/shrink exposed to light. (However, this can also be a symptom of strong migraine.) c) Clear fluid and/or blood coming from ears and/or nose. d) Amnesia and/or disorientation/confusion e) Gushing vomiting without warning f) Unconsciousness g) Slurring of words (sounding like you are drunk) h) Anxiety i) Over-sensitivity to outside stimulation (sounds etc.) (points g to i added by thesingingasgardian) Obviously, there are several risks here: Permanent damage to the brain, choking on your own vomit, the general dangers of unconsciousness (more on that later) etc. Mild concussions can fix themselves if the victim rests. However, the italicized points are signs that the skull has been fractured which will not solve itself, obviously. Aside from the head, there is also a high chance the spine, especially the neck area, are damaged. This is dangerous because within the spine lies a thick bundle of nerves; if their contact with the brain is broken or otherwise intercepted, the injured person will be paralyzed. First Aid: 1. Immobilize their head to avoid further, unintentional and self-inflicted damage 2. Only move them if unavoidable 3. Try to keep them focused and awake; have them tell you what happened, for example 4. If you can, cool the spot the force was applied to. However, avoid actual pressure! UNCONSCIOUSNESS & KNOCKING PEOPLE OUT First: Knocking someone out with a blow to a head is not as good an idea as stories like to pretend it is. If you have been trained and strike the base of the skull, you might not do fatal damage. (Even so, no dont do that.) A blow to the temple can kill someone as the skull is thinnest there, even though major veins are running right below that spot. A far better method of knocking someone out would be chemically (sedatives or chloroform, for example) or by applying force to the carotis on the side of the neck. This is will send a message to the brain High blood pressure!! which will, in turn, make the body lower the blood pressure. The sudden lack of oxygen will cause a person to faint. Okay, now the person is unconscious, either by accident or because someone wanted them knocked out. While unconscious, the body loses its adverse-effects reflexes - the muscles relax - which includes choking and swallowing.

The relaxed tongue can slip into the back of the throat, causing the victim to suffocate. If anything, like puke or food or liquids, end up in the airways, the victim will inhale it, sucking it into the lung, where it will cause pneumonia. I would like to mention that prolonged unconsciousness (days or even weeks) would actually be considerdd and actual coma and comes with severe (head) injuries, weakened body (by sicknesses/poisoning for example) or mental reasons. A mild concussion will not knock someone out for days! (added as requested by resurrecttheliving) First Aid: 1. Recovery position, you can look up what it looks like on google. 2. Tilt the head back and open the mouth. If you have strong suspicions that the neck/spine is injured, place your fingers under the jaw, below the ears, and push it upwards. (Never do that to a conscious person though, with tense muscles it hurts.) 3. Regularly check the victims breathing (!!!). To do so, lean down over their face and turn your head so your ear is over their mouth. So you can hear, feel their breath and see if their chest is rising and falling. 4. Talk to the patient. In some cases, they still notice part of what is going on and having someone talk to you and explain what is going on can make the situation decidedly less scary. (pointed out by foolishvessel) SHOCK Shock can be caused by both emotional (trauma) and physical (blood loss, large burns etc) means. Symptoms are restlessness, paleness, dizziness or nausea, cold sweat, pale & cool skin, increased heart rate, inability to focus, shaking, sometimes increased aggressiveness, in rare cases vomiting and fainting. First Aid: 1. Shock position: Laying down, head cushioned, legs up (they could rest on a bench or suitcase or only a balled up jacket). Does not apply if the abdomen is bleeding!! 2. Keeping them warm.

STABBING WOUNDS The following refers to wounds where the item the person was stabbed with has not been removed yet. For other cases, refer to the section about bleeding further up. There is a high chance people who have been stabbed will go into shock. First Aid: 1. Do. not. remove. the item. Also dont move it around or let the victim remove the item (they will try!!). That will only increase the damage. 2. Either with bandages or your bare hands, immobilize the item. HYPOTHERMIA Hypothermia means the body temperature has dropped down to far, causing shaking, icy cold, pale skin, blue-ish or purple lips and tiredness.

First Aid: 1.Obviously, warming them up: Wrapping them in blankets, jackets etc; giving them hot beverages (No alcohol!! Alcohol widens the veins, causing the body to lose more warmth!) 2. If they are wearing wet clothes, get rid of them. If they are wet in general, get them dry! 3. Keep them awake (!!) DEHYDRATION Dehydration is the lack of water in a persons body. It causes headaches, nausea, lack of sweat (noticeable during warm weather or physical activities) and flushed, hot and red face/skin. First Aid: 1.Get them to drink 2.Get them to rest/calm down. HEAT STROKE Heat stroke is, in essence, overheating of the brain due to too much exposure to the sun with no or little protection through hats or the like. It shares many symptoms with head trauma, like nausea, vomiting, dizziness, possibly fainting and pupil differences. The head of a victim of heat stroke will be very red and hot, the rest of their skin cool and covered in cold sweat. They might be aggressive and are unable to put their chin on their chest and are restless. First Aid: 1.Bring them out of the sun, preferably somewhere cool. 2.Keep them awake. 3.Get them to lay down or at least sit. ALLERGIC REACTIONS & ASTHMA Allergic reactions can range from rash to more dangerous swelling of the air passages. Symptoms vary and usually, the victim will have to tell you that they are caused by an allergy. Asthma can be caused by allergies, though it isnt necessarily triggered by that. First Aid: 1.Get them away from whatever caused (or you think caused) the attack. Plants, animals, food, anything. 2.With permission, obviously, remove clothing and use a wet cloth to wipe over exposed part of skin; if possible, get hair wet. Allergens tend to cling. 3.Calm them down. The quicker their heart beats, the more blood goes to the swelling, increasing it. 4.If they have an inhalator on them, try to make them use it. If they cant, help them. 5.If the allergic reaction was caused by an insect bite, possibly remove a remaining spine and try to identify what kind of insect it was. POISONING

In general poisonings often have very different symptoms. More or less common indicators someone was poisoned can be changed color of lips/skin in general, dilation of pupils, cramps, nausea and a lack of other sources. They can occur by eating poisonous plants, being dosed with a toxic substance, being bitten/stung by a poisonous animal, overdosing medicine or working with chemicals without proper protection. Common poisonings occur by swallowing soaps or corrosive chemicals, like shampoo, drain cleaner or the like. Both take immediate effect, often resulting in gagging or outright vomiting. First Aid: 1.If the substance is corrosive, try to avoid having the victim throw up. The stomach can handle stomach acid, no drain cleaner can do any damage. The path down there and back up however is vulnerable. 2.If the substance is soapy, do not have the victim drink anything!! Bubbles will form and they will suffocate on them!! 3.Soapy substance can be vomited up, acidic ones should remain inside. 4.In case of an acidic substance, clean the mouth with small doses of water, then have them drink small amounts of water. BURNS Burns can occurs either through extreme heat (fire, steam) or cold. The latter often happens with metallic jewelry (like ear studs) during cold winters). Depending on the size and depth of the wound, the skin is red, white and/or peeling. The victim might go into shock. First Aid: 1.Cooling, with lukewarm (not cold, that would trap the warmth within the skin) water. 2.If the burnt area is bigger than your palm, do not use running water; soak a cloth in lukewarm water and place it on the wound. Unlike what most people believe, applying ice to a burn does not help, and in fact sometimes makes it worse and heal slower. BLOCKED AIRWAY If something is stuck in a persons throat, they will choke, their face will turn red, lips acquire a blue-ish or purple tint and small veins in the white of the eyes might burst. If the blockade isnt removed, they will faint. Panic is guaranteed. First Aid: 1.Bent them over a chair or your knee and hit them between the shoulder blades with the heel of your hand three to five times. Make sure your hits are facing toward their head! 2.If this doesnt succeed, have them stand, position yourself behind them and do the Heimlich Maneuver. HYPERVENTILATION

Hyperventilation means that a person inhales quickly and too often, giving their body too much oxygen. The causes can be allergic reactions, in some case shock, panic attacks and many mental causes. The victim feels like they do not get enough air, though they actually have too much already. Too much oxygen causes dizziness, a tingling sensation in the fingers and toes that will start curling after a while and will eventually lead to fainting. Patients will be panicked. First Aid: 1. Calm them down. 2. Give them a bag (must not have crumbs in it, be bigger than can be filled with one breath, or be made of very thin material that will cling together) to breathe in. Do not push it into their face, that will increase the panic!! !!It has been brought to my attention by chaseraydis (and at least one other person commented on it as well, I believe) that giving a hyperventaliting person a bag is not the way to go. It seems this information is outdated and can cause more trouble than it is worth!! 3. Try to get them to breath through tightly squeezed together lips. LOW OR HIGH BLOOD SUGAR If a person does not eat enough, their blood sugar level will drop. This causes the same symptoms as high blood sugar: Dizziness, shaking, sweating, disorientation bordering on unconsciousness, slurred speech and nausea. Once the blood sugar level goes back to normal, the symptoms fade quickly. First Aid: 1.Give the victim sugar, preferably glucose. If the sugar is low, this will help. If it is high, a little more will not harm them and you cant help them anyway. 1.b. If you know the patient has diabetes (they might have a card saying so in their wallet), do not give them any more sugar! (pointed out by kanjiragana) As pointed out by ink-splotch, my original assumption of giving sugar in any case was correct:A diabetic with a low blood sugar can die within an hour or less if not treated. A diabetic with a high blood sugar will go into a coma in a week or two if not treated. One of these is obviously more severe. 2. If you can, measure their blood sugar. However, be aware that you need to prick their skin for that, so you need to get their permission, or, better yet, have them do that themselves. You can actually be sued for injuring them otherwise! 3.Best way to give sugar is in the form of fluids (soda, liquid sugar etc.). If they are passed out already, turn their head to the side so they wont choke and dribble small (you dont want them to choke or, if they are unconscious, inhale anything!) amounts of the liquid into their cheek. You can rub it into the skin there or their gums, too. (kanjiragana again) BROKEN BONES & DISLOCATED JOINTS Only three signs qualify as doubtless indicators of a broken bone: a)open skin that shows bone b)unnatural angles and flexibility or a limb c)forming of stairs - one part of the bone is higher up than the rest.

Everything else, pain or bruises, can hint at a broken bone, but arent proof. Depending on how far broken a bone is, the victim - especially in a stressful situation - can continue using the broken limb. The area around the break will swell and turn hot, pressure will hurt. Dislocated joints have similar symptoms: Increased, unnatural flexibility, swelling, pain. First Aid: 1.Immobilize the break or joint. Splints can be improvised from scarves and branches even. 1.b.If nothing else is available, lay the patient down and use your legs as a splint. 2.Cool as much as possible as quick as possible.
The first thing to do is look for complications. They include but are not limited to: severe bleeding, a bone that has pierced the skin (called a compound fracture, and has its own set of complications, the least of which is contagion), symptoms of shock (pale skin, cold sweat, confusion), or a joint/bone that looks out of place. In a perfect world, you would call an ambulance. Your character isnt in a perfect world. They need to tend to the bone themselves. 1. Stop the bleeding, if any. Hold a preferably sterile cloth over the wound. (Cloth can be sterilized by dunking it in rubbing alcohol or boiling water/wine/drinkable liquid, or by ironing it. Avoid cotton/wool/burlap/other texture material because the little hairs will stick to the wound and cause later infection) Hold cloth with gentle but firm pressure. DO NOT REMOVE LARGE OBJECTS EMBEDDED IN THE SKIN. It may cause more bleeding. Likewise, do not remove the cloth from the wound. If the wound bleeds through, add more cloth. 2. 3. Make sure the person will not move the wounded area, but make no attempt to return the limb back to the normal position. This will cause the bone to heal improperly. Splint the broken limb. Do this by tying a rigid object (board, scabbard, stick, or rolled-up newspaper) to the injured bone. Place padding between the object and limb for comfort. Tie the board to the injury above and below the break, but not on it. Tape broken fingers and toes to the adjacent finger or toe with as much padding as possible. Fasten broken arms at about heart level with a belt or sling that loops over the arm and around the neck. 4. Check blood circulation by pressing two fingers into the skin past the break site and then removing them. If the skin doesnt return to normal color in two seconds, the circulation has been affected. Other indications include blue skin, numbness, and lack of pulse. Combat the lack of circulation by moving the limb into resting position. (IRL, dont do this unless there is no medical help readily available.) 5. Find painkillers. Alcohol is the old standby, but adding a depressant onto poor circulation will probably cause your character to lose a limb. Humans have used an opiate made from poppy plants since before recorded history, and it was well-known to doctors even in the Middle Ages. If it is wintertime, use ice or snow to numb the wound, but do not apply directly to the skin, or the character will get frostbite on top of their broken appendage. Other tips: DO NOT MOVE A HEAD, NECK, HIP, OR BACK INJURY. You might make it worse. Do not put slings on babies If the wrist, hand, or finger is injured, remove all rings, bracelets, watches, etc. because the

wound will swell and make later removal very difficult

SEVERED LIMBS & KNOCKED OUT TEETH Like broken bones, a high stress level and the resulting adrenaline can keep a person going despite a severed limb, sometimes even making them oblivious to the injury until later. A severed limb usually means severe blood loss. This has been explained further up before. Shock is to be expected, also possible panic. Knocked out teeth often cause swelling and bruises in the mouth that is visible on the outside. Saliva mixed with blood tends to turn into bubbles. First Aid: 1.Treat the bleeding as described under Blood Loss: Pressure is your friend! 2.Take severed limbs along! Put them in a bag and that bag in a second bag filled with icy water as quick as possible. Do not clean the limb. 3.Teeth have to be taken along as well. If you dont have a proper teeth rescue box, transport in milk. If no milks is available, saltwater will work, too. 3.b. A tooth can also be stored in the patients own mouth, under the tongue. (as pointed out by an anon and thezonesystems) 3.c. Saving the tooth is most likely if you get to the hospital in less than 30 minutes. (added by a kind anon) BRUISES Bruises are darkly colored, swollen parts of the skin where blunt force ripped small veins inside. They are pressure sensitive and warm. First Aid: 1.Cool as much as possible as fast as possible. ELECTRIC SHOCK (People often incorrectly use the word electrocution, which should only be used when the person has died from the electric shock) Those can be caused by touching energized water, open cables, sockets etc. Unlike what movies tend to show, a victim will not be thrown off in a cloud of sparks - they will be stuck on the power source until it is turned off or the contact with it is otherwise intercepted. The persons muscles will spasm even after being away from the power source. The heart might lose its rhythm. Nerves will not function normally as the brains electrical impulses are intercepted and/or overshadowed by the power from the outside. This leads to uncontrolled twitching and likely fainting. First Aid: 1.Break contact of victim and power source (be aware of surroundings, like a wet floor!!), turn off power source if possible. 2.Treat unconsciousness. 3.Notes on CPR coming later! SEIZURES Seizures can be caused by various things. Most common are photosensitive epilepsy and lasting brain damage due to infections caused by ticks.

The victim will twitch or outright spasm uncontrollably for a while. In some cases, they will have foam on their lips. First Aid: 1.Do not attempt to hold them still!! 2.Try to clear the area of anything that can be damaged to cause damage to the patient. 2.b If sharp/hard objects cannot be moved, try to cushion them with towels, blankets or pillow between them and the patient. (I forgot who pointed that out, sorry! ;;) 3.If you can, look for a card on them that describes their illness. 4.If the seizure takes longer than 10 minutes 2 minutes (as pointed out by a kind anon!) to end or you cant find a card like mentioned before, call an ambulance. CPR CPR is administered when the victim unresponsive and does not breathe for twenty seconds or longer, regardless of heartbeat. The patient is turned on their back, their head tilted back and mouth opened. You place your hands on the sternum, between the nipples and about 5cm down, (location added as suggested by nerdtoyota), heel over heel, and press down about 10cm deep. Do so quickly 30 times, then cover their nose and blow breath into their mouth strongly two times. If more than one helper is around, split the work and do both at the same time. Ribs and sternum are likely to be broken in the process; continue anyway! (added as requested by foolishvessel) If the patient was drowning, start with 5 breaths before you start the regular 30-pushes-2breaths rhythm. The pushing is supposed to send the blood and the oxygen in it flowing through the body again; however, a drowned person doesnt have that oxygen in the bloodstream, so you need to get that into the body first again. (as pointed out by nerdtoyota) Most public places nowadays have AEDs, Automated External Defibrillators. Since they tell you exactly what to do (where to put the electrodes, when no one should touch the patient) once you activate them, there is really nothing you can do wrong with those; they wont even misfire since they check for pulse before doing anything. Locations with AEDs are usually marked with a sign like those:

STROKE A stroke is caused by a blood clot in the brain that cuts off the oxygen supply of a part of the brain. This shows in form of slurred speech, impaired movement control, half-sided

paralyzation of facial muscles (especially noticeable on the lips and eyelids), possible nausea and increased impairment of cognitive abilities, such as short term memory or speech (patients might unknowingly replace words in their speech). First Aid: 1.Keep them where they are and get an ambulance. 2.Try to keep them conscious and focused: Talk to them! 3.Note down when the symptoms started. This is very important information for the EMTs and/or the hospital since there is a certain time window where medicine can be given to dissolve the blood clot in the brain. (kindly pointed out by thelawisnotbooped) 4.As half-sided paralysis is characteristcal for stroke, ask them to cross their arms (note possibly impaired movement control!) and hold your hands, then have them squeeze. If one hand is significantly weaker, that can indicate a stroke. HEART ATTACK Heart attacks are usually caused by a blood clot getting stuck in the coronary blood vessels, cutting off the oxygen supply of the heart or part of it. Victims will sweat and flush, feel strong pains in the chest that transfer to the left shoulder and have trouble breathing which often leads to panic and/or hyperventilation. Fainting is common as well as death. First Aid: 1.Treat lack of air psychologically: Open windows & loosen ties, open the top button of shirts. 2.Calm them, get them to sit or lie down. 3.Prepare of CPR. APPENDICITIS Appendicitis is the inflammation of the appendix. It characteristically causes a stinging pain on the right side below the navel, a pain that intensifies if you let go after putting pressure on the spot. Also, the patient will have trouble bringing the knee up to the chest. It might be accompanied by slight nausea and fever. Patients will usually assume fetal position out of instinct. If untreated, the appendix can burst, causing a quick rising of the fever and danger to life. First Aid: 1.Cool, dont warm! MENINGITIS Meningitis describes an infection in the brain. It is highly infective and indicated by high, quickly rising fever, coughing, nausea and the inability to place the chin on the chest. First Aid: 1.As with all infective patients, convince them to wear a surgical mask or cover their mouth in other ways; do the same.

2.Try to stay behind or next to them, out of the way of coughs. RULES OF COOLING Cooling is important; it is estimated that for every minute a wound remains uncooled, the healing process is slowed down for about a day. You should always cool for as long as possible. However, try to avoid ice pack touching bare skin! Cool a wound if: - There is a bruise - There is a warm swelling - Yes, that includes insect bites, sprained or dislocated joints, broken bones etc. There are cases where you have extra rules added, like in case of burns; refer to that section of the post for that information. Never cool an inflammation! RULES OF WARMING Warming an injury is much less often needed. You will need warmth to help muscles relax, meaning in case of stomach or muscle cramps in general. Obviously, someone with hypothermia should be warmed, too. Do not warm a bruised/warm & swollen injury. Warming widens the veins, causing more blood to flow. This will worsen a swelling, but relax clenched muscles. BODY CHECK A body check is a quick check for injuries from head to toes that is supposed to detect injuries. Below is a quick list of what to look for where. -Head: Bumps/bruises, blood or clear liquid coming from nose or ears, pupil size and reaction, airways -Shoulders, upper body: Heartbeat, stability of sternum, collar bone and ribs determined by gentle pressure. Caution with the ribs especially, you dont want them to puncture a lung if they are broken! -Arms & hands: Broken bones or dislocated joints (refer to appropriate category!), possibly check how long it takes for a spot (palm right below the thumb) on the hand to refill with blood after gentle (!) pressure. If that takes longer than one or two seconds tops, blood pressure is too low! -Abdomen: Hardness (can indicate interior bleeding!), bruises/other signs of force -Bowel: Stability. If the bowel turns out to be broken, use pants tops or, even better, the belt to keep it pressed together, move it as little as possible top avoid severing veins! -Legs & feet: Same as arms & hands. Always get permission first if patient is conscious!! SOME NOTES IN GENERAL - A situation is defined as an emergency if vital functions are defective or expected to become defective: Call an ambulance!! - Always get as much information as you can

- Talk the person you are helping calmly. It will calm them, you can get information and it will keep them awake and focused. - Explain to the patient what you are doing. If you are working in a team, talk to patient and teammate equally. Talking over or ignoring the injured person can and likely will scare them or at least cause nervousness. - Never step over a patient and try to stay on eye-level with them whenever possible. Otherwise, you will aggravate them. - Document what you can. - Get information (name, birth date, medication, last meal, has an event like this happened before, what happened, what pains are you feeling where, how intense is the pain, what causes pain, do you have allergies, where are you from, are you pregnant, do you have any illnesses etc) - Always wear gloves. Always. Especially if bodily fluids are involved. A short note on emergency numbers: They vary. Calling 911 in, say, Germany or Scotland wont do you any good. If you want a character to call an ambulance and mention the number, look up which one they would have to call! Generally, you only need to give a brief explanation of the issue (A teenager boy collapsed during PE and is now unresponsive. We are at [insert location]. My name is [insert name]. Always mention the number of patients or possible dangers, for example a still burning fire. They will ask if they want to know more.) After the call, if there are any bystanders/more helpers, send someone to the street so they can lead the paramedics to the patient. If possible, send several people to form a chain leading from the street to the patient. Give clear, short instructions as they will likely be panicked! A short note on handing over a patient to paramedics: Information. They need it. If you documented anything, give it to them. Tell them what you know: Who is the patient, what happened, what happened/did the patient do while you were present, allergies, last meal, medications, known illnesses, pregnancy, age, etc. So, several years of school first aid medic training cut down to the essentials and crammed into one post. I hope it helps and feel free to correct me, ask me about unclear/missing stuff or add something!