FIRST AID

How to Use This PamphletThe secret to successfully earning a merit badge is for you to use both the pamphlet and the suggestions of your counselor.

Your counselor can be as important to you as a coach is to an athlete. Use all of the resources your counselor can make available to you. This may be the best chance you will have to learn about this particular subject. Make it count.

If you or your counselor feels that any information in this pamphlet is incorrect, please let us know. Please state your source of information.

Merit badge pamphlets are reprinted annually and requirements updated regularly. Your suggestions for improvement are welcome.

Send comments along with a brief statement about yourself to Youth Development, S209 • Boy Scouts of America • 1325 West Walnut Hill Lane • P.O. Box 152079 • Irving, TX 75015-2079.

Who Pays for This Pamphlet?This merit badge pamphlet is one in a series of more than 100 covering all kinds of hobby and career subjects. It is made available for you to buy as a service of the national and local councils, Boy Scouts of America. The costs of the development, writing, and editing of the merit badge pamphlets are paid for by the Boy Scouts of America in order to bring you the best book at a reasonable price.

first aid

BOY sCOUts Of aMEriCaMErit BadGE sEriEs

The Boy Scouts of America is indebted to the American Red Cross for its subject matter expertise, review, and other assistance with this edition of the First Aid merit badge pamphlet.

Requirements1. Satisfyyourcounselorthatyouhavecurrentknowledge

ofallfirst-aidrequirementsforTenderfoot,SecondClass,andFirstClassranks.

2. Dothefollowing:

a. Explainhowyouwouldobtainemergencymedical assistancefromyourhome,onawildernesscamping trip,andduringanactivityonopenwater.

b. Explainthetermtriage.

c. Explainthestandardprecautionsasappliedto bloodbornepathogens.

d. Prepareafirst-aidkitforyourhome.Displayand discussitscontentswithyourcounselor.

3.Dothefollowing:

a. Explainwhatactionyoushouldtakeforsomeone whoshowssignalsofshock,forsomeonewho showssignalsofaheartattack,andforsomeone whoshowssignalsofstroke.

b. Identifytheconditionsthatmustexistbefore performingCPRonaperson.Thendemonstrate propertechniqueinperformingCPRusingatraining deviceapprovedbyyourcounselor.

c. Explaintheuseofanautomatedexternal defibrillator(AED).

d. Showthestepsthatneedtobetakenforsomeone sufferingfromaseverecutonthelegandonthe wrist.Tellthedangersintheuseofatourniquetand theconditionsunderwhichitsuseisjustified.

e. Explainwhenabeestingcouldbelifethreatening andwhatactionshouldbetakenforprevention andforfirstaid.

35897ISBN 978-0-8395-3301-6©2007 Boy Scouts of America2010 Printing

BANG/Brainerd, MN3-2010/059719

fiRST Aid        3

f. Explainthesymptomsofheatstrokeandwhataction shouldbetakenforfirstaidandforprevention.

4.Dothefollowing:

a. Describethesignalsofabrokenbone.Showfirst-aid proceduresforhandlingfractures(brokenbones), includingopen(compound)fracturesofthe forearm,wrist,upperleg,andlowerlegusing improvisedmaterials.

b. Describethesymptomsandpossiblecomplications anddemonstrateproperproceduresfortreating suspectedinjuriestothehead,neck,andback. Explainwhatmeasuresshouldbetakentoreduce thepossibilityoffurthercomplicatingtheseinjuries.

5.Describethesymptoms,properfirst-aidprocedures,andpossiblepreventionmeasuresforthefollowingconditions:

a. Hypothermia

b. Convulsions/seizures

c. Frostbite

d. Dehydration

e. Bruises,strains,sprains

f. Burns

g. Abdominalpain

h. Broken,chipped,orloosenedtooth

i. Knockedouttooth

j. Musclecramps

6.DoTWOofthefollowing:

a. Ifasickoraninjuredpersonmustbemoved,tell howyouwoulddeterminethebestmethod. Demonstratethismethod.

b. Withhelpersunderyoursupervision,improvisea stretcherandmoveapresumablyunconsciousperson.

c. Withyourcounselor’sapproval,arrangeavisitwith yourpatrolortrooptoanemergencymedicalfacility orthroughanAmericanRedCrosschapterfora demonstrationofhowanAEDisused.

7.TeachanotherScoutafirst-aidskillselectedbyyourcounselor.

4        fiRST Aid

Contents

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 ReducingRisk. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

HowtoHandleanEmergency. . . . . . . . . . . . . . . . . . . . . . . 11 1.ChecktheScene..............................11 2.CallforHelp . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 3.ApproachSafely. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 4.ProvideUrgentTreatment. . . . . . . . . . . . . . . . . . . . . . . 15 5.ProtectFromFurtherInjury. . . . . . . . . . . . . . . . . . . . . 16 6.TreatEveryAccidentVictimforShock . . . . . . . . . . . . . 17 7.MakeaThoroughExamination. . . . . . . . . . . . . . . . . . . 18 8.PlanaCourseofAction. . . . . . . . . . . . . . . . . . . . . . . . 19

First-AidSuppliesandSkills . . . . . . . . . . . . . . . . . . . . . . . . 21 PersonalFirst-AidKit. . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 HomeorPatrol/TroopFirst-AidKit. . . . . . . . . . . . . . . . . . 22 MovinganIllorInjuredPerson. . . . . . . . . . . . . . . . . . . . 23

MinorWoundsandInjuries. . . . . . . . . . . . . . . . . . . . . . . . . 31 Bruises . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 PunctureWounds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 CutsandScrapes(Abrasions). . . . . . . . . . . . . . . . . . . . . . 34 BlistersontheHandandFoot . . . . . . . . . . . . . . . . . . . . . 36

Muscle,Joint,andBoneInjuries . . . . . . . . . . . . . . . . . . . . . 38 MuscleCramps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 SprainsandStrains . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 BrokenBones . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 Head,Neck,andBackInjuries. . . . . . . . . . . . . . . . . . . . . 48

fiRST Aid        5

Cold-andHeat-RelatedConditionsandInjuries. . . . . . . . . . 51 Hypothermia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 Frostbite . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 Dehydration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 HeatExhaustion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54 Heatstroke. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

Burns. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 Superficial(First-Degree)Burns. . . . . . . . . . . . . . . . . . . . 56 Partial-Thickness(Second-Degree)Burns . . . . . . . . . . . . . 57 Full-Thickness(Third-Degree)Burns . . . . . . . . . . . . . . . . 58 ChemicalBurns. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 ElectricalBurns. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

OtherFirst-AidCases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 Fainting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 LossofConsciousness. . . . . . . . . . . . . . . . . . . . . . . . . . . 64 Seizures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64 Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 ForeignObjectintheEye. . . . . . . . . . . . . . . . . . . . . . . . . 68 Nosebleeds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68 PoisonousPlants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70 AbdominalPain. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71 DentalInjuries. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72 BitesandStings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74

Life-ThreateningEmergencies . . . . . . . . . . . . . . . . . . . . . . . 81 HeartAttack . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86 Stroke. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87 SevereBleeding. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89 AnaphylacticShock(Anaphylaxis). . . . . . . . . . . . . . . . . . 91

First-AidResources. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93

Acknowledgments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95

fiRST Aid        7

.introduction

IntroductionFirstaid—caringforinjuredorillpersonsuntiltheycanreceiveprofessionalmedicalcare—isanimportantskillforeveryScout.Withsomeknowledgeoffirstaid,youcanprovideimmediatecareandhelptosomeonewhoishurtorwhobecomesill.Firstaidcanhelppreventinfectionandseriouslossofblood.Itcouldevensavealimboralife.

First-aidrequirementsfortheTenderfoot,SecondClass,andFirstClassranksencourageyoutopracticetreatingcertaininjuriesandailments.EarningtheFirstAidmeritbadgewillhelpyouunderstandthatemergencymedicaltreatmentisasetofclearactionsteps.Byfollowingthestepseverytimeyoucomeuponafirst-aidemergency,youcanquicklyevaluatethesituation,comeupwithafirst-aidplan,andthenseethatplanthrough.

The Goals of First Aid•  Protect a person who is injured or ill from  

further harm.

•  Stop life-threatening medical emergencies. (Keep  the airway open. Maintain breathing and circulation. Stop serious bleeding. Treat for shock.)

•  Get the person under professional medical care. 

To learn how to

treat for shock,

see “How to

Handle an

Emergency.”

8        fiRST Aid

introduction.

First-Aid Rank RequirementsTenderfoot

  11.  Identify local poisonous plants; tell how to treat for exposure to them.

  12a. Demonstrate how to care for someone who is choking.

  12b. Show first aid for the following:

  • Simple cuts and scrapes      • Venomous snakebite

  • Blisters on the hand and foot    • Nosebleed

  • Minor (thermal/heat) burns or     • Frostbite and sunburn     scalds (superficial, or first-degree)    • Bites or stings of insects and ticks

Second Class

  6a.  Show what to do for “hurry” cases of stopped breathing, serious      bleeding, and ingested poisoning.

  6b.  Prepare a personal first-aid kit to take with you on a hike.

  6c.  Demonstrate first aid for the following:

  • Object in the eye

  • Bite of a suspected rabid animal

  • Puncture wounds from a splinter, nail, and fishhook

  • Serious burns (partial-thickness, or second-degree)

  • Heat exhaustion

  • Shock

  • Heatstroke, dehydration, hypothermia, and hyperventilation

First Class

  8b.  Demonstrate bandages for a sprained ankle and for injuries on the      head, the upper arm, and the collarbone.

  8c.  Show how to transport by yourself, and with one other person,      a person

  • From a smoke-filled room

  • With a sprained ankle, for at least 25 yards

  8d.  Tell the five most common signals of a heart attack. Explain the steps      (procedures) in cardiopulmonary resuscitation (CPR).

fiRST Aid        9

.introduction

Reducing RiskOnewaytostayhealthyandsafebothathomeandwhenyouareintheout-of-doorsistorecognizethatthereisanelementofriskinmanyactivities.Bybeingawareofriskandadjustingyourbehaviortomanageit,youwillalsobeinastrongerposi-tiontoprovideassistanceshouldanemergencyarise.AmongthewaysyoucanincreaseyourroleinriskmanagementduringScoutingadventuresarethefollowing:

• Stayingoodphysicalconditionsothatyouarereadyforthedemandsoftheactivitiesyouenjoy.

• Knowwhereyouaregoingandwhattoexpect.

• Adjustclothinglayerstomatchchangingconditions.

• Drinkplentyofwater.

• Protectyourselffromexposuretothesun,bitinginsects,andpoisonousplants.

• Takecareofyourgear.

Scouttroopsandpatrolscanalsomanageriskasagroup:

• Reviewandpracticefirst-aidskillsandtechniquesonaregularbasis.

• Takeresponsibilityforhavingasafeexperience.

• Besureeveryoneunderstandsandfollowsgroupguide-linesestablishedtominimizerisk.

• Ensureeveryonehasasayinrecognizinganddealingwithrisksthatmightarise.

After you learn the first-aid skills and techniques required for the First Aid merit badge, you can teach another Scout what you have learned. Teaching a fellow Scout a simple first-aid skill is a great way to practice and gain mastery of the skill and will also allow you to complete requirement 7.

fiRST Aid        11

.How to Handle an Emergency

HowtoHandleanEmergencyEventhebestplanscanfallapart.Accidentswillhappen.Peoplewillbecomesick.Youmightbethepersonwhoismostabletotakechargeofanemergencyscene.Hereishowyoushouldproceed.

1. Check the SceneThesiteofanaccidentcanbeconfusing,especiallywhenseri-ousinjurieshaveoccurredorthereismorethanonepersoninvolved.Thereareanumberofthingstoconsider.Thehazardthatcausedtheaccidentmaystillposeathreat.Seeingblood,brokenbones,vomit,orpeopleinpainmightdisturbbystandersandfirst-aiders.

Beforeyoutakeanyaction,stopforamomenttolookovertheentiresceneandcollectyourthoughts.Considerthefollowingquestions:• Whatcausedtheaccident?• Aretheredangersinthearea?• Howmanyvictimsarethere?• Ifthereareotherpeoplenearby,cantheyassistwithfirstaid

orwithgettinghelp?• Willbystandersneedguidancesothattheydonotbecome

injuredorillthemselves?

Do Your BestGood Samaritan laws legally protect anyone making a good-faith effort to help the victim of an injury or illness. Whenever you are confronted with  a first-aid emergency, use your skills to the best of your ability. No one expects you to have the knowledge of a physician. However, Scouting’s history is filled with stories of Scouts who used their training to help  others, sometimes even saving lives.

12        fiRST Aid

How to Handle an Emergency.

2. Call for HelpShouldyouencounterasituationwheresomeonehasmorethanaminorillnessorinjury,actquicklytogetemergencymedicalhelp.YoucanreachemergencyservicesinmuchoftheUnitedStatesbycalling911.Somecommunitiesuseotheremergency-alertsystemssuchasdialing0orcallingalocalsheriff’sofficeorfiredepartment.Instructabystanderoranotherfirst-aidertocallforhelpimmediately:“You, call for help right now. Tell them where we are and what has happened, then report back to me.”

Awildernesscampingtripcantakeyoufarfromtelephones.AninjuredScoutwhocanwalkonhisownorwithsomesup-portmaybeabletohiketoaroad.AgroupofScoutsmaybeabletobuildastretcherandcarryavictim.Forseriousinjuries,though,itisusuallybesttotreatthevictimattheaccidentsite—providedthatdoingsowouldnotfurtherendangerthevictimorthefirst-aiders—andsendtwoormorepeopleforhelp.

Mobile phones

are unreliable in

wilderness areas.

If you take a

mobile phone on

an outing, have a

backup plan for

summoning emer-

gency assistance.

fiRST Aid        13

.How to Handle an Emergency

Writeanotecontainingthefollowinginformationandsenditwiththemessengers:

• Locationofthevictim

• Descriptionoftheinjuriesorillness

• Timetheinjuriesorillnessoccurred

• Treatmentthevictimhasreceived

• Numberofpeoplewiththevictimandtheirgeneralskilllevelforfirstaid

• Requestsforspecialassistanceorequipment,includingfood,shelter,orcarefornonvictims

Activitiesonopenwatersometimestakepeoplefarfromanyhelp.Largerboatsoftenhaveradioequipmentthatcanbeusedtosummonaid.Whenphonesorradiosarenotavailable,however,passengerswillneedtomakeandcarryoutaplanforgettinghelp.Suchaplanmightinvolvesendingtwopeopletotheclosesttelephonetocallforhelp.

3. Approach SafelyAfterassessingthesituationandsummoninghelp,determinethebestwaytoreachtheinjuredpersonorpersons.Perhapsanaccidentvictimislyingonabusyhighwayorhasfallenandtumbledpartwaydownamountainside.Willyoualsobeindan-gerifyoudashontothehighwayorrushdowntheslope?Figureoutasafewaytoapproachthevictimortoremovethedangersfromanarea.Do not become an accident victim yourself.

See “First-Aid

Supplies and

Skills” for

information on

how to build

an improvised

stretcher.

In Case of EmergencyMany people carry mobile phones these days, but not everyone carries details of whom should be called on their behalf in case they are involved in a serious  accident. If you add the acronym ICE—for “In Case  of Emergency”—as a contact in your mobile phone, emergency workers can quickly find someone to notify about your condition. Ask your parent whom to list as your ICE contact. 

14        fiRST Aid

How to Handle an Emergency.

Onceyouhavefiguredoutthesafestwaytoapproach,introduceyourselftoinjuredpersonsandtobystanders.Assurethemthatmedicalprofessionalshavebeencalledandareontheway.Speakinginacalmvoice,explainthatyouareaScouttrainedinfirstaidandthatyouaretheretohelp.Askvictimsiftheywillallowyoutoassistthem.Continuetospeaktoinjuredorillpersonsasyouadministerfirstaid,keepingtheminformedofwhatyouaredoing.

Sometimesavictim’slocationthreatenshisorhersafetyandthatoffirst-aiders.Forexample,supposeyouareouthikingandabuddyfallsintoastreamorgetshurtwhileonanunsta-bleboulderfieldoravalancheslope.Itmightbenecessarytomovehimtoasaferlocationbeforefirst-aidtreatmentcanbegin.Tomovehim,getthehelpofseveralothersinyourgroupandliftthevictiminthesamepositioninwhichhewasfound.Thencarryhimtosafetyandgentlyputhimdown.(See“MovinganIllorInjuredPerson”laterinthispamphlet.)Takespecialcaretopreventhisneckfrommovingbysupportinghisheadbefore,during,andaftertheemergencymove.

When a person is

unconscious,

assume it is OK to

render aid.

See “First-Aid

Supplies and

Skills” for

precautions to

be taken

when moving

accident victims.

fiRST Aid        15

.How to Handle an Emergency

4. Provide Urgent TreatmentBreathingandbleeding—theseareyourimmediateconcernswhentreatingthevictimofanaccidentorillness.Victimswhohavestoppedbreathingorwhoarebleedingseverelyarecalledhurry casesbecausetheirlivesareinimmediatedanger.Theyrequiresmart,timelyactiononthepartofafirst-aider.

Wheneveryoucomeuponaninjuredperson,takenomorethan15to20secondstodoaquicksurveyofhisorhercondi-tiontofindoutthefollowing:

• Is the person conscious and breathing?Ifheorsheseemstobeunconscious,tapthepersonontheshoulderandask(orshout)ifheorsheisallright.Ifthepersondoesnotrespond,opentheairwaybytiltingtheheadandliftinguponthechin,thenplaceyourearnearthemouthandnosewhereyoucanhearandfeelthemovementofair.Watchforthechesttoriseandfall.

• Is there severe bleeding?Openraingearandouterclothingthatmighthidewoundsfromview.

• Are there other contributing factors?LookforamedicalIDbracelet,necklace,orcardthatmightgiveinformationaboutallergies,diabetes,orotherpossiblecausesofanemergencysituation.Personswhohaveasthmaorallergiestoinsectstingsorcertainfoods(suchaspeanuts)mightcarrytreat-mentfortheircondition.

See“Life-ThreateningEmergencies”formoredetails.

TriageEmergency situations involving more than one victim can require triage (pronounced tree-ahge)—quickly checking each victim for injuries or symptoms of illness and then determining how best to use available  first-aid resources. In its simplest form, triage occurs whenever first- aiders approach an emergency scene that involves two or more persons who are injured or ill. Once on the scene, medical professionals will deter-mine who requires urgent care, who can be treated later, who needs to be monitored in case his or her condition changes, and who is well enough to help out.

If the person is

breathing, the

breaths should

not be irregular

or shallow or

short; the person

should not be

gasping for air.

16        fiRST Aid

How to Handle an Emergency.

5. Protect from further injuryAnimportantpartoffirstaidisprotectinganaccidentvictimfromfurtherinjury.Followtheseguidelines.

• Avoidmovinganinjuredpersonunlesshisorherbodyposi-tionmakesitimpossibletoperformurgentfirstaidorheorsheisinadangerouslocation.Ifaperson’spositionmustbeadjusted,forexample,toallowthemtobreathe,dosowiththeminimumamountofmovement.

• Stabilizethevictim’sheadandnecktopreventanyneckbonesthatmaybebrokenfromdamagingthespinalcord.Askafellowfirst-aiderorabystandertoholdthevictim’sheadandnecksteadytokeeptheneckinproperalignment.

For children age 11 and under, check for a pulse to make sure the heart is beating. This should not take more than 10 seconds.

While awaiting emergency personnel, support the victim’s head in the position you found it, in line with the person’s body.

fiRST Aid        17

.How to Handle an Emergency

6. Treat Every Accident Victim for ShockThecirculatorysystemofapersonwhoisinjuredorundergreatstressmightnotprovideenoughbloodandoxygentothetissuesofthebody.Thisconditioniscalledshock,anditcanbedeadly(asorganscanbegintofail).Ashockvictimcanhavesome,all,ornoneofthefollowingsymptoms:

• Restlessnessorirritability

• Afeelingofweakness

• Confusion,fear,dizziness

• Skinthatismoist,clammy,cool,andpale

• Aquick,weakpulse

• Shallow,rapid,andirregularbreathing

• Nauseaandvomiting

• Extremethirst

Seriousinjuriesandsuddenillnessesarealmostalwaysaccompaniedbysomedegreeofshock,butthevictimmightnotbeaffectedrightaway.Treateveryaccidentvictimforshockevenifnosymptomsappear.Promptfirstaidmaypreventshockfromsettingin.

Fearanduncertaintycanincreaseshock.Inacalmvoice,assurethepersonthateverythingpossibleisbeingdoneandthathelpisontheway.Apersonwhoappearstobeuncon-sciousmaystillbeabletohearyou.Neverleaveanaccidentvictimaloneunlessyoumustbrieflygotocallforhelp.

18        fiRST Aid

How to Handle an Emergency.

7. Make a Thorough ExaminationBythetimeyouhavedealtwithurgentconditionsandprovidedtreatmentforshock,medicalprofessionalsarelikelytohavearrived.Whentheirarrivalisdelayedorthelocationwillrequiregreatertraveltime,conductamorethoroughexamina-tiontobesureyouhavefoundallthevictim’sinjuriesthatrequireattention.Ifthevictimisalert,askwhereitispainfulandwhetherthevictimcanmovethearms,legs,andsoon.Getbeneathjacketsandotherclothingthatcouldobscureorhidewoundsthatarebleeding.

First Aid for Shock1. Try to eliminate the causes of shock by restoring 

breathing and circulation, controlling bleeding, relieving severe pain, and treating wounds.

2. Summon emergency aid.

3. Monitor the victim closely to make sure the airway stays open for breathing.

4. If the victim is not already doing so, help the injured person lie down. If you do not suspect back, neck, or head injuries, or fractures in the hip or leg, raise the feet about 12 inches to move blood from the legs to the vital organs.

5. Keep the victim warm with blankets, coats, or  sleeping bags.

fiRST Aid        19

.How to Handle an Emergency

8. Plan a Course of ActionAfterconductingtheexamination,determinewhattodonext.Thebestcourseofactioninmostcasesistomakethevictimcomfortableandcontinuetowaitformedicalhelptoarrive.Maintaintreatmentforshock,keeptheairwayopen,monitorthevictimforanychanges,andbereadytoprovideanyothertreatmentthevictimmightrequire.

Inthebackcountryitmaybewisetosetupcampandtoshelterthevictimwithatent.Ratherthanliftingabadlyinjuredpersonintoatent,youcanslitthefloorofastandingtentandthenplacethetentovertheperson.

Beawareofyourownneeds,too,andthoseofothersaroundyou.Staywarmanddry.Ifafirst-aidemergencylastsverylong,besuretoeatanddrinkenough.Beawarethatothergroupmembersmaybefrightenedordisorientedbywhattheyhaveseen.Besuretheydonotwanderoff.Givingpeoplespecificresponsibilities—fixingamealormakingcamp,forexample—canfocustheirattentionandhelpkeepthemcalm.

Learn all the first aid you can and review it often. Perhaps one day you will be able to do just the right thing at a time when your actions make all the difference.

fiRST Aid        21

.first-aid supplies and skills

First-AidSuppliesandSkillsYoucannotrenderfirstaidifyoudonothavethetoolsandsuppliesnecessarytotreataninjuredorillperson.Awell-stockedfirst-aidkitisanessentialitemforallfirst-aiders.Equallyimportantislearningandpracticingdifficultfirst-aidskillssuchashowtosafelytransportanillpersonoranaccidentvictim.

Personal first-Aid KitCarryingafewfirst-aiditemsonhikesandcampoutswillallowyoutotreatscratches,blisters,andotherminorinjuriesandtoprovideinitialcareformoreseriousemergencies.Youshouldbeabletofiteverythinginaresealableplasticbag.Alwaystakeyourpersonalfirst-aidkitwhenyousetoutonaScoutadven-ture.Yourkitshouldincludeasaminimumthefollowing:

❑Adhesivebandages(6)

❑Sterilegauzepads,3-by-3-inch(2)

❑Adhesivetape(1smallroll)

❑Moleskin,3-by-6-inch(1)

❑Soap(1smallbar)oralcohol-basedhandsanitizinggel(1travelsizebottle)

❑Tripleantibioticointment(1smalltube)

❑Scissors(1pair)

❑Nonlatexdisposablegloves(1pair)

❑CPRbreathingbarrier(1)

❑Pencilandpaper

22        fiRST Aid

first-aid supplies and skills.

Home or Patrol/Troop first-Aid Kit Amorecomprehensivefirst-aidkitsuitableforhomeuseorusebyyourpatrolortroopcantreatawiderangeofinjuries.Afterassemblingyourhomekit,besureeveryoneinyourfamilyknowswherethekitisbeingstored.Italsoisagoodideatocarryafirst-aidkitinthecarincaseofroadsideemergencies.OnScoutoutings,thepatrolortroopfirst-aidkitcanbecarriedinafannypackthatismarkedsothatitwillbeeasyforanyonetolocate.Ataminimum,thekitshouldcontainthefollowing:

❑Rollerbandage,2-inch(1)

❑Rollerbandage,1-inch(2)

❑Adhesivetape,1-inch(1roll)

❑Alcoholswabs(24)

❑Assortedadhesivebandages(1box)

❑Elasticbandages,3-inch-wide(2)

❑Sterilegauzepads,3-by-3-inch(12)

❑Moleskin,3-by-6-inch(4)

❑Gelpadsforblistersandburns(2packets)

❑Tripleantibioticointment(1tube)

❑Triangularbandages(4)

❑Soap(1smallbar)oralcohol-basedhandsanitizinggel(1travelsizebottle)

❑Scissors(1pair)

❑Tweezers(1pair)

❑Safetypins(12)

❑Nonlatexdisposablegloves(6pairs)

❑Protectivegoggles/safetyglasses(1pair)

❑CPRbreathingbarrier(1)

❑Pencilandpaper

fiRST Aid        23

.first-aid supplies and skills

Moving an ill or injured PersonThedecisiontomoveanaccidentvictimshouldbemadecare-fully.Inmanycases,therewillbeemergencymedicalcrews,firedepartmentpersonnel,orotherswithspecialequipmentandtrainingwhowilltransportaninjuredperson.If,however,someoneisindangerfromfire,smoke,water,electricalhaz-ards,poisonousgases,exposure,orotherimmediatedanger,youmustmovethatpersontosafety.Youmightalsoneedtomoveaninjuredpersoninordertogivethatpersonpropercare,orreachanothervictim.Movethepersononlyasfarasisnecessary,anddonotendangeryourself.

Sometimesyouwillfindthatavictim’sinjuriesareminorenoughthatthepersoncanmovewithsomeassistance.Beforeattemptingtomovesomeone,makesurethepersonisnotsuf-feringfromanyofthefollowingconditions.Thendeterminethebesttechniquetouseformovingthevictimorwhetherthevictimshouldnotbemovedatall.

• Shock

• Heartattack

• Head,neck,orback(spinal)injury

• Frostbittenorburnedfeet

• Boneorjointinjuryatthehipsorbelow

Foravictimofavenomousbiteorsting,gettingthevictimtomedicalattentionisthemostimportantgoal.Thismaycallformovingthevictimbeforetheswellingbecomestoosevere.

Herearesomeadditionalassistsandhandcarriestocon-sider.Somecanbeperformedbyasinglerescuer,whileothersrequiretwoormorerescuers.Practicesingle-andmultiple-rescuerassistsfirstwithanuninjuredperson.Thiswillhelpyouworksmoothlyandsafelyduringarealemergency.

Signals includes both signs (what you would observe) as well as symptoms (what a person would  communicate to you).

24        fiRST Aid

first-aid supplies and skills.

Single-Rescuer AssistsWhenaninjuredpersonmustbemoved,choosethemethod

carefullytoavoidmakingtheinjuriesworseandtoavoidinjuringyourself.Recommendedassistsforasinglerescuerincludethefollowing.

Walking assist.Ifthevictimisconscious,hasonlyminorinjuries,andcanmove,youcansafelyhelpthepersonwalk.Putoneofthevictim’sarmsaroundyourneck.Holdthat

hand.Placeyourotherarmaroundtheperson’swaist.

Ankle drag.Thefastestmethodforashortdistanceonasmoothsurface,ortomovesomeonewhoistoolargeorheavytotransportinanyotherway,istodragthepersonbybothankles.

Shoulder drag.Forshortdistancesoveraroughersurface,andtomoveaconsciousorunconsciouspersonwhomayhavehead,neck,orbackinjuries,usetheclothesdrag.Firmlygrabtheperson’sclothingbehindtheshoulderandneckareaandpullheadfirst.

Blanket drag.Rollthepersonontoablanket,coat,tarp,ortablecloth,coverthepersonasshown,ifpossible,anddragfrombehindthehead.

fiRST Aid        25

One-person lift. Youmaybeabletocarryachildorsomeonewhodoesnotweighmuchifyouplaceonearmunderthevictim’skneesandonearoundtheupperback.Donotusethismethodifyoususpectspinalinjury.

firefighter carry.Totravellongerdistances,carrythevictimoveryourshoulderifinjurieswillallowit.Thefirefightercarryshould

neverbeusedifyoususpectthevictimhasaspinalinjury.

Pack-strap carry. Thepack-strapcarryisbetterforlongerdistancesthantheone-personliftandwhenthefirefightercarryisnotpractical.Usethismethodonlyifyoudonotsuspectspinalinjury.

26        fiRST Aid

first-aid supplies and skills.

Multiple-Rescuer AssistsRecommendedassistsfortwoormorerescuersincludethefollowing.

Helping the person walk.Ifthevictimisconsciousandshowsnosignalsoftheconditionsorinjurieslistedearlier,tworescuerscansafelyhelpthepersonwalk.Putoneofthevictim’sarmsaroundeachrescuer’sneck.Holdthehands.Rescuersplacetheirfreearmsaroundthevictim’swaist.

four-handed seat. Whennoequipmentisavailable,thefour-handedseatistheeasiesttwo-rescuercarry.Itissafeonlyifthevictimisconsciousandcanholdon.Positionthehandsasshown.

Two-handed seat.Usethismethodifthevictimisconsciousbutnotseriouslyinjured.Rescuersplacearmsoneachother’sshoulderandlockarmsforstabilityasthevictimgetsintoposition,thenmovearmsfromshoulderstoacrossthevictim’sback.

fiRST Aid        27

.first-aid supplies and skills

Chair carry. Thisisagoodmethodforcarryinganinjuredpersonupstairsorthroughnarrow,windingspaces.

Hammock carry. Threetosixrescuersstandoneithersideofthevictimandlinkhandsbeneaththeperson.

Rescue From a Smoke-Filled RoomA smoke-filled room is an extremely hazardous environment. Rushing into a smoke-filled room or other dangerous scene to help someone will do no good if you also become a victim. If your safety will be threatened, wait until trained rescuers arrive. 

Moving an injured or unconscious person should be done quickly. Avoid using any method that might make the victim’s injuries worse.  A victim can be moved to safety with any of the rescuer assists  described in this chapter.

scout 1

scout 2

scout 3

28        fiRST Aid

first-aid supplies and skills.

StretchersWhenapersonmustbemovedforsomedistanceorhisorherinjuriesareserious,youshouldcarrythepersononastretcher.

Whenavailable,usealitterorrescuebasketmadeespeciallyfortransportinginjuredpersons.Ifnoneisavailable,makeoneofthefollowingimprovisedstretchersandusethemethodshownintheillustrationstoplacethevictimontheimprovisedstretcher:

Shirt stretcher.Makeastretcheroutoftwopoles(longerthanthevictimistall),forexample,strongbranches,toolhandles,oars,orthepolesfromawalltent.SecuretwoScoutshirts(insideout,withallthebuttonsbut-toned)overthepolestoformastretcher.Ifpossible,overlapthebottomsoftheshirtstoformamoresecurebedding.

overlap bottoms of the shirts.

fiRST Aid        29

.first-aid supplies and skills

Blanket stretcher.Placeapoleontheblanket.Foldovertwo-fifthsoftheblanket.Placeasecondpole6inchesfromtheedgeofthefolded-overpart.Bringtheedgeoftheblanketoverthepole.Foldovertherestoftheblanket.Theperson’sweightwillkeeptheblanketfromunwinding.

Board stretcher.Useasurfboard,door,bench,orironingboardtomakethisstretcher.Aboardstretcherissturdierthanablanketstretcherbutheavierandlesscomfortableforthevic-tim.Whentworescuerscarryastretcher,haveoneortwootherrescuers,ifavailable,walkatthesidestosharetheweightandhelpkeepthevictimfromrollingoff.

Transportingsomeonebystretcher(orimprovisedstretcher)canbedifficultandexhaustingwork,requiringatleastfourrescuers.Stretcherbearersshouldtradeoffwitheachothertoconservetheirstrength.Atleastonefirst-aidershouldstaybythevictim’sheadatalltimestomonitortheperson’sconditionandnoteanychanges.

Toplacesomeoneonastretcherorimprovisedstretcher,havethreerescuersholdthevictimstraightandsteady.Afourthrescuercanslidethestretcherbeneaththevictim.Gentlyplacethevictimonthestretcher.Therescuerscanliftandcarrythestretcher.

Ifonlythreerescuersareavailable,theymaytrythehammockcarrywithoutastretcher.First,theyshouldpositionthemselvesatthevictim’sshoulders,torso,andlegstoachievefullsupport.Then,theyshouldliftandcarrythevictim,beingsuretosupportthehead,arms,andlegs.

A stretcher can

be formed by

lashing three

metal pack frames

together. To work

well, the frames

must have roughly

the same width.

Use sleeping bags

for padding.

.Minor Wounds and injuries

MinorWoundsandInjuriesAlthoughyoushouldbepreparedtodealwithawiderangeofmedicalemergencies,yourfirst-aidskillswillprobablybeputtousemostofteninthetreatmentofrelativelyminorwoundsandinjuries.

BruisesTheblack-and-bluemarkthatistypicalofabruiseiscausedbybloodleakingintoskintissues,oftenasaresultofablowfromabluntobject.Theskinisnotbroken.Somebruisesareindica-torsofmoreseriousinjuriesincludingfracturedbonesordam-agetointernalorgans.Thistypeofbruiserequirestheattentionofaphysician.

Mostbruises,however,canbetreatedbyapersontrainedinfirstaid.Totreatabruise,placesomeice(preferably)orarefreezablegelpackinaplasticbagordampcloth.Placeatowelorcleanclothoverthebruisedareaandapplytheicepackforperiodsofnomorethan20minutes.Thistreatmentwillslowbloodfromleakingintothetissues.Minimizingmove-mentoftheaffectedareaalsoslowsbleedingintothebruise.

32        fiRST Aid

Minor Wounds and injuries.

To sterilize

tweezers, soak

them in rubbing

alcohol for a few

minutes, or hold

them over a flame

for a few seconds,

or place them in

boiling water for a

few minutes; cool

before using.

Puncture WoundsPuncturewoundscanbecausedbypins,splinters,nails,orfishhooks.Allcanbedangerousbecausethenatureofapunc-turewoundmakesithardtocleanandeasilyinfected.Totreatapuncturewound,helpflushoutdirtorparticlesthatmayhavebeenforcedinsidethewoundwhentheinjuryoccurredbyirrigatingtheareawithclean,runningwaterforaboutfiveminutes.Usesterilizedtweezerstopulloutsplinters,bitsofglass,orothersmallobjectsyoucansee.Ifalargeobjectisembedded,donottrytoremoveit.Controlanybleeding,andstabilizetheobjectwithrolledorfoldedsterilegauzepads,applyasterilebandage,andgetthevictimtoadoctor.

fishhook in the SkinAfishhookembeddedintheskinisafrequentoutdoorinjury.Remembertwothings:Donottrytoremoveafishhookfromthefaceorfromaneyeoranearlobe,andnevertrytoremoveanembeddedhookbypullingitbackthewayitwentin.Cutthefishinglineand,ifpossible,letadoctorremovethehookfromtheflesh.Ifthatisn’tpossible,youmighthavetodothejobyourself.First,washyourhandswithsoapandwarmwater.Wearnonlatexdisposableglovesandprotectiveeyeweartoavoidcontactwithblood.

Step 1—Wrapa3-footlengthoffishinglinearoundthebendofthehook,asshown,andsecurelywraptheendsaroundyourindexormiddlefinger.

1

fiRST Aid        33

.Minor Wounds and injuries

Step 2—Keeptheaffectedbodypartflatandstable,thengentlypushdownontheshanktofreethebarbfromtheinjuredtissue.Theshankshouldbeparalleltotheinjuredtissue.

Step 3—Keepbystanderswellawayfromthearea.Givethelineaquick,sharpjerk,andbecarefultoavoidgettingsnaggedbytheoutcominghook.

Step 4—Washandbandagetheinjury,andkeepthewoundclean.Applytripleantibioticointmentiftherearenoknownallergiesorsensitivitiestothemedication.Seeadoctorassoonaspossible,becausetheriskofinfectionishighwiththistypeofinjury.

2 3

if the hook has lodged so that the barb is visible above the skin, try this method:

1. Cut off the barbed end with wire cutters or pliers.

2. Back the shank of the hook out through the entry wound.

Because the risk of infection is high with any type of puncture wound, be sure to see a doctor as soon as possible.

1 2

34        fiRST Aid

Minor Wounds and injuries.

Cuts and Scrapes (Abrasions)Cutsmaybecausedbyknives,razors,orbrokenglass.Anabrasionisawoundthatoccursasaresultoftheouterlayersoftheskinbeingrubbedorscrapedoff.Abrasionsmayhappenwhentheskinisscrapedagainstahardsurface,forexample,whenabicyclistfallsontothepavement.Thewoundmaynotbleedverymuch.Thegreatestdangerliesincontaminationandpossibleinfectionofthewound.

Toprotectyourselffromcutsandscrapes,dressappropri-atelyfortheactivity—forinstance,jeans,boots,gloves,long-sleevedshirt.Afewsimpleprecautionscanhelpyouavoidthepainofthetreatmentandhealingprocess.

Treataminorcutorscrapebyflushingtheareawithcleanwaterforatleastfiveminutes,oruntilallforeignmatterappearstobewashedaway.Applytripleantibioticointmentifthepersonhasnoknownallergiesorsensitivitiestothemedi-cation,andthencoverwithadry,steriledressingandbandageorwithanadhesivebandage.

When the weather is cold, keep the victim’s hands and feet covered with mittens or socks. Remove mittens  or socks frequently to check that circulation is not  being restricted.

fiRST Aid        35

.Minor Wounds and injuries

Dressings and BandagesAfter cleaning a wound in which the skin has been broken, protect it with a dressing. A dressing is a protective covering placed over a wound that helps to control bleeding and absorb blood and wound secretions. Sterile dressings are free from germs and should be used to dress wounds whenever possible. If a sterile dressing is not available, use the cleanest cloth you have. 

A bandage is a strip of material used to hold a dressing or splint in place. It helps immobilize, support, and protect the injury. Common ban-dages include rolls of gauze, elastic bandages, and triangular bandages. Combination dressing-bandages include adhesive strips with attached gauze pads.

Secure the dressing with a bandage or tape. Watch for swelling, color changes, or coldness of the fingertips or toes. If any of these symptoms appear, it is a signal that circulation is being compromised. Loosen  bandages if the victim complains of tingling or numbness.

When using a bandage to secure a dressing, be sure not to wrap it too tightly. Be sure the person’s fingertips or toes are accessible when a splint or bandage is applied to the arm or leg.

To dress and bandage a wound, use a dressing large enough to extend an inch or more beyond the edge of the wound. Hold the dressing over the wound and lower it directly into place. if the dressing slips onto the surrounding skin before it has been anchored, discard it and use a fresh dressing.

36        fiRST Aid

Minor Wounds and injuries.

Blisters on the Hand and footBlistersarepocketsoffluidthatformwhentheskinisaggra-vatedbyfriction.Footblistersarecommoninjuriesamongbackpackers,whereasblistersonthehandsmightbemorecommonamongcanoeists.Tohelppreventfootblisters,wearshoesorbootsthatfit,changesocksiftheybecomesweatyorwet,andpayattentiontohowyourfeetfeel.Tohelppreventblistersonthehands,wearglovesforprotectionandpayatten-tiontohowyourhandsfeel.

Ahot spot—thetenderareaasablisterstartstoform—isasignaltostopimmediately.Totreatahotspotorblister,coverthepinkish,tenderareawithapieceofmoleskinormolefoamslightlylargerthanthehotspot.Useseverallayersifnecessary.Thereareacoupleofhelpfulnewproductsonthemarket—SecondSkin®andBlist-O-Ban®—thatmaybeworthtrying.Followthemanufacturer’sinstructions.Changebandageseverydaytohelpkeepwoundscleanandavoidinfection.

Ifyoumustcontinueyouractivityeventhoughyouthinkasmallblisterwillburst,youmightwanttodrainthefluid.First,washtheskinwithsoapandwater,thensterilizeapinintheflameofamatch.Pricktheblisternearitsloweredgeandpressoutthefluid.Keepthewoundcleanwithasterilebandageorgelpadandmoleskin.

Blisters are best

left unbroken.

If a blister does

break, treat the

broken blister as

you would a minor

cut or abrasion.

Diabetics who

develop blisters

should see

a physician.

fiRST Aid        37

.Minor Wounds and injuries

In some situations,

such as a

life-threatening

one, it might not

be possible or

practical to spend

15 or 20 seconds

washing your

hands. Do the

best you can,

and use your

good judgment.

Protection From Bloodborne PathogensWhenever you provide first-aid care—no matter how minor the wound or injury—you should take steps to protect yourself and others from bloodborne patho-gens, viruses, or bacteria carried in the blood that can cause disease in humans and may be present in the blood or other body fluids of the victims you treat. Bloodborne pathogens include the human immunodefi-ciency virus (HIV), which causes AIDS, and the hepatitis B and C viruses, which cause liver disease.

Recommendations from the Boy Scouts of America:

•  Treat all blood as if it were contaminated with blood-borne pathogens. 

•  Thoroughly wash your hands with soap and  warm water before and after treating a sick or  injured person.

•  Never use your bare hands to stop bleeding. Use a protective barrier, preferably nonlatex disposable gloves (a new, unused plastic food storage bag will work in a pinch).

•  Safely discard all soiled gloves, bandages, dressings, and other used first-aid items by putting them in a double bag until they can be disposed of properly  in a receptacle for biohazards.

•  Always wash your hands and other exposed skin with soap and warm water or an alcohol-based hand sanitizer immediately after treating a victim, even if protective equipment was used.

38        fiRST Aid

Muscle, Joint, and Bone injuries.

Muscle cramps

most often affect

the legs, but

they also can

occur in the

muscles of the

ribs, arms,

and hands.

Muscle,Joint,andBoneInjuries

Muscles,joints,andbonesareallinvolvedinhelpingthebodymove.Falls,slips,collisions,andevenfatigueanddehydrationcancom-promiseorinjurethesebodyparts.

Muscle CrampsAmusclecrampoccurswhenamusclecontractsonitsownanddoesnoteasilyrelax.Theytendtohappenmostwhenthebodyisfatiguedandthemuscleshavenotbeenstretchedwell.Dehydration,exertioninhotweather,anddepletionofelectro-lytes(calcium,chloride,phosphate,potassium,sodium)inthebodymayalsoleadtomusclecramping.Withseverecramping,themusclemayfeelhardandknotted.

Allowapersonexperiencingmusclecrampstorest.Oftenacrampwilldisappearonitsowninafewminutes.Tohelprecovery,gentlymassagethemuscleandlightlystretchit.Iftheweatheriswarmandthepersonhasbeenexercising,besurethepersonrehydrateswithwateror,ideally,asportsdrinkthatwillhelpthebodyandrestoreitsproperelectrolytebalance.

Decrease the likelihood of muscle cramps by staying  in good physical shape, stretching before exercising, warming down, and drinking plenty of fluids before, during, and after you work out. 

fiRST Aid        39

.Muscle, Joint, and Bone injuries

Sprains and StrainsAsprainoccurswhenanankle,wrist,orotherjointisbentfarenoughtooverstretchtheligaments,thetoughbandsthatholdjointstogether.Twistingananklewhilerunningisonewayapersoncouldsustainasprain.Astrainoccurswhenmusclesareoverstretched,creatingtearsinthemusclefibers.Lowerbackpainisoftentheresultofmusclesstrainedbyoveruseorbyliftingloadsthataretooheavy.

Minorsprainsandstrainscauseonlymilddiscomfort,butmoreserioussprainsandstrainsmightbetemporarilydisabling.Asprainedjointwillbetenderandpainfulwhenmovedandmightshowswellinganddiscoloration.Strainedbacks,arms,andlegswillalsobetenderandcanhurtifactivitycontinues.

Assumethatanyinjurytoajointalsomayincludeabonefracture.Usethefollowingproceduretotreatsprainsandstrainsandpreventfurtherinjury.Havethevictimtakeanyweightoffoftheinjuredjointandinstructthepersonnottousethejoint.Donottrytomoveorstraightenaninjuredlimb.Coveranyopenwoundswithasteriledressing.Applyicepacksorcoldcompressestotheaffectedareafornomorethan20minutesatatime.Besuretoplaceabarriersuchasathintowelbetweentheicepackandbareskin.Seekmedicaltreatmentifthepainispersistentorsevere.

If continued icing

is needed, remove

the pack for 20

minutes before

reapplying.

40        fiRST Aid

Muscle, Joint, and Bone injuries.

Sprains While HikingIf someone suffers an ankle sprain during a hike and your group must keep walking, do not remove the  hiking boot from the injured foot. The boot will help support the ankle. If you do take the boot off, the  injury may swell so much it will not be possible to  get the boot back on. Reinforce the ankle by wrapping it, boot and all, with a bandage, neckerchief, or some other strip of cloth.

As soon as you have reached your destination, have the person take off the boot. Treat with cold packs and seek medical care.

1

3

4

2

fiRST Aid        41

.Muscle, Joint, and Bone injuries

See “Life-

Threatening

Emergencies” for

procedures to follow

in hurry cases.

Broken Bones Afall,aviolentblow,acollision—allthesecancauseafracture, orbrokenbone.Whenyoususpectafracture,donotmovetheperson.Lookforabnormalshapeorpositionofaboneorjoint,andswellingorabluishcolorattheinjuredsite.

Askthevictimthesequestions:

• Didyouhearorfeelabonesnap?

• Doyoufeelpainwhenyoupressontheskinoverthesuspectedfracture?

• Areyouunabletomovetheinjuredlimb?

Ifthevictimanswers“yes”tothesequestions,thepersonlikelyhasafracture.

Closed (Simple) fracture.Aclosed fracture(alsoknownasasimple fracture)isabrokenbonethatdoesnotcutthroughtheskin.Foraclosedfracture,dothefollowing.

• Call911oryourlocalemergency-responsenumber.

• Treathurrycases—nosignsoflife(movementandbreathing)inadults;inchildrenandinfants,nosignsoflifeandnopulse.

• Protectthespinalcolumnbysupportingthevictim’sheadandneckinthepositionfound.

• Treatforshock(butavoidraisingalegthatmightbebroken).

Before administering first aid, you should try to obtain the victim’s consent. If the victim is unconscious, disori-ented, or otherwise appears unable to knowingly grant consent, you can assume it is all right to proceed.

Closed (simple) fracture

42        fiRST Aid

Muscle, Joint, and Bone injuries.

The saying “splint

it where it lies”

is usually

good advice.

Open (Compound) fracture.Anopen fracture(alsoknownasacompound fracture)isabrokenbonethatbreaksthroughtheskinandcreatesanopenwound.Takethefollowingactionsforanopenfracture.

• Call911oryourlocalemergency-responsenumber.

• Treathurrycases—nosignsoflife(movementandbreathing)inadults;inchildrenandinfants,nosignsoflifeandnopulse.

• Protectthespinalcolumnbysupportingthevictim’sheadandneckinthepositionfound.

• Controlbleedingbyplacingasterilegauzearoundthewoundasyouwouldforanembeddedobject.Donotusedirectpressure,asthatcouldmovethebone.

• Donottrytocleanthewound.

• Treatforshock(butavoidraisingalegthatmightbebroken).

Whetheryouaretreatingaclosedoranopenfracture,allowthepersontoliewhereyoufoundhimorher,unlessthesiteposesanimmediatehazardtothevictimorrescuers.Makethepersoncomfortablebytuckingblankets,sleepingbags,orclothingunderandoverthebody.

SPLinTSIfthevictimmustbemoved,splintingabrokenbonecanhelprelievepainandreducethechancesofadditionalinjury.Asplintisanymaterial,softorrigid,thatcanbeboundtoafrac-turedlimb.Usesplintingonlyifnecessary,tostabilizetheinjuredareaandpreventitfrommovingandcausingfurtherinjuryandpain.Makethesplintlongenoughtoimmobilizethejointsabove,below,andoneithersideofafracture,asneeded.

Makesplintsfromwhateverishandy—boards,branches,blankets,hikingsticks,skipoles,shovelhandles,ortent-polesections.Foldednewspapers,magazines,orpiecesofcardboardorasleepingpadwillwork,too.Takeenoughtimetodesignaneffectivesplintandsecureitwithgoodknotstoprovideenoughsupport.

Do not try to

replace nor move

a bone that seems

to be sticking out

from the wound.

Open (compound) fracture

fiRST Aid        43

.Muscle, Joint, and Bone injuries

Paddingallowsasplinttofitbetterandcanmakethevic-timmorecomfortable.Cushionasplintwithclothing,blankets,pillows,crumpledpaper,orothersoftmaterial.Holdthesplintsandpaddinginplacewithneckerchiefs,handkerchiefs,rollerbandages,orotherwidestripsofcloth,asshown.

HOW TO SPLinT An injUREd LiMBSplintallfracturesandsuspectedfrac-turesinthesamepositionasyoufoundthem.Donottrytostraightenorreposi-tiontheinjuredarea.

Step 1—Keeptheareaaboveandbelowtheinjurystillandstable.

Step 2—Checkforcirculation(feeling,warmth,color).

Step 3—Extendsplintsbeyondthejointaboveandthejointbelowthesuspectedinjury.Minimizemovementwhileapply-ingsplintsbyprovidingsupportaboveandbelowthefracture.

Step 4—Securesplintswithbandages,neckerchiefs,orotherwidestripsofcloth.Tieatleastoneplaceabovetheinjuredareaandonebelow.Donottiebandagesdirectlyovertheinjuryitself.

Step 5—Afterthesplintisinplace,recheckforcirculation(feeling,warmth,color)tomakesureyouhaven’tcutoffcirculation.

improvised splint for the lower arm, using a magazine and padding

1

2

3

4

44        fiRST Aid

Muscle, Joint, and Bone injuries.

Soft splint on the lower leg.Whenapplyingasoftsplintonthelowerleg,donotremovetheinjuredperson’sshoe;itwillprovidesupportandhelpcontrolswelling.

Step 1—Supporttheinjuredarea,aboveandbelow,withonehandundertheankleandtheotherhandkeepingthefootupright.

Step 2—Withoutremovingtheshoe,carefullycheckforcircu-lation(feeling,warmth,color).

Step 3—Positionseveraltriangularbandages,asshown,undertheinjuredarea.

Step 4—Gentlywrapsomethingsoft(smallblanketortowel)aroundtheinjuredarea,asshown.

Step 5—Tiethetriangularbandagesinplacesecurelywithknots.

Step 6—Rechecktheareaforcirculation(feeling,warmth,color).Nocirculationisanindicationthatthebandageistootightandshouldbeloosened.

2 3

4 5 6

fiRST Aid        45

.Muscle, Joint, and Bone injuries

Lower-leg fracture. Usesplintsthatarelongenoughtoreachfromthemiddleofthethightopasttheheel.Placeonesplintoneachsideoftheinjuredlimbandbindthemtogether.

Upper-leg fracture. Applytwopaddedsplints,oneoutsidethelegextendingfromheeltoarmpit,theotherinsidethelegfromtheheeltothecrotch.Bindthesplintstogether.

The muscles of the upper leg are strong enough to pull the ends of a broken thigh bone into the flesh, some-times causing serious internal bleeding that may pose a threat to the victim’s life. For this reason, in addition to the first aid described here for a thigh bone (femur) fracture, treat this injury as a hurry case. Call for medi-cal help immediately. Keep the victim still and quiet. Control any bleeding, and treat for shock.

46        fiRST Aid

Muscle, Joint, and Bone injuries.

SLingSSlingshelpsupportaninjuredhand,arm,collarbone,orshoulder.

Step 1—Supporttheinjuredlimbaboveandbelowtheinjuredarea.

Step 2—Checktheinjuredareaforcirculation(feeling,warmth,color).

1

3 4

5 6a

6b 7

2

fiRST Aid        47

.Muscle, Joint, and Bone injuries

Step 3—Positionatriangularsling(suchasafoldedScoutneckerchieforalargetriangularbandage)acrossthechestasshown.Ifoneisavailable,placeacleangauzebandageoverthesideoftheneckforcomfort,attheareawheretheslingwillbeknotted.

Step 4—Bringtheupperfreeendoftheslingbehindtheneckandthelowerfreecornerupward(asshown)andtietheendstogetherwithasquareknot,formingthesling.

Step 5—Tokeeptheinjuredareamorestable,bindtheslingtothechestusingasecondtriangularbandage.Rollthebandageupasshown.Comfortablybutnottoolooselypositionthebandageabovetheinjuredarea,overtheslingandacrossthevictim’sfront.

Step 6—Bringoneendoftherolled-upbandageunderthevictim’suninjuredarmandtheothersidearoundtheback(6a).Tietheendstogetherwithasquareknotandputacleangauzepadundertheknotforcomfort(6b).

Step 7—Rechecktheinjuredareaforfeeling,warmth,andcolor.

Cravat BandageTo make a cravat bandage from a Scout neckerchief or triangular bandage: 

1. Fold the point up to the long edge.

2. Finish by folding the bottom edge  several times toward the top edge.

3. Tie all bandages in place with  square knots.

Upper-arm fracture. Tie a splint to the out-side of the upper-arm. Place the arm in a sling with the hand raised about 3 inches above level, then use a cravat bandage to hold the upper arm against the side of the chest. The body will act as a splint to immobilize the elbow and shoulder.

48        fiRST Aid

Muscle, Joint, and Bone injuries.

Head, neck, and Back injuriesThebackbone(spinalcolumn)ismadeupofsmallbonescalledvertebraethatsurroundandprotectthespinalcord.Ifavertebraisbrokenordislocated,thespinalcordmaybeinjured.Fracturesofthehead,neck,andbackareextremelydangerous,becausemovementmightfurtherdamagethespinalcordandcausepermanentparalysisorevendeath.

Wheneversomeonehasfallen,beeninvolvedinanauto-mobileaccident,orsufferedablowtothehead,assumethereisaninjurytothehead,neck,orback.Suchinjuriesareoftennoteasytodetect.Thevictimmayormaynotbesufferingfrompain,paralysis,cutsandbruises,orswelling.Theinjuredareamaybedeformedorabnormallyshaped,ortheremaybenosymptomsatall.Someonewithaheadinjurymightbedis-oriented,irritable,confused,orcombative—symptomsthatcanbepresentrightawayormightdevelopovertime.Alwayspro-ceedwithgreatcautionwhenyouareaidingapersonwhomyoususpecthashead,neck,orbackinjuries.

Collarbone or shoulder fracture. Place the forearm in a sling with the hand raised higher than the elbow, then tie the upper arm against the side of the body with a wide cravat bandage. no further splinting is necessary.

Lower-arm fracture. Splint to hold the hand and forearm motionless. Placing the splinted arm in a sling with the hand slightly raised will also immobi-lize the elbow joint.

fiRST Aid        49

.Muscle, Joint, and Bone injuries

Whenyoususpectaninjurytothehead,neck,orback,followthesesteps.

Step 1—Stabilizetheheadandneckofthevictimuntilitcanbedeterminedwhetherthespinalcolumnhasbeeninjured.Afirst-aiderorabystandercanholdthevictim’sheadandnecksteady.

Step 2—Provideurgenttreatmentifnecessary.

Step 3—Donotmovethepersonorlethimorhermoveunlessthreatenedbyanimmediatedangersuchasfire,potentialava-lanche,orhighwaytraffic.

Step 4—Ifthevictimishavingtroublebreathing,gentlyadjustthepositionoftheheadandneckjustenoughtomaintainanopenairway.Donotputapillowunderthehead.

Step 5—Treatforshockbutdonotunnecessarilychangethevictim’sposition.

Wheneveryoususpecthead,neck,orbackinjuriesandthevictimmustbemoved(toopenanairway,forexample,ortogetthepersonoutofthepathofdanger),askotherScoutsorbystanderstohelpsothatthevictim’sbodycanbeturnedorliftedallatoncewithoutcausinganytwistsorturns.

It is safe to suspect possible head, neck, or back injury when the victim

•  Has been in a motor vehicle crash

•  Has fallen from higher than a standing height

•  Complains of neck or back pain

•  Feels tingling or weakness in the fingers or toes

•  Is not fully alert

•  Appears to be intoxicated

•  Appears to be frail or over 65 years of age

See “Life-

Threatening

Emergencies” for

more information

about urgent

treatment. For

more on moving

an accident

victim, see

“First-Aid Supplies

and Skills.”

fiRST Aid        51

.Cold- and Heat-related Conditions and injuries

Cold-andHeat-RelatedConditionsandInjuriesThehumanbodyworksbestifithasaconstanttemperatureof98.6degrees.Apersonwhoisexposedtocoldenvironmentalconditionsandlosesbodyheatfasterthanitcanbegeneratedwillbeingravedanger.Theperson’sbodytemperaturemaybecometoolowtosupportlife.Likewise,apersonwhosebodyhasoverheatedandcannotcoolitselfsufficientlymaydieiffastemergencymedicalcarecannotbefound.Thesetemperature-relatedemergenciesrequirefast,lifesavingfirstaid.

HypothermiaHypothermiaoccurswhenaperson’sbodyislosingmoreheatthanitcangenerate.Itisadangerforanyonewhoisnotdressedwarmlyenough,althoughexposuretocoldisseldomtheonlycause.Dehydrationisacommoncontributingfactortohypothermia.Wind,rain,hunger,andexhaustioncanfurthercompoundthedanger.Temperaturesdonotneedtobebelowfreezing,either.Ahikercaughtoutinacool,windyrainshowerwithoutproperraingearcanbeatgreatrisk.Aswim-mertoofaroutinchillywaterorapaddlerwhocapsizesalsoisatriskforhypothermia.

52        fiRST Aid

Cold- and Heat-related Conditions and injuries .

If one person is

being treated for

hypothermia, the

rest of a group

might also be at

risk. Protect your-

selves by taking

shelter, putting on

layers of warm

clothing, and hav-

ing something to

eat and something

warm to drink.

first Aid for HypothermiaAhypothermiavictimmayexperiencenumbness,fatigue,irrita-bility,slurredspeech,uncontrollableshivering,poorjudgmentordecisionmaking,andlossofconsciousness.

Treatahypothermiavictimbypreventingthepersonfromgettingcolder.Aftersummoninghelp,useanyorallofthefollowingmethodstohelpbringthebodytemperaturebackuptonormal:

• Iffullyconsciousandabletoswallow,havethepersondrinkwarmliquids(soup,fruitjuices,water;nocaffeineoralcohol).

• Movethepersonintotheshelterofabuildingoratent.Removewetclothing.Gethimorherintodry,warmclothesorwrapthepersoninblankets,clothing,oranythinghandythatcouldbeused,likejacketsorasleepingbag.

• Wraptowelsaroundwaterbottlesfilledwithwarmfluid,thenpositionthebottlesinthearmpitandgroinareas.

• Monitorthepersoncloselyforanychangeincondition.Donotrewarmthepersontooquickly(forinstance,byimmersingthepersoninwarmwater);doingsocancauseanirregularanddangerousheartbeat(rhythms).

frostbiteFrostbiteisaconditionthatoccurswhenskinisexposedtotemperaturescoldenoughthaticecrystalsbegintoforminthetissues.Afrostbitevictimmightcomplainthattheears,nose,fingers,orfeetfeelpainfulandthennumb,butsometimesthepersonwillnotnoticeanysuchsensation.Grayish-whitepatchesontheskin—indicatingthaticecrystalshavebeguntoforminthetoplayersoftheskin—aresignalsofthefirststageoffrostbite,orfrostnip. Withcontinuedexposure,frostnipworsensandthefreezingextendstodeeperlayersoftheskinandtothemuscles.Frostbitecanbeveryserious,asitcancutoffbloodflowtotheaffectedareaandleadtogangrene,ortissuedeath.

Far from the warmth of the body’s core, toes and  fingers are especially vulnerable, as are the nose,  ears, and cheeks.

fiRST Aid        53

.Cold- and Heat-related Conditions and injuries

first Aid for frostbiteIfyoususpectthatfrostbiteextendsbelowskinlevel,removewetclothingandwraptheinjuredareainadryblanket.Getthevictimunderthecareofaphysicianassoonaspossible.Donotmassagetheareaorrubitwithsnow.Rewarm the area only if there is no chance of refreezing. Exposetheaffectedareatowarm(100to105degrees)wateruntilnormalcolorreturnsanditfeelswarm,andbandagethearealoosely(placingdry,sterilegauzebetweenfingersandtoes).

Totreatfrostnip,movethevictimintoatentorbuilding,thenwarmtheinjuredarea.Ifanearorcheekisfrozen,removeagloveandwarmtheinjurywiththepalmofyourhand.Slipafrostnippedhandunderyourclothingandtuckitbeneathanarmpit.Treatfrostnippedtoesbyputtingthevic-tim’sbarefeetagainstthewarmskinofyourbelly.

dehydrationThehumanbodyis70percentwater,whichisessentialtomaintainourbodytemperature.Vitalorganslikethebrainandthekidneyswillnotfunctionwellwithoutenoughwater.Welosewatermostlybybreathing,sweating,digestion,andurination.Whenwelosemorewaterthanwetakein,webecomedehydrated.Signalsofmilddehydrationincludeincreasedthirst,drylips,anddarkyellowurine.Signalsofmoderatetoseveredehydrationincludeseverethirst,drymouthwithlittlesaliva,dryskin,weakness,dizziness,confusion,nausea,fainting,musclecramps,lossofappetite,decreasedsweating(evenwithexertion),decreasedurinepro-duction,andlessfrequentanddarkbrownurine.

Dehydration increases the danger of frostbite, so cold-weather travelers must be just as diligent about drink-ing fluids as they are when the weather is hot.

The importance of

drinking plenty of

fluids cannot be

overemphasized.

Do not wait until

you feel thirsty—

thirst is an

indication you are

already becoming

dehydrated.

54        fiRST Aid

Cold- and Heat-related Conditions and injuries .

Dehydration can

play a significant

role in a number of

serious conditions,

including heat

exhaustion, heat-

stroke, hypothermia,

and frostbite.

Dehydration can

happen in hot-

and cold-weather

conditions.

first Aid for dehydrationTotreatmilddehydration,drinkplentyofwaterorasportsdrinktoreplacefluidsandminerals.Drinkonetotwoquarts(orliters)ofliquidsovertwotofourhours.Seeaphysicianformoderateorseveredehydration.Severedehydrationrequiresemergencycare;thevictimwillneedintravenousfluids.Restfor24hoursandcontinuedrinkingfluids.Avoidtiringphysicalactivity.Althoughmostpeoplebegintofeelbetterwithinafewhours,ittakesabout36hourstocompletelyrestorethefluidslostindehydration.

Heat ExhaustionHeatexhaustioncanbebroughtonbyacombinationofdehy-drationandawarmenvironment.Heatexhaustionisnotuncommonduringoutdooractivitiesconductedinhotweather,especiallyifparticipantsarenotfullyacclimatedtothecondi-tions.Signalsofheatexhaustionincludeseverelackofenergy,generalweakness,headache,nausea,faintness,andsweating;cool,pale,moistskin;andarapidpulse.

first Aid for Heat ExhaustionGetthepersonintheshade(oranair-conditionedvehicleorbuilding).Encouragehimorhertodrinksmallamountsoffluids,suchascoolwaterorasportsdrink.Applywatertotheskinandclothingandfanthepersontohelpthecoolingprocess.Raisingthelegsmayhelppreventafeelingoffaintnesswhenthepersonstands.Usuallyaftertwoorthreehoursofrestandfluids,thevictimwillfeelbetterbutshouldrestfortheremainderofthedayandbeextracarefulaboutstayinghydrated.

fiRST Aid        55

.Cold- and Heat-related Conditions and injuries

HeatstrokeHeatstroke—muchmoreseriousthanheatexhaustion—canleadtodeathifnottreatedimmediately.Leftuntreated,heatexhaus-tioncandevelopintoheatstroke.Inheatstroke,thebody’scool-ingsystembeginstofailandtheperson’scoretemperaturerisestolife-threateninglevels(above105degrees).Onetypeofheat-strokedevelopsinyoung,healthypeoplefromdehydrationandoverexertioninhotweather,especiallyinhighhumidity.Signalsofexercise-relatedheatstrokecanincludeanysignalsofheatexhaustionaswellashot,sweaty,redskin,confusion,disorientation,andarapidpulse.

Theothertypeofheatstrokeusuallyhappensinelderlypeo-plewhentheweatherisveryhot,especiallywithhighhumidity.Thesignalsaresimilartoexercise-relatedheatstrokeexceptthattheskinishotanddrybecausethereisnosweating.

First Aid for HeatstrokeHeatstroke is a life-threatening condition. Call for medical assistance immediately. While waiting for medical per-sonnel to arrive, work to lower the victim’s temperature. Move the person to an air-conditioned or shady area. Loosen tight clothing and further cool the victim by  fanning and applying wet towels. If you have ice packs, wrap them in a thin barrier (such as a thin towel) and place them under the armpits and against the neck and groin. If the person is able to drink, give small amounts of cool water.

56        fiRST Aid

BurnsAsparkfromacampfire,boilingwaterspilledfromapot,afaultywire,amishapwithchemicalsinascienceclass,theraysofthesunonbareskin—thecausesofburnsaremany.Burnsaregenerallycharacterizedbydegree,ortheseverityoftheskinandtissuedamage.

Superficial (first-degree) BurnsMildburns,suchasyoumightgetfromtouchingabakingdishthathasjustcomeoutofanoven,willcauseapainfulreddeningoftheskin.Suchburnsareclassifiedassuperficial,orfirst-degreeburns—theyaffectonlytheouterlayerofskin,orepidermis.Treatthembyholdingtheburnundercoldwaterorapplyingcool,wetcompressesuntilthepaineases.Superficialburnsdonotusuallyrequirefurthermedicaltreatmentunlesstheycovermorethan20to25percentofthebody.

Remember to check the scene before you proceed. Always get a victim away from the source of a burn before proceeding with treatment.

Sunburn is

the most

common type of

superficial burn.

fiRST Aid        57

.Burns

Partial-Thickness (Second-degree) BurnsApartial-thickness (second-degree)burnaffectstheepidermisandpartofthelayerofskinbelowit,thedermis.Partial-thicknessburnsaremoreseriousthansuperficialburnsandtypicallyincludeareddeningandblisteringoftheskin.Beingscaldedbyboilingwaterisanexampleofanaccidentthatcouldresultinpartial-thicknessburns.Totreatsuchburns,firstremovethepersonfromthesourceoftheburn.Cooltheburnedareawithcold,runningwateruntilthepainisrelieved.Lettheburndry,thenprotectitwithalooselyapplied,sterilegauzepadandbandage.

While the general public continues to be more familiar with the terms “first degree,” “second degree,” and “third degree” to classify burns, med-ical professionals identify burns by their “thickness.” For instance, minor (first-degree) burns are called superficial. Those that cause blistering of the skin (second-degree) are called partial-thickness burns. The most seri-ous burns (third-degree) are called full-thickness burns.

Partial thicknessSuperficial full thickness

Get immediate medical treatment for the victim if the burns

•  Cause trouble breathing

•  Cover more than one body part or a large surface

•  Have caused possible burns to the airway (such as burns to the mouth and nose)

•  Affect the head, neck, hands, feet, or genitalia

•  Are full thickness and the victim is younger than  age 5 or older than age 60

•  Are the result of chemicals, explosions, or electricity

58        fiRST Aid

Burns.

Never break

burn blisters.

Doing so will

create an open

wound that may

become infected.

Do not apply

butter, creams,

ointments, or

sprays—they are

difficult to remove

and may slow the

healing process. full-Thickness (Third-degree) BurnsFull-thickness(third-degree)burnsareveryserious.Theydestroytheepidermisandthedermis.Avictimwhohasbeenexposedtoopenflames,electricity,orchemicalsmaysustainfull-thicknessburns.Theskinmaybeburnedawayandthefleshcharred.Ifnervesaredamaged,thevictimmayfeelnopain.Suchburnsconstituteamedicalemergency.Donottrytoremoveanyclothing,asitmaybestickingtothevictim’sflesh.Aftercoolingtheburn,covertheburnedareawithdry,steriledressings,treatforshock,andseekimmediatemedicalattention.

Treat thermal burns like this scalded forearm by running the affected area under cool running water, or by applying cool, wet compresses. Cover the area loosely with a sterile gauze pad and bandage.

Co

urt

esy

of

the

Am

eric

an n

atio

nal

Red

Cro

ss. A

ll ri

gh

ts r

eser

ved

in a

ll co

un

trie

s.

fiRST Aid        59

Chemical BurnsChemicalburnscanbecausedbyexposureoftheskinoreyestosubstancesthatarestrongacidsorstrongbasessuchasmodelglue,draincleaners,toilet-bowlcleaners,metalcleaners,andbatteryacid.

Herearestepsfortreatingachemicalburn.

Step 1—Usingglovesorapieceofcloth,brushoffpow-deredchemicalsfromthevictim’sskin.Removeanyofthevictim’sclothingwithchemicalsonit.Donotcontaminateyourselfintheprocess.

Step 2—Immediatelyfloodtheaffectedareawithcool,cleanwater.Continueflushingthewoundforatleast20minutestoremovetracesofthechemical.

Step 3—Ifthechemicalgotintotheeyes,flushtheeyeswithcleanwater.Itmaybeeasiertohavethevictimliedownwhileflushingtheeyeswithwater.Actasquicklyaspossible.Continueflushingforatleast15minutes,oruntilemergencymedicalprofessionalsarrive.

Step 4—Covertheburnslooselywithsteriledressingsorgauze.

Step 5—Getmedicalhelpbycalling911oryourlocalemergency-responsenumberimmediately.Ifyouknowthenameoftheproductorsubstancethatcausedtheburn,besuretoinformemergencyworkers.

The damage from a chemical burn can take hours—even days—to fully develop. For this reason, it is ini-tially difficult to evaluate the extent of the burn. The most important first aid for a chemical burn is to dilute the exposure by continuously flushing the area with water for at least 15 to 20 minutes, or until emergency medical help arrives. Remember also that inhaling chemicals can damage your airway and lungs, too.

3

Co

urt

esy

of

the

Am

eric

an n

atio

nal

Red

Cro

ss.

All

rig

hts

res

erve

d in

all

cou

ntr

ies.

60        fiRST Aid

Burns.

Never touch

a person who

is in contact with

a live electrical

power source.

Electrical BurnsIfelectricitytravelsthroughapartofyourbody,youcangetanelectricalburn.Besidesaburn,toomuchelectricitycanevenstoptheheartfrombeatingcorrectlyordamageotherinternalorgans.Superficialandpartial-thicknessburnsfromelectricitylooklikeburnsfromtoomuchheat;theskinmaylookcharred.Full-thicknesselectricalburnsmaynotleavecharredskin.Instead,theskincanlookleatheryandwhiteandbehardtothetouch.Call911orthelocalemergency-responsenumberifsomeonehasanelectricalburn.

Ifyouencounteravictimofanelectricalburn,shutoffthepoweratitssource,andcallanambulanceimmediately.Checkthesceneforsafety,thentakethefollowingsteps:

Step 1—PerformrescuebreathingorCPRifthevictimisnotbreathingormoving.(See“Life-ThreateningEmergencies.”)

Step 2—Coverburnswithsterilegauzepads.Coolelectricalburnsasforthermalburns.

Step 3—Treatforshock.

Burns From Dry ChemicalsAs long as the dry chemical is on the skin, it will con-tinue to burn. So, it’s important to quickly brush off as much of the chemical as possible using a gloved hand. Then flush the area with tap water, taking care not to recontaminate the victim or to contaminate yourself.

fiRST Aid        61

.Burns

SunburnSunburn is a common injury among people who enjoy being outdoors. Most sunburns are first-degree burns, but prolonged exposure to the  sun can cause blistering—a second-degree burn. Repeated sunburns  over a long period of time can cause skin damage and increase the risk  of skin cancer. People with lighter skin are most at risk, although others are not immune. 

Treat painful sunburn as for any heat burn or with cool, damp or wet cloths; change the cloths frequently. Prevent further injury by getting the person under shade. If no shade is available or you are out on a hiking or boating trip, have the person wear a brimmed hat, pants, and a long-sleeved shirt for protection from the sun. 

It is best to prevent sunburn. Whenever you are outdoors, use plenty of sunscreen with a sun protection factor (SPF) rating of at least 15. Apply sunscreen liberally about a half-hour before sunlight exposure and reap-ply every two hours, especially if you are sweating or have been in water. A broad-brimmed hat, long-sleeved shirt, and long pants provide even more protection. 

Remember this: it’s easy to forget the sunscreen in wintry conditions.

62        fiRST Aid

Other first-aid Cases.

OtherFirst-AidCasesAsafirst-aider,youwillencountermanyrelativelyminorcases.Nevertheless,alwaystakeallinjuries,illnesses,orconditionsseriously.Theycanbesignalsofamoreserioushealththreat.Abdominalpain,forexample,couldbeamongthefirstsignalsofappendicitis.Afaintingspellcouldoccurasaresultofaheartattack,stroke,orinternalbleeding.

Manypeoplehaveheathconditionssuchasdiabetesorepilepsy.Signalsoftheseconditionscanflareupunexpectedlyandmayrequirefirstaid.Wheneveryouprepareforagroupoutingsuchasacampingorcanoeingtrip,findoutifanypar-ticipantshavesuchconditionsandhavetheminformgroupleadersoftheirhealthhistories,treatmentregimens,medica-tions,andthelocationsofthosemedications.

faintingFaintingisabrieflossofconsciousness.Itusuallyoccursbecausethereistemporarylossofbloodflowtothebrain.Itcanbecausedbygettinguptooquicklyorstandingtoolong,byoverheatingordehydration,byemotionalstresssuchasfrightorbadnews,orbyseverepain.

Faintingcanoccursuddenly,ortheremightfirstbesignalssuchasdizziness,nausea,paleness,sweating,numbnessandtinglingofthehandsorfeet,visionblackoutorwhiteout,andcoldnessoftheskin.Thevictimmightfalltotheground.Ifapersonbeginstofeelfaint,havehimorhersitdownwiththeheadbetweenthekneesorliedownandraisethelegsabout12inches.

Sometimes fainting

is a signal of

a more serious

condition such as

an irregular heart-

beat, heart valve

problems, or

internal bleeding.

Any important medical information should be included on a medical id bracelet.

fiRST Aid        63

.Other first-aid Cases

Someonewhohasfaintedshouldbeencouragedtostaylyingdownuntilheorsheawakensandfeelsbetter.Raisethefeetandlegsabout12inches.Makesuretheperson’sbreathingpassage(airway)staysopen.Ifthevictimbeginstovomitwhilelyingdown,turnthepersonontoonesideandkeeptheairwayclear.Supporttheheadwithapilloworletthevictimrestitononearm.Loosenclothingaroundtheneck.Wipethevictim’sforeheadwithacool,wetcloth.Ifthepersonisalertenoughandmightbedehydrated,givefluidstodrink.Ifthepersondoesnotawakenwithintwominutes,orfullyrecoverwithafewminutes,getmedicalhelp.

HyperventilationHyperventilation happens when you are breath-ing faster and deeper than your body needs. Involuntary (or unintentional) hyperventilation may be caused by severe pain, infection,  severe bleeding, heart attack, cold water  immersion, diabetic coma, poisoning, or  conditions such as anxiety attacks. The victim  can feel dizzy, faint, and numbness, tingling,  and cramping in the fingers and toes. Involuntary hyperventilation usually requires immediate medical attention. Voluntary (or deliberate) hyperventilation is unhealthy and can be dangerous, especially if it is followed by breath holding. A person who does this  can pass out or faint from lack of oxygen before he feels the need to breathe. If this occurs while a person is underwater, the result can be drowning. Be alert to abnormal breathing patterns in individuals.

64        fiRST Aid

Other first-aid Cases.

Loss of ConsciousnessAlossofconsciousnessformorethantwominutesisaseriousmedicalcondition.Anunconsciouspersonmighthavebeenhitintheheadorhadaheartattackorstroke.Diabeticscanloseconsciousnessfromeitherveryhighorverylowbloodsugar.LookforanemergencymedicalIDbraceletornecklaceoraninformationcardthatidentifieshealthproblemssuchasdiabetes.Followtheinstructionsonthecardexactly.

Wheneverapersonisunconsciousformorethanaminuteortwo,call911oryourlocalemergency-responsenumberformedicalassistance.Checktoseeifthepersonisbreathingandforothersignsoflife.BeginCPRifappropriate.Iftherehasbeenanaccident,protectthevictim’sheadandneckfrommovement.

Iftheunconsciouspersonhasnotbeeninvolvedinanaccident,lookaroundthesceneforevidenceofpoisoning,druguse,orotherpossiblecausesforthelossofconsciousness.Ifyoususpectpoisonordrugswereinvolved,takethecontainerorsuspectedpoisontotheemergencyroomwiththevictim.Ifthevictimrecoversbeforemedicalpersonnelarrive,heorsheshouldseekmedicaladviceassoonaspossible.Any loss of consciousness after a head injury, even if only for a short time, requires immediate evaluation by a health-care professional.

SeizuresAseizureisachangeinawarenessorbehaviorthatiscausedbyabnormalelectricalactivityinthebrain.Inadultsandchil-drenoverage6,seizuresareusuallyduetoepilepsy,adisorderofthebrain.Aseizurecouldbeasignalofaseriousmedicalproblem.Seizurescanoccurinapersonwhoissufferingfromaheadinjury,braintumor,stroke,poisoning,electricalshock,heatstroke,infection,ahighfever(usuallyinchildren),lowbloodsugar,orlowbloodpressure.

Epilepsymaybethecauseofaseizure.Thereareseveralcommonformsofepilepsy.Ingrand malepilepsy(alsoknownastonic/clonicseizure),thevictimmayloseconsciousnessandfalltotheground.Thearmsandlegsstiffenthenjerkforcefully.Somemusclesortheentirebodycanstiffenortwitchwithsud-denmusclespasmsknownasconvulsions.Thevictimmaybitethetongue.Neckveinsmaybeswollenandthefacemayturnredorblue.Breathingmaydecreaseandisoftenloudand

Taking too

many drugs or

drinking too

much alcohol

can make a

person lose

consciousness.

Never give an

unconscious

person anything

to drink, throw

water on the face,

or offer stimulants

such as smelling

salts. Do not

shake or slap the

person in an effort

to wake him or

her up.

fiRST Aid        65

.Other first-aid Cases

labored,accompaniedbygruntsorsnortswithanunusualhissingsound.Thevictimmaydroolorfoamatthemouthandmaylosebladderorbowelcontrol.

Anotherkindofepilepticseizureisthepetit mal seizureinwhichthepersonseemstobrieflyloseawarenessofhisorhersurroundingsandappearstostareintospace.Thisbehaviorisoftenmistakenfordaydreaming.Althoughawake,theindivid-ualdoesnotrespondnormally.Afterward,thepersondoesnotrecalltheepisode.Focalseizurescauseonepartofthebodytojerkortwitch,andthepersonseemsdistantorunaware.

Whilethereisnofirst-aidmeasurethatwillstopaseizure,youcanprovidegoodfirstaidbyprotectingthepersonfrombeinginjuredwhileexperiencingaseizure.Breaktheperson’sfall,ifpossible,andlowerhimorhergentlytothefloororground.

Step 1—Moveawayanyfurnitureandhardorsharpobjectsthatcouldcauseinjury.Avoidmovingthepersonunlessthereispotentialdangernearby—afireplace,stairway,glassdoor,swimmingpool,orotherhazard.

Step 2—Loosentightclothingaroundtheneckandwaist.

Step 3—Donottrytoholdtheperson.Tryingtorestrainsomeoneduringaseizurerisksinjurytothatpersonandtothefirst-aider.

Step 4—Donotforceanythingintothemouthorbetweentheteeth.

Step 5—Makesuretheairwayremainsopen.

Step 6—Whentheseizureisover,placethepersoninarecoveryposition.

Step 7—Letthepersonrest.Keepcuriousonlookersaway.

Step 8—Ifthepersonisnotknowntohaveepilepsy,iftheseizurelastsmorethanfiveminutes,recurs,orcausesinjury,orifthepersonisslowtorecover,call911oryourlocalemergency-responsenumber.Callforemergencyassistanceimmediatelyifaseizurevictimispregnant,diabetic,uncon-scious,orinjured,orhasswallowedlargeamountsofwater(asaresultofanaquaticaccident).

Epilepsy is

controlled by

medications.

While it may

not always be

necessary to call

911 for a seizure

victim who has

epilepsy, when in

doubt, call 911.

Regardless, a

seizure victim

may still need

medical attention.

66        fiRST Aid

Other first-aid Cases.

You may need to

turn a person who

has been in a

recovery position

for 30 minutes or

longer to the

opposite side to

stimulate circula-

tion. However, do

not move a person

with suspected

spinal injury

unless it is abso-

lutely necessary.

Recovery PositionPlace a victim who is unconscious but who is breathing normally in a recovery position. To do this, extend the person’s lower arm, in line with his or her body; support the head and neck as you grasp the victim’s hip and shoulder, and roll the person toward you so that he or she is lying on the side. This will prevent the person from choking on saliva, blood (from a bitten tongue),  or vomit, and will help keep the airway open. Continue to monitor the person’s breathing until medical help arrives.

Recovery position for a person who does not have a suspected spinal injury

Recovery position for a person who may have a spinal injury

fiRST Aid        67

.Other first-aid Cases

diabetesDiabetesisadisorderthatimpairsthebody’sabilitytocontrolitsbloodsugarlevel.Insomecases,thebodystopsmakinginsulin.Insulinisahormonethathelpsthebodyusesugarforenergy.Somepeoplewhohavediabetesmustinjectinsulintolive.Peoplewithdiabeteswhodonothavetouseinsulincankeeptheirbloodsugarattheproperlevelsbywatchingwhattheyeatandtakingotherdiabetes-controllingmedications.

Whenadiabeticperson’sblood-sugarlevelistoohighortoolow,thepersoncanbecomeunconscious.Thisisadiabeticemergency.Averyhighbloodsugarlevel(hyperglycemia)willrarelycausedeath;alowbloodsugarlevel(hypoglycemia)isextremelydangerousbecausewithoutsugar,braincellsdiequicklyandpermanentbraindamagecanresult.Becauseitisimpossibletoknowifthereistoomuchortoolittlesugarwith-outdoingabloodtest,allunconsciousdiabeticsshouldbetreatedasthoughtheirbloodsugarlevelsaretoolow.

AdiabeticpersonmaybewearingamedicalIDnecklaceorbraceletorhaveacardexplainingwhatshouldbedonedur-ingadiabeticemergency.Thepersonmightalsocarrysomeformofconcentratedsugar,tobetakenorallyiflowbloodsugarissuspected.Followtheinstructionsexactly.

Diabeticswhouseinsulinsometimeshavealowbloodsugarlevelwithoutbecomingunconscious.Thiscanhappeniftheytaketoomuchinsulin,don’teatenoughfood,exercisealotwithouteatingasnack,oriftheydecreasetheirdoseofinsulinaheadoftimeorwaittoolongbetweenmeals.Withmildcasesofhypoglycemialikethese(andthevictimisfullyconsciousandabletosafelyswallowfoodordrinks),givethevictimfruitjuiceorasoftdrinkthatcontainssugar(nondiet).

Warning signals of hypoglycemia include headache; sweating; pale, moist skin; weakness; dizziness; shallow breathing; and a rapid pulse. Signals of hyperglycemia include extreme thirst, frequent urination, drowsiness, lack of appetite, and labored breathing.

Hypoglycemia is

also called

insulin reaction

or insulin shock.

68        fiRST Aid

Other first-aid Cases.

When you are

outdoors on

windy days,

help protect

your eyes by wear-

ing sunglasses.

foreign Object in the EyeSomethingintheeyeisnotjustpainful—itcouldendangereyesight.TheNationalSocietytoPreventBlindnesssaysthat90percentofalleyedamageispreventable.Toprotectyoureyes,alwayswearsafetyglassesorgoggleswhenusingpowertools,lawnandgardenequipment,andothermachinerythatslingsdirtanddebris.Becarefulnottoletfumesfromsolventsandcleaningagentsburnyoureyes.

Ifaforeignobjectgetsintheeye,donotrubtheeye;rub-bingmightscratchthecornea(theclearcoveringofthecoloredpartoftheeye).Havethepersonblinktheeyes;tearsmightflushouttheobject.Ifthatdoesn’twork,washyourhandswithsoapandwater,thentrytoflushouttheforeignparticleswithcleanrunningwaterorcleanwaterpouredfromaglassorbottle.

Foreignmatterthatisembeddedintheeyeorthatwillnotwashoutmustbetreatedbyaphysician.Stabilizetheobjectifpossibleandcovertheinjuredeyewithadry,sterilegauzepad.Takethepersontoadoctor.

nosebleedsNosebleedsmightlookbad,buttheynormallyarenotveryseri-ousandwillusuallystopinjustafewminutes.Thebleedingusuallystemsfromasmallveininthenoseandcanbecaused

byirritationtotheareafromcolds,allergies,picking,coldanddryweather,andoveruse

ofnosedropsorsprays.

fiRST Aid        69

.Other first-aid Cases

Havethevictimsitleaningslightlyforwardsothattheblooddoesnotrundownthethroat.Askthepersontousethumbandforefingertopinchthenosefirmlybutgently,andapplypressureontheupperlip,justbelowthenose.Whilethepersonispinching,applyacoldcompresstothenoseandsurroundingarea.

Afterabout10minutes,havethepersonslowlyreleasethenosepinch.Ifthebleedingreappears,pinchthenoseandapplypressureonceagain.Afterthebleedingstops,donotirritate,pick,orblowthenoseforseveralhours.Ifthebleedingcontin-uesformorethan15minutes,seekmedicalattention.

For Ingested Poisoning, Call 800-222-1222A poison is a drug, chemical, or toxic liquid that can cause illness or death if swallowed. Any drug or medi-cine can be poisonous if not taken according to a  doctor’s instructions or the directions on the label. Many cosmetics, cleaning products, pesticides, paints, and other household products also contain chemicals that may be harmful if swallowed.

Call the Poison Control Center toll-free at  800-222-1222 if you have a poisoning emergency. Keep this number handy. Meanwhile, follow these steps.

Step 1—Immediately take any poison containers to a telephone. Call the poison control center toll-free at 800-222-1222, or 911, or your local emergency response number (if a life-threatening condition such as uncon-sciousness, a change in consciousness, or no breathing is found), and follow the instructions you are given.

Step 2—Treat the victim for shock and monitor breath-ing. Do not give anything by mouth unless you are told to do so by medical professionals.

Step 3—Save any vomit (use a bowl, cook pot, or plas-tic bag). It will help a physician identify the poison and give the right treatment.

70        fiRST Aid

Other first-aid Cases.

Poison Control

Center

800-222-1222

Poisonous PlantsTheoilysapfromtheleaves,stem,androotsofpoisonivy,poi-sonoak,andpoisonsumacirritatestheskinofmostpeople.Oncethesapgetsonskin,itcanspreadtootherpartsofthebodyandcausearashwithredness,blisters,swelling,itching,burning,fever,andheadache.Theseverityofthereactiondependsontheindividualandtheextentoftheexposure.Thebestformofpreventionistolearnhowtorecognizethepoison-ousplantsinyourareaandtoavoidcontactwiththem.

Learn what poisonous plants look like and stay away from them. “Leaflets three, let it be” might help you remember to avoid plants that have leaflets grouped  in threes, such as poison ivy. White berries are another  signal of poisonous plants, although not all plants with three leaves or white berries are poisonous. Wear pro-tective clothing (disposable coveralls, rubber-coated or nonlatex gloves) and take care when handling tools, clothing, and gear that could be contaminated.

Poison oak Poison ivy

Poison sumac

fiRST Aid        71

.Other first-aid Cases

Thesapoftheseplantsmustbeonyourskinfor10to20minutesbeforeitstartstocauseproblems.So,ifyouthinkyouhavetouchedapoisonousplant,immediatelystoptowashtheexposedareawellwithsoapandwater.Wipewithrubbingalcoholandapplycalamineorothersoothingskintreatment.Ifthereactionissevere,ifthegenitalareaisaffected,orifplantpartswerechewedorswallowed,seekimmediatemedicalattention.

Thesapalsobindswelltoclothing,sochangeclothes.Keeptheoutfityouwerewearingseparatefromyourotherclothing,andwashitseparatelybackhome.

Abdominal PainTherearemanycausesofabdominalpain.Itmightbeasharm-lessasanupsetstomachorasdangerousasappendicitis.Alwaystakeallcomplaintsofabdominalpainseriously.Watchthepersoncloselyforincreasingpainorchangesinthelevelofconsciousness.Mostpeoplewhohaveappendicitiswillhavethesamesymptoms.Firstthereisalossofappetite.Thenapainbeginsinthelowerrightquarteroftheabdomenandgetsworseoverseveralhours.Finally,thereisnauseaandvomiting.

Ifyouthinksomeonemighthaveappendicitis,donotallowthepersontoeatordrink.Call911oraphysicianimme-diately.Alsoseekmedicalattentionifsomeonesufferingabdominalpainhasatemperatureof102degreesorhigheroriftherearesignalsofbloodintheurine,vomit,orstool.

right upper quarter

left upper quarter

right lower quarter

left lower quarter

72        fiRST Aid

dental injuries Ablowtothefacecanknockoutatoothorbreak

ajaw.Thesedentalinjuriesrequireimmediatemedi-caltreatment.However,aninfectedtoothwithpain,

fever,orswellingcanbejustasseriousandalsorequirestreatmentwithoutdelay.

Braces and retainers.Ifawireiscausingirritation,covertheendofthewirewithasmallcottonball,beeswax,coldcandlewax,orapieceofgauzeuntilyoucangetthepersontothedentist.Ifawireisembeddedinthecheek,tongue,orgumtissue,donotattempttoremoveit.Seeadentistororthodontistimmediately.

Bitten lip or tongue. Applydirectpressuretothebleedingareawithacleancloth.Ifswellingispresent,applyacold,wetclothorpad.Ifthebleedingdoesnotstop,theinjuredpersonshouldseekmedicalattention.

Toothache. Havethevictimrinsethemouthvigorouslywithwarmwater(tocleanoutdebris);usedentalflosstoremoveanyfoodthatmightbetrappedbetweentheteeth.Ifswellingispresent,placeacold,wetclothorpadontheoutsideofthecheek.Havethepersonseeadentistimmediately—toothachemaybeasignalthatinfectionispresent.

Broken, chipped, or loosened tooth.Gentlyrinsethemouthwithwarmwater.Placeacold,wetclothorpadintheareaoftheinjury,tominimizeswelling.Thevictimshouldseeadentistimmediately;takethebrokenorchippedpieceoftoothalong.

Knocked-out tooth.Pickupthetoothcarefullybythecrown(nottheroot).Rinsethetoothgentlyundercoldrunningwaterorwithmilk,ifitisavailable.Donotscrub,scrape,ordrythetooth,anddonotallowthetoothtodry.Flushthewoundwithcleanwaterorsalinesolution.Applypressurewithacleanclothorgauzetostopanybleeding.Placethetoothinacon-tainerofmilkorcoolwater.Takethevictimandthetoothandgodirectlytothedentist’sofficeoremergencyroom,ideallywithin30minutes.

Possible fractured jaw. Keepthejawfrommovingbyusingahandkerchief,necktie,towel,orsimilaritem.Ifswellingispres-ent,applycold,wetclothsorpads.Calladentistortakethevictimimmediatelytotheemergencyroom.

fiRST Aid        73

.Other first-aid Cases

Do not use heat or

place aspirin on

an aching tooth or

gum tissues.

Proper dental care and maintenance will prevent many dental injuries. To reduce the chance of tooth injury,  follow these tips.

•  Always use your safety belt when riding in  an automobile.

•  Wear the proper safety gear, including a mouth guard, when playing contact sports.

•  Never bite down on hard items such as popcorn  kernels, ice, or nutshells.

•  Do not use your teeth to open packages or bottles.

74        fiRST Aid

Bites and StingsThebitesofmosquitoes,chiggers,andno-see-umsareirritatingbutnotusuallydangerous.Moretroublesomeareticks,somespiders,andsomeants.Toavoidgettingbittenbyticks,wearlongpantsandalong-sleevedshirtwheneveryouareintick-infestedwoodlandsandfields.Buttonyourcollarandtuckyourpantcuffsintoyourbootsor

socks.Inspectyourselfdaily,especiallythehairypartsofyourbody,andimmediately

removeanyticksyoufind.Ticksburytheirheadsbeneaththeskinof

theirvictims.Toremoveatick,withglovedhands,graspitwithtweezersclosetotheskinandgentlypulluntilitcomesloose.Don’tsqueeze,twist,orjerkthetick,asdoingsocouldleaveitsmouthpartsstillburiedintheskin.Washthewoundwithsoapandwaterandapplyanantiseptic.Thoroughlywashyourhandsafterhandlingatick.

Thefemaleblack widow spider(whichisresponsibleforbites)isglossyblackwithared-orange

hourglassmarkingontheundersideofitsabdomen.Thesespidersliketodwellunderstonesandlogs,in

longgrass,brushpiles,barns,garages,latrines,andothershadowyspots.Itsbitecancauserednessand

sharppain,sweating,nauseaandvomiting,stomachpainand

cramps,andseveremusclepainandspasms.Breathingmight

becomedifficult.

When removing a tick, do not burn the tick, prick it with a pin, or cover it with petroleum jelly or nail polish. doing so may cause the tick to release more of the disease-carrying bacteria.

Black widow spider

fiRST Aid        75

.Other first-aid Cases

Fire ants live in

loose mounds of

dirt. If you see

such a structure,

do not disturb it.

Thebrown recluseisamedium-sized,yellow-tantodarkbrownspiderwithaviolin-shapedmarkonitsback.Thesespidersoftenhideinlittle-usedstorageareassuchascellarsandclosets,andoutdoorsinpro-tectedareasunderrocksandloosetreebark.Avictimmightnotnoticethebiteatfirst,butwithintwotoeighthours,therewillbemildtoseverepainwithrednessatthebitesite.Theareabecomesswollenandtender,andasmallblisterusuallyforms,followedbyanopensore.Thevictimmightsufferfever,chills,nausea,vomiting,jointpain,andafaintrash.Washthebitesitewithsoapandwater,andapplyacoldpacktothearea.Seekmedicalattentionimmediately.

Thestingofa fire antcanbeextremelypainful.Ifdis-turbed,fireantswillswarmandattackcooperativelyandaggressively,oftengrabbingholdofthevictim’sskinandsting-ingrepeatedly.Becarefulnottobreakthetinyblistersthatformfromthestings.Washtheinjuredareawell,usingantisepticorsoapandwater.Coverwithasterilebandageand,forrelief,tryapastemadeofbakingsodaandwater,andtakeamildnonaspirinpainreliever.Theblisteredareashouldhealwithinaweek.

Brown recluse spider (enlarged)

Some people may be highly allergic to fire ant bites, which can cause the life-threatening reaction called anaphylactic shock (anaphylaxis). For more information, see “Life-Threatening Emergencies.”

76        fiRST Aid

Other first-aid Cases.

Ifyouarestungbyabeebutarenotallergictobeestings,youcansimplyremovethestingerbyscrapingitoutwithaknifeblade.Don’ttrytosqueezethestingerout.Doingsowillforcemorevenomintotheskinfromthesacattachedtothestinger.Forbee,wasp,orhornetstings,useanicepacktohelpreducepainandswelling.

Common scorpion stingsoftencausesevere,sharppainwithswellinganddiscoloration,butgenerallycausenolastingilleffects.Anicepackorcoldcompressshouldhelprelieveanyitchingandpain.Anover-the-counterantihistaminemayhelprelievesymptoms.However,ifthevictimhasahistoryofaller-gicreactionstoinsectstingsorshowssignalsofillness,seekmedicalhelpatonce.

For information about anaphylactic shock (anaphylaxis), a severe allergic reaction, see “Life-Threatening Emergencies.” Without immediate treatment, a person who goes into anaphylactic shock can die. People who are allergic to bee or wasp stings, fire ant bites, or pea-nuts, shellfish, and certain other foods can have similar anaphylactic reactions. Small children may be especially vulnerable to a severe reaction.

Honeybees Paper waspMud dauber wasp

.Other first-aid Cases

Animal bites. Thebiteofadog,cat,oranyotherwarm-bloodedanimalisaseriouspuncturewound.Theanimalmightsufferfromrabies,adeadlyillnessthatcanbetransmittedthroughthesalivaofsomemammals,inparticulardogs,skunks,raccoons,foxes,andbats.Theonlywaytolearnifananimalisinfectedistocatchitandhaveittestedbymedicalexperts.

Totreatananimalbite,scrubtheareawithsoapandwaterand,ifpossible,flushthewoundwithcleanwaterforafullfiveminutestoremovesaliva.Controlthebleedingandcoverthewoundwithasterilebandage.Thevictimmustseeadoctor,whocandeterminewhethertogiverabiesshots.

Ifthebiteisthatofapetdogorcat,getthename,address,andphonenumberoftheowner,ifpossible.Ifbittenbyawildanimal,donottrytocaptureit.Instead,havesomeonemakenoteofthetypeofanimal,itsdescription,andthedirectioninwhichitwasheaded,thencontactthelocalpublichealthauthoritiestoreportthebite.

An unprovoked attack could be a sign that an animal is rabid. Report all animal bites to your local public health authorities or the police. Do not kill the animal unless necessary, and do not put yourself at risk by trying to catch the animal. Call the police, rangers, or animal control officers, who are trained to do the job safely. Suspicious animals may be confined and observed, or destroyed so that their brains can be tested for rabies.

Raccoon

78        fiRST Aid

Other first-aid Cases.

Snakebites.Thebiteofanonvenomoussnakecausesonlyminorpuncturewoundsandcanbetreatedassuch.Sincesnakesarenotwarm-blooded,theycannotcarryrabies.Scrubthebitewithsoapandwater,treatwithanantiseptic,andcoverwithasterilebandage.However,avenomoussnakebiterequiresspecialcare.

ThevenomoussnakesofNorthAmericaarepitvipersandcoralsnakes.Pitvipers,includingrattlesnakes,copperheads,andcottonmouths,havetriangular-shapedheadswithpitsoneachsideinfrontoftheireyes.Signalsofapitviperbiteincludepuncturemarks,pain(perhapsextreme)andswelling(possiblysevere),skindiscoloration,nauseaandvomiting,shallowbreathing,blurredvision,andshock.

Coralsnakeshaveblacknosesandaremarkedwithredandyellowbandsside-by-side,separatedbybandsofblack.Theyinjectapowerfulvenomthataffectsthevictim’snervoussystem.Thesignalsofacoralsnakebiteincludeslowedphysicalandmentalreactions,sleepiness,nausea,shortnessofbreath,convulsions,shock,andcoma.

Thebiteofavenomoussnakecancausesharp,burningpain.Theareaaroundthebitemightswellandbecomediscol-ored;however,avenomoussnakedoesnotinjectvenomeverytimeitbites.Herearethestepsfortreatingthebiteofvenomoussnakes.

Step 1—Getthevictimundermedicalcareassoonaspossiblesothatphysicianscanneutralizethevenom.

Step 2—Removeringsandotherjewelrythatmightcauseproblemsiftheareaaroundthebiteswells.

Step 3—Ifthevictimmustwaitformedicalattentiontoarrive,washthewound.Ifitisabiteofacoralsnake,wraptheareasnugly(butcomfortably)withanelasticrollerbandage.

Step 4—Havethevictimliedownandpositionthebittenpartlowerthantherestofhisbody.Encouragehimtostaycalm.Hemightbeveryfrightened,sokeepassuringhimthatheisbeingcaredfor.

Step 5—Treatforshock.

Donotmakeanycutsonorapplysuctiontothebite,applyatourniquet,oruseelectricshocksuchasfromacarbattery.Thesemethodscouldcausemoreharmtothevictimorarenotproventobeeffective.

As a precaution,

use a hiking stick

to poke among

stones and brush

ahead of you

when you walk

through areas

where snakes are

common. Watch

where you put

your hands as you

collect firewood

or climb over

rocks and logs.

Do not give a

snakebite victim

alcohol, sedatives,

or aspirin. Do not

apply ice to the

snakebite. Ice

will not help the

injury but could

damage the skin

and tissue.

fiRST Aid        79

.Other first-aid Cases

Rattlesnake

Copperhead

Cottonmouth moccasin

Remember this ditty for safety around coral snakes: red and black—friendly jack; red and yellow–deadly fellow.

Since nearly all snakebites occur on the limbs, wearing gloves and boots or high leather shoes will protect the most vulnerable areas. The best rule is to never put your feet or hands where you cannot see them. Don’t reach over blind hedges or poke around in crev-ices, hollow logs, or woodpiles.

fiRST Aid        81

.Life-threatening Emergencies

Learn to recognize

life-threatening

conditions and be

prepared to take

quick action. The

procedures for

adults, children,

and infants may

differ slightly.

Life-ThreateningEmergenciesTherightfirstaidgivenquicklycansavealife.Apersonwhohasstoppedbreathingmustreceiverescuebreathingwithinthreetofiveminutesorbraindamagewilloccur.Peoplewhomayneedlifesavingfirstaidincludevictimsofheartattacks,deepcutswithseverebleeding,submersionemergency(ornear-drowning),andlightningstrikes.Aftercallingforhelp,assessthesituationtodecidewhatyoushoulddoandinwhichorder.

Aneasywaytorecalltheorderoftreatmentinalife-threateningemergencyisA-B-C-D:Airway,Breathing,Circulation,anddefibrillation.

A is for AirwayTheairwayisthepassagethatallowsairenteringthemouthornosetoreachthelungs.Alwaysprotecttheairwayofanyacci-dentvictim.Ifthepersonbeginstovomit,turnthevictimontohisorhersidesothatthevomitcomesoutofthemouthandisnotaspirated(inhaled)intothelungs.

Put A-B-C-D Into PracticeIs the person conscious? Tap the person on the shoul-der to see if he or she responds. Ask a question such as, “Are you OK?” If there is no response to sound  or touch, the person is unconscious. Call or send  for medical help. 

82        fiRST Aid

Life-threatening Emergencies.

Ifavictimisuncon-scious,carefullyplacethepersononhisorherback,protectingtheheadandneckifyoumustrollthepersonover.Then,opentheairwaybypressing(ortilting)ontheforeheadwithonehandandliftingthechinwiththeothertotiltbackthehead.Thisactionwillkeepthetonguefromblockingtheperson’sairway.

B is for BreathingAfteropeningthevictim’sairway,checktoseeifthepersoncanbreathenormally.Placeyourcheekinfrontofthevictim’smouth(about1to2inchesaway).Look,listen,andfeelformovementandbreathing(signalsofcirculation,or“signsoflife”)fornomorethan10seconds.Ifthepersonisbreathingeffectively,youwillfeelandheartheairflowonyourcheekandseeandfeelthechestrisingandfallingatregularintervals.If there is no breathing or movement; give two rescue breaths, then begin cardiopulmonary resuscitation.

Look, listen, feel—these are the steps to check for breathing.

Tilt the head and

lift up on the chin

to open the airway

of an unconscious

person.

If opening the

airway restores

breathing, place

the victim in a

recovery position.

Continue to moni-

tor the person’s

breathing until

help arrives.

fiRST Aid        83

.Life-threatening Emergencies

Onceyouhaveopenedtheairway,checkformovementandbreathingfornomorethan10seconds.Ifthepersonstillisnotbreathing,givetworescuebreaths.

Step 1—PlaceaCPRbreathingbarrieroverthevictim’smouth.Thatmayprotectbothofyoufromorallytransmitteddiseases.

Step 2—Givetworescuebreaths.Whilemaintainingthehead-tilt,pinchthenostrils,sealyourmouthoverthevictim’smouthandblowintoittofilltheperson’slungs.(Foraninfant,sealyourmouthoverboththemouthandnose,thenbreathegently.)Eachbreathshouldlastabout1second.Watchtoseeifthechestclearlyrises.Removeyourmouthandthengiveanotherrescuebreath.

Step 3—for a child or an infant,aftertworescuebreaths,checkforapulsefornomorethan10seconds.Ifthereisstillnobreathing,beginrescuebreathing(1breathaboutevery3seconds)andrecheckforbreathingandpulseevery2minutesaslongasthereisapulsebutnobreathing.for an adult,aftertworescuebreaths,beginCPRimmediatelyifthevictimdoesnotresumebreathing.

If the victim revives, put him or her in a recovery position and treat for shock. Monitor the person to make sure breathing does not stop again.

Rescue breathing techniques are constantly being improved. Check with your Scout leaders and local American Red Cross chapter or American Heart Association office for current methods and  training opportunities.

84        fiRST Aid

Life-threatening Emergencies.

C is for CirculationSignalsofcirculationmeanthattheheartisstillbeatingandcirculatingbloodthroughthebody.Normalbreathingandmovementaresignalsoflifeandthatthereisaheartbeat.Inthecaseofyoungchildren(underage12)andinfants,feelingforapulsefornomorethan10secondscanalsobeperformed.If there are no signals that the heart is beating, begin CPR immediately.

Accidentsormedicalconditionsthatcauseapersontostopbreathingcanalsostoptheheart.Iftheheartisnotpumpingandcirculatingbloodthroughthebody,thevictimwillnotbebreathing,moving,ormakingnormalsounds.Ifyouhavedeliveredtworescuebreathsandthevictimdoesnotbegintobreathe,youshouldperformcardiopulmonary

resuscitation,orCPR,immediately.LearningCPRrequirescarefulinstructionfrom

acertifiedteacher.PerhapsyoucanpracticeCPRatScoutmeetings.TheAmericanRedCrossandAmericanHeartAssociationofferclasses,too.YourScoutleaderscanhelpyoufindtrainingtolearnthislifesavingskill.

While the techniques for CPR are different for adults, children, and infants, the cycle of 30 chest compressions followed by two rescue breaths applies to everyone. To receive full and proper CPR training, contact your American Red Cross chapter or the American Heart Association. See the resources section in the back of this pamphlet for more information.

Adult

Child (one or two hands) infant (two or three fingers)

fiRST Aid        85

.Life-threatening Emergencies

d is for defibrillationTheheartismadeupofmanymusclefibersthatusuallycon-tractandrelaxinunisontopumpblood.Duringaheartattack,thosemusclefibersdonotworktogether.Aheartattackcanleadtowhatisknownas“cardiacarrest.”Anothercauseofcar-diacarrestisanabnormalelectricalheartrhythm,mostcom-monlyknownasventricularfibrillation.

Amachinecalledadefibrillatorcansendanelectricalshockthroughthehearttomomentarilystopallelectricalactiv-ity.Thispausegivestheheartenoughtimetotrytorestoreaneffectiveheartbeat(rhythm).Apersonwhosehearthasstoppedfunctioningcanbetreatedwiththisspecialdevice,ifoneisavailable.Ideally,thisshouldhappenwithinseveralminutesofthevictim’scollapse.

Mostambulances,hospitals,andemergencycarefacilitiesareequippedwithdefibrillatorsforusebytrainedmedicalper-sonnel.Becauseadefibrillatormustbeusedquickly(withinseveralminutes)tosaveaperson’slife,anewtypeofdefibrilla-torcalledanautomated external defibrillator (AED)hasbeendeveloped.ManyfirstresponderssuchaspoliceofficersandfirefighterscarryandaretrainedintheuseofAEDs.

AnAEDiscomputerized.Itcancheckaperson’sheartrhythmandrecognizearhythmthatrequiresashock.Itcanalsoadvisetherescuerwhenashockisneeded.AEDsusevoiceprompts,lights,andtextmessagestotelltherescuerthestepstotake.

AEDsareveryaccurateandeasytouse.Withonlyafewhoursoftraining,alaypersoncanlearnhowtooperateanAED.However,youmustbetrainedtooperateonesafelyandeffectively.

Many public places such as airports and shopping malls now have installed AEDs in clearly marked, desig-nated areas much the same way that fire extinguishers are made readily available for access in an emergency.

86        fiRST Aid

Life-threatening Emergencies.

Heart AttackAheartattackisalife-threateningconditionthatcausesdeathofordamagetotheheartmuscle.Whenanarterythatsuppliesbloodtotheheartisblocked,aheartattackcanoccur.Heartattackrequiresquickactiontopossiblysavealife.Learntorec-ognizethewarningsignalsofaheartattack,thenbepreparedtotakepromptactionbycalling911orthelocalemergency-responsenumber.ImmediatelyadministerCPRifnecessary.

Common Warning Signals of Heart AttackHerearesomecommonwarningsignalsofheartattack.

• Persistent,uncomfortablepressure,squeezing,fullness,orpaininthecenterofthechestbehindthebreastbone.Thefeelingmayspreadtotheshoulders,arms,andneck.Itmaylastseveralminutesorlongerandmaycomeandgo.Itneednotbesevere.(Sharp,stabbingtwingesofpainusuallyarenotsignalsofheartattack.)

• Unusualsweating—forinstance,perspiringeventhougharoomiscool.

• Nausea—stomachdistresswithanurgetovomit.

• Shortnessofbreath.

• Afeelingofweakness.

Shouldanyonecomplainofthesesymptoms,getmedicalattentionforthevictimrightaway.Beawarethatacommonreactionofmenandwomenwhoareexperiencingsignalsofheartattackistodenythatanythingiswrong.BereadytobeginCPRiftheheartbeatandbreathingstop.

Women may

experience differ-

ent symptoms

than do men. A

woman might also

have intermittent

back, abdominal,

and upper-body

pain; unexplained

fatigue; and dizzi-

ness. She might

feel heaviness in

the chest or a

burning sensation

rather than pain.

If you suspect someone is having a heart attack and this person is con-scious, try to find out the following.

•  Is the person taking any type of blood-thinning medication?

•  Is the person allergic to aspirin?

•  Does this person have stomach problems?

•  Has the person ever been advised by a physician not to take aspirin?If the answer is “no” to all of the questions above, when you call 911, 

emergency responders may advise you to offer the person two uncoated baby aspirin tablets (81 mg apiece). Aspirin must be used, not painkillers such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol).

fiRST Aid        87

.Life-threatening Emergencies

StrokeAstrokeoccurswhenanarterytothebraineitherburstsorisblockedbyaclot.Whenbloodsupplytothebrainisinter-rupted,braincellsbegintodie.

Common Warning Signals of StrokeThiscardiovasculardiseaseinjuresthebrain,andthesignalshappenfast;thevictimmightnotbeawareastrokeisoccur-ring.Othersnearbymightnotknowit,either.Thisiswhyitissoimportanttoknowthecommonwarningsignalsofstroke.

• Suddenweaknessornumbnessoftheface,arm,orleg(especiallyononesideofthebody)

• Suddenconfusionortroublespeakingorunderstandingspeech

• Suddentroubleseeing

• Suddendizziness,withlossofbalanceorcoordinationandtroublewalking

• Suddenandsevereheadachewithnoknowncause

Perhapssomeonehassuddenlylosttheabilitytospeakclearlyortomoveonesideofthebody,orsuddenlyhastroublewalkingorseeing.Ifyouthinksomeoneishavingastroke,notethelasttimeyousawthepersonactingnormally,thencall911immediately;fastactionisvital.

Think FASTUse this quick method to help determine whether someone might have suffered a stroke.f = face. Ask the person to smile. Watch for weakness   to one side of the face.A = Arm. Ask the person to raise both arms. Watch for   weakness or numbness in the limbs.S = Speech. Ask the person to say a simple sentence   such as, “May I have a cookie?” Listen for    slurred speech.T = Time. Time to call 911 right away if the person   cannot perform any of the simple tasks above or   shows any other signals of stroke. Be sure to note    the time the signals began.

While waiting for

medical personnel

to arrive, keep

the person calm

and comfortable.

A stroke could

make a person

nervous and

afraid. Reassure

the person that

help is on the way.

Do not give the

victim anything to

eat or drink.

88        fiRST Aid

Life-threatening Emergencies.

When Someone Is ChokingA person who is choking and can cough, speak, or breathe is still getting some air to the lungs. Encourage him or her to cough up the object, and be ready to administer first aid if it is needed. However, if the person is coughing weakly or making high-pitched noises, or if the person can’t cough, speak, or breathe, you will need to take quick action.

Have someone call for help, then do  the following.

Step 1—If the child or adult is conscious, give a series of five back blows as shown. From behind, place one arm across the person’s chest and lean forward. Firmly strike the per-son’s back with the palm of your hand. Follow the five back blows with abdominal thrusts as described in steps 2 and 3.

Step 2—Stand behind the victim. Put your arms around the waist and clasp your hands together. The knuckle of one thumb should  be just above the victim’s navel but below  the rib cage.

Step 3—Thrust your clasped hands inward and upward with enough force to pop loose the obstruction.

Step 4—Repeat steps 1 through 3 until the obstruction clears or medical help arrives.

Someone who is choking on food may grasp the throat to signal that he or she is unable to breathe. Treat by performing back blows and abdominal thrusts.

1

2

3

fiRST Aid        89

.Life-threatening Emergencies

Severe BleedingAcarelessmomentwithaknife,anax,orapowertooloranynumberofotheraccidentscanseveralargebloodvesselinthearmorleg,causingseverebleeding.Quickfirst-aidactioncanstopbleedingandperhapssaveapersonfrombleedingtodeath.

first Aid for Severe BleedingStep 1—Putonnonlatexdisposableglovesandprotectivegog-gles.Withacleanclothorsteriledressingasapad,usethepalmofyourhandtoapplyfirmpressuredirectlyoverthewound.Ifyouhaveanelasticbandagehandy,useittosecurethepadtightlyoverthesourceofthebleeding.

Step 2—Afterthebleedingstops,holdthepadinplacewithasterilebandage—anathleticwrap,stripstornfromcleancloth-ing,orsomethingelsesimilarcloseathand.Bindthepadfirmlybutnotsotightlythatcirculationiscutoff.

Step 3—Ifthebandageisonanarmoraleg,periodicallycheckforcirculation(feeling,warmth,color).Nocirculationisanindicationthatthebandageshouldbeloosened.

Step 4—Ifapressurepadhasbecomesoakedwithblood,placeafreshpadoverthefirstone(donotremoveit)andcontinueapplyingpressure.

Wounds can be incisions—clean cuts through the skin, such as those caused by knives, razors, broken glass,  or other sharp objects, or lacerations—rough, jagged cuts. Deep wounds may injure muscles, tendons, and nerves. Contamination of any wound increases the chances of infection.

A paramedic or

physician will

probably want to

know when the

injured person

was immunized

against tetanus—

a serious illness

that can some-

times result when

bacteria are

introduced

through cuts,

abrasions, and

other breaks in

the skin.

Applying direct pressure on a wound will stop most bleeding.

90        fiRST Aid

Life-threatening Emergencies.

TOURniqUETSForthemostextremecasesofseverebleeding,first-aidershavesometimesusedatourniquet—adevicedesignedspecificallytobetightenedabovealimbthathasbeenpartiallyorcompletelysevered—asalastresortforstoppingbleeding.Thismethodisusedonlywhenallothereffortshavefailedandadvancedpro-fessionalmedicalcareiseitherdelayedbyatleast30minutesornotavailable.Atourniquetwillcompletelystoptheflowofbloodtothelimb.Itcanalsocausegangrene(tissuedeath)andmayrequiresurgicalamputationofthelimb.

Inthepast,fieldtourniquetsweremadefromastripofclothatleast2incheswide(neveracord,wire,rope,oranyotherthinmaterial).Thestripwastiedwithanoverhandknotabovethewound,andastick,tentpeg,orsimilarrod-shapedobjectwasplacedontheknotandtieddownwithasquareknot.Thestickwasthentwistedjustuntilthebleedingstopped,andthensecuredsothetourniquetwouldnotcomeloose.Today,ifatourniquetmustbeused,itisgenerallyacommerciallymadedevicedesignedforthisspecificpurpose.

Onceatourniquethasbeenapplied,awrittennoteofthelocationofthetourniquetandthetimeitwasappliedismadeandattachedtothevictim’sclothing.Thevictimshouldbetreatedforshockandgivenfirstaidforotherinjuries.Thetourniquetmustnotbecovered.

Ifitislikelythatitwillbehoursbeforeadvancedmedicalhelpisavailable,thenthetourniquetshouldbeloosenedtodetermineifbleedinghasstoppedandalsotoallowsomebloodflowtothelimbafterfiveminutes.Ifbleedingcontinues,thetourniquetshouldbetightenedandrecheckedafteranotherfive-minuteperiod.Ifthebleedinghasstopped,theloosenedtourniquetshouldbeleftinplace.Toavoidcrushingthetissueandcausingpermanentdamagetonervesandbloodvessels,thetourniquetshouldbeperiodicallycheckedandloosened.

Foranycaseofseverebleeding,summonemergencymedi-calhelpimmediately.Youshouldalwaysusenonlatex,dispos-ableglovesandprotectivegoggleswhenrenderingaidtoapersonwhoisbleeding.Becauseofthemanyrisksassociatedwiththeapplicationofatourniquet,thismethodisbestlefttotrainedmedicalprofessionalsorskilledrespondersspeciallytrainedintheapplicationoftourniquets.

If the injury is on

a flexible part of

the body—an

elbow or knee, for

example—after

the bleeding has

stopped, use a

splint to immobi-

lize the joint and

prevent the

wound from

pulling open.

fiRST Aid        91

.Life-threatening Emergencies

Anaphylactic Shock (Anaphylaxis)Formostpeople,beeorwaspstingswillcausepain,redness,andalittleswellingaroundtheaffectedareaandperhapsafewdaysofitching.Forthesmallnumberofpeoplewhoareallergictobeeorwaspvenomorfireantbites,thesestingsandbitescancausealife-threateningreactioncalledanaphylactic shock (anaphylaxis). Symptomscanincludeaswellingofthroattis-suesortonguethatrestrictsairpassagesandmakesbreathingdifficultorevenimpossible.

Without immediate treatment, a person who goes into anaphylactic shock can die. People who are allergic to peanuts, shellfish, and certain other foods can have similar anaphylactic reactions if they ingest or even 

inhale particles of these foods. For instance, people 

who are allergic to pea-nuts cannot consume 

foods cooked in peanut oil.

Any Scout who

has an allergy

that could cause

anaphylactic

shock should

share that infor-

mation with Scout

leaders and

always let group

leaders know

where he carries

anaphylaxis medi-

cations so that

they can be made

available at a

moment’s notice.

92        fiRST Aid

Life-threatening Emergencies.

People who know they are susceptible to anaphylaxis should carry emergency kits that contain an injection of epinephrine, a rapidly acting hormone that reverses the effects of anaphylactic shock.

first Aid for Anaphylactic ShockStep 1—Call911oryourlocalemergency-responsenumber.

Step 2—CheckthevictimforamedicalIDbracelet,necklace,orinformationcard.Askifthepersoniscarryingaprescribedemergencymedicalkit.YoumaybeabletoassistthepersonundercertaincircumstancesANDifyouaretrainedandallowedtoassistbystateorlocalregulations.Ifso,followthekitinstructionsexactlyandassistthepersonbylocatingthemedicationkitandhandingittohimorher.Itisbestthattheindividualadministersthemedication.Ifthepersonisuncon-scious,followtheA-B-C-Dlifesavingsequenceand/orfollowinstructionsprovidedbyemergencymedicalprofessionals.

Step 3—Seethatthevictimreceivesfollow-upmedicaltreatment.

Ifyouarenotqualifiedtoadministerepinephrine,youshouldhelpmakesurethepersonstaysinacomfortableposi-tionforbreathingwhileawaitingmedicalhelp.Thiswillusu-allybeasittingposition.

Life-threatening food allergies are rare. However, an increasing number of people suffer from food-allergy reactions that, although not life-threatening, can cause great discomfort. If you have a food allergy, always be sure to let Scout leaders know about it. They can then work with members of the patrol and troop to ensure that the foods that trigger an allergic reaction are avoided during the planning and carrying out of Scout events. Making a situation safe for everyone is also a way to increase the sense of cooperation and support within a Scout unit.

fiRST Aid        93

.first-aid resources

First-AidResourcesScouting LiteratureBoy Scout Handbook;Fieldbook; Deck of First Aid; Basic Illustrated Wilderness First Aid; Emergency First Aid pocketguide; Be Prepared First Aid Book; Dentistry, Emergency Preparedness, Fire Safety, Lifesaving, Medicine, Public Health, Safety, andWilderness Survival meritbadgepamphlets

Books

American Medical Association Handbook of First Aid and Emergency Care,reviseded.RandomHouse,2000.

Auerbach,PaulS.Medicine for the Outdoors: The Essential Guide to Emergency Medical Procedures and First Aid. LyonsPress,2003.

Backer,Howard,etal.Wilderness First Aid: Emergency Care for Remote Locations.JonesandBartlett,2005.

First Aid, 4thed.AmericanAcademyofOrthopaedicSurgeons,2005.

Forgey,William.Wilderness Medicine: Beyond First Aid,5thed.GlobePequotPress,1999.

Gill,PaulG.Wilderness First Aid: A Pocket Guide. RaggedMountainPress,2002.

Isaac,Jeffrey.The Outward Bound Wilderness First-Aid Handbook, reviseded.Lyons&Burford,1998.

Rickey,Brad,andKurtDuffens.FastAct Pocket First Aid Guide. FastAct,1999.

Schimelpfenig,Todd,andLindaLindsey.NOLS Wilderness First Aid,3rded.NationalOutdoorLeadershipSchoolandStackpoleBooks,2000.

Tilton,Buck.Backcountry First Aid and Extended Care,4thed.Falcon,2002.

Weiss,EricA.Wilderness 911: A Step-by-Step Guide for Medical Emergencies and Improvised Care in the Backcountry. TheMountaineersBooks,1998.

Wilkerson,JamesA.,ed.Medicine for Mountaineering and Other Wilderness Activities,5thed.TheMountaineersBooks,2001.

Visit the Boy Scouts of America’s official retail Web site (with your parent’s permission) at http://www.scoutstuff.org for a complete listing of all merit badge pam-phlets and other helpful Scouting materials and supplies.

94        fiRST Aid

first-aid resources.

Organizations and Web SitesAmerican Heart Association7272GreenvilleAve.Dallas,TX75231Toll-freetelephone:800-242-8721Website:http://www.americanheart.org

American Medical Association515N.StateSt.Chicago,IL60610Toll-freetelephone:800-621-8335Website:http://www.ama-assn.org

American Red Cross2025ESt.NWWashington,DC20006Telephone:202-303-4498Website:http://www.redcross.org

American Stroke Association7272GreenvilleAve.Dallas,TX75231Toll-freetelephone:888-478-7653Website:http://www.strokeassociation.org

national Safety Council1121SpringLakeDriveItasca,IL60143-3201Toll-freetelephone:800-621-7619Website:http://www.nsc.org

The American Red Cross produces several resources that may be of  particular interest to Scouts, Scout leaders, and merit badge counselors.

American Red Cross. First Aid/CPR/AED for Schools and the Community (participant’s manual). Staywell, 2006.

American Red Cross. First Aid/CPR/AED for Schools and the Community (DVD). Staywell, 2006.

American Red Cross. American Red Cross First Aid—Responding to Emergencies (participant’s man-ual). Staywell, 2007.

American Red Cross. American Red Cross Sport Safety Training Handbook. Staywell, 2007.

fiRST Aid        95

.first-aid resources

Acknowledgments

ForthisrevisionoftheFirst Aidmeritbadgepamphlet,theBoyScoutsofAmericaisgratefultoRichardThomas,Pharm.D.,Scottsdale,Arizona,forhisthoroughreviewsandinput.Dr.Thomasisalongtime,avidsup-porterofScoutingwhohasprovidedhissubjectexpertiseforanumberofmeritbadgepamphlets.WearegratefultoMurphyGreen,M.D.,Harlan,Kentucky,forhisearlyinvolvement.

ThanksalsototheBSAHealthandSafetyCommittee,inparticularcommitteechairGeorgeAllen,M.D.;andmembersCalvinBanning;DavidCohen,M.D.;StephenLomber,M.D.,Ph.D.;andHaroldYocum,M.D.

WeappreciatetheQuicklistConsultingCommitteeoftheAssociationforLibraryServicetoChildren,adivisionoftheAmericanLibraryAssociation,foritsassistancewithupdatingtheresourcessectionofthismeritbadgepamphlet.

The Boy Scouts of America is grateful  to the American Red Cross for providing hands-on assistance from beginning  to end with this edition of the First Aid merit badge pamphlet. From the text  to photos and illustrations, subject 

expertise, and a multitude of other lines of support, the American Red Cross has been indispensable, professional, and obliging in every way.  In particular, the BSA would like to thank the following individuals from the American Red Cross National Headquarters, Preparedness and Health and Safety Services: Ted T. Crites, CHES, manager, Technical Development, First Aid, CPR/AED Programs, Research and Product Development;  John E. Hendrickson, senior associate, Program Management and Field Support; and Kate Tunney, M.A.Ed., CHES, senior associate, Technical Development, Research and Product Development. 

96        fiRST Aid

first-aid resources.

Photo and illustration Credits

AmericanNationalRedCross,courtesy—pages58(both),59(step 3),and94(all)

LisaAmes,UniversityofGeorgia,Bugwood.org,courtesy—page75

ScottBauer,USDAAgriculturalResourceService,Bugwood.org, courtesy—page74(top, center)

RonaldF.Billings,TexasForestService,Bugwood.org,courtesy—cover(spider) andpage74(bottom)

WhitneyCranshaw,ColoradoStateUniversity,Bugwood.org, courtesy—page76(right)

JohnnyN.Dell,retired,Bugwood.org, courtesy—page76(center)

CarlDennis,AuburnUniversity,Bugwood.org,courtesy—page76(left)

©Photos.com—cover(medicine bottles); pages9(top), 22(center, bottom), 37–38(all),53–56(all), 57(bottom),60,63,72–73(all),77,89,and91(right)

U.S.FishandWildlifeService/LutherC.Goldman,courtesy—page79(top)

Wikipedia.org,courtesy—page79(rattlesnake)

Wikipedia.org/JohnWillson,SavannahRiverEcologyLaboratory(SREL),courtesy—page79(cottonmouth moccasin)

Wikipedia.org/EdwardJ.Wozniak,DVM,Ph.D.,courtesy—page79(copperhead)

AllotherphotosandillustrationsnotmentionedabovearethepropertyoforareprotectedbytheBoyScoutsofAmerica.

DanielGiles—page17

JohnMcDearmon—pages16(top illustrations),18,24(illustrations),27–29(illustrations),32–33(all),40–42(all),45,47–48(all),57(illustrations), 71, 82–84(illustrations),and89

BrianPayne—cover(rescue litter);pages28,36,51,and61

RandyPiland—page70(top left)

Merit badge libraryThough intended as an aid to Boy Scouts, Varsity Scouts, and qualified Venturers in meeting merit badge requirements, these pamphlets are of general interest and are made available by many schools and public libraries. The latest revision date of each pamphlet might not correspond with the copyright date shown below, because this list is corrected only once a year, in January. Any number of merit badge pamphlets may be revised throughout the year; others are simply reprinted until a revision becomes necessary.

If a Scout has already started working on a merit badge when a new edition for that pamphlet is introduced, he may continue to use the same merit badge pamphlet to earn the badge and fulfill the requirements therein. In other words, the Scout need not start all over again with the new pamphlet and possibly revised requirements.

American Business 2002American Cultures 2005American Heritage 2005American Labor 2006Animal Science 2006Archaeology 2006Archery 2004Architecture 2008Art 2006Astronomy 2004Athletics 2006Automotive Maintenance 2008Aviation 2006Backpacking 2007Basketry 2003Bird Study 2005Bugling (see Music)Camping 2005Canoeing 2004Chemistry 2004Cinematography 2008Citizenship in the

Community 2005Citizenship in the Nation 2005Citizenship in the World 2005Climbing 2006Coin Collecting 2008Collections 2008Communication 2009Composite Materials 2006Computers 2009Cooking 2007Crime Prevention 2005Cycling 2003Dentistry 2006Disabilities Awareness 2005Dog Care 2003Drafting 2008Electricity 2004Electronics 2004Emergency Preparedness 2008Energy 2005

Photography 2005Pioneering 2006Plant Science 2005Plumbing 2004Pottery 2008Public Health 2005Public Speaking 2002Pulp and Paper 2006Radio 2008Railroading 2003Reading 2003Reptile and

Amphibian Study 2005Rifle Shooting 2001Rowing 2006Safety 2006Salesmanship 2003Scholarship 2004Scuba Diving 2009Sculpture 2007Shotgun Shooting 2005Skating 2005Small-Boat Sailing 2004Snow Sports 2007Soil and Water

Conservation 2004Space Exploration 2004Sports 2006Stamp Collecting 2007Surveying 2004Swimming 2008Textile 2003Theater 2005Traffic Safety 2006Truck Transportation 2005Veterinary Medicine 2005Water Sports 2007Weather 2006Whitewater 2005Wilderness Survival 2007Wood Carving 2006Woodwork 2003

Engineering 2008Entrepreneurship 2006Environmental Science 2006Family Life 2005Farm Mechanics 2008Fingerprinting 2003Fire Safety 2004First Aid 2007Fish and Wildlife

Management 2004Fishing 2009Fly-Fishing 2009Forestry 2005Gardening 2002Genealogy 2005Geology 2005Golf 2002Graphic Arts 2006Hiking 2007Home Repairs 2009Horsemanship 2003Indian Lore 2008Insect Study 2008Journalism 2006Landscape Architecture 2008Law 2003Leatherwork 2002Lifesaving 2008Mammal Study 2003Medicine 2009Metalwork 2007Model Design and Building 2003Motorboating 2008Music and Bugling 2003Nature 2003Nuclear Science 2004Oceanography 2009Orienteering 2003Painting 2008Personal Fitness 2006Personal Management 2003Pets 2003

BOY SCOUTS OF AMERICA • SUPPLY GROUP

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