What lifesaving acts must one know how to do?

What are ABCs?
ABCs are: the Airway; the Breathing; and the Circulation. The first things to check and to constantly ensure to keep the patient alive. If nothing else is done, these essentials are the most likely to save life.

What about Airway?
An open path or tube for air to actually reach the lungs when the patient breathes or is helped to breathe is essential. If someone chokes on food or vomit, the airway can be clogged so that air cannot flow and the lungs can be damaged by inhaled fluids. When a person is unconscious (cannot be easily woken), the body relaxes and slumps more than usual. The tongue, especially, then being about four ounces of floppy meat can sag making it difficult for air to fight its way through: the person may be snoring or even not moving any air at all.

Getting the tongue out of the way is done by lifting the neck and tilting the head backwards, and pulling the chin or jaw upwards, so that the front of the neck is stretched tight. This pulls on the attachments of the tongue and other tissues and opens the airway. If the patient is capable of breathing on his own, he can do so now; he can then be turned on his side with the head supported in this position so that any drool or vomit can drain. If he does not move his own air, one can now breathe for him with mouth-to-mouth or mouth-to-nose artificial respiration.

What about Breathing?
If he breathes fully and sufficiently on his own with ease and seems OK, ---watch him and keep him that way.

If he is awake, seems to be choking and can�t talk, and clutches his throat in a universal sign of distress, ---he may need to have a Heimlich maneuver done until he can move air or you can breathe air for him into his lungs.

If he does not breathe on his own or his efforts are feeble, he will need to have you assist or replace his breathing with your own. (You may use a CPR pocket mask or face shield, or cover his mouth and nose with a handkerchief or layer of T-shirt. With the airway stretched open, and having taken a full breath, place your mouth around his mouth or nose with a good seal, and blow in smoothly until the chest makes a nice easy rise from your breath; stop; turn away and watch the chest smoothly fall; and repeat twelve times a minute for adults (every 5"), twenty times a minute for children (every 3"), and thirty times a minute (every 2") for babies. Have someone call for help.

What about Circulation?
If breathing is OK, or is being done for him, check the pulse to make sure the heart is beating and blood is being pumped. If you check carefully, and can�t feel a pulse, then chest compressions will need to be added to the mouth-to-mouth to provide CPR -- Cardio-Pulmonary-Resuscitation. Activate 911.

What about Bleeding?
The most effective way to stop bleeding is to press hard right where the blood is coming from and don�t let go. Think of the story of "the little Dutch boy with his finger in the dike" who saved his whole country from being flooded by the North Sea by plugging the leak. It will also help if you can also have the victim lie down, and raise the bleeding part well above heart level.

What about getting help?
Emergency help can usually be gotten by calling 911. No coin is needed. Cellular phones in California have 911 calls answered, at present, by the Highway Patrol rather than a local operator: you will need to know how to clearly describe your address or location if using a cell-phone.! Some locations such as the UC Campus may have special reporting numbers to call. Major public locations and some streets may have fire-alarm boxes or emergency telephones. Learn the special methods for any location that you frequent.

What about broken bones and other injuries?
Let the victim keep himself in any position in which he is comfortable. Injured arms can be tied to the chest and legs can be tied to the other one for extra support with a little padding in-between. The aim is to provide comfort and prevent further injury by keeping the broken bone ends and the joints above and below from moving.

If the accident involved massive force, move the person as little as is necessary to save life, until rescuers arrive. Open wounds and burns can be covered to keep them clean.

How does one know if the bone is broken?
If the break is not obvious by deformity or angulation, the key finding is "point tenderness" along the path of the bone, e.g., it hurts to touch and pressure where the injury is. If the part hurts to move or bear weight, it should be rested and protected.

What about muscle strains and joint sprains?
These stretching-tearing injuries to "soft tissues" of muscle and gristle can be due to sudden excessive force beyond the usual range of motion. They can be taken care of with "R-I-C-E":

What about Overdoses and Poisonings?
If unconscious, do only the ABCs and get help. Call the SF Bay Area Regional Poison Control Center: 1 (800) 523-2222 for specific help and advice, if at all uncertain of what to do.

When does a cut need stitches?

What about Tetanus?
Tetanus is a horrible and deadly disease that is completely preventable and has been designated "the inexcusable disease." Immunization should be every ten years for your entire life, and a booster vaccination may be given anytime there has been a risky wound or status is uncertain.

The germ is "everywhere" and in wounds where there is little air, gives off a toxin that attacks the spinal nervous system so that body-bending convulsions occur, in which one is perfectly awake, until one stops breathing or the back is broken. It is very difficult to treat.

What First Aid Supplies are needed?
Mainly knowledge and willingness. Bandages and splints can be improvised. A CPR pocket mask or face shield, and vinyl or latex gloves are desirable. While neckties, Kotex�, and panty-hose can all be used to give first aid, some sterile dressings and bandages are good to have. Clean non-fuzzy cloth can be substituted.

Disorders of Consciousness
Regardless of the cause of unconsciousness, the first aider has the job of protecting the patient from the dangers of being unconscious.

In healthy young adults, the commonest causes of unconsciousness are self-induced intoxication with alcohol, narcotics, and sedatives; simple faints; epileptic convulsions; and forceful injury to the brain.

Simple faints usually occur through several mechanisms when the heart�s output decreases to less than that needed to perfuse the brain with blood carrying oxygen and nutrients. Classic examples are sudden intense physical discomfort or emotional distress putting the brakes on the heartrate and the blood vessels dilating so that blood pressure drops. When the victim lies down (or falls), he recovers naturally as it takes less pressure to perfuse a person lying down than one who is upright.

Seizures are the convulsions that occur in epilepsy and other malfunctions of the brain�s electrical circuitry; ---not seizure and possession by demons . "He doesn�t act right" or interact with other people, and possibly uncontrolled stiffness and shaking of major muscle groups of the body. It�s hard to breathe because of the tightness of the muscle spasms so his face may turn first pale then dark. He might be hurt in falling or hitting things. The teeth and jaw might be clamped shut bite injuries happen to the victim and to his rescuer. He might pee, poop, or puke uncontrollably. As the seizure ends, the patient "sleeps" for a while, then wakens, perhaps gradually, usually without memory for the event.

Head Injury: This is the term for when the working of the brain has been temporarily or permanently altered by an injury. The danger is not whether there has been a "concussion" or even a "skull fracture" but whether progressive or permanent injury has occurred to the brain inside. Because there is no extra room inside the closed skull for an injured brain to expand as it swells from injury, unrelenting swelling can lead to unrelenting pressure on the brain and death.

Man would never have evolved without surviving many lesser injuries yet the cumulative effects of many small injuries can be bad as in the sad case of Muhammed Ali.

Burns: The largest organ of the body and the one that most protects us from the environment is the skin. If a large portion of our corporal envelope is damaged, the stress and decreased ability to regulate our internal environment may kill us.

Regardless of the physical agent causing the "burn", whether thermal (wet = scald, dry = burn e.g. flame, contact); radiant energy such as ultraviolet from the sun, "radiation" from atomic energy, x-rays, microwaves; electrical or lightning; or chemical, such as strong acids or alkalis; ---the effect is to denature or coagulate proteins in the tissues i.e. the albumin egg white is cooked. Further, the amount and degree of injury may progress and become worse as a result of the burning agent itself or of subsequent infection. The body, and even Life, may be severely stressed or overcome by serious burns.

Which burns are minor and which are major ---requiring immediate 911 response and treatment en route to a burn or trauma center? Minor burns, (the ordinary touch of a hot pot) can often be self-treated at home by cooling the burn, a non-stick airtight dressing and bandage, and simple pain relievers such as Ibuprofen, Aspirin, or Acetaminophen.

Serious or Major burns are:

With serious burns such as these, little first aid needs to be done other than to

For minor and "in-between" burns, cool the burn (this stops a "soft-boiled egg" burn from becoming a "hard-boiled egg" burn) by immersing it in water or covering it with clean wet cloths for 15-20 minutes, then wrap it airtight with a clean tight-weave cloth such as pillow cases or sheets. Go soon to the nearest appropriate hospital emergency department, to have the burn examined, cleaned and dressed, and for medicines to relieve pain and prevent infection.