First aid is the immediate care given to a person who has been injured or suddenly taken ill. It includes self-help and home care if medical assistance is not available or is delayed. It also includes well-selected words of encouragement, evidence of willingness to help, and promotion of confidence by demonstration of competence. The person giving first aid, the first-alder, deals with the whole situation, the injured person, and the injury or illness. He knows what not to do as well as what to do; he avoids errors that are frequently made by untrained persons through well-meant but misguided efforts.
He knows, too, that his first aid knowledge and skill can mean the difference between life and death, between temporary and permanent disability, and between rapid recovery and long hospitalization. The following is advice for how to handle common emergency medical conditions. This section does not contain all the signs or symptoms of medical emergencies, and the advice is not intended to be a substitute for consulting with a medical professional. If you think you are experiencing a medical emergency, seek immediate medical attention.
Bug Bites and Stings
Bug bites and stings are, for the most part, no more unpleasant than a homework assignment — kind of annoying but basically harmless. Occasionally, though, an insect bite or sting can cause serious problems. You should know when a simple ice pack can bring some relief or when a visit to the local hospital is in order. Before you find out how to handle your unwelcome guests, come meet the critters who want a little piece of you.
Bee and Wasp Stings
For most people, being stung by a bee is a minor nuisance. The affected area may get a little red or swollen and it may be slightly painful, but that’s about it. Bee and wasp stings can cause real problems for people who are allergic, though. A person can get a localized allergic reaction (swelling, heat, or itching of the skin around the bite area) or a systemic allergic reaction, meaning that the poison causes a reaction throughout a person’s body, not just around the bite area. In the case of a systemic reaction, the person may break out in hives. Other symptoms include wheezing; shortness of breath; rapid heartbeat; faintness; and swelling of the face, lips, or tongue. If a person has these symptoms, it’s important to get help immediately. It hardly ever happens, but severe allergic reactions to bee stings can be fatal if the person doesn’t get medical help.
Flea and Tick Bites
Fleas can be lumped into the irritating-but-not-serious category as well. They are often found on Fido or Fluffy, but they can also be attracted to you. Depending on where you live, ticks could ruin a good camping trip. One variety known as deer ticks is known to carry Lyme disease, so the trick is to get them off your body fast. In the United States, the northeastern and upper midwestern states are most affected by the threat of disease from ticks, but some cases have been found in the Pacific Northwest and in northern and southern Europe. Ticks can carry other diseases, too, such as Rocky Mountain spotted fever. Ticks are usually found in heavily wooded areas.
Mosquitoes hang out anywhere people, food, or pools of still water are found. Generally they aren’t anything to worry about: They bite, you itch, end of story. However, there is some concern about West Nile virus, which is transmitted to humans by mosquitoes. The good news is that healthy kids, teens, and adults under 50 are at low risk of catching West Nile virus. And although the virus can put people at risk for developing a serious infection called encephalitis, in reality this hardly ever happens. Less than 1% of the people who are infected with West Nile virus become seriously ill.
Most spider bites are minor, although they can cause mild swelling or allergic reactions. But a small percentage of teens become ill after being bitten by brown recluse or black widow spiders. Although not everyone will have a reaction, you should see a doctor and get treatment quickly if you know you’ve been bitten by one of these spiders. The brown recluse is brown (big surprise) with a small shape of a violin in a darker brown area on the back of its head. These spiders are small but tough: a half-inch body (about 1 centimeter) with legs stretching another inch (3 centimeters) or even more. They are found mostly in midwestern and southern parts of the United States, and they like to hide in dark, quiet places like attics or garages. When humans enter their space unexpectedly, they bite out of fear.
The bites usually don’t hurt at first — and most people don’t even know that they’ve been bitten. Brown recluse bites don’t cause problems for most people. But in a small percentage of cases, they can lead to skin damage and scarring. The few people who do have a reaction may notice swelling and skin changes 4 to 8 hours after the bite. The swelling may form a blister. If this happens, a dark, scabby material called eschar (pronounced: es-kar) may cover the blister within a week after the bite. Most brown recluse bites get better on their own — but it can take a couple of months. So it’s always a good idea to see a doctor for proper treatment.
The black widow is found in southern Canada, throughout the United States, and in Mexico. Easily identified by its shiny coal-black body and orange hourglass shape on its underbelly, it’s a similar size to the brown recluse spider and it should be treated as carefully. Most often, people who have been bitten by a black widow don’t even know it until they feel the symptoms. But the good news is that there are lots of warning signs that give you time to act before things get too serious. The venom (poison) in a black widow bite causes a systemic reaction.
Someone who has been bitten by a black widow may get painful cramps within a few hours. These cramps usually make a person feel achy all over, and can spread to include abdominal cramping, which may be severe. The person may also have nausea, vomiting, chills, fever, and headache. If you show any of these symptoms, get to the hospital immediately. Spider bites can sound scary, but it’s actually extremely rare that a person will die from one. Fewer than 1% of the people who report being bitten by a black widow die, and even fewer people die from brown recluse bites. Young children are most at risk.
What to Do
For most varieties of bug bites and stings, antihistamines will help to stop itching and lessen swelling, and acetaminophen can help relieve any pain. Ibuprofen can help reduce swelling while relieving some pain. Some people use a topical 1% hydrocortisone cream (sold in pharmacies without a prescription) to alleviate itching. Say goodbye to ticks by removing them with a pair of tweezers as soon as you notice them. Ticks removed within 24 to 48 hours are less likely to transmit diseases like Lyme disease. Be sure to pull a tick out from the head, which is closest to your skin, to ensure that you remove the whole thing. Have someone help you get the hard-to-reach places of your body, and pull each one out very slowly. Clean the site with soap and water, and treat with an antiseptic or antibiotic cream to avoid infection.
Do not try to burn a tick off, as the flame only agitates the insect, causing it to burrow deeper into your skin. When you’ve pulled the tick out, put it in a jar of rubbing alcohol to kill it. (Your doctor may also want you to save the tick so that its type can be identified.) After a bee sting, if you can see the stinger, remove it as quickly as possible to lessen your exposure to the venom. Wash the sting or bite with soap and water and keep it clean. Apply some calamine lotion or a paste of water and baking soda (unless the sting is near your eyes). Put an ice pack on the affected area for 15 minutes every few hours or so, or cover the sting with a cold compress.
Apply an antibiotic cream to prevent further infection. Using a 1% hydrocortisone cream can reduce redness, swelling, itching, and pain. If you are allergic to bee stings, see your doctor for a prescription for an epinephrine kit. If used immediately after a bee attack, this shot will stop the allergic reaction before it starts, which could save your life. An epinephrine kit is easy to use — your doctor or pharmacist will explain how. If you’re severely allergic to bug bites and stings, talk to a doctor about getting venom immunotherapy (shots) from an allergist.
Serious Stuff — Seek Medical Help
How do you know when a sting or bite is too much for you to handle alone? If you have any symptoms of a systemic allergic reaction, get to the emergency department right away. These symptoms include:
•shortness of breath
•redness or hives over most of your body
•swelling of the face, lips, or tongue
•feeling like your throat is closing up
•muscle aches or cramps
In the case of a black widow spider bite, or if you have any doubt about what kind of spider bit you and you’re feeling sick and have cramps, get to the emergency department immediately. (Take the spider with you if you were able to kill it safely.) If bites or stings get infected or if an open sore or blister refuses to heal, make an appointment with your family doctor.
Preventing Bites and Stings
Human beings don’t have to sit around and wait to be a sample on the insect buffet. Here are some steps we can take to protect ourselves: •Prevent flea infestations by treating your house (including all carpets, furniture, and pets) regularly during the warmer months. Frequent vacuuming can also help. •Avoid mosquitoes by staying away from areas where mosquitoes breed, such as still pools or ponds, during hot weather. Remove standing water from birdbaths, buckets, etc.; try to stay inside when mosquitoes are most active (dawn and dusk); and wear insect repellent when you are outside.
•When in tick country, take turns with friends and family checking one another for ticks every few hours. Remove any you find immediately. The most important places to check are behind your ears, on your scalp, on the back of your neck, in your armpits, in your groin area, and behind your knees. If you have a pet with you, check your pet, too! Use tick products on pets to prevent them from being bitten. •Use insect repellent when spending time outdoors camping, hiking, or on the beach. Repellents that contain 10% to 30% DEET (N,N-diethyl-meta-toluamide) are approved for mosquitoes, ticks, and some other bugs.
Repellents that contain picaridin (KBR 3023) or oil of lemon eucalyptus (p-menthane 3,8-diol or PMD) are effective against mosquitoes. Follow the instructions carefully and don’t overuse the product — using more than you need won’t give you any extra protection. Reapply insect repellent after swimming or if you’ve been sweating for a long time. •When you are in wooded areas, tuck your clothes in and try to keep as covered up as possible. Tuck pants into socks, shirts into pants, and sleeves into gloves. Wear shoes and socks when walking on grass, even it’s just for a minute. Bees and wasps can sting your unprotected feet. •Wear gloves if you’re gardening.
•Don’t disturb bee or wasp nests. •Don’t swat at buzzing insects — they will sting if they feel threatened. •Be aware that spiders might be hiding in undisturbed piles of wood, seldom-opened boxes, or corners behind furniture, and proceed with caution.
Cuts, Scratches, and Scrapes
You wipe out on your skateboard. The knife you’re using slices your finger instead of the tomato. Your new puppy doesn’t know how sharp his baby teeth are. You might think a cut or scrape is no big deal, but any time the skin gets broken, there’s a risk of infection. So it helps to understand how to care for cuts and scrapes at home — and know when you need to see a doctor.
What to Do
Many small cuts, scrapes, or abrasions will heal well without medical care. Here’s what to do if the injury isn’t serious: •Stop bleeding by pressing a clean, soft cloth against the wound for a few minutes. If the wound is bleeding a lot, you’ll need to hold pressure for longer (sometimes up to 15 minutes). If the wound is small, the bleeding should stop in a few minutes as the blood’s clotting factors do their work to seal the wound. •As you keep the pressure on and the wound, avoid the urge to peek. Lifting the bandage may start the bleeding again.
•Clean the wound. Run warm water over the cut for 5 minutes. Then use soap to gently wash the skin around the cut or scrape thoroughly. If there’s dirt or debris in the wound (like gravel from a scrape), remove it if you can — a soft, damp cloth can help. Cleaning the wound helps get infection-causing bacteria out of the injured area. If you can’t get all the dirt out, call your doctor’s office. •If you want, put a light layer of an antibiotic ointment around the cut to kill germs. Make sure you’re not allergic to the medications in the ointment. •Dry the area lightly and cover it with gauze or other type of bandage. A bandage helps prevent germs. If the bandage gets wet or dirty, change it right away. •Each day, take off the bandage and gently wash the injury. Watch for signs of infection. •To prevent infection and reduce scarring, don’t pick at the scab or skin around the wound.
When to Get Help
If blood is spurting out of a cut or it won’t stop bleeding, get a parent or call your doctor right away. Cover the wound with a sterile bandage or clean cloth. If the blood soaks through, don’t remove the first bandage — put a new covering on top of it. Raising the injured body part above your head (or holding it up as high as you can) may help slow the bleeding. If a wound is very long or deep, or if its edges are far apart, a doctor will need to close it with stitches. A doctor or nurse will numb your skin with an anesthetic shot (sometimes they put an anesthetic cream on the skin first to numb the area).
If you hate the idea of a shot, it can help to keep in mind that getting multiple stitches feels like getting multiple shots, so you’re better off feeling only one! If you get stitches, you’ll probably need to go back to the doctor in 5 to 10 days to get them taken out (some stitches dissolve on their own). To remove stitches, a doctor or nurse will snip the thread with scissors and gently pull out the threads. It feels ticklish and a little funny, but usually doesn’t hurt. Doctors sometimes close small, straight cuts on certain parts of the body with medical glue or steri-strips (thin pieces of tape). Glue and steri-strips will dissolve or fall off on their own. Getting a cut usually means that there will be some scarring. If your cut needs to be stitched or glued but you don’t see a doctor in time, your scar may be more noticeable.
Let a parent, coach, or other adult know if you get injured. You’ll especially want to tell someone if you cut yourself on something dirty or rusty, if you are bleeding, or if you get bitten or scratched (by an animal or a person!). Bites that break the skin need medical care. Germs from animal or human saliva can get into the wound, and you will usually need antibiotics to prevent infection. Your doctor or nurse will also want to make sure the animal didn’t have rabies. Certain cuts or bites could lead to a tetanus infection if your tetanus shots are not up to date. You (or your mom or dad) will need to check your medical records to be sure that you have had a tetanus shot recently. If you haven’t, you will probably need to get one when the cut is repaired.
Signs of Infection
Sometimes, a cut, scratch, or scrape starts out as no big deal, but then gets infected. A skin infection happens when there are too many germs for your body’s white blood cells to handle. If you notice any of these signs of infection, call your doctor right away: •expanding redness around the wound
•yellow or greenish-colored pus or cloudy wound drainage
•red streaking spreading from the wound
•increased swelling, tenderness, or pain around the wound
The doctor will prescribe antibiotics to help your body fight off the infection. Most of the time small cuts, scratches, and abrasions go away on their own, thanks to your body’s amazing ability to heal itself. If a cut looks serious or infected, though, see a doctor.
Sitting in science class one afternoon, you feel your nose begin to run. As you wonder if you’re catching a cold, you swipe your nose with a tissue and are shocked to see blood! You have a nosebleed, and if you’re like most teens, you may be embarrassed. You might hope no one will notice, and you might be a little scared, too. Although nosebleeds are usually harmless and easily controlled, it may look like a quart of blood is coming from your nose! Try not to worry — nosebleeds are almost always easy to stop.
Stopping the Gush
Try these simple tips to stop your nosebleed:
•Get some tissues or a damp cloth to catch the blood.
•Sit or stand so your head is above your heart.
•Tilt your head forward and pinch the soft part of your nose (the nostrils) together just below the bony center part of your nose. Applying pressure helps stop the blood flow and the nosebleed will usually stop with 10 minutes of steady pressure — don’t keep checking to see if the bleeding has stopped. If you get a nosebleed, don’t blow your nose. Doing so can cause additional nosebleeds. Also, don’t tilt your head back. This common practice will cause blood to run into your throat.
This can make you cough or choke, and if you swallow a lot of blood, you might begin vomiting. If you’ve tried the steps above twice and the bleeding continues after the second attempt, you’ll need to see your school nurse or a doctor. Once you’ve stopped the initial nosebleed, don’t lift heavy objects or do other activities that cause you to strain, and try not to blow your nose for 24 hours. Now that your nosebleed is over, let’s take a look at what a nosebleed is and what can cause it.
Different Kinds of Nosebleeds
The most common kind of nosebleed is an anterior nosebleed, which comes from the front of the nose. Capillaries, or very small blood vessels, that are inside the nose may break and bleed, causing this type of nosebleed. Another kind of nosebleed is a posterior nosebleed, which comes from the deepest part of the nose. Blood from a posterior nosebleed flows down the back of the throat even if the person is sitting or standing. Teens rarely have posterior nosebleeds, which occur most often in older people, people who have high blood pressure, and people who have had nose or face injuries.
Causes and Remedies
The most common cause of anterior nosebleeds is dry air. A dry climate or heated indoor air irritates and dries out nasal membranes, causing crusts that may itch and then bleed when scratched or picked. Colds may also irritate the lining of the nose. Bleeding may occur after repeated blowing. When you combine a cold with dry winter air, you have the perfect formula for nosebleeds. Allergies can also cause problems, and a doctor may prescribe medications such as antihistamines or decongestants to control an itchy, runny, or stuffy nose. This can also dry out the nasal membranes and contribute to nosebleeds. An injury or blow to the nose may cause bleeding and isn’t usually cause for alarm. If you ever have a facial injury, use the tips outlined earlier to stop the nosebleed.
If you can’t stop the bleeding after 10 minutes or you are concerned about other facial injuries, see a medical professional right away. Nosebleeds are rarely cause for alarm, but frequent nosebleeds might indicate a more serious problem. If you get nosebleeds more than once a week, you should see your doctor. Most cases of frequent nosebleeds are easily treated. Sometimes tiny blood vessels inside the nose become irritated and don’t heal. This happens more frequently in teens who have ongoing allergies or frequent colds.
A doctor may have a solution if you have this problem. If your doctor rules out a sinus infection, allergies, or irritated blood vessels, he or she may order other tests to see why you’re getting frequent nosebleeds. Rarely, a bleeding disorder or abnormally formed blood vessels could be a possibility. Cocaine (or other drugs that are snorted through the nose) can also cause nosebleeds. If you suspect a friend is using cocaine, try talking about it and get help from a trusted adult.
•Whenever you blow your nose (especially when you have a cold), you should blow gently into a soft tissue. Don’t blow forcefully or pick your nose. •Your doctor may recommend a humidifier to moisten your indoor air. You can also prevent your nasal passages from becoming too dry in winter months by using lubricants such as an antibiotic ointment before going to bed at night. Apply a pea-sized dab to a cotton swab and gently rub just the cotton tip up inside each nostril, especially on the middle part of the nose (called the nasal septum). Some doctors prescribe saline (salt water) drops for the same purpose. •Wear protective athletic equipment when participating in sports that could cause injury to the nose. An occasional nosebleed may make you worry, but there’s no need to panic — now you know what to do!
You probably don’t get as many splinters as you did when you were a kid. But they can still zap you when you least expect it. It might be tempting to ignore a splinter, especially if it doesn’t hurt. But a splinter can become infected, so you should try to get it out as soon as you notice it. Removing a splinter right away means the skin won’t have time to heal over so the splinter will pull out more easily.
Here’s how to remove a splinter:
1.Clean the area. Wash your hands, then wash the area surrounding the splinter with soap and warm tap water. 2.Sterilize a needle and some tweezers. The best way to do this is to immerse the ends of the needle and tweezers in boiling water or run boiling water over them. Wipe them off with a clean cotton pad, cotton ball, or alcohol pad after boiling. 3.Gently pull out the splinter. If the end of the splinter is still poking out of your skin, you should be able to remove it using just tweezers.
Be sure the tweezers have a firm grip on the end of the splinter and pull slowly and gently at the same angle as the splinter went into the skin. (Pulling too quickly or at the wrong angle can break the splinter and make it harder to remove the part that remains in your skin.) If there’s no end to grab, use the sterilized needle to gently scrape the skin away from the splinter until there’s enough of an end to grab with the tweezers. 4.Clean the wound. Check to be sure all pieces of the splinter came out. Then, wash the area with soap and warm water once more. (You can also dab it with an alcohol pad or rubbing alcohol if you wish.) If the opening left by the splinter is noticeable, it’s a good idea to cover it with a bandage to prevent infection.
When to Call the Doctor
Usually, splinters can be handled at home. But in some cases, you might have to visit the doctor. See a doctor if:
•The splinter seems to be too deep.
•The wound is bleeding a lot.
•It can’t be removed.
•The splinter seems infected (red, puffy, warm to the touch, or containing pus).
Not all splinters can be prevented. But you can protect yourself from getting them in the first place: •Wear shoes. It makes sense to wear sandals or flip-flops instead of barefooting it over a rough wood boardwalk or deck. But it’s also a good idea to wear water shoes to protect your feet when diving off a dock or wading in water. Of course wood’s not the only thing that splinters. If you drop a glass or bottle (or someone with you does), grab some slippers or shoes until the floor’s been swept. •Work smart. If you’re working with glass, metal, or wood (such as chopping or sawing tree limbs), eye goggles are a must for protecting your vision. It’s also smart to wear gloves to protect your hands from any flying debris. Also, wear gloves when gardening to protect your hands from thorns.
In many emergency situations, timing could be the key to saving someone’s life. But it is extremely important to know what to do in these situations, and to do it quickly. 1)Take deep breaths. Your brain can’t function properly without oxygen. Take long, deep breaths, not short ones. If you begin panting, you will increase the rush of adrenaline. Continue taking deep breaths until you agree to yourself that you can take care of the situation. If you don’t think you can handle it, even after one minute of deep breathing, get help. If you don’t think you can handle the situation, there’s no point in trying, because you’ll probably do something wrong. Call your local emergency number if you aren’t calm enough to take care of the situation after one minute of deep breathing. Don’t continue deep breaths to calm down after one minute, because waiting too long could affect the situation dramatically. In these situations, it’s either you can do it, or you can’t.
2)Figure out what you need to do, and do it. Make sure you do it right while still being timely. Run in your head each choice you make, and determine the affects of it. Be fast. Don’t rush things to the point you can’t remain calm, but don’t take your time either. Rushing can lead to pointless decisions that will only waste more time. Before going through with any choice, make sure it’s worth the while. And as soon as you start, go through with it.
3)Call your local emergency number such as 10111, 112 or 911.] After you’ve gone through your choice, call your local emergency number immediately. Your choice could help stall the situation, but no matter how good you think it was, call your emergency number. If you’re with other people in the situation, while you’re making your decision, yell at someone to call the emergency number. Don’t yell generally, yell at one specific person, preferably the first one you see. If you yell at one person, they’ll do it. If you yell at everyone, they will all assume someone else will do it.
4)Follow the instructions of the emergency dispatcher on the phone and don’t hang up. Help any injured people and imagine what you would need in their situation. If there are multiple injured people, help the most critically injured first. If you need a cloth or water ask a bystander to get it. Don’t leave someone unattended unless absolutely necessary.
5)Relax. Wait for the emergency specialists to come. There’s basically nothing you can do after you’ve made your choice and have called the emergency number. Don’t go completely numb, but don’t freak out either. Continue taking deep breaths, and constantly remind yourself that you’ve done all you can. Don’t feel you need to make another decision to make things right, because the specialists will know exactly what to do once they arrive.
Courtney from Study Moose
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