Hand position
One finger’s width below the nipple line (be sure not to press the tip of the breastbone)
Lower sternum (same as adults)
Depress sternum
About 11⁄2 inches (2.5 cm)
About 2 inches (5 cm)
Rate of compression
30 compressions to 2 full breaths; at least 100 compressions per minute
30 compressions to 2 full breaths; at least 100 compressions per minute
Waiting for Help
If an individual doesn’t regain consciousness, keep CPR going for as long as you are safely able to, whether it’s a child or an adult. In a group, take turns, switching every 2 minutes.
Abdominal Thrusts (Heimlich Maneuver)
Abdominal thrusts are used to aid an individual who is choking. In effect, the under-the-diaphragm series of thrusts forces enough air from the lungs to artificially create a cough, which is intended to move or expel a foreign object that is obstructing the victim’s breathing. After performing abdominal thrusts, have the victim examined by a medical professional.
The technique should be performed only when the victim’s airway is completely obstructed by a foreign object. Abdominal thrusts are not recommended if he or she can cough or speak. So before beginning, encourage the person who is choking to cough, as this may be enough to dislodge any blockage.
If the victim is having trouble coughing or breathing, however, ask if he is choking:
If he can cough or speak, let him try to expel the blockage on his own.
If he can’t cough but is breathing, his airway is only partially obstructed. Arrange for immediate transport to an emergency medical facility to remove the blockage.
If he cannot speak or cough, his airway is obstructed. Get someone to call for medical help while you perform lifesaving abdominal thrusts.
Tip
The universal sign for chocking is clutching the throat.
An Illustrated Guide to Abdominal Thrusts
If the victim is conscious:
1.Ask, “Are you choking?” If the victim can speak, cough, or breathe, do not interfere.
2.If the victim cannot speak, cough, or breathe, give abdominal thrusts until the foreign object is expelled or the victim becomes unconscious.Note: If the victim is extremely obese or in the late stages of pregnancy, give chest thrusts.
Abdominal thrusts
Chest thrusts
3.Be persistent. Continue uninterrupted until the obstruction is relieved or advanced life support is available. In either case, the victim should be examined by a physician as soon as possible.
If the victim becomes unconscious:
1.Activate the emergency medical system (911 or local number).
2.Perform a tongue-jaw lift followed by a finger sweep to try to remove the foreign object. Tongue-jaw lift
Finger sweep
3.Open the airway and try to give 2 slow rescue breaths. If unsuccessful, reposition the head and try again. Rescue breathing
4.If unsuccessful, give up to 5 abdominal thrusts. Abdominal thrusts
5.Repeat steps 5 through 7 until effective. If the victim resumes effective breathing, place the person in the recovery position.
6.After the obstruction is removed, begin the C-A-B of CPR if necessary.
7.Be persistent. Continue uninterrupted until the obstruction is relieved or advanced life support is available. When successful, have the victim examined by a physician as soon as possible.
Abdominal Thrusts for Infants and Children
When there are signs of choking in an infant (birth to 1 year) or child (1 to 8 years):
If the infant or child is breathing and continues to be able to speak or cough, do not interfere, but take to an advanced life support facility.
If the infant or child has a fever or history of illness, the air passages may be swollen. Take him or her to an emergency care facility.
If the infant or child has ineffective coughing and high-pitched inspirations and is unable to speak or cry, immediately begin to clear the airway.
If an infant is conscious:
1.Support the infant’s head and neck with one hand firmly holding the jaw. Place the infant facedown on your forearm, keeping the head lower than the trunk.
2.With the heel of your free hand, deliver up to 5 back blows forcefully between the infant’s shoulder blades. Forceful back blows
3.Supporting the head, sandwich the infant between your hands and arms and turn the infant on his or her back, keeping the head lower than the trunk. Using two fingers, deliver up to 5 thrusts over the lower half of the breastbone (sternum). Two-finger chest thrusts
If the infant becomes unconscious:
1.Call for help. If someone comes, that person should activate the emergency medical system (911 or local number). If no one comes, provide 2 minutes of care, then call.
2.Open the airway (head tilt and chin lift), and try to give 2 slow rescue breaths. If the airway is still obstructed, reposition the head and try again to give rescue breaths.
3.Give up to 5 back blows and then up to 5 chest thrusts.
4.Perform a tongue-jaw lift, and if you see the obstructing object, perform a finger sweep to remove it.
5.If the foreign body is not removed, repeat steps 2 through 4 until successful. If the infant resumes effective breathing, place in the recovery position.
6.If the foreign body is removed and the victim is not breathing, begin the C-A-B of CPR for infants.
7.When successful, have the infant examined by a health-care professional as soon as possible.
If a child is conscious, perform abdominal thrusts as described for adults.
If the child becomes unconscious, continue as for an adult, but do not perform blind finger sweeps. Instead, perform a tongue-jaw lift and try to remove the foreign object only if you see it.
Bandaging Limbs
Bandages should be long enough to encircle the limb and at least an inch wider than the wound. Keep them loose enough to avoid impairing circulation, and bandage a limb in the position in which it will remain during transport or while the wound heals.
1.Begin by placing the end of the bandage on the limb.
2.Make a firm turn around the limb to hold the bandage end in place. Secure the bandage with first-aid tape, with a safety pin, or by cutting the end of the bandage in two, putting one end on each side of the limb, and then tying the ends into a knot.
Immobilization: Applying Splints and Slings
Splints are support devices used to immobilize a potentially fractured bone or injured joint when medical attention is not immediately available. Slings are used to immobilize the splinted limb. Unless you are in a situation where medical attention is unavailable, they should only be applied by those who are trained to do so. However, if you are the only one available in an emergency situation, here are the basics:
A splint can be fashioned from rolled-up newspapers, rolled blankets, pillows, boards, and so forth. Ideally, a splint should be long enough to extend a few inches past either end of a suspected fracture and past the nearest joints. It is important to splint an injury in the position you found it. Do not attempt to move or straighten an injured limb.
To hold a splint in place, use bandannas, neckties, or strips of cloth as a sling. Tie the splint about 3 inches (7.6 cm) above and below the injury. Secure the joints above and below the injury. The splint should provide firm support for the injury while allowing for good circulation. Indications that circulation is impeded include blue or pale fingers or toes on the splinted limb. Have all the knots on the same side, and do not allow them to press into the injury. Here’s how to apply splints or slings on specific areas:
Wrist or lower arm. Put the injured arm across the patient’s torso with the elbow at a right angle. The palm should be in, the thumb up. Splint each side of the arm from the elbow to beyond the wrist, leaving the fingers visible. Check the fingers frequently to see if circulation is impeded by tight bandages.
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bsp; In emergency situations, splints and slings can be improvised. In this case, rolled sturdy paper or cardboard makes an adequate splint, and a long-sleeved shirt has been tied as a sling.
Finger and toe. Tape the injured finger or toe to the one next to it, with cotton or other soft material between the two.
Foot and ankle. Remove the shoe from the injured appendage. Tie padding, such as towels, blankets, or spare clothing, around the shin and foot, leaving the toes exposed. Check the toes frequently to see that circulation is not impeded by tight bandages.
The Recovery Position
Text on Recovery Position © 2017 National Safety Council. Reproduced with permission.
The recovery position prevents the windpipe from getting blocked by saliva, blood, or the tongue. Never place a person with a suspected spinal injury in the recovery position. For all others, here’s what to do:
1.Position the victim’s arm farthest from you across the victim’s body.
2.Grasp the victim at the shoulder and hips, and roll them toward you.
3.Bend both legs so the victim’s position in stabilized.
4.With the victim now in position, check the airway and open the mouth to allow drainage. Adult in the recovery position
In the case of a small child, hold the infant facedown on your arm with the head slightly lower than the body. Support the head and neck with your hand, being sure to keep the mouth and nose clear.
Infant in the recovery position
If the patient is too heavy for you to move, have another person support the head while you turn the body with both hands.
If the individual has a broken leg or arm, lay her in the recovery position with a rolled blanket under the uninjured side.
Once the victim is in the recovery position, continue to monitor breathing while waiting for advanced help to arrive. Observe the victim for bleeding, medical alert bracelets or insignia, and any deformities that may indicate a serious injury. Give this information to responding EMS professionals.
Text on Recovery Position © 2017 National Safety Council. Reproduced with permission.
Moving the Injured
Never move a person with serious injuries, especially if you suspect a neck or spinal injury. For all others, here’s what to do:
1.Immobilize any injured parts before moving.
2.If the injured person is unable to walk, he or she can be dragged on a blanket or coat if necessary — lengthwise rather than sideways, and carefully secured so that he or she doesn’t roll off the blanket during transport. Place a pillow under the head and neck of an unconscious victim to avoid inadvertently closing the airway.
3.If the injured individual is conscious, sitting up, and does not have a leg injury, but is unable to walk, two people can clasp hands to make a chair.
Rescue Remedy for Emergencies
Rescue Remedy is a homeopathic preparation (available in health food stores) made from five flower essences. It can be given for trauma, accidents, and emotional distress to help restore calm and bolster confidence. The essences in this Bach flower remedy are: star of Bethlehem for shock, rock rose for terror and panic, impatiens for stress and tension, cherry plum for despair and fear of losing control, and clematis for loss of consciousness or feeling “out of it.” Two to 4 drops can be placed under the tongue and held there a minute or so before swallowing. The drops can also be mixed into a small glass of water and sipped. If the person to whom you are administering first aid is unconscious, place the drops on the lips, forehead, wrists, or back of the neck or behind the ears.
Using Homeopathic Medicines
Homeopathy is a system of medicine based on the principle that “like cures like.” For example, the remedy suggested for treating poison ivy rashes is rhus tox, which is made from the poison ivy plant itself. In large amounts, some of the ingredients in homeopathic remedies can be toxic. However, the preparations are so diluted that what you are getting is the “energy” of the remedy that can help stimulate the body’s own healing process.
Homeopathic Dosages
Homeopathic remedies are usually taken by placing 4 pellets under the tongue every 4 hours for the first few days following an injury or onset of an illness, or until results are seen. Children should take smaller doses.
Age
Dosage
Infants under 1 year of age
1 pellet every 4 hours
Children ages 1 to 5 years
2 pellets every 4 hours
Children ages 6 to 12 years
3 pellets every 4 hours
Children over 12 years of age
Adult dosage
In all cases, consult with a trained practitioner before treating children with homeopathy. And remember, homeopathic medicines use minute doses of sometimes toxic substances that can be dangerous in large amounts — stick with the homeopathic dose.
02
An A–Z Guide to Ailments and Injuries
Read through this chapter before you need it. Make sure your first-aid supplies (see chapter 4 for complete lists) are readily available. Many of the supplies and remedies you need are in your kitchen, garden, and natural food stores. If you don’t have what’s called for, improvise.
The information in this chapter is not meant to replace competent medical care when needed, but to guide appropriate action until help can be obtained. Call for help as soon as possible, but do your best not to leave the injured person alone. Keep calm and encourage the person to breathe deeply and slowly. Identify yourself and ask for permission to help, keeping in mind the injured person may be temporarily irrational. Speak positively but not more than necessary. Be conscious of not invading the person’s sense of modesty unnecessarily.
Abdominal Injuries
(See also Bruises or Stomach Pain )
Seek immediate medical attention if the injured individual experiences:
Heavy bleeding
Nausea or vomiting
Muscle spasms
Faintness
Tenderness or pain
Discoloration of urine, stool, vomit, or sputum
Swelling
While you wait for medical attention:
1.Keep the injured person as comfortable and still as possible. Loosen tight clothes at neck and waist, and cover the injured person with a blanket. If you suspect internal injuries, do not move the individual. If he or she is bleeding from an abdominal wound, however, position the person as follows (after slipping on a pair of latex gloves, if possible): If the wound is lengthwise to the body, place the injured person on his or her back, with the feet slightly elevated. Do not raise the head, as that will tense abdominal muscles that affect the wound.
If the wound is across the abdomen, have the individual lie on his or her back, but place a pillow or a clean folded cloth behind the head and knees. This will relax the abdominal muscles and help keep the wound closed.
If bleeding, try to keep the injured area clean. Gently remove the clothing surrounding the injury. If any internal parts are protruding, do not push them back inside. Place a dressing or folded clean cloth on the wound and bind it loosely in place with tape or a bandage. Do not press down on the bandage.
2.Do not allow the injured person to eat or drink. If he or she asks for a drink, dip a cloth in water and moisten the lips. Two drops of Rescue Remedy can be added to 8 ounces (240 ml) of water and the cloth dipped in that solution, if desired.
Abrasions and Lacerations
See Bleeding and Shock
Alcohol Poisoning
(See also Drug/Alcohol Overdose )
Seek immediate medical attention if the individual:
Cannot be roused
Has diabetes
Has a slow pulse
Is having difficulty breathing
Has dilated pupils
Has pale skin or is sweating
Cannot stop vomiting
While you wait for medical attention:
1. Loosen any tight or restrictive clothing.
2.If the individual is unconscious, place him or her in the recovery position.
3.Monitor breathing; if the individual stops breathing, initiate CPR.
Allergic Reaction (Acute)
(See also Hives )
Seek immediate medical attention if the individual:
Has difficulty breathing
Becomes weak
Experiences nausea
Develops facial swelling
While you wait for medical attention:
1.Think. Ask the victim if he or she has any known allergies. Do your best to figure out what caused the allergic reaction. Prevent further ingestion or contact.
2.Reach for ephedra. If breathing is impaired, give 2 dropperfuls of ephedra (Ephedra sinica) tincture to dilate bronchioles and prevent anaphylactic shock. In emergencies of severe allergies, take in addition a dose of 1 teaspoon (5 ml) baking soda mixed in a glass of water to alleviate symptoms. Caution: Ephedra should not be used by those taking medication for heart conditions or high blood pressure. Ephedra should be used with caution by those suffering from angina, diabetes, glaucoma, heart disease, high blood pressure, enlarged prostate gland, or overactive thyroid gland — do not exceed the recommended dosage! Note: Ephedra tincture was banned by the FDA in 2004 and is no longer sold in the United States but is still available online from Canada and other countries, and it can be wildcrafted by a trained herbalist from the fresh plant. Administer strong black tea if ephedra is unavailable.
The Natural First Aid Handbook Page 2