Fire-Rescue

Medical Emergencies

"First Aid for Emergencies" is a guide to the individual with little or no knowledge of First Aid. This guide provides you with step-by-step procedures on what to do in an emergency. It is not a First Aid course.

The primary objectives of First Aid are:

  • to save lives
  • to prevent conditions from worsening
  • to promote recovery.

Be prepared to face your next emergency:

  • take a First Aid course that includes CPR (cardiopulmonary resuscitation) and keep your certificate current;
  • have a well stocked First. Aid Kit (including syrup of Ipecac) in the home, and know how to use it;
  • ensure children and babysitter know your emergency ambulance number.

Prevention is better than cure.

Safety
How to call an Ambulance
Unconsciousness
Artificial Respiration
CPR (Cardiopulmonary Resuscitation)
Choking
Heart Attack
Stroke
Bleeding
Bone and Joint Injuries
Eye Injuries
Severe Burns and Scalds
Heat Exposure
Cold Exposure
Poisoning

Safety
Before starting any First Aid, always ensure the area is safe

  • For yourself
  • For the casualty

How to call an Ambulance or a First Responder

  • Call 911
    • Keep calm
    • Speak clearly
    • Answer questions
  • State type of emergency
  • Give Location of Emergency
  • Confirm that the dispatcher has all necessary information before you hang up.

Unconsciousness

  • Check for unconsciousness
    • Call out to Casualty
    • Gently tap shoulders
  • If no response
    • Send for an ambulance or a First Responder. If alone and a phone is nearby, place casualty in recovery position before leaving to call for an ambulance, unless the casualty is in view when making a call.

If Injuries Are Not Suspected

  • Position casualty face up
  • Open the airway
    • Use one hand to tilt the forehead
    • Use the other hand to lift the chin.
  • Check for breathing
    • Look for chest movement
    • Listen for breathing
    • Feel for breath on your cheek
  • If casualty is not breathing, begin Artificial Respiration
  • Place in recovery position if...
    • Unconscious casualty is breathing and injuries are not suspected
    • Breathing is noisy (gurgling or snoring sounds)
    • Casualty starts to vomit
    • Casualty is bleeding from the mouth
    • You must leave the casualty unattended

If Injuries Are Suspected

  • Check breathing without moving the casualty
    • Look for chest movement
    • Listen for breathing
    • Feel for breath on your cheek

If Not Breathing

  • Position Casualty face up - minimize neck movement
  • Open the airway and check breathing
    • Lift both sides of the jaw without moving neck
    • Look, listen and feel for breathing

Artificial Respiration
Adult Casualty

  • Give 2 breaths
    • Open the airway.
    • Cover casualty's mouth with yours and pinch nostril.
    • Give enough air to make chest rise.
  • If air does not go in, perform steps for choking adult.
  • Check for signs of circulation (no more than 10 seconds): carotid pulse, movement and coughing. If no signs of circulation, begin CPR. If available, apply defibrillation immediately.

Child Casualty

  • Give 2 breaths
    • Open the airway.
    • Cover child's mouth with your mouth and pinch nostrils.
    • Give just enough air to make chest rise.
  • If air does not go in, perform steps for choking child.
  • Check for signs of circulation (no more than 10 seconds): carotid pulse, movement and coughing. If no signs of circulation, begin CPR.

Infant Casualty

  • Give 2 breaths
    • Open the airway.
    • Cover infant's mouth and nose with your mouth.
    • Give just enough air to make chest rise.
  • If air does not go in, perform steps for choking infant.
  • Check for signs of circulation (no more than 10 seconds): carotid pulse, movement and coughing. If no signs of circulation, begin CPR.

Cardiopulmonary Resuscitation (CPR)
Perform CPR Only if the Casualty is:

  • Unconscious and
  • Not breathing and
  • No signs of circulation (pulse, coughing, movement)

Adult CPR

  • Check for signs of circulation (no more than 10 seconds): carotid pulse, movement and coughing. If no signs of circulation, begin CPR. If available, apply defibrillation immediately.
  • Do CPR compressions
    • Place the heel of one hand on the lower half of the breastbone in center of chest.
    • Place the heel of other hand on top of first hand.
    • Press straight down to compress chest 1.5 to 2 inches (3.8 to 5 cm) Give 15 compressions in 9 seconds.
  • Give 2 breaths after every 15 compressions.
  • Re-check for breathing and signs of circulation after 1 minute of CPR.
  • If circulation is still absent, continue CPR until help arrives.

Child CPR

  • Check for signs of circulation (no more than 10 seconds): carotid pulse, movement and coughing. If no signs of circulation, begin CPR.
  • Do CPR compressions
    • Place the heel of one hand on the lower half of the breastbone in center of chest.
    • Press straight down to compress chest 1 to 1.5 inches (2.5 to 3.8cm) Give 5 compressions in 3 seconds.
  • Give 1 breath after every 5 compressions.
  • Re-check for breathing and signs of circulation after 1 minute of CPR.
  • If circulation is still absent, continue CPR until help arrives.

Infant CPR

  • If circulation is still absent, continue CPR until help arrives.
  • Do CPR compressions
    • Place 2 fingers of one hand in the center of the chest, one finger width below the nipple line.
    • Press straight down to compress chest .5 to 1 inch. Give 5 compressions in 3 seconds.
  • Give 1 breath after every 5 compressions.
  • Re-check for breathing and signs of circulation after 1 minute of CPR.
  • If circulation is still absent, continue CPR until help arrives. 

Choking
Conscious Adult or Child

  • Ask: "Are you choking?"
    • If casualty can speak or cough, airway is open enough to force out obstructing object.
  • If casualty CAN speak or cough
    • Reassure and encourage coughing.
    • Do not hit on back.
  • If casualty CANNOT speak or cough
    • Stand behind casualty, locate hipbones and wrap your arms around waist.
    • Make a fist with one hand and place above navel, at hip level. Grasp fist with other hand.
    • Thrust inward and upward into abdomen.
    • Repeat abdominal thrusts until airway is clear or casualty becomes unconscious.
    • If casualty becomes unconscious, call medical help, and then follow steps in UNCONSCIOUS ADULT OR CHILD.
  • If the casualty is pregnant or obese
    • Wrap your arms around the casualty's chest at armpit level
    • Place the thumb side of one fist over the center of the chest. Place the second hand over top of the first.
    • Give inward chest thrusts until the airway is cleared or the casualty becomes unconscious.

Unconscious Adult or Child

  • Send for medical help.
  • Position face up on the floor. For a pregnant casualty, place a wedge (if readily available) under the right hip.
  • Open the mouth and look. If object is seen, remove c. with a hooked finger.
  • Open the airway and check breathing (up to 10 seconds). If no breathing...
  • Attempt to give two breaths. If air does not go in.
  • Reposition head, ensure good seal and try again. If air still does not go in..
  • Adult: Give 15 chest compressions
    • Place heel of one hand on the lower half of breastbone in center of chest.
    • Place heel of the other hand on top of first hand.
    • Press straight down to compress chest 1.5 to 2 inches. Give 15 compressions in 9 seconds.
  • Child: Give 5 chest compressions
    • Place the heel of one hand on lower half of breastbone in center of the chest.
    • Press straight down to compress the chest 1 to 1.5 inches (2.5 to 3.8 cm). Give 5 compressions in 3 seconds.
  • Repeat steps until successful.

Conscious Infant
If obstruction is due to upper respiratory tract infection (cough, cold, etc.), do not give First Aid for choking. Get immediate medical attention.

  • Determine if infant is choking on foreign substance
  • Give 5 back blows
    • Place infant face down, head lower than trunk.
    • Support head.
    • Give 5 back blows between shoulder blades using heel of one hand.
  • Give 5 chest thrusts
    • Turn infant face up, keeping head lower than trunk.
    • Support head.
    • Place 2 fingers on breastbone, 1 finger width below nipple line, and give 5 chest thrusts.
  • Continue back blows and chest thrusts until object is removed or infant becomes unconscious.
  • If infant becomes unconscious, call medical help, then follow steps in UNCONSCIOUS INFANT.

Unconscious Infant

  • Send for medical help.
  • Place infant on a firm, flat surface.
  • Open mouth and look. If object is seen, remove with a hooked finger.
  • Open airway and check breathing (up to 10 seconds)
  • Attempt to give two breaths. If air does not go in...
  • Reposition head, ensure good seal and try again. If air still does not go in...
  • Give 5 chest compressions
    • Place 2 fingers of one hand in the center of the chest, one finger width below the nipple line.
    • Press straight down to compress chest .5 to 1 inch. Give 5 compressions in 3 seconds.
  • Repeat steps until successful.

Heart Attack
Warning signals of heart attack may include:

  • Feeling of heavy pressure or squeezing pain in chest, arms or jaw.
  • Shortness of breath, pale skin, sweating and weakness.
  • Nausea and vomiting casualty
  • Abdominal discomfort with indigestion and belching.
  • Apprehension or fright.
  • Denial of impending heart attack.

Action
When you suspect a heart attack:

  • Help casualty to rest, sitting or lying in most comfortable position
  • Assist casualty to take the correct dose of medication if prescribed for his condition. If casualtys medication does not provide relief, or If they have no prescribed medication, recommend the casualty chew I regular strength ASA tablet (325mg) or 2 children's ASA tablets (160mg) only if they are not allergic to ASA.
  • Ensure prompt medical attention by calling your emergency ambulance number.
  • Reassure casualty "Help is on the way."
  • Loosen collar, belt and other tight clothing.
  • Keep casualty quiet but avoid physical restraint.

Stroke
Warning signals of stroke may Include:

  • Sudden one-sided numbness, weakness or paralysis of the face, arm or leg.
  • Sudden blurred or decreased vision in one or both eyes (e.g. double vision)
  • Difficulty speaking, swallowing, or understanding simple statements (e.g. slurred speech or drooling)
  • Sudden, loss of balance or loss of coordination (especially when combined with other symptoms).
  • Sudden severe unexplained headache.
  • Decreased level of consciousness.

Action
When you suspect a stroke: Time is Critical

  • Ensure prompt medical attention by calling your emergency ambulance number.
  • Place the casualty at rest in the most comfortable position - usually semi sitting.
  • Give nothing by mouth. If the casualty is thirsty, moisten the lips with a wet cloth.
  • Protect the casualty from injury when lifted, moved or during convulsions.
  • Reassure the casualty and keep warm
  • If the casualty becomes semiconscious or unconscious place in the recovery position (lie on side). If there is paralysis, place the paralyzed side down. This will make breathing easier.
  • If breathing stops, start AR (Artificial Respiration). If there are no signs of circulation, start CPR.

Bleeding
Serious bleeding may occur with deep cuts and severed blood vessels

  • Ensure safety.
  • Send for an ambulance when bleeding is severe.
  • Control bleeding
    • Assist casualty to sit or lie down.
    • Remove clothing to expose extent of wound,
    • Cover with sterile dressing or clean cloth.
    • Apply firm pressure directly over the dressings. If dressings are not available, have casualty use own hand to apply pressure.
    • Elevate limb if a fracture is not suspected.
  • Apply a firm bandage.
  • If blood soaks through, apply additional dressings on top and bandage more firmly.

Broken bones, glass or objects protruding through skin

  • Do not remove embedded objects.
  • Cover wound with clean dressings.
  • Apply pressure close to wound but not pressing on broken bone or object.
  • Maintain pressure and prevent movement of object by applying bulk pads around the object. Bandage pads in place.

Nosebleeds

  • Seat casualty with head tilted forward.
  • Pinch nostrils firmly for 10 minutes.
  • Avoid nose blowing for several hours.
  • If bleeding persists, call an ambulance.

Bone and Joint Injuries
Suspect a broken bone if injured limb is painful or swollen or shows deformity.

  • Ensure safety
    • Do not move casualty except for reasons of safety.
  • Call an ambulance.
  • Check breathing.
  • Control severe bleeding.
  • When in doubt, treat all bone and joint injuries as, broken bones.
    • To relieve pain, apply cold (not heat) to injuries of bones and joints.
    • Support limb with your hands to prevent movement.
  • For neck and back injuries
    • Warn casualty not to move.
    • Support head and neck by hand in position found to prevent movement.
    • Keep body still until help arrives

Eye Injuries

  • Call an ambulance for all serious eye injuries.
  • Chemicals in eye.
    • Wash eye immediately with large amounts of cool, running water for at least 15 minutes.
  • Foreign object in eye.
    • Never rub eye and do not try to remove embedded foreign objects.
    • Cover eye lightly with bandage.
  • Puncture wounds.
    • Help casualty to lie down in face up position. Caution not to move.
    • Cover injured eye with clean dressing and secure lightly with bandage.

Severe Burns and Scalds

  • Ensure safety.
  • Call ambulance for severe burns or scalds.
  • For burns or scalds caused by fire, hot solids, hot liquids or sun:
    • Cool affected part with cool water.
    • Remove rings and bracelets before part starts to swell.
    • Cover burn with clean cloth and secure lightly with bandage.
    • Ensure hospital treatment for deep burns and scalds of areas larger than a quarter.
    • DO NOT breathe on, cough on, or touch burns.
    • DO NOT break blisters
    • DO NOT remove clothing stuck to burn.
    • DO NOT apply medications, ointments, or greasy substances to burns.
  • For burns caused by dry chemicals:
    • Brush off dry chemicals.
    • Flood with running water for 15 to 20 minutes.
    • Cover burn with clean cloth and lightly secure with bandage.
  • For electrical burns:
    • Turn off electricity before touching casualty.
    • Check for breathing and pulse.
    • Cover burn with clean cloth and secure lightly with bandage.
    • Ensure hospital treatment.

Heat Exposure (Hyperthermia)
Definition: High body temperature due to overexertion or high temperature.

Treatment:

  • Remove casualty to a cool area.
  • If unconscious
    • Call an ambulance.
    • Ensure breathing and circulation.
    • Place in recovery position.
  • If conscious, give fluids to drink,
  • If hot, sponge with cool water.

Cold Exposure (Hypothermia)
Definition: Loss of body heat.

Treatment:

  • If unconscious
    • Call an ambulance.
    • Ensure breathing and circulation.
    • Remove from cold environment; protect from further cooling.
    • Do not attempt to rewarm casualty.
  • If conscious
    • Remove from cold environment.
    • Remove wet clothing.
    • Give warm, sweet drinks (no alcohol).
    • Warm slowly by wrapping in prewarmed sleeping bag, blankets or warm clothing.

Poisoning
In all cases:

  • Ensure safety.
  • Identify poison and container, if possible.
  • Phone Poison Control Centre 604 682-5050.
  • Outside GVRD 1 800567-8911.
  • Call an ambulance. Send container and contents with casualty to hospital.

Inhaled poisons such as exhaust fumes

  • Remove source of fumes.
  • Move casualty to fresh air.
  • Check breathing and circulation.
  • Give artificial respiration or CPR as required.

Poisons in contact with skin or eyes

  • Flood area with a gentle stream of cool running water for at least 15 minutes.
  • Continue flooding area until ambulance takes over.
  • Remove contaminated clothing.
  • Do not use chemical antidotes.

For swallowed household chemical poisons

  • Conscious casualty
    • Phone Poison Control Centre 604 682-5050. Follow their advice on first aid.
    • Only induce vomiting on advice of Poison Control Centre or Physician. If advised, use Syrup of Ipecac (available without prescription at pharmacies). If poison is hydrocarbon or corrosive, DO NOT induce vomiting.
    • To avoid inhalation of vomit, place casualty's head lower than body in recovery position.
  • If Unconscious
    • Call an ambulance.
    • Check breathing and circulation.
    • Place casualty in recovery position.
    • DO NOT induce vomiting. 
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