Edgemont North Stake Young Women's Camp: May 2017

Rescue Flow

*Check the scene for safety*

Don’t become part of the problem

· Compressions

· Airway

· B breathing

· D direct help/ level of consciousness

· E exposure

· F feel for broken bones, gently

· G give comfort

· H history, cause of problem

· I inspect surfaces

Rescue Flow – expanded version

*Always check the scene for safety before entering. Do not proceed until the area is safe. Eliminate safety hazards before proceeding.

When coming on to someone who seems in need of help first determine if they are conscious or not. If they are able to communicate ask them questions to determine what their problems might be and proceed to treat them depending on what you see and how they respond.

If they are unconscious, gasping, not breathing or not responding

1. The first person at the scene will send someone to go for help by calling 911 and telling them to bring an AED if they have one. The person designated to go for help will return back to the scene accompanied by the help.

2. Move directly to CPR starting with chest compressions.

Compressions

Chest compressions are started as soon as the person is found to be unresponsive and help has been called. Compressions should be given hard and fast on the center of the chest. This circulates the blood in the heart while another person prepares to open the airway to give mouth-to-mouth breaths.

Airway & Breathing

Another rescuer manages airway and breathing by tilting the victims head back and lifting the chin to open the airway. Then give mouth-to-mouth breaths.

30 compressions to 2 breaths

The person managing the airway is designated to be the group leader and monitor the airway and breathing through the entire scenario. She communicates with the other team members about each step and delegates the duties to others to perform while continuing to monitor the airway and breathing of the victim. She is responsible with direct help to lay the victim down gently on their back keeping the spine in a straight line. It’s a good assumption that if there is any head or facial injury to treat them as if they had a neck or spine injury. If at any point the victim stops breathing assess the need for 2 person CPR.

Direct help

This person will be the one to make sure help is on their way and guide them back to the victim after help arrives.

Exposure

Treat the victim for shock keeping them lying down and elevating the feet unless there is a chance of a head injury. Determine if they might be too cold or too hot and treat them by covering to retain heat or cool cloths to decrease heat. Do not give them anything to eat or drink if they are nauseated.

Feel

Gently feel for broken bones, dislocations or other boney abnormalities. Treat them appropriately with splints or slings.

Give comfort

Comfort the victim emotionally and attempt to keep them calm by explaining that you are trying to help them and help is on the way. This is also a good tool to continue checking their alertness and if they have other needs or ways to help them.

History

Determine what happened to the victim. Ask questions that will give you information to figure out how they got injured or what types of health problems they may have.

Inspect

Inspect the entire body looking for injuries that might have been missed then treat them appropriately. Continue to reevaluate their injuries especially the airway, breathing and circulation. Keep aware of other potential dangers that might still be a threat and eliminate the risk of further injury if any are found.

First Aid for Injuries Listed (Mayo Clinic website)

Allergic Reaction

· Immediately call 911 or your local medical emergency number.

· Ask the person if he or she is carrying an epinephrine autoinjector (EpiPen, Auvi-Q, others) to treat an allergic attack.

· If the person says he or she needs to use an Epi pen, ask whether you should help inject the medication. This is usually done by pressing the Epi pen against the person's thigh and pushing the injector button.

· Have the person lie still on his or her back.

· Loosen tight clothing and cover the person with a blanket. Don't give the person anything to drink.

· If there's vomiting or bleeding from the mouth, turn the person on his or her side to prevent choking.

· If there are no signs of breathing, coughing or movement, begin CPR. Do uninterrupted chest compresses — about 100 every minute — until paramedics arrive.

· Get emergency treatment even if symptoms start to improve. After anaphylaxis, it's possible for symptoms to recur. Monitoring in a hospital for several hours is usually necessary.

If you're with someone having signs and symptoms of anaphylaxis, don't wait to see whether symptoms get better. Seek emergency treatment right away. In severe cases, untreated anaphylaxis can lead to death within half an hour. An antihistamine pill, such as diphenhydramine (Benadryl), isn't sufficient to treat anaphylaxis. These medications can help relieve allergy symptoms, but work too slowly in a severe reaction.

Signs and symptoms of anaphylaxis include:

· Skin reactions, including hives, itching, and flushed or pale skin

· Swelling of the face, eyes, lips or throat

· Constriction of the airways, leading to wheezing and trouble breathing

· A weak and rapid pulse

· Nausea, vomiting or diarrhea

· Dizziness, fainting or unconsciousness

Some common anaphylaxis triggers include:

· Medications

· Foods such as peanuts, tree nuts, fish and shellfish

· Insect stings from bees, yellow jackets, wasps, hornets and fire ants

Animal Bites

For minor wounds. If the bite barely breaks the skin and there's no danger of rabies, treat it as a minor wound. Wash the wound thoroughly with soap and water. Apply an antibiotic cream to prevent infection and cover the bite with a clean bandage.
For deep wounds. If the animal bite creates a deep puncture of the skin or the skin is badly torn and bleeding, apply pressure with a clean, dry cloth to stop the bleeding and see your doctor.
For infection. If you notice signs of infection, such as swelling, redness, increased pain or oozing, see your doctor immediately.
For suspected rabies. If you suspect the bite was caused by an animal that might carry rabies — including any wild or domestic animal of unknown immunization status, particularly bats — see your doctor immediately.

Broken Bones

A fracture is a broken bone. It requires medical attention. If the broken bone is the result of major trauma or injury, call 911 or your local emergency number.

Also call for emergency help if:

· The person is unresponsive, isn't breathing or isn't moving. Begin CPR if there's no breathing or heartbeat.

· There is heavy bleeding.

· Even gentle pressure or movement causes pain.

· The limb or joint appears deformed.

· The bone has pierced the skin.

· The extremity of the injured arm or leg, such as a toe or finger, is numb or bluish at the tip.

· You suspect a bone is broken in the neck, head or back.

Don't move the person except if necessary to avoid further injury. Take these actions immediately while waiting for medical help:

· Stop any bleeding. Apply pressure to the wound with a sterile bandage, a clean cloth or a clean piece of clothing.

· Immobilize the injured area. Don't try to realign the bone or push a bone that's sticking out back in. Apply a splint to the area above and below the fracture sites. Padding the splints can help reduce discomfort.

· Apply ice packs to limit swelling and help relieve pain. Don't apply ice directly to the skin. Wrap the ice in a towel, piece of cloth or some other material.

· Treat for shock. If the person feels faint or is breathing in short, rapid breaths, lay the person down with the head slightly lower than the trunk and, if possible, elevate the legs.

Burns

Minor burns:

· Cool the burn to help soothe the pain. Hold the burned area under cool (not cold) running water for 10 to 15 minutes or until the pain eases. Or apply a clean towel dampened with cool tap water.

· Remove rings or other tight items from the burned area. Try to do this quickly and gently, before the area swells.

· Don't break small blisters (no bigger than your little fingernail). If blisters break, gently clean the area with mild soap and water, apply an antibiotic ointment, and cover it with a nonstick gauze bandage.

· Apply moisturizer or aloe vera lotion or gel, which may provide relief in some cases.

· If needed, take an over-the-counter pain reliever, such as ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve) or acetaminophen (Tylenol, others).

Major burns

Call 911 or emergency medical help for major burns. Until an emergency unit arrives, take these actions:

· Protect the burned person from further harm. If you can do so safely, make sure the person you're helping is not in contact with smoldering materials or exposed to smoke or heat. But don't remove burned clothing stuck to the skin.

· Check for signs of circulation. Look for breathing, coughing or movement. Begin CPR if needed.

· Remove jewelry, belts and other restrictive items, especially from around burned areas and the neck. Burned areas swell rapidly.

· Don't immerse large severe burns in cold water. Doing so could cause a serious loss of body heat (hypothermia) or a drop in blood pressure and decreased blood flow (shock).

· Elevate the burned area. Raise the wound above heart level, if possible.

· Cover the area of the burn. Use a cool, moist, bandage or a clean cloth.

Is it a minor burn or a major burn?

If it's not clear what level of care is needed, try to judge the extent of tissue damage, based on the following burn categories:

1st-degree burn

A first-degree burn is the least serious type, involving only the outer layer of skin. It may cause:

· Redness

· Swelling

· Pain

You can usually treat a first-degree burn as a minor burn. If it involves much of the hands, feet, face, groin, buttocks or a major joint, seek emergency medical attention.

2nd-degree burn

A second-degree burn is more serious. It may cause:

· Red, white or splotchy skin

· Swelling

· Pain

· Blisters

If the second-degree burn is no larger than 3 inches (7.6 centimeters) in diameter, treat it as a minor burn. If the burned area is larger or covers the hands, feet, face, groin, buttocks or a major joint, treat it as a major burn and get medical help immediately.

3rd-degree burns

The most serious burns involve all layers of the skin and underlying fat. Muscle and even bone may be affected. Burned areas may be charred black or white. The person may experience:

· Difficulty breathing

· Carbon monoxide poisoning

Choking

Choking occurs when a foreign object becomes lodged in the throat or windpipe, blocking the flow of air. In adults, a piece of food often is the culprit. Young children often swallow small objects. Because choking cuts off oxygen to the brain, administer first aid as quickly as possible.

The universal sign for choking is hands clutched to the throat. If the person doesn't give the signal, look for these indications:

· Inability to talk

· Difficulty breathing or noisy breathing

· Inability to cough forcefully

· Skin, lips and nails turning blue or dusky

· Loss of consciousness

If choking is occurring, the Red Cross recommends a "five-and-five" approach to delivering first aid:

· Give 5 back blows. First, deliver five back blows between the person's shoulder blades with the heel of your hand.

· Give 5 abdominal thrusts. Perform five abdominal thrusts (also known as the Heimlich maneuver).

· Alternate between 5 blows and 5 thrusts until the blockage is dislodged.

It's OK not to use back blows, if you haven't learned the technique. Both approaches are acceptable

To perform abdominal thrusts (Heimlich maneuver) on someone else:

· Stand behind the person. Wrap your arms around the waist. Tip the person forward slightly.

· Make a fist with one hand. Position it slightly above the person's navel.

· Grasp the fist with the other hand. Press hard into the abdomen with a quick, upward thrust — as if trying to lift the person up.

· Perform a total of 5 abdominal thrusts, if needed. If the blockage still isn't dislodged, repeat the five-and-five cycle.

If you're the only rescuer, perform back blows and abdominal thrusts before calling 911 or your local emergency number for help. If another person is available, have that person call for help while you perform first aid.

If the person becomes unconscious, perform standard CPR with chest compressions and rescue breaths.

To perform abdominal thrusts (Heimlich maneuver) on yourself:

First, if you're alone and choking, call 911 or your local emergency number immediately. Then, although you'll be unable to effectively deliver back blows to yourself, you can still perform abdominal thrusts to dislodge the item.

· Place a fist slightly above your navel.

· Grasp your fist with the other hand and bend over a hard surface — a countertop or chair will do.

· Shove your fist inward and upward.

To clear the airway of a pregnant woman or obese person:

· Position your hands a little bit higher than with a normal Heimlich maneuver, at the base of the breastbone, just above the joining of the lowest ribs.

· Proceed as with the Heimlich maneuver, pressing hard into the chest, with a quick thrust.

· Repeat until the food or other blockage is dislodged or the person becomes unconscious.

To clear the airway of an unconscious person:

· Lower the person on his or her back onto the floor.

· Clear the airway. If a blockage is visible at the back of the throat or high in the throat, reach a finger into the mouth and sweep out the cause of the blockage. Be careful not to push the food or object deeper into the airway, which can happen easily in young children.

· Begin cardiopulmonary resuscitation (CPR) if the object remains lodged and the person doesn't respond after you take the above measures. The chest compressions used in CPR may dislodge the object. Remember to recheck the mouth periodically.

To clear the airway of a choking infant younger than age 1:

· Assume a seated position and hold the infant facedown on your forearm, which is resting on your thigh.

· Thump the infant gently but firmly five times on the middle of the back using the heel of your hand. The combination of gravity and the back blows should release the blocking object.

· Hold the infant face up on your forearm with the head lower than the trunk if the above doesn't work. Using two fingers placed at the center of the infant's breastbone, give five quick chest compressions.

· Repeat the back blows and chest thrusts if breathing doesn't resume. Call for emergency medical help.

· Begin infant CPR if one of these techniques opens the airway but the infant doesn't resume breathing.

If the child is older than age 1, give abdominal thrusts only.

Cuts and Scratches

Minor cuts and scrapes usually don't require a trip to the emergency room. These guidelines can help you care for such wounds:

1. Wash your hands. This helps avoid infection. Also put on disposable protective gloves if they're available.

2. Stop the bleeding. Minor cuts and scrapes usually stop bleeding on their own. If not, apply gentle pressure with a sterile bandage or clean cloth and elevate the wound.

3. Clean the wound. Use clear water to rinse the wound. Also clean around the wound with soap and a washcloth. Keep soap out of the wound, as it can cause irritation. If dirt or debris remains in the wound after washing, use tweezers cleaned with alcohol to remove the particles. If debris still remains, see your doctor. Thorough cleaning reduces the risk of infection and tetanus. There's no need to use hydrogen peroxide, iodine or an iodine-containing cleanser, which can be irritating to tissue already injured.

4. Apply an antibiotic. Apply a thin layer of an antibiotic cream or ointment (Neosporin, Polysporin) to help keep the surface moist they can discourage infection and help the body's natural healing process. Certain ingredients in some ointments can cause a mild rash in some people. If a rash appears, stop using the ointment.

5. Cover the wound. Bandages can help keep the wound clean and keep harmful bacteria out. If the injury is just a minor scrape, or scratch, leave it uncovered.

6. Change the dressing. Do this at least once a day or whenever the bandage becomes wet or dirty. If the injured person is allergic to the adhesive in tapes and bandages, switch to adhesive-free dressings or sterile gauze held in place with paper tape, rolled gauze or a loosely applied elastic bandage.

7. Get stitches for deep wounds. A deep — all the way through the skin — gaping or jagged wound with exposed fat or muscle will need stitches. Adhesive strips or butterfly tape may hold a minor cut together, but if you can't easily close the wound, see your doctor as soon as possible. Proper closure within a few hours minimizes scarring and reduces the risk of infection.

8. Watch for signs of infection. See your doctor if the wound isn't healing or you notice any redness, increasing pain, drainage, warmth or swelling.

9. Get a tetanus shot. If the injured person hasn't had a tetanus shot in the past five years and the wound is deep or dirty, he or she may need a booster shot, as soon as possible.

Fainting

Fainting occurs when the blood supply to your brain is momentarily inadequate, causing you to lose consciousness. This loss of consciousness is usually brief.

Fainting can have no medical significance, or the cause can be a serious disorder. Therefore, treat loss of consciousness as a medical emergency until the signs and symptoms are relieved and the cause is known. Discuss recurrent fainting spells with your doctor.

If you feel faint

· Lie down or sit down. To reduce the chance of fainting again, don't get up too quickly.

· Place your head between your knees if you sit down.

If someone else faints

· Position the person on his or her back. If the person is breathing, restore blood flow to the brain by raising the person's legs above heart level — about 12 inches (30 centimeters) — if possible. Loosen belts, collars or other constrictive clothing. To reduce the chance of fainting again, don't get the person up too quickly. If the person doesn't regain consciousness within one minute, call 911 or your local emergency number.

· Check the person's airway to be sure it's clear. Watch for vomiting.

· Check for signs of circulation (breathing, coughing or movement). If absent, begin CPR. Call 911 or your local emergency number. Continue CPR until help arrives or the person responds and begins to breathe.

If the person was injured in a fall associated with a faint, treat any bumps, bruises or cuts appropriately. Control bleeding with direct pressure.

Heat Stroke

Heatstroke occurs when your body temperature rises rapidly and you're unable to cool down. It can be life-threatening by causing damage to your brain and other vital organs. It may be caused by strenuous activity in the heat or by being in a hot place for too long.

Heatstroke can occur without any previous heat-related condition, such as heat exhaustion. Heatstroke signs and symptoms include:

· Fever of 104 F (40 C) or greater

· Changes in mental status or behavior, such as confusion, agitation, slurred speech

· Hot, dry skin or heavy sweating

· Nausea and vomiting

· Flushed skin

· Rapid pulse

· Rapid breathing

· Headache

· Fainting, which may be the first sign in older adults

Seek emergency medical care

If you suspect heatstroke, call 911 or your local emergency number. Then immediately move the person out of the heat and cool him or her by whatever means available, for example:

· Put the person in a cool tub of water or a cool shower.

· Spray with a garden hose.

· Sponge with cool water.

· Fan while misting with cool water.

· Place ice packs or cool wet towels on the neck, armpits and groin.

· Cover with cool damp sheets.

Let the person drink cool water or other nonalcoholic beverage without caffeine, if he or she is able.

Begin CPR if the person loses consciousness and shows no signs of circulation or breathing.

Hypothermia

Hypothermia occurs when your body loses heat faster than it can produce heat and your body temperature falls below 95 F (35 C). Left untreated, it can be life-threatening.

Hypothermia is often caused by exposure to cold weather or immersion in a cold body of water. It can also be caused by ongoing exposure to indoor temperatures below 50 F (10 C). You could be at increased risk if you're also exhausted or dehydrated.

Signs and symptoms of hypothermia usually develop slowly and may include:

· Shivering, though this may stop as body temperature drops

· Slurred speech or mumbling

· Slow, shallow breathing

· Weak pulse

· Clumsiness or lack of coordination

· Drowsiness or very low energy

· Confusion or memory loss

· Loss of consciousness

· Bright red, cold skin (in infants)

Seek emergency medical care

If you suspect someone has hypothermia, call 911 or your local emergency number. Then immediately take these steps:

· Gently move the person out of the cold. If going indoors isn't possible, protect the person from the wind, especially around the neck and head. Insulate the individual from the cold ground.

· Gently remove wet clothing. Replace wet things with warm, dry coats or blankets.

· If further warming is needed, do so gradually. For example, apply warm, dry compresses to the center of the body — neck, chest and groin. If you use hot water bottles or a chemical hot pack, first wrap it in a towel before applying.

· Offer the person warm, sweet, nonalcoholic drinks.

· Begin CPR if the person shows no signs of life, such as breathing or circulation.

Caution

· Do not rewarm the person too quickly, such as with a heating lamp or hot bath.

· Don't attempt to warm the arms and legs. Heating or massaging the limbs of someone in this condition can stress the heart and lungs.

Insect Stings

To take care of an insect bite or sting that causes a mild reaction:

· Move to a safe area to avoid more bites or stings.

· If needed, remove the stinger.

· Wash the area with soap and water.

· Apply a cool compress. Use a cloth dampened with cold water or filled with ice. This helps reduce pain and swelling. If the injury is on an arm or leg, elevate it.

· Apply a cream, gel or lotion to the injured area. Use products containing ingredients such as hydrocortisone, to help control pain. Use creams such as calamine lotion or those containing colloidal oatmeal or baking soda to help soothe itchy skin.

· Use over-the-counter medications. Try a pain reliever, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others), or an antihistamine (Benadryl, Chlor-Trimeton, others).

Usually, the signs and symptoms of a bite or sting disappear in a day or two. If you're concerned — even if your reaction is minor — call your doctor.

When to seek emergency care

Call 911 or your local emergency number if the injured person experiences:

· Difficulty breathing

· Swelling of the lips, eyelids or throat

· Dizziness, faintness or confusion

· Rapid heartbeat

· Hives

· Nausea, cramps or vomiting

· A scorpion sting and is a child

Take these actions immediately while waiting for medical help:

· Ask the person if he or she is carrying an epinephrine autoinjector (EpiPen, Auvi-Q, others) to treat an allergic attack.

· If the person says he or she needs to use an autoinjector, ask whether you should help inject the medication. This is usually done by pressing the autoinjector against the person's thigh and holding it in place for several seconds.

· Loosen tight clothing and cover the person with a blanket. Don't give him or her anything to drink.

· Turn the person on a side to prevent choking if he or she is vomiting or bleeding from the mouth.

· Begin CPR if the person shows no signs of circulation, such as breathing, coughing or movement.

Nosebleeds

Nosebleeds are common. Most often they are a nuisance and not a true medical problem. But they can be both.

Nosebleed care

· Sit upright and lean forward. By remaining upright, you reduce blood pressure in the veins of your nose. This discourages further bleeding. Sitting forward will help you avoid swallowing blood, which can irritate your stomach.

· Pinch your nose. Use your thumb and index finger to pinch your nostrils shut. Breathe through your mouth. Continue to pinch for five to 10 minutes. Pinching sends pressure to the bleeding point on the nasal septum and often stops the flow of blood.

· To prevent re-bleeding, don't pick or blow your nose and don't bend down for several hours after the bleeding episode. During this time remember to keep your head higher than the level of your heart.

· If re-bleeding occurs, blow out forcefully to clear your nose of blood clots and spray both sides of your nose with a decongestant nasal spray containing oxymetazoline (Afrin, Mucinex Moisture Smart, others). Pinch your nose again as described above and call your doctor.

When to seek emergency care

· The bleeding lasts for more than 20 minutes

· The nosebleed follows an accident, a fall or an injury to your head, including a punch in the face that may have broken your nose

Poisoning

Poisoning is injury or death due to swallowing, inhaling, touching or injecting various drugs, chemicals, venoms or gases. Many substances — such as drugs and carbon monoxide — are poisonous only in higher concentrations or dosages. And others — such as cleaners — are dangerous only if ingested. Children are particularly sensitive to even small amounts of certain drugs and chemicals.

How you treat someone who may have been poisoned depends on:

· The person's symptoms

· The person's age

· Whether you know the type and amount of the substance that caused poisoning

If you are concerned about possible poisoning, call Poison Help at 800-222-1222 in the United States or your regional poison control center. Poison control centers are excellent resources for poisoning information and, in many situations, may advise that in-home observation is all that's needed.

When to suspect poisoning

Poisoning signs and symptoms can mimic other conditions, such as seizure, alcohol intoxication, stroke and insulin reaction. Signs and symptoms of poisoning may include:

· Burns or redness around the mouth and lips

· Breath that smells like chemicals, such as gasoline or paint thinner

· Vomiting

· Difficulty breathing

· Drowsiness

· Confusion or other altered mental status

If you suspect poisoning, be alert for clues such as empty pill bottles or packages, scattered pills, and burns, stains and odors on the person or nearby objects. With a child, consider the possibility that he or she may have applied medicated patches or swallowed a button battery.

When to call for help

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

· Drowsy or unconscious

· Having difficulty breathing or has stopped breathing

· Uncontrollably restless or agitated

· Having seizures

· Known to have taken medications, or any other substance, intentionally or accidentally overdosed (in these situations the poisoning typically involves larger amounts, often along with alcohol).

Call Poison Help at 800-222-1222 in the United States or your regional poison control center in the following situations:

· The person is stable and has no symptoms

· The person is going to be transported to the local emergency department

Be ready to describe the person's symptoms, age, weight, other medications he or she is taking, and any information you have about the poison. Try to determine the amount ingested and how long since the person was exposed to it. If possible, have on hand the pill bottle, medication package or other suspect container so you can refer to its label when speaking with the poison control center.

What to do while waiting for help

Take the following actions until help arrives:

· Swallowed poison. Remove anything remaining in the person's mouth. If the suspected poison is a household cleaner or other chemical, read the container's label and follow instructions for accidental poisoning.

· Poison on the skin. Remove any contaminated clothing using gloves. Rinse the skin for 15 to 20 minutes in a shower or with a hose.

· Poison in the eye. Gently flush the eye with cool or lukewarm water for 20 minutes or until help arrives.

· Inhaled poison. Get the person into fresh air as soon as possible.

· If the person vomits, turn his or her head to the side to prevent choking.

· Begin CPR if the person shows no signs of life, such as moving, breathing or coughing.

· Call Poison Help at 800-222-1222 in the United States or your regional poison control for additional instructions.

· Have somebody gather pill bottles, packages or containers with labels, and any other information about the poison to send along with the ambulance team.

Caution

· Syrup of ipecac. Don't give syrup of ipecac or do anything to induce vomiting. Expert groups, including the American Association of Poison Control Centers and the American Academy of Pediatrics, no longer endorse using ipecac in children or adults who have taken pills or other potentially poisonous substances. No good evidence proves its effectiveness, and it often can do more harm than good.

If you still have old bottles of syrup of ipecac in your home, throw them away.

· Button batteries. The small, flat batteries used in watches and other electronics — particularly the larger, nickel-sized ones — are especially dangerous to small children. A battery stuck in the esophagus can cause severe burns in as little as 2 hours.

If you suspect that a child has swallowed one of these batteries, immediately take him or her for an emergency X-ray to determine its location. If the battery is in the esophagus, it will have to be removed. If it has passed into the stomach, it's usually safe to allow it to pass on through the intestinal tract.

· Medicated patches. If you think a child got hold of medicated patches (adhesive products for transdermal drug delivery), carefully inspect the child's skin and remove any that are attached. Also check the roof of the mouth, where they can get stuck if the child sucks on them.

Shock

Shock may result from trauma, heatstroke, blood loss, an allergic reaction, severe infection, poisoning, severe burns or other causes. When a person is in shock, his or her organs aren't getting enough blood or oxygen. If untreated, this can lead to permanent organ damage or even death.

Signs and symptoms of shock vary depending on circumstances and may include:

· Cool, clammy skin

· Pale or ashen skin

· Rapid pulse

· Rapid breathing

· Nausea or vomiting

· Enlarged pupils

· Weakness or fatigue

· Dizziness or fainting

· Changes in mental status or behavior, such as anxiousness or agitation

Seek emergency medical care

If you suspect a person is in shock, call 911 or your local emergency number. Then immediately take the following steps:

· Lay the person down and elevate the legs and feet slightly, unless you think this may cause pain or further injury.

· Keep the person still and don't move him or her unless necessary.

· Begin CPR if the person shows no signs of life, such as breathing, coughing or movement.

· Loosen tight clothing and, if needed, cover the person with a blanket to prevent chilling.

· Don't let the person eat or drink anything.

· If the person vomits or begins bleeding from the mouth, turn him or her onto a side to prevent choking, unless you suspect a spinal injury.

Snake Bites

Most North American snakes aren't dangerous to humans. Some exceptions include the rattlesnake, coral snake, water moccasin and copperhead. Their bites can be life threatening.

If a venomous snake bites you, call 911 or your local emergency number immediately, especially if the area changes color, begins to swell or is painful. Many hospitals stock antivenin drugs, which may help you.

If possible, take these steps while waiting for medical help:

· Remain calm and move beyond the snake's striking distance.

· Remove jewelry and tight clothing before you start to swell.

· Position yourself, if possible, so that the bite is at or below the level of your heart.

· Clean the wound, but don't flush it with water. Cover it with a clean, dry dressing.

· Place a constricting bandage above the bite to slow the blood blow back to the heart.

Caution

· Don't cut the wound or attempt to remove the venom.

· Don't drink caffeine or alcohol, which could speed the rate at which your body absorbs venom.

· Don't try to capture the snake. Try to remember its color and shape so that you can describe it, which will help in your treatment.

Venomous snakes in North America

Of the venomous snakes found in North America, all but the coral snake have slit-like eyes and are known as pit vipers. Their heads are triangular, with a depression (pit) midway between the eye and nostril on either side of the head.

Other characteristics are unique to certain venomous snakes:

· Rattlesnakes rattle by shaking the rings at the end of their tails.

· Water moccasins' mouths have a white, cottony lining.

· Coral snakes have red, yellow and black rings along the length of their bodies.

Tick Bites

Most tick bites cause only minor injury. But some ticks may transmit bacteria that cause illnesses, such as Lyme disease or Rocky Mountain spotted fever.

To take care of a tick bite

· Remove the tick promptly and carefully. Use tweezers to grasp the tick near its head or mouth and pull gently to remove the whole tick without crushing it. Other methods — such as applying petroleum jelly, fingernail polish, rubbing alcohol or a hot match — aren't recommended.

· If possible, seal the tick in a container. Put the container in a freezer. Your doctor may want to see the tick if you develop signs or symptoms of illness after a tick bite.

· Wash your hands with soap and water. Also wash the area around the tick bite.

When to seek emergency care

Call 911 or your local emergency number if you develop:

· A severe headache

· Difficulty breathing

· Paralysis

· Heart palpitations

When to contact your doctor

· You aren't able to completely remove the tick. The longer the tick remains attached to your skin, the greater your risk of getting a disease from it.

· The rash gets bigger. A small red bump may appear at the site of the tick bite. This is normal. But if it develops into a larger rash, perhaps with a bull's-eye pattern, it may indicate Lyme disease. Also consult your doctor if signs and symptoms disappear because you may still be at risk of the disease. Your risk of contracting a disease from a tick bite depends on where you live or travel to, how much time you spend outside in woody and grassy areas, and how well you protect yourself.

· You develop flu-like signs and symptoms. Fever, chills, fatigue, body aches and a headache may accompany the rash.

· You think the bite site is infected. Signs and symptoms include redness or oozing.

If possible, bring the tick with you to your doctor's appointment.

Seizures

If you see someone having a seizure:

· Call for medical help.

· Gently roll the person onto one side and put something soft under his or her head.

· Loosen tight neckwear.

· Don't put anything in the mouth — the tongue can't be swallowed and objects placed in the mouth can be bitten or inhaled.

· Don't try to restrain the person.

· Look for a medical alert bracelet, which may indicate an emergency contact person and other information.

· Note how long the seizure lasts.

A grand mal seizure lasting more than five minutes, or immediately followed by a second seizure, should be considered a medical emergency in most people. This is also a medical emergency if the person is pregnant, injured or diabetic. Seek emergency care as quickly as possible.

Joint Sprains

If you have a minor sprain, you can probably treat it at home with R.I.C.E., which stands for rest, ice, compress and elevate. Rest the injured area, but don't avoid all activity. Ice the area as soon as possible after the injury. Compress the area with an elastic wrap or bandage. Elevate the injured limb above your heart whenever possible to limit swelling. As the pain and swelling improve, gently begin using the injured area. Over-the-counter pain relievers, such as ibuprofen and acetaminophen, may be helpful to manage pain during the healing process.