Three Hurry Cases

Stopped breathing:

1) Causes of this can include: near drowning, cervical spine fractures, head injuries, asthma, smoke in a fire, electric shock and lightning strike, excessive sedatives(intentional or not), excessive alcohol, drug abuse/use, and foreign objects especially in young children resulting in choking

2) How to check: as in CPR listen to mouth and nose or feel for air outflow and carefully look at the chest for spontaneous rise and fall

3) How to treat: 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, vomitus if necessary, 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 as in the choking scenario.

Breathe how many times a minute in the case of an adult? 12 /min ( 1 per 5 seconds) Don′t forget to check for pulse after you establish you can ventilate the lungs. Child: 20( per minute or 1 per 3 seconds).

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. Why? (to reduce risk of aspiration secondary to vomiting)

Severe Bleeding or Hemorrhaging :

If bleeding brisk and from large vessel fast action needed in order to prevent shock and subsequent death.

First aid kits should have readily available gloves, protective eye wear and a mouth-barrier device.

Discuss differences between arterial and venous bleeding and significance of each.

How to treat:

a) Firm pressure with a sterile pad if available. If not clean washed hands next best.

b) Apply pressure in the case of an arterial bleed 10-15 minutes firmly.

c) May try raising limb above heart if continues to bleed.

d) 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 axillary(armpit) or brachial artery(elbow) depending where the laceration is located in the case of the arm.
e) If a bandage is used be sure a distal pulse is felt beyond the laceration. If not loosen up the bandage a bit.

f) 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.

g) Tourniquet should be wide i.e. 2-3 inches wide. Why? 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.


Common signs and symptoms to look for include:

  • Burns or redness around the mouth and lips, from drinking certain poisons
  • Breath that smells like chemicals, such as gasoline or paint thinner
  • Burns, stains and odors on the person, on clothing, or on furniture, floor, rugs or other objects in the surrounding area
  • Empty medication bottles or scattered pills
  • Vomiting, difficulty breathing, sleepiness, confusion or other unexpected signs

When to call for help

Call 911 or your local emergency number immediately if the person is:

  • Drowsy or unconscious
  • Having difficulty breathing or has stopped breathing
  • Uncontrollably restless or agitated
  • Having seizures

If the person seems stable and has no symptoms, but you suspect poisoning, call your regional poison control center or, in the United States, the National Capital Poison Center at 800-222-1222. Provide information about the person's symptoms, age and weight, and any information you have about the poison, such as amount and how long since the person was exposed to it. It helps to have the pill bottle or poison container on hand when you call.

What to do while waiting for help

Some things you can do for the person until help arrives:

  • If the person has been exposed to poisonous fumes, such as carbon monoxide, get him or her into fresh air immediately.
  • If the person swallowed the poison, remove anything remaining in the mouth.
  • If the suspected poison is a household cleaner or other chemical, read the label and follow instructions for accidental poisoning. If the product is toxic, the label will likely advise you to call the poison center at 800-222-1222. Also call this 800 number if you can't identify the poison, if it's medication or if there are no instructions.
  • Follow treatment directions that are given by the poison control center.
  • If the poison spilled on the person's clothing, skin or eyes, remove the clothing. Flush the skin or eyes with cool or lukewarm water, such as by using a shower for 20 minutes or until help arrives.
  • Make sure the person is breathing. If not, start CPR and rescue breathing.
  • Take the poison container (or any pill bottles) with you to the hospital.

What NOT to do

Don't give ipecac syrup or do anything to induce vomiting. The American Academy of Pediatrics advises discarding ipecac in the home, saying there's no good evidence of effectiveness and that it can do more harm than good.

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