Simple First Aid• Simple Cuts and Scrapes

– Wash with soap and water; apply first aid ointment; cover with dry sterile dressing or bandage, clean and re-bandage wound each day.• Puncture Wound

– If the object that caused the puncture is small and you can easily remove it, do so.– Stop the Bleeding (apply firm, direct pressure with sterile gauze or clean cloth until bleeding stops)– Clean and Protect the Wound– Rinse the wound under clean water for several minutes. Then wash the area with mild soap and water and rinse again.– Apply an antibiotic cream.– Use a sterile bandage to protect the puncture wound from dirt or further injury.– Treat Pain and follow-up with doctor if infection.– Call 911 if it bleeds excessively, spurts blood, or does not stop bleeding after 10 minutes of firm pressure, is to the chest, abdomen, or neck and

there are any emergency symptoms: severe pain, fast breathing or trouble breathing, vomiting, dizziness, unconsciousness. – Do not remove if it is in the eye or throat.

• Blister on Hand or Foot– A blister is a separation of the layers in the skin; a pocket of fluid building up between the outer layer and the inner layer of the epidermis. The

fluid is generally water, but it can also be blood or pus. – Individuals should not pop the blister. Care should be taken to avoid infection.– If on heel, apply mole skin cut larger that blistered area with a hole in the middle for the blister.

• Nose Bleeds– Sit and leaning forward (prevents blood from going down throat)– Pinch nose firmly/gently, apply pressure on upper lip (pressure points)– Hold a cold compress on area, after 10 minutes check to see if bleeding has stopped. – Seek medical attention if longer than 15 minutes.

Bites and Stings• Bee Sting

– Do not pull or squeeze stinger. Use credit card edge or knife edge to scrape away the stinger– Clean wound and watch for infection. If allergic reaction, dizziness, or respiratory stress, treat for shock and get medical help 911.– If they have a anaphylactic shock kit administer by reading directions. Is anyone in your patrol allergic to bees?

• Tick Bite– Put on gloves, use tweezers and grasp close to skin (head of tic not the body), pull straight out (don't twist, squeeze, or jerk), wash wound, apply antiseptic, wash

your hands. – Don’t use hot poker or match to burn off the tic.– See doctor if rash or flu symptoms occur days or weeks later.

• Spiders– See a doctor ASAP, especially for black widow and brown recluse. – Treat for shock and observe for symptoms.

• Venomous Snakes– Remove rings and jewelry, – Get to doctor ASAP, possible reaction 1 hour, walk victim or help carry, – If victim must wait then wash the wound (if Coral snake wrap with Ace bandage), – Have the victim lie down with limb lower than rest of body – Treat for shock but don't elevate effected limb.

• Non-Venomous Snakes– Non-venomous snake bite should be cared like a puncture wound (wash, ointment, bandage)

• Animal Bite– Animal bite is puncture wound… wash it, flush with water, control bleeding, cover with sterile bandage.– Rabid animal? Must see doctor to determine if rabies shots are required. Unprovoked attack may mean rabies, report bite, don't kill animal, don't catch animal, call

police/ranger/animal control. If Pet, write down owners info; if wild write down description and where last seen.

Fish Hook Removal• Fishhooks

– Cut line from hook. Let doctor remove if possible. – Don't try to remove from face, eye, or earlob.– Check location of the barb.

• If barb exposed: – cut barb off if you have the right tools.– Back out hook

• If barb embedded in skin– wrap 3 foot length around bend and index finger, – keep body part stable, – push down on shank to free barb, – keep bystanders away and avoid being snagged by outcoming hook, – give quick, sharp yank to free hook. – Wash, Ointment, Bandage injury. See doctor ASAP.

Choking• How do you know someone is choking?

– Grabs throat with hands, face turning red– Coughing weakly or making high pitch noises– Cannot cough, speak, or breath

• What is the universal sign of choking?– Cross arms/hands and grab your neck

• Demonstrate how to care for someone who is choking?1) If couscous, stand behind, place arm across chest, lean victim forward, strike back 5 times with heel of hand2) Stand behind victim, clasp hands together, thumb knuckle between navel and rib cage3) Thrust hands in and up with enough force to pop loose object, repeat up to 5 times.– Repeat steps 1-3 until object is removed, medical help arrives, or person is unconscious.– Treat for shock, treat any additional injuries, if help is delayed decide how to care for victim -

comfort and watch closely.

Hurry Cases• Hurry Cases:

– First Aid: First aid is the first help given to the victim of an accident. – There are three primary objectives in giving first aid:

• Stop life-threatening dangers.• Keep the victim safe from further harm.• Get proper medical help for the victim.

• Take Charge: The scene of an accident can be scary. An injured person may be crying or screaming. The sight of blood might frighten you. Other people may be too stunned to help. The most important thing you can do is to stay clam. Focus your attention on the job of making people safe. Act with confidence, using the first aid skills you know. Cheerfulness will help the victim and the people around you lose their fear.

• Approach Carefully: Keep your own safety and the safety of others rescuers in mind. At the scene of a car accident, watch for others cars on the road. in the backcountry, be aware of falling rocks, slipping footing, steep slopes, and other hazards.

• Do First Things First: Here are five vital steps for treating accident victims. Perform them in the order they • are given.

– Treat "hurry cases" immediately. A hurry case is any condition that threatens victim's life. The most serious are: stopped breathing, no heartbeat, severe bleeding, choking, and poisoning by mouth.

– Send someone to a phone to call for help. Give full information about your location and the extent of the injuries.– Treat every accident victim for shock.– Examine the victim for other injuries that may require first aid.– Plan what to do next. If help is on the way, keep the victim comfortable and watch for any changes in his condition. Where there are no phones,

decide on a clear course of action. A victim who can walk alone or with some support may be able to hike a road. When injuries are serious, though, it is usually best to send two people for help.

Hurry Case - Poisoning• If you suspect poisoning call for help immediately!• The best source for poisoning information:

– Call Poison Control at 800-222-1222 or call 911• Try to identify possible causes of poisoning for first responder• Be aware of Carbon Monoxide Poisoning

– Comes from open flame or combustion in enclosed space.– Symptoms may include Headache, Dizziness. Nausea, Flu-like symptoms, fatigue,

Shortness of breath on exertion, Impaired judgment, Chest pain, Confusion, Depression, Hallucinations, Agitation, Vomiting, Abdominal pain, Drowsiness, Fainting, Seizure

– Get victim(s) to fresh air outside– If unconscious, call for help and get victim to fresh air but avoid becoming a victim

Hurry Case – Stopped Breathing• Stopped Breathing

– Causes: near drowning; cervical spine fractures; head injuries; asthma; smoke in a fire; electric shock and lightening strike; excessive sedatives (intentional or not); excessive alcohol; drug abuse/use; foreign objects in airway

– Check: listen to mouth and nose or feel for air outflow and carefully look at the chest for spontaneous rise and fall.– Treatment: Begin rescue breathing after calling for help in the adult and after 1 minute of CPR in the child or infant. – Consider injury to neck as to whether you want to move the victim. This may be necessary if you cannot get the

airway adequately open in the position the victim is lying. – Remember head tilt and chin lift with the thumb. – Clear mouth of foreign material or vomit, pinch nose and make a good seal over mouth of victim with yours. – Give two adequate breaths and be sure to look for rise in chest. If not present treat for obstructed airway. – Start CPR (remember Airway, Breathing, Circulatory, Defilation)– Check for pulse after you establish you can ventilate the lungs. – If spontaneous breathing develops in the victim stay close by as he may tire and fail again due to underlying process

or fatigue or both. – Place in the recovery position which is on the victim's side, to reduce risk of aspiration and secondary to vomiting

Hurry Case – Severe Bleeding• Causes: Amputation, Severe lacerations, head wound

– Check: If bleeding is brisk and from large vessel, spurting. Note: Fast action is needed in order to prevent shock and subsequent death. First aid kits with the troop should have readily available gloves, protective eye wear and a mouth-barrier device.

• Treatment: – Firm pressure with a sterile pad if available. If not clean washed hands next best. – Apply pressure in the case of an arterial bleed 10-15 minutes firmly. – Don’t remove soaked pads, just apply more on top.– May try raising limb above heart if continues to bleed. – If continues to bleed apply firm pressure with opposite hand or second individual at one of major pressure points proximal to

wound i.e. femoral artery in the case of the leg up in the groin and auxiliary (armpit) or brachial artery (elbow) depending where the laceration is located in the case of the arm.

– If a bandage is used be sure a distal pulse is felt beyond the laceration. If not loosen up the bandage a bit. If bleeding uncontrolled in spite of above measures resort as last ditch effort to tourniquet.

– Tourniquets are best suited in amputations where the stump can be secured or in badly mangled limbs where bleeding may not be confined to just a neat spurting artery. Tourniquet should be wide i.e. 2-3 inches wide. May incorporate a rod or stick tied to the tourniquet which is subsequently used to rotate ends of the tourniquet in order to close off the oozing that might occur from an injured stump. A second bandage tie could anchor the stick or rod that is being turned to apply pressure on the bleeding limb and thus allow the caregiver free use of his hands. Tie only as tight that a faint distal pulse can be felt. If no pulse felt and limb looks blue or grey loosen the tourniquet. Tourniquets are used only in a last resort.

Heat and Cold• Minor (heat / thermal) Burns or Scalds (first degree)

– Skin may be red or tender, hold under cold water or apply cool wet compresses until little or no pain. – First-degree burns usually heal with home treatment in about 3 to 5 days.– Apply some petroleum jelly to add moisture back to the skin and loosely wrap with clean gauze.

• Sunburn– Prevent overexposure to sun with waterproof sunscreen / clothing and hats / stay in shade – Avoid further exposure to sun– Keep cool / keep moist. If blisters, leave alone and consult a doctor.– Take over the counter pain reliever (parents)– Treat peeling skin gently

• Frost Bite– When tissue becomes cold enough to freeze. Greyish white patches on skin means that ice crystals are forming. – Move to shelter. Warm cheek or ears with hand/gloves or limb against body. – If severe; dry clothing, wrap area in blanket, doctor ASAP. Don't rub area. – If no chance that area will refreeze then place in warm water until color returns. – If on hand or foot, place gauze between fingers or toes and a loose bandage.

Poisonous Plants• Poison Oak

– Normally found near water like a creek or canyon– Usually found in partial shade– Not found at very high elevations– Is deciduous, so leaves may be green, brown, or red.– All parts of plant can transfer poison – leaves, step, and

roots.– Simple saying – Leaves of 3, Let it Be!– See examples in handbook or other photos

Heat Exhaustion• What

– Heat exhaustion and Heatstroke us when body can’t keep itself cool– Dizziness / faintness / nausea/ lack of energy / dark urine / headache /

muscle cramps / severe sweating or lack of sweat / rapid pulse / looks pale • Prevent

– Drink plenty of water / stay out of sun / rest• Treatment

– Have the person lie down in a cool, shady spot with their feet raised. – Loosen their clothing, place damp cloths on them and provide plenty of

water. Fan them. Sip Water.– If symptoms get worse, get help.

Heat Stroke• What

– Extreme and life threatening. – When body can’t keep itself cool and is at a dangerously high level.– Dehydration caused high body temperature– Victims cooling system has started to fail– Hot sweaty / red skinned / confusion / Dizziness / faintness / nausea/ lack of energy / dark urine /

headache / muscle cramps / severe sweating or lack of sweat / rapid pulse / looks pale • Prevent

– Drink plenty of water / stay out of sun / rest• Treatment

– Have the person lie down in a cool, shady spot with their feet raised. – Loosen their clothing, place damp cloths on them and provide plenty of water. Fan them. Sip Water.– Apply ice packs to groin and arm pits.– Treat for shock.– If symptoms get worse, get help.

Hypothermia• What

• Body’s core temperature falls below normal range and loosing more body heat than body can produce

• Pulse rate slows and blood directed to organs (away from extremities)• Bluish lips / shivering / impairs ability to think clearly and do simple tasks

• Prevention• Dress warmly / drink warm fluids / raise body temperature with exercise / share body

heat / keep clothes dry• Treatment

• If unconscious, check airway and if breathing• Help move them to a sheltered place and remove their wet clothing.• Put dry clothes on them and cover them with a warm blanket.• If the victim is conscious and able to swallow, have them drink warm liquids.• Position warm water bottles around their groin and armpits• Do NOT re-warm the victim too quickly. This can cause an irregular heart beat.

Dehydration• What

– Body has lost more liquid than is being replaced– Dizziness / faintness / nausea/ lack of energy / dark urine / headache / muscle

cramps / severe sweating / red faced• Prevention

– Drink plenty of water / stay out of sun / rest• Treatment

– Have the person drink water or a sports drink. Drink 1-2 quarts over 2-4 hours.– If severe dehydration requires emergency care and intravenous fluids.– Have the person rest, avoid physical activities, and drink plenty of water over

the next 36 hours.

Hyperventilation• What

– Victim is over breathing / decreases CO2 in blood / suppresses the breathing reflex.

– Light headed / dizziness / fainting• Prevention

– Stay calm / slow breathing• Treatment

– Get the victim out of the water and have them sit down and relax. – Paper bag method to increase CO2– AVOID hyperventilating in order to dive under water and suppress

breathing.

Shock• Understand the possible causes of shock. Shock usually is associated with:

– Blood loss (hypovolemic shock)– Severe head injury, traumatic brain injury (TBI)– Severe infections (septic shock)– Heart failure (cardiogenic shock)– Severe burns– Severe trauma– Dehydration– Severe allergic reaction (anaphylactic shock) - this may be due to drugs, foods, insect stings or snakebites.

• Assess the situation• Look for shock signs/symptoms.

– Pale, cold, clammy skin (cool to the touch, and sweaty)– Rapid pulse– Sweating– Nervousness, agitation– Disorientation/confusion, giddiness– Thirst– Bleeding/blood loss– Rapid breathing, gasping for air– Blue-tinged skin (especially lips) or fingernails– Nausea or vomiting– Weakened pulse– Dizziness / fainting– Unconsciousness (possible eventually).

• Call 911• Communicate with the victim if he or she is conscious. Keep victim calm• Lay victim on back and elevate legs about a foot• Maintain normal body temperature• Watch for vomiting

5 Most Common Signs of a Heart AttackHandbook Additional notes (Red Cross)

Persistent, uncomfortable pressure, squeezing, fullness, or pain in the center of the chest behind the breastbone. The feeling may spread to the shoulders, arms, and neck. It might last several minutes or longer and may come and go. It is not always severe. (Sharp, stabbing twinges of pain usually are not signals of a heart attack).

Pain lasting longer than 3-5 minutes, or goes away and comes back.Note that in women, pain may not occur in the chest but in the back, shoulders and arms.

Unusual sweating. A person experiencing a heart attack may perspire even though a room is cool.

Pale, ashen (grayish) or bluish skin are also symptoms.

Nausea. Stomach distress with an urge to vomit is an example of nausea that may occur in a person experiencing a heart attack.

Shortness of breath. Or trouble breathing

A feeling of weakness. Dizziness, lightheaded, or fainting

Summoning Help

From Home•Call 911. If the phone is working, this is the best option.•NOTE: Do not call 911 from a cell phone if you have a choice: the operator will not be able to trace your call and find your address.

•NOTE: Do not call 911 from an internet phone: most VOIP providers do not provide 911 service at all.

•If you have an alarm system, press the emergency button.

•If someone in the house has an "emergency button", press the button.

•Call the police department, fire department or poison control center directly.

•Ask a neighbor for help.•NOTE: DO NOT leave the victim alone.

•Flag down a passing car and ask for help.•NOTE: DO NOT leave the victim alone

On A Wilderness Camping Trip

•If anyone has a working cell phone, use it to call 911. Be prepared to give detailed directions to your location.

•If anyone has a working radio or satellite phone, use it to call for help. Be prepared to give detailed directions to your location.

•Send several people back to the vehicles and have them drive to the nearest phone.•NOTE: DO NOT leave the injured person alone.•NOTE: Tell them to stay at the phone until help arrives, then lead the responders back to the injured person.

•Use three loud noises to signal rescuers (whistle blasts, gunshots, car horns)

•Use a signalling mirror to get a low-flying aircraft's attention.

•Create an emergency marker:•Light a large, smoky fire that will draw attention. NOTE: DO NOT start a forest fire.

•Flip a canoe in the water and put a red cloth over it.•Use rocks, logs or branches to create a large "X" or "HELP" in an open area that will be visible from the air.

•Place three unusual markers in a row: piles of brush, piles of rocks, fires, etc

•If you cannot immediately summon help, stay where you are. Rescuers will look for you in your last-known

During an Activity on Open Water

•If the boat has an EPIRB (Emergency Position Indicating Radio Beacon), activate it.•If the boat has a radio, call for help on the emergency frequency.•If anyone has a working cell phone or satellite phone, use it to call for help.•If the boat can still navigate, move it into busy traffic where you can signal for help.•If the boat has a flag, fly it upside-down.•Make the boat appear to be in obvious distress to attract an aircraft's attention. For example, place the sail or debris in the water.•Use a signalling mirror to attract attention from a low-flying aircraft or the shore.•Devise a smoke signal (a smoke flare or a very small smoky fire) only when rescuers are visible.•Use a flare only at night and only when rescuers are nearby.•DO NOT attempt to swim to shore.

Convulsions/Seizures & Abdominal Pain

Convulsions/Seizures

•A seizure is a when a victim involuntarily loses control of his muscles, which spasm and jerk violently. Seizures are essentially a malfunction of the central nervous system and can be caused by many things, including head injuries, high fever, dehydration and drug overdose. Seizures are violent and scary. There is no "treatment" for a seizure, only a proper response:•Move any sharp or hard objects away from the victim so he won't hit them and hurt himself.

•If possible, try to cradle and protect the victim's head from hitting the floor.

•When responding to a seizure, there are several things you should never do:Do not attempt to restrain the victim. You will only hurt him and yourself.

•Do not attempt to prevent the victim from "swallowing his tongue". If you attempt to put your fingers in the victim's mouth, you stand a good chance of choking the victim or losing your fingers.

•Seizures cannot be prevented. Seek medical attention unless the victim has regular seizures and feels medical attention is not required (e.g. epilepsy patients). If the victim does not regain consciousness after the seizure ends, seek medical attention.

Abdominal Pain

•Most abdominal pain is caused by gas, which causes sharp, stabbing pains. The best course of action is to encourage the victim to lie down so the gas bubble will move and relieve the pain.

•However, if the victim has suffered a trauma (e.g. a car accident) or if the pain does not subside after lying down for a short time, he may have internal injuries. There is no first aid for internal injuries -- seek medical attention.

•The Appendix is a small finger-shaped pouch that is attached to the large intestine. The appendix location is in the lower right area of the abdomen. If you have pain in this area of the stomach, you may be having an appendix pain. About 7% of the population in Western countries suffers from Appendix Pain at some point during lifetime. Depending on the nature and duration of the attack, Appendix Pains are classified into Chronic Appendix Pain and Acute Appendix Pain.•Appendix Pain may be a sign of Appendicitis, a severe disease that leads to inflammation of the appendix.

•Symptoms may be Tenderness, Nausea, Sudden Pain, Indigestion, Bowel problems, and Anorexia. See your doctor if you are having these appendix pain symptoms.

Bruises, Strains and SprainsBruises, Strains and SprainsInjury Definition Treatment

Bruise

A bruise is a place where blood vessels have broken beneath the surface of the skin. Most bruises are shallow and only cause some soreness.Bruises can also be a good indicator that a more serious injury has occurred. If a large or painful bruise appears near vital organs (e.g. over the ribcage after a fall or on the stomach after an impact), assume that internal injuries have occurred and seek immediate medical attention.

Most bruises require no treatment.If swelling or pain is a problem, applying a cool compress for the first hour or so after injury will keep the swelling down. After that, applying low heat will help the bruise heal and clear. If the pain is acute or severe, seek medical attention.

Strain

A strain occurs when a muscle is stretched beyond its limits and injury occurs. This is a fairly common sports injury. Mild strains may not cause pain immediately.

Apply cold to help reduce the inflammation. Headache medication may be appropriate as well, since it also reduces inflammation. Rest the muscle and allow it to heal.If intense pain continues despite treatment, medical attention may be required.

Sprain

A sprain occurs when a ligament around a joint is stretched beyond its limits and injury occurs. If the injury is severe enough, the ligaments can be torn.Sprains cause immediate pain and swelling. They can be difficult to distinguish from broken bones.

When the exact nature of the injury is unknown, treat it as a broken bone. Wrap, elevate and rest the joint, monitor the patient's condition and seek medical attention.If the injury is known to be a sprain, remember the acronym I.C.E.Ice: apply coldCompression: wrap the injury in a compression bandage to help keep swelling downElevation: keep the injury elevated and rested

Oral InjuriesOral InjuriesInjury Definition Treatment

Chipped toothA chipped tooth occurs when a small part of the tooth enamel breaks away but the nerve is not exposed.

No treatment is required. A dentist's attention may be required to smooth the broken edges and/or make cosmetic changes.

Broken tooth

A broken tooth is much more serious than a chipped tooth. When a tooth is broken, the nerve is exposed and can cause a great deal of pain.

Breaking a tooth can be extremely painful, which increases the stress of the situation. Unfortunately, very little first aid can be done. Apply a cold pack from outside the mouth (do not put ice directly on the tooth).

Loosened toothA loose tooth occurs when a tooth's roots have torn free and the tooth can move in its socket.

There is very little that can be done. The tooth will heal and firm up on its own. In the meantime, the patient should be very careful not to chew with the tooth.If there is significant pain, seek dental assistance.

Knocked-out toothWhen a tooth is knocked out completely without being broken (avulsed), it will still have the roots attached.

If the tooth is undamaged, there is a good chance it can be re-inserted and heal normally. This should be done as soon as possible after the injury, before swelling has a chance to start.The tooth should only be handled by the crown, not the root. Do not touch or brush off the roots. If the tooth is dirty, gently clean it with cool water.To re-insert the tooth, use gentle pressure and slowly work the tooth back into its socket. Have the patient gently bite down on gauze to hold the tooth in place. The patient should seek a dentist to ensure that no serious injury has occurred.If the tooth cannot be re-inserted on the scene, get the patient to a dentist within 30 minutes of the injury. Keep the tooth submerged in milk or cool water.

Frostbite• Frostbite is the opposite of a burn: when the skin and underlying tissue has been damaged or destroyed by being frozen.

Symptoms of frostbite include:– Pale or grey coloring of skin– Numbness– Hard, solid, cold tissue

• Frostbite most commonly occurs on exposed skin such as the nose, cheeks and ears. To treat frostbite in those areas:– Cover the exposed areas to protect them from further damage.– Seek shelter to evaluate the injury.

• When evaluating the frostbite, attempt to determine how deeply the skin has been frozen.If just the surface has been frozen, it may be gently rewarmed by placing a bare hand over the affected area and very gently rubbed by the victim. This will encourage circulation and healing. Being gentle is very important -- the skin is damaged and vigorous rubbing will cause further injury. Having the victim do this is best because he will be able to be gentle enough to prevent causing pain.

– If the tissue beneath the surface has been frozen or an extremity has frozen, do not thaw it. This type of frostbite is life-threatening. Seek medical attention immediately.

– If you cannot determine the depth of the damage, assume the tissue has been frozen solid and seek medical attention immediately.

– Preventing frostbite to exposed skin involves wearing appropriate clothing or equipment to cover skin in cold weather. Seek shelter occasionally to warm up and rest.

– Preventing frostbite to extremities requires changing any wet clothing immediately and stopping occasionally to check feet and hands for damage. When hiking in the cold, frostbite can attack feet without the victim feeling the damage until it is too late.

Severe Cuts on Legs or Wrists• Bleeding can come from two possible sources -- veins and arteries. Both are part of the body's internal plumbing but

they serve different purposes. As blood circulates within the body, it is occasionally recharged with oxygen at the lungs and pumped through the heart. As it carries oxygen away from the lungs, it flows through arteries. Arteries are large blood vessels that are protected by being buried deep within the body, usually next to bones. Arteries have pulses and are pressurized. For this reason, arterial wounds are always life-threatening.

• Veins are the vessels blood uses to return to the heart after giving up its oxygen. Veins are generally smaller, nearer the surface and not pressurized. Severe bleeding from a vein can be life-threatening.

• When delivering first aid for bleeding, there are three steps to follow:– DIRECT PRESSUREApplying direct pressure means placing a dressing over the wound and pressing on it, hard. Direct pressure hurts and a conscious victim will complain (yell) when pressure is applied to a serious wound. Direct pressure is the best way to stop bleeding, however.If the dressing becomes completely soaked with blood, do not remove it. Instead, simply place more absorbent dressing on top of it and continue applying pressure. Removing the dressing will reopen any part of the wound that has started to close.– ELEVATIONTo elevate a wound means to raise it above the level of the heart. By elevating a wound, gravity helps to stop the blood flow. If possible, have the victim lay down and raise the wound as high as possible. If the wound is in the victim's torso or abdomen, try to have the victim roll on his side or place padding beneath the victim.– PRESSURE POINTSPressure points are places within the body where an artery passes close to a bone. In those places, applied pressure can pinch off the artery and stop the blood flow to a limb. Each arm and leg has one main artery that supplies most of the blood to that limb.

Tourniquets• A tourniquet is a pressure bandage that will stop all blood flow.

• There is only one situation when a tourniquet should be used: When the limb has already been amputated.

• When considering a tourniquet, remember:– Any part of the body below the tourniquet will die. If you apply the tourniquet too high on the limb, the victim may lose more of the limb

than is necessary.– Once a tourniquet is applied, it cannot be removed.– A tourniquet will cause severe pain. It may break bones.

• To apply a tourniquet:– Wrap a wide cloth band around the limb, a few inches above the point of amputation. DO NOT use rope or wire. – Tie a stick or rod into the knot. – Twist the stick until the bleeding stops. – Tie the stick to the limb so it will not loosen.– Do not loosen or remove the tourniquet.– Write down the time you applied the tourniquet and attach it to the victim's clothing. Doctors will need to know before they can safely

remove it.– Seek medical assistance immediately.

Bee Stings Could Be Life Threatening• There are several situations where bee stings can become life threatening. First, if the victim is stung in the back of the mouth or the throat, the sensitive

tissues there can swell more than a sting would swell on the skin. The swelling can partially block or completely block the victim's airway, causing them to begin suffocating. Second, if the victim is allergic to bee stings, a whole-body reaction can occur -- a condition known as Anaphylaxis (or Anaphylactic Shock). Symptoms of anaphylactic shock include:

– Areas of spreading hives, rash, swelling or redness away from the site of the sting. These areas may itch or become painful.– Difficulty breathing– Confusion, light-headedness, dizziness and fainting– Slurred speech– Rapid or weak pulse– Blue lips or fingernails– Nausea, diarrhea and abdominal pain

• Symptoms appear very quickly; often within minutes or seconds. Anaphylaxis kills in three different ways:– Dangerously low blood pressure causes severe shock– Fluid fills the lungs and causes suffocation– Swelling blocks the airway and causes suffocation

• Anaphylaxis always requires immediate medical attention. Victims who have been diagnosed as prone to anaphylaxis will often carry an emergency dose of epinephrine (known as an "Epi-Pen"). These devices are small, single-dose, spring-loaded syringes that will inject at the press of a button. If the victim is conscious, always allow him to administer the epinephrine himself. Do not do it for him unless he is unable. Third, bee stings can be life-threatening if the victim receives a large number of stings. In essence, this causes the victim's body to react as though he were severely allergic to bee stings and results in anaphylaxis.

• Preventing bee stings can be difficult.– If the location of a hive is known, stay away from it.– If a bee is spotted, do not swat it or kill it -- bees release a scent when they are attacked or killed that summons other bees. Instead, calmly walk

away or just ignore the bee.– Be aware of the aggressiveness of different species of bees. European honeybees, for example, are usually very pacific and will not sting unless

provoked. Yellowjackets, on the other hand, are much more aggressive and will attack anything that disturbs the area around their hive.

First Aid & Triage Meanings• What is First Aid

– First aid is the immediate response to an injury.– For major injuries, it is how a responder prevents an injury from worsening and sustains life until professional medical help

arrives.– For minor injuries, first aid is the response to an injury and often includes treatment.

• Rules of Thumb– Don't panic. Think about what you're doing and move carefully. If you're calm, your patient will be calm.– Never move an injured person unless they are in immediate danger.– Never leave an injured person unless you are unable to continue giving aid or you are relieved by someone more qualified than

yourself.– When in doubt, assume a head/neck injury especially when a person falls from a height taller than themselves.– Never be afraid to improvise. First aid is rarely required when first aid kits are handy.

• What does Triage mean? The process of determining the priority of patients' treatments based on the severity of their condition. Triage can separate injured into four groups:

– The persons who are beyond help– The injured who can be helped by immediate transportation– The injured whose transport can be delayed– Those with minor injuries, who need help less urgently

Broken Bones• A broken bone can be identified by a number of symptoms:

– An unusual bend in a limb.– Swelling or bruising in a limb or joint.– Tenderness or pain at a specific point along a bone.– Inability to move a limb or joint.– Hearing or feeling a bone snap.

• Broken bones fall into two categories: simple and compound.– A simple fracture is one where the bone is broken and both broken ends are beneath the surface of the skin.

Simple fractures can be dangerous if they are moved; the ends of the broken bones are sharp and will cut through blood vessels and tissue caught between them.

– A compound fracture is one where the bone is broken and one or both broken ends are sticking out of the skin. Compound fractures can be dangerous because they can become easily infected.

• To treat a compound fracture, dress and bandage the exposed bone like any other puncture wound, then apply a splint as with a simple fracture.

• Do not attempt to push the bone beneath the skin.• Broken bones, both simple and compound, require immediate medical attention.