First Aid for Drowning

Drowning is the fourth leading cause of accidental death. Each year, over 4,000 people
drown and about one-third of them are children under 14 years of age.

It takes very little water for a child to drown. In fact, as little as two inches of water in a
bathtub, sink or shower can kill a toddler. Toilet bowls are unsafe, too, if a small child
falls into one head first.

Adults drown under different conditions. When the weather is hot, for example, adults are
tempted to cool off with alcoholic beverages while swimming and boating. This is not a
good idea. Alcohol interferes with good judgement and is a major factor in among adults
drownings.

Causes of Drowning

• Leg or stomach cramps

• Loss of consciousness
• Playing in water too deep and too rough for one's ability to swim
• Not knowing how to swim
• Stroke
• Heart attack
• Falling through the ice while fishing, skating or snowmobiling during the winter
• Not wearing life preservers

Prevention
To prevent a child from drowning:

• Never leave a child alone near water, swimming pools or any large container of
water.
• Never turn away from an infant in a baby bathtub or one sitting in a bathtub
"supporting ring". A child could drown or get seriously injured in the seconds it
takes to answer a phone or go to the door.
• Teach your child to swim. Classes for children as young as six months teach them
how to kick so if they fall in the water, they can break through the water surface.
• Tell your children never to swim alone and never to swim too far from shore
without the company of an experienced adult swimmer.
• Warn your children to always check the depth of water before diving in.
• Build a secure fence around your swimming pool and install self-closing and self-
latching gates. Make sure the gates are always locked.
• Make sure neighbors also have high fences with locked gates around their pools.
• Consider using a cordless phone out-of-doors so you can call 911 right away in
the event of emergency.
• Keep young children out of the bathroom unless supervised by an adult. Put child-
proof handles on door knobs, if necessary.
 • Take cardiopulmonary resuscitation (CPR) and water safety courses.

To prevent an adult from drowning:

• Swim, when possible, in sight of a lifeguard.

• Never swim alone at the beach or in a swimming pool. Someone should be nearby
in case you suffer a leg cramp or other potential emergency.
• Never swim alone in unknown waters.
• Never sit alone in a hot tub. And, do not immerse yourself in a hot tub if you've
had any alcoholic drinks. You could fall asleep in the warm, relaxing water, slip
under the surface and drown.
• Learn to swim. Take classes at your local YMCA or in adult education programs
offered at city schools.
• If you can't swim, always wear a personal flotation device when you enter a lake,
a pool or ride in a boat.
• Always check the depth of the water before diving. It should be at least 9 feet
deep.
• Take a cardiopulmonary resuscitation (CPR) and water safety course.

Questions to Ask

Is the person
unconscious, not
breathing and has no
pulse?

Get Emergency Care and give first aid before emergency care:

• Get the victim out of the water if you can do so safety. See "First
Aid Procedures Before Emergency Care" for Neck and Spine
Injury if you suspect the victim has injured his or her neck in a
diving or other water accident. Do CPR. (See "CPR") Start CPR
in the water if safe to do so.

Is the person not

breathing, but has a
pulse?

Get Emergency Care and give first aid before emergency care:

• Get the victim out of the water if you can do so safety.

• Do rescue breathing.

• Start rescue breathing in the water if it is safe to do so.

Does the person have
blue lips and ears and is
the skin cold and pale?

Get Emergency Care and give first aid before emergency care:

• Get the victim out of the water if you can do so safely.

• Monitor for breathing and pulse. If no breathing and no pulse, do
CPR. (See "CPR".) If no breathing, but there is a pulse, do
rescue breathing.If victim is breathing and has a pulse, put him
or her in the recovery position. This position keeps the airway
clear and allows swallowed water or vomit to drain.

• Take cold, wet clothes off the victim and cover him or her with
something warm to prevent hypothermia.
Does the person in the
water show these signs of
near drowning?

• Waving, shouting
for help
• Uneven
swimming
motions

• Inability to stay
above water

Get Emergency Care and give first aid before emergency care:

[Note: Saving a drowning person carries risk. Before swimming out to someone in
trouble, be sure you can handle the situation. Many people drown in the brave effort of
trying to save someone else because they are not well trained and have not properly
thought through the risks of the situation.]

• First try to reach the person with a pole or extended hand. If you can't reach him
or her, use a life preserver or rope.
• If the person is further than you can reach and you decide to enter the water,
approach the person carefully and from behind. Talk to the person, trying to calm
him or her as you slowly move closer. Get the person to talk. Ask if everything is
all right and tell him or her to do as you instruct.
• Grab a piece of clothing or cup one hand under the person's chin and pull the
person on his or her back to shore.
• Tell the person to extend his or her arms away from you. Continue talking to the
person to reassure him or her.
• Start rescue breathing right away if the person has stopped breathing.
After a near-drowning incident, does the person have a fever, cough or muscle pain?

[Note: Self-Care Procedures do not apply to near-drowning victims. All victims should see
their health care provider because lung problems are common following a near-drowning
episode.]

Drowning
The drowning victim may be flailing his/her arms or lying face down in the water.
The victim needs to be removed from the water without endangering yourself.
Signs

1. Pale, cool skin

2. Absence of breathing
3. Blue lips
4. Weak or absence of pulse
5. Maybe unconscious
Treatment

1. Start mouth-to-mouth ventilation (see

Absence of Breathing). Do not stop until the
victim breathes on his or her own again or
medical help arrives.
2. If the victim begins coughing or spurting
water from their nose and mouth, you should
turn them on their side. This will aid water
removal from the lungs, keeping the victim's
head lower than the rest of the body.
3. Once the victim is breathing naturally, keep him/her warm.
4. Call a doctor as soon as possible.

First Aid for Drug Overdose

Drug overdoses can be accidental or on purpose. The amount of a certain drug needed to
cause an overdose varies with the type of drug and the person taking it. Overdoses from
prescription or over-the-counter (OTC) medicines, "street" drugs, and/or alcohol can be
life-threatening. Know, too, that mixing certain medications or "street" drugs with alcohol
can also kill.

Physical symptoms of a drug overdose vary with the type of drug(s) taken. They include:

• Abnormal breathing
• Slurred speech
• Lack of coordination
• Slow or rapid pulse
• Low or elevated body temperature
• Enlarged or small eye pupils
• Reddish face
• Heavy sweating
• Drowsiness
• Delusions and/or hallucinations
• Unconsciousness which may lead to coma

Parents need to watch for signs of illegal drug and alcohol use in their children. Morning
hangovers, the odor of alcohol, and red streaks in the whites of the eyes are obvious signs
of alcohol use. Items such as pipes, rolling papers, eye droppers and butane lighters may
be the first telling clues that someone is abusing drugs. Another clue is behavior changes
such as:

• Lack of appetite
• Insomnia
• Hostility
• Mental confusion
• Depression
• Mood swings
• Secretive behavior
• Social isolation
• Deep sleep
• Hallucinations

Prevention
Accidental prescription and over-the-counter medication overdoses may be prevented by
asking your doctor or pharmacist:

• What is the medication and why is it being prescribed?

• How and when should the medication be taken and for how long? (Follow the
instructions exactly as given.)
 • Can the medication be taken with other medicines or alcohol or should it not be?
• Are there are any foods to avoid while taking this medication?
• What are the possible side effects?
• What are the symptoms of an overdose and what should be done if it occurs?
• Should any activities be avoided such as sitting in the sun, operating heavy
machinery, driving?
• Should the medicine still be taken if there is a pre-existing medical condition?

Medication overdoses can be avoided:

• Never take a medicine prescribed for someone else.

• Never give or take medication in the dark. Before each dose, always read the label
on the bottle to be certain it is the correct medication.
• Always tell the doctor of any previous side effects or adverse reactions to
medication as well as new and unusual symptoms that occur after taking the
medicine.
• Always store medications in bottles with child-proof lids and place those bottles
on high shelves, out of a child's reach, or in locked cabinets.
• Take the prescribed dose, not more.
• Keep medications in their original containers.

Illicit drug use among children should be discouraged:

• Set a good example for your children by not using drugs yourself.
• Teach your child to say "NO" to drugs and alcohol. Explain the dangers of drug
use, including the risk of AIDS.
• Get to know your children's friends and their parents.
• Know where your children are and who they are with.
• Listen to your children and help them to express their feelings and fears.
• Encourage your children to engage in healthy activities such as sports, scouting,
community- based youth programs and volunteer work.
• Learn to recognize the signs of drug and alcohol abuse.

Questions to Ask

Is the person not breathing

and has no pulse?

Perform CPR and Get Emergency Care. (See "CPR".)

Is the person not breathing,
but has a pulse?

Perform Rescue Breathing and Get Emergency Care. (See "Airway

and Breathing" under CPR.)

Is the person unconscious?

Get Emergency Care and give first aid before emergency care. (See
"First Aid for Unconsciousness".) Lie the victim down on his or her left
side and check airway, breathing and pulse often before emergency
care. Do CPR or Rescue Breathing (see "Airway and Breathing") as
needed.
Does the person have any of
these signs?

• Hallucinating
• Confusion
• Convulsions

• Breathing slow and

shallow and/or
slurring their words

Do you suspect the person

has taken an overdose of
drugs?

Get Emergency Care and call Poison Control Center.

Tell the Poison Control Center:

• The name of the medication or drug, if known.

• The amount of the drug taken, if known. For example, the number of pills or
amount of liquid you suspect was swallowed.
• When the medication or drug was taken.
• The person's age, gender and weight.
• How the person is feeling and reacting.
 • Any medical problems the person has.

Follow the Poison Control Center's instructions:

• If poison control tells you to induce vomiting:

o Approach the victim calmly and carefully.
o Give the person syrup of ipecac as instructed. General guidelines are:
o One tablespoon to children 1 to 6 years and two tablespoons to those older
than 6 years followed by a large glass of water or milk.
o Walk the person around to help the ipecac work faster and to keep him or
her awake.
o Give syrup of ipecac again in 20 minutes if the person has not yet
vomited.
o Touch the back of the person's throat with a finger or spoon, if syrup of
ipecac is not available.
o After vomiting begins, continue giving clear fluids until the vomited
material is clear.
o When the vomiting has stopped, give nothing by mouth for 2 hours to give
the stomach a chance to rest.

Note: If after taking two doses of syrup of ipecac the person has not vomited,
seek emergency care.

Is the person's personality suddenly hostile, violent and aggressive?

NOTE: Use caution. Protect yourself. Do not turn your back to the victim or move suddenly in
front of him or her. If you can, see that the victim does not harm you, himself or herself.
Remember, the victim is under the influence of a drug. Call the police to assist you if you cannot
handle the situation. Leave and find a safe place to stay until the police arrive.

Have you or someone else accidentally taken more than the prescribed dose of a prescription or

over-the-counter medicine? Call Doctor. If

doctor is not available, call Poison Control Center. Follow instructions given.

First Aid for Electric Shock

Electric shocks can result in:

• Slight shocking sensations

 • Muscle spasms
• Seizures
• Interrupted breathing
• Irregular heart beats
• Third degree burns (at the spots where the electricity enters and exits the body)
• Unconsciousness

People can be electrocuted when they touch high-tension wires that fall during a storm or
are struck by lightning. A bolt of lightning carries as many as 30 million volts, more than
250,000 times the voltage of ordinary household current. July is the most dangerous
month for lightning.

Take care when rescuing someone who has been electrocuted so you do not become a
victim as well.

Prevention
• Take a first aid course that covers electrical burns, electric shocks as well as
cardiopulmonary resuscitation (CPR).
• Install ground-fault circuit-interrupters (GFCIs) in wall outlets located in
bathroom, kitchens, basements, garages and outdoor boxes. These act as circuit
breakers. When an electrical appliance falls into the water, the current is instantly
cut off.
• Cover all electric sockets with plastic safety caps so children can't stick their
fingers or a metal object in the sockets.
• Replace worn cords and wiring.
• Never use an electrical appliance, like a radio or curling iron, near water. Only
buy hair dryers and curling irons that have built-in shock protectors.
• Never turn electrical switches on or off, or touch an electric appliance with wet
hands, while standing in water or sitting in a bathtub.
• Know the location of fuse boxes and circuit breakers in your home and place of
work.
• Remove the appropriate fuse or switch off the circuit breaker before doing
household electrical repairs. Turning off the appliance or light switch is not
enough.
• Pay attention to weather warnings. Find a safe place inside, away from windows
and doors. And, don't iron or use the telephone during a thunderstorm.
• Avoid tall trees, metal items, open water and high ground during a thunderstorm.
If you are caught outside, look for a ravine or other low-lying place and crawl in.
• Install a lightning rod on your house.

Questions to Ask
Has the person
received a shock
from a high
voltage wire?

Get Emergency Care and give first aid before emergency care:

• Do not try to remove the person from the wire and stay at least 20 feet
away. Make an emergency call to the power company right away. Be
able to state the location of the high voltage wire. Act fast. Call 911 or
the operator and state the problem quickly.
• Do not remove the victim from the electric source until the power
source has been shut off.
• Separate the person from the source of electric current using a dry
broom handle or other type of non-conducting material such as wood or
rubber. It may be easier to loop dry rope or cloth, throw it around a
person's arm or leg and drag the person away from the live wire.
• Or, dry your hands and put on dry gloves or use a dry cloth. Stand on
something dry like a stack of newspapers, a thick book or a rubber door
mat before removing the person from the source of the electric shock.
Unless you do this first, you may also get a shock when you touch the
person.
• Check for heartbeat and breathing. Feel for a pulse along the neck,
under the earlobe, on the chest or on the wrist. Watch the rise and fall
of the chest to see if the person is breathing. If there is no heartbeat
and no breathing, do CPR. (See "CPR"). Get Emergency Care. If there
is a heartbeat, but no breathing, immediately start rescue breathing.
(See "Airway and Breathing" .) Get Emergency Care.
• Check for burns and treat as third degree burns. (See "Burns".) Get
emergency care.

• If the person is breathing, put them in the recovery position.

Has the person

been struck by
lightning?

Check immediately to see if the person is breathing and has a heartbeat. (Note:
You will not get an electric shock from someone who has been struck by
lightning.)

• If the person has no heartbeat and is not breathing, do CPR. (See

"CPR".) Get Emergency Care.
• If the person has a heartbeat, but is not breathing, start rescue
breathing. (See "Airway and Breathing" on page 000.) Get Emergency
Care.

• When the person starts breathing again, elevate the feet and cover with
a blanket to prevent shock. Get Emergency Care.
Has the person
received a shock
from low-voltage
current?

Give first aid:

Switch off the current, if possible, by removing the fuse or switching off the circuit
breaker.
Do not touch the person who is in contact with electricity.
If you can't turn off the source of current, use a board, wooden stick, rope or other
non- insulating device to pull the victim away from the source of the electric current.
Make sure your hands and feet are dry and you are standing on a dry surface.
If it is safe for you to touch the victim:

• Check for heartbeat and breathing. Feel for a pulse along the neck, under the
earlobe, on the chest or on the wrist. Watch the rise and fall of the chest to see if
the person is breathing. If no heartbeat and no breathing, do CPR. (See "CPR".)
Get Emergency Care.
• If there is a heartbeat, but no breathing, immediately start rescue breathing. (See
"Airway and Breathing".) Get Emergency Care.
• Check for burns and treat as third degree burns. (See "Burns".) Get Emergency
Care.

Has the person received a mild shock and does his or her heart keep skipping beats?

After recovering from an electric shock, does the person have a fever or cough up sputum?
 Electric shock
Electric shock can cause unconsciousness or stop breathing and heartbeat.
Determine what has happened, then perform the appropriate procedure.

FIRST AID CANNOT BE PERFORMED UNTIL VICTIM HAS BEEN SEPARATED

FROM THE CURRENT.

What To Do
1. If casualty has been struck by
lightining, perform first aid immediately.
2. Otherwise, turn off the electricity,
make sure the victim is no longer in
contact with the electric current before
you attemt to treat him/her.
3. If you are unable to turn off the
current, stand on a dry insulating
material (such as a rubber mat or a
thick pile of newspaper).
4. Use a wooden broom, stool or chair
to push the victim's body away from the
electrical appliance or outlet.
5. If the victim is unconscious, perform
mouth-to-mouth ventilation (see
Absence of Breathing)
6. Get help.

First Aid for Eye Injuries

There are many causes of eye injuries. These include:

• Physical blow to the eye.

 • Harsh chemicals like lye, bleach and acids can burn eye tissue and permanently
damage the eyes.
• A grain of sand, fleck of paint, sliver of metal or splinter of wood can scratch the
cornea and induce infection.
• Excessive exposure to the sun, very low humidity or a strong wind may dry the
eyes so much they feel like sandpaper rubbing against your lids.
• Insect bites.

Prevention
• Wear protective plastic glasses during sports and other potentially dangerous
activities.
• Be careful when using harsh chemicals. Wear rubber gloves and protective
glasses. Don't rub your eyes if you've touched harsh chemicals. Wash your hands.
Turn your head away from chemical vapors so as not to let any get into your eyes.
• Don't allow a child to stick his or her head out of the window of a moving vehicle.
Sand, insects and other flying objects can strike the eye and irritate or damage the
cornea.
• Avoid alcohol, use a humidifier and limit exposure to smoke, dust and wind to
help prevent dry eyes.
• Use artificial tear drops with your doctor's okay.
• Never stare directly at the sun, especially during a solar eclipse.
• Wear sunglasses that block UV rays anytime you're in the sun.

All eye injuries should be taken seriously and all should be checked by a physician.

Questions to Ask

Is there a foreign body sticking into the eye?

Get Emergency Care and give first aid before

emergency care:

• Do not try to remove object.

• Do not press on, touch or rub eye(s).
• Wash hands with soap and water.
• Cover the affected eye with a paper cup or
other clean object that will not touch the eye
or the foreign object. Hold the paper cup in
place with tape without putting pressure on
the eye or the foreign object.
 • Gently cover unaffected eye as well with a
clean bandage and tape. This will help to
keep the affected eye from moving Note: If
you are alone, do not cover the unaffected
eye, but try to keep it from moving side to
side or up and down. Phone for or yell for
help.

Is there a severe blow to the eye, with or

without a broken bone of the face?

Get Emergency Care and give first aid before

emergency care:

• Close the eye.

• Put a cold compress over the injured area,
not directly on, the eye. You can use ice in a
plastic bag or wrapped in a cloth or a bag of
frozen vegetables.
• Do not use firm pressure.
• Keep the victim lying down with eyes closed,
if possible.

Note: If you are alone, phone for or yell for help.

Is there a cut to the eye or eyelid?

Get Emergency Care and give first aid before

emergency care:

• Loosely cover both eyes with a sterile cloth

or pad and gently tape in place.

• Keep the victim lying flat on his or her back

when seeking emergency care.
Note: If you are alone, phone for
help. Loosely cover only the
affected eye with a sterile cloth or
pad and try to keep your other eye
from moving side to side or up and
down.
Have harmful chemicals gotten into
the eye(s)?

FLUSH THE EYE(S) WITH WATER

IMMEDIATELY! Then Get Emergency Care.

How to flush the eyes with water:

• Have the victim lie down and turn his or

her head to the side with the affected eye
lower than the other eye.
• Hold the affected eye open with your
thumb and forefinger.
• Pour large quantities of warm, not hot,
water, from a pitcher or other clean
container, over the entire eye starting at
the inside corner and downward to the
outside corner. This lets the water drain
away from the body and keeps it from
getting in the other eye. Continue pouring
the water for at least 10 minutes, 30
minutes is better.
• Loosely bandage the eye with sterile cloth
and tape.
• Do not touch the eye.
• If both eyes are affected, pour water over
both eyes at the same time or quickly
alternate the above procedure from one
eye to another.
• Or, place the victim's face in a sink or
container filled with warm water. Have
him or her move his or her eyelids up and
down. Do this procedure on yourself if
you are the victim and are alone.

• You can also use industrial eye solutions,

if available.
Has a bee sting or insect bite to the
eye caused a severe allergic reaction
with these symptoms?

• Wheezing, shortness of breath

and breathing difficulties
• Severe swelling the eye and in
other parts of the body such
as the tongue, lips, throat
• Bluish lips and skin

• Collapse
 Give shot from and follow other instructions in
emergency insect kit, if available, and get
Emergency Care

Note: You can only get this kit with a doctor's

prescription.
Do any of these problems occur after
an eye injury?

• Blurred or double vision

• Blood in the pupil

Does eye pain last longer than 2

days?

First Aid for Non-Emergencies

To remove a foreign object in the eye:

1. Wash your hands.

2. Twist a piece of tissue, moisten the tip with tap water, not saliva, and gently try to
touch the speck with the tip. As you carefully pass the tissue over the speck, it
should cling to the tip.
3. If the foreign object is under the upper lid, look down and pull the upper lid away
from the eyeball by gently grabbing the eyelashes. Try to touch the debris with the
tip of a moistened tissue until it is caught on the tissue.
4. Do not rub the eye. And, never use tweezers or anything sharp to remove a
foreign object. Doing so can scratch the cornea.
5. Gently wash the eye with cool water.
6. Cover the eye with a patch and leave it on for at least 24 hours. This helps to
relieve the pain.

To treat a black eye from a minor injury:

 • Immediately put a cold compress over the injured area. This helps to slow the
bleeding under the skin and lessens swelling and discoloration.
• Take aspirin, ibuprofen or naproxen sodium for the pain and inflammation.
Acetaminophen will help the pain, but not the inflammation.

(Note: Do not give aspirin or any medication that has salicylates to anyone 19
years of age or younger unless a doctor tells you to.)

• Later, put a warm compress over the injured area.

• Seek medical attention if these measures do not help.

To ease the discomfort of dry eyes, try an over-the-counter artificial tear product such as
Ocu- Lube, Refresh or Liquifilm. Check the label. If there are no preservatives, keep the
solution refrigerated. Always wash your hands before putting drops in the eyes.

To ease the discomfort of an insect bite that has not caused a severe allergic reaction:

• Gently wash the eye(s) with warm water.

• Ask your doctor whether or not you should take an antihistamine and have him or
her recommend one.

First Aid for Fainting

Fainting is a brief loss of consciousness. Someone who faints may pass out for several
seconds or up to an hour.

There are many reasons people faint. Medical reasons include:

• Low blood sugar (hypoglycemia) which is common in early pregnancy.

• Anemia.
• Any condition in which there is a rapid loss of blood. This can be from internal
bleeding such as with a peptic ulcer, or a tubal pregnancy or ruptured ovarian cyst
in females.
• Heart and circulatory problems such as abnormal heart rhythm, heart attack or
stroke.
• Heat stroke or heat exhaustion
• Eating disorders such as anorexia, bulimia.
• Toxic shock syndrome.

Other things that can lead to feeling faint or fainting include:

• A sudden change in body position like standing up too quickly (postural

hypotension).
• Extreme pain.
• Any procedure in women that stretches the cervix such as having an IUD inserted,
especially in women who have never been pregnant.
• Sudden emotional stress or fright.
 • Anxiety
• Taking some prescription medicines. Examples are: some that lower high blood
pressure, tranquilizers, antidepressants, or even some over-the-counter medicines
when taken in excessive amounts.

Know, also, that the risk for fainting increases if you are in hot, humid weather, are in a
stuffy room or have consumed excessive amounts of alcohol.

Just before fainting, a person may:

• Feel a sense of dread

• Feel dizzy
• See spots before his or her eyes
• Have nausea

Here are some dos and don'ts to remember if someone is about to faint or faints:

Dos:

• Catch the person before he or she falls.

• Have the person lie down with the head below the level of the heart. Raise the
legs 8 to 12 inches. This promotes blood flow to the brain. If a victim who is
about to faint can lie down right away, he or she may not lose consciousness.
• Turn the victim's head to the side so the tongue doesn't fall back into the throat.
• Loosen any tight clothing.
• Apply moist towels to the person's face and neck.
• Keep the victim warm, especially if the surroundings are chilly.

Don'ts:

• Don't slap or shake anyone who's just fainted.

• Don't try to give the person anything to eat or drink, not even water, until they are
fully conscious.

Don't allow the person who's fainted to get up until the sense of physical weakness
passes. Then be watchful for a few minutes to be sure he or she doesn't faint again.

Questions to Ask

Is the person who fainted not breathing and

does he/she not have a pulse?
 Do CPR and Get Emergency Care. (See CPR.)

Are signs of a heart attack also present with

the fainting?

• Chest pain or pressure.

• Pain that spreads to the arm, neck or
jaw.
• Shortness of breath or difficulty
breathing.
• Nausea and/or vomiting.
• Sweating.
• Rapid, slow or irregular heartbeat.

• Anxiety.

Get Emergency Care and give first aid before

emergency care. (See "Chest Pain".)

Are signs of a stroke also present with the

fainting?

• Numbness or weakness in the face,

arm or leg.
• Temporary loss of vision or speech,
double vision.

• Sudden, severe headache.

Did the fainting come after an injury to the

head?

Get Emergency Care and give first aid before

emergency care. (See "Head Injuries".)

Do you have any of these with the fainting?

• Pelvic pain.

• Black stools.
Have you fainted more than once?

Do any of these apply?

• You are take high blood pressure

medicine.
• You started taking a new medicine.

• You increased the dose of a

medicine you take.

Self-Care/First Aid
Do these things when you feel faint:

• Sit down, bend forward and put your head between your knees, or
• Lie down and elevate both legs 8 to 12 inches.

If you faint easily:

• Get up slowly from bed or from a sitting position.

• Follow your doctor's advice to treat any medical condition which may lead to
fainting. Take medicines as prescribed, but let your doctor know about any side
effects so he/she can monitor your condition.
• Don't wear tight-fitting clothing around your neck.
• Avoid turning your head suddenly.
• Stay out of stuffy rooms and hot, humid places. If you can't, use a fan.
• Avoid activities that can put your life in danger if you have frequent fainting
spells. Examples include: Driving and climbing high places.
• Drink alcoholic beverages in moderation.

For women who are pregnant:

 • Get out of bed slowly.
• Keep crackers at your bedside and eat a few before getting out of bed. Try other
foods such as dry toast, graham crackers, bananas, etc.
• Eat small, frequent meals instead of a few large ones. Have a good food source of
protein, such as lean meat, low-fat cheese, milk, etc. with each meal. Avoid
sweets. Don't skip meals or go for a long time without eating.
• Don't sit for long periods of time.
• Keep your legs elevated when you sit.
• When you stand, as in a line, don't stand still. Move your legs to pump blood up
to your heart.
• Take vitamin and mineral supplements as your doctor prescribes.
• Never lay on your back during the 3rd trimester. It is best to lay on your left side.
If you can't, lay on your right side.

First Aid for Head Injuries

Any blow to the head can result in a head injury. Head injuries can cause damage to the:

• Scalp - such as a minor bump on the head or scalp wound that bleeds
• Skull - such as a skull fracture (a break or crack in the bone that surrounds the
brain)
• Spinal fluid in the brain
• Brain itself such as: a concussion, a contusion (the brain tissue is bruised), or a
hematoma (blood collects in an area of the brain from a broken blood vessel)

Blood from broken vessels may seep into the brain even though you may not be able to
see any bumps, cuts or bruises. The blood has nowhere to go because skull bones don't
expand. This puts pressure on the vital areas of the brain. This can cause serious
problems.

Bleeding in the brain often starts within the first 24 hours after a head injury and can last
for three days or longer. It is very important that you watch for signs and symptoms of a
serious head injury during the first 24 hours.

[Note: Also, suspect a neck injury when there is a blow to the head. (See "Neck and
Spine Injury".)]

Signs and Symptoms of head injuries that alert the need for medical care include:

• Loss of consciousness, confusion, drowsiness

• Inability to move any part of the body or weakness in an arm or leg
• Dent, bruise, cut or blood on the scalp
• Severe headache
• Stiff neck
• Vomiting
• Blood or fluid that comes from the mouth, nose or ear
• Loss of vision, blurred or double vision, pupils of unequal size
 • Convulsions

Note: Some of these signs can happen at the time of the injury. Other times they come
later.

Prevention
Ways to prevent head injuries:

• Wear a helmet when biking, roller-blading, horseback riding, riding in an all-

terrain vehicle or boxing. Insist that your child does, too.
• Use child safety seats and/or seatbelts in any car, van or truck.
• Teach your child:
o To stop and look both ways before crossing a street
o About the dangers of running into the street without first looking
o Not to run under the garage door as it closes
o Not to bang his or her head against something hard during a temper
tantrum
• Don't leave a child alone in a shopping cart. When available, use carts with
seatbelts or child safety seats.
• Don't leave a child alone on a high place like a sofa, changing table or bed. (Take
caution yourself when climbing ladders or walking on the roof, etc.)
• Install window locks or guards on windows on upper floors.
• Place a sturdy gate at the top of the stairs.
• Lock the door to the basement .
• Keep stairs free of clutter.

Questions to Ask

With head injury, does the victim have any

of these signs?

• No pulse
• No breathing

• Neck injury
Get Emergency Care and give first aid before
emergency care:

NOTE: IF YOU SUSPECT A NECK OR BACK

INJURY IN YOUR OR SOMEONE ELSE, YOU MUST
KEEP THE NECK AND/OR BACK PERFECTLY
STILL UNTIL AN EMERGENCY CREW ARRIVES. DO
NOT MOVE SOMEONE WITH A SUSPECTED NECK
 OR SPINE INJURY UNLESS THE PERSON MUST
BE MOVED BECAUSE HIS OR HER SAFETY IS IN
DANGER. ANY MOVEMENT OF THE HEAD, NECK
OR BACK COULD RESULT IN PARALYSIS OR
DEATH. IMMOBILIZE THE NECK BY HOLDING THE
HEAD, NECK AND SHOULDERS PERFECTLY
STILL. USE BOTH HANDS, ONE ON EACH SIDE OF
THE HEAD. (See "Neck/Spine Injury".)

• Check for breathing and pulse. If no breathing

and no pulse, do CPR.* (See "CPR".*)

• If no breathing, but there is a pulse, do rescue

breathing.(See "Airway and Breathing".)
* If you suspect a neck injury:
Do not tilt the head back or
move the head or neck when you
do the "Airway and Breathing"
part of CPR.

Instead, pull the lower jaw

(chin) forward to open the
airway.
Control bleeding. (See
"First Aid" in next question to
ask.)

Is the victim of a head injury

bleeding?

Get Emergency Care and give first aid before

emergency care:

• If bleeding from the scalp:

o Control bleeding by putting
pressure around the edges of the
wound, not on the wound. Make a
ring pad (shaped like a doughnut)
with a narrow bandage or narrow,
but long strips of cloth. Start with
one end of the narrow bandage and
wrap it around all four fingers on
one hand until you form a loop.
Leave a long strip of the bandage
material to weave in and around the
loop so it doesn't ravel. Use this
ring pad to apply pressure around
the edges of the wound.
o Don't wash the wound or apply an
 antiseptic or any other fluid to it.

• If blood or pink-colored fluid is coming from

the ear, nose or mouth, let it drain. Do not
try to stop its flow.

Is the head injury victim

unconscious longer than five
minutes?

Get Emergency Care and give first aid before

emergency care:

• Immobilize the victim's head and neck in the

position in which they were found. Place
rolled towels, articles of clothing, etc. on
both sides of the head and neck Tie and
wrap in place, but don't interfere with the
victim's breathing. If necessary, use your
hands, one on each side of the victim's
head to keep the head from moving. Roll
the victim on his or her side. This position
will allow any vomit to drain and keep the
airway open.
• Monitor for breathing and pulse. (See CPR.)
• Keep the victim's head and shoulders
slightly elevated if neck or spinal injury is
not suspected.
• Do not give the victim anything to drink or
eat.

• Do not elevate the victim's legs.

Is the head injury victim

unconscious less than 5 minutes?

See Doctor and give first aid before seeing doctor:

• Lift the victim's head and shoulders if neck

and spinal injury are not suspected, but
don't elevate the legs.

• Do not give victim anything to drink or eat.

Do any of these problems occur
within 48 hours of a head injury?

• Headache that lasts longer

than one or two days or
gets worse with time
• Inability to move arms or
 legs, weakness in limbs
• Blurred or double vision,
pupils of unequal size
• Slurred speech
• Convulsions
• Drowsiness or it is hard to
awaken the victim
• Memory loss, confusion,
disorientation

• Nausea, vomiting, dry

heaves

First Aid
• Apply an ice pack to the injured area to reduce swelling or bruising. Change it
every 15 to 20 minutes for an hour or two. Do not put ice directly on the skin. To
make an ice pack:
o Put ice cubes into a plastic bag with a little cold water and seal it. Wrap it
in a clean towel and apply to the bump or bruise.
o Cover a bag of frozen vegetables with a towel and place on the injured
area.
• Cover an open cut with gauze and first aid tape or a band-aid.
• Take only clear liquids until vomiting has stopped for six hours.
• Resume normal activities once you know there is no serious head injury.
• Take aspirin, acetaminophen, ibuprofen or naproxen sodium for pain.

[NOTE: Do not give aspirin or any medication that has salicylates to anyone 19 years of
age or younger unless a doctor tells you to.]

First Aid for Hyperventilation

Hyperventilation means breathing faster than normal. Hyperventilating can be scary for
any child or adult. When you hyperventilate, your heart pounds and it feels like you can't
get enough air. Arms, legs and mouth tingle and may feel numb because you are taking in
too much oxygen and not giving off enough carbon dioxide. Other symptoms and signs
include visual changes, a feeling of impending doom and sometimes loss of
consciousness.
The symptoms usually last 20 to 30 minutes, though it may seem like hours to anyone
having them. Though scary, hyperventilation is not usually dangerous.

Causes of Hyperventilation

• Anxiety (the most common cause)

• Severe stomach pains
• Heart or lung disease
• Extensive physical injuries
• Panic attacks
• Disorders of the central nervous system

Prevention
Probably the best way to prevent hyperventilation is to avoid situations and activities that
cause anxiety. To help yourself or your child avoid hyperventilating:

• Learn meditation and practice it every day. Meditation is a form of mental

relaxation. It relieves stress as you focus on a single word or visual image.
• Practice relaxing your muscles.
o Lie down in a quiet room.
o Close your eyes and take "deep" breaths.
o Start with your feet. Tense the muscles in one foot, hold for 10 seconds
and relax them. Repeat with the other foot.
o Next, tense and relax the muscle in your legs, back, stomach, hands, arms,
shoulders, neck and face.
• Talk to friends, family or even a counselor to help relieve anxiety.
• Keep a journal to help you focus on your problems and find solutions you can live
with.
• Exercise on a regular basis. People in good physical shape are less likely to
buckle under stress.
• Reduce caffeine. Drink less coffee, tea and colas. Eat less chocolate.

Questions to Ask

Are you also having chest pain and/or pain that

spreads to the arm, neck or jaw?

Get Emergency Care and give first aid before

emergency care. (See "First Aid for Heart Attack".)
Do you hyperventilate often and/or have you
had four or more panic attacks in four weeks
time?

Self-Care/First Aid
Breathing into a paper bag increases the amount of carbon dioxide in the blood and
relieves the symptoms. Follow these steps:

1. Loosely cover your nose and mouth with a small paper bag.
2. Breathe slowly into the bag and rebreathe the air in the bag about 10 times.
3. Set the bag aside and breathe normally for a couple of minutes.
4. Repeat steps 2 and 3 until the symptoms lessen or go away.
5. Try to breathe slowly. Focus on taking one breath every 5 seconds.

[Note: If you continue to hyperventilate after using self-care/first aid, call your doctor.]

First Aid for Nosebleeds

Most nosebleeds are from broken blood vessels just inside the front of the nose. Causes
for these minor nosebleeds include:

• Frequent or hard nose blowings or coughs

• Nose picking
• Common cold
• Allergies
• Very cold or very dry air
• A punch or blow to the nose

Blood usually comes out of just one nostril. Medical care is seldom needed for this kind
of nosebleed. Self-care/first aid can help stop the bleeding. (See below.) Often the
bleeding stops on its own.

Medical care is needed, though, when there is a lot of bleeding from the back of the nose
and the blood goes down the back of the throat or backward into the mouth. This type is
called a posterior nosebleed and can be caused by:
 • Atherosclerosis (hardening) of the nasal passages
• High blood pressure
• Taking blood-thinning medicines
• Bleeding disorders like hemophilia
• A tumor in the nose

Older persons are more likely to get this type of nosebleed.

Questions to Ask

Is the nosebleed from an injury to the nose and is there

also a head, neck or spinal injury?

Get Emergency Care and give first aid

before emergency care for Head Injury or
Neck/Spine Injury.

Is the nosebleed from an injury without a head, neck or

spine injury, but is the victim unconscious?

Get Emergency Care and give first aid

before emergency care:

• Put the victim on his or her side.

This will help prevent choking on
blood and/or inhaling bloodinto the
lungs.
• Bend the victim's head slightly
forward to help blood come out the
front of the nose.
• Pinch the nostrils shut using your
thumb and forefinger. Apply steady
pressure for 10 minutes.

(Note: Monitor for breathing. Since

 the nostrils are pinched shut, the
victim should be breathing through
his or her mouth. If not breathing,
see Airway and Breathing on page
000.)

• If bleeding has not stopped, apply

pressure for another 10 minutes.
(Also, see "Unconsciousness".)

Does the nosebleed?

• Come from a nose injury without a head, neck

or spine injury or unconsciousness?

• Happen after taking newly prescribed

medicine?

Give first aid and See Doctor.

First Aid:

• Stay calm.
• Breathe through the mouth, not
the nose.
• Sit up and bend the head slightly
forward.
• Pinch both nostrils shut using a
thumb and forefinger. Apply
steady pressure for 10 minutes.
• Spit out any blood that collects in
the mouth.
• Check to see if an object is stuck
in a nostril. If so, press on the
opposite nostril and sneeze or
blow the nose gently to expel the
object. Sniff pepper, if available,
to help induce a sneeze. Don't
push an object in further or use
tweezers or other sharp objects to
remove an object stuck in a
nostril.
• If bleeding has not stopped after
10 minutes of applied pressure,
 pinch the nostrils for 10 more
minutes. Keep breathing through
the mouth.

• At the same time, apply cold

compresses (such as ice in a soft
cloth) to the area around the nose.

Do nosebleeds recur often and/or are they

becoming more frequent?

Self-Care/First Aid
The following procedure is recommended by the American Academy of Otolaryngology--
Head and Neck Surgery for minor nosebleeds:

1. Sit with your head leaning forward.

2. Pinch the nostrils shut, using your thumb and forefinger in such a way that the
nasal septum (the nose's midsection) is being gently squeezed.
3. Hold for 15 uninterrupted minutes, breathing through your mouth.
4. At the same time, apply cold compresses (such as ice in a soft cloth) to the area
around the nose.
5. For the next 24 hours, make sure your head is elevated above the level of your
heart.
6. Also, wait 24 hours before blowing your nose, lifting heavy objects, or exercising
strenuously.

Other self-care tips after the nose has stopped bleeding:

• Do things to keep the nostrils most such as:

o Use a cool-mist vaporizer or humidifier in your bedroom, especially in the
winter.
o Put a dab of petroleum jelly inside the nostril.
• Don't pick or rub the nose.

Don't smoke, take aspirin or drink very hot or alcoholic beverages for one week.