Hypothermia

Hypothermia is caused by prolonged exposure to the cold (cold weather or cold water).

• Shivering and loss of coordination
• Slurred speech, apathy, confusion
• Extremely slow breathing
• Loss of consciousness (severe hypothermia)

If you suspect someone has hypothermia, there are several things you can do to help the victim:

• Call 9-1-1
• Move the person to a warmer environment.
• Remove any wet clothing and cover the victim with a dry blanket (or dress in dry clothing for mild cases).
• Begin to actively warm the victim by applying hot water bottles or chemical hot packs (wrapped in towels or blankets to prevent burns) to the chest and abdominal areas (core areas). Do not worry about warming the arms and legs; warm the blood at the center (core) of the body and allow that warm blood to warm the extremities.
• Do NOT immerse the victim in hot water- warming the victim too quickly may cause lethal heart rhythms
• Do NOT use a heating pad or heating lamp.
• If the victim is awake enough to drink and is not vomiting, try giving warm liquids to drink. Do NOT give the person alcohol or caffeinated beverages.
• If the victim is unconscious, monitor breathing and pulse and prepare to perform CPR if necessary.

Burns

Many burns are minor and can be treated with first aid; others burns are more serious and require medical attention. The severity of a burn can depend on many factors, including:

• The age of the victim- burns can be more severe in babies, young children and the elderly
• The size of the burn- how much of the body is affected, often described as a percentage, which may be an indicator of survivability
• The depth of the burn- how deeply the burn extends down into the subcutaneous tissue
• The location of the burn- burns located on the hands, face, groin/genitals, neck, hands and feet can have severe functional and cosmetic consequences
• The presence of other injuries- burns combined with other severe injuries may affect outcome and survivability

It is important to be able to recognize the type of burn in order to provide the correct care.

Smoke inhalation may be as deadly as severe burns. If a burn victim has soot around or in their mouth or nose, this indicates that the airway may be affected and breathing may become a problem. If you suspect smoke inhalation, call 9-1-1.

Anaphylaxis ( Life Threatening Allergic Reactions )

Some people are highly allergic to certain insect bites or stings. Certain foods, such as peanuts, can also cause a severe and life-threatening allergic reaction.

Anaphylaxis is a severe allergic reaction that can rapidly cause death if not immediately treated. Anaphylaxis causes a dangerous drop in blood pressure leading to shock. It can also cause swelling of the airway leading to inability to breathe. Symptoms may occur within minutes of exposure to the allergen.

Symptoms and signs may include:

• Shortness of breath
• Swelling of lips, eyes, mouth or throat
• Dizziness or faintness
• Wheezing or difficulty breathing
• Rapid heart rate
• Nausea/vomiting or diarrhea
• Hives or rash
• Flushed or pale skin
• Loss of consciousness

If you are with someone experiencing an anaphylactic reaction:

• Call 9-1-1 immediately.
• Check to see if he/she is carrying an EpiPen. If the victim is able, have them inject themselves; if they are unable, assist them to use the EpiPen. EpiPen use is simple: Remember “blue to the sky, orange to the thigh”. Hold the pen firmly with the orange side pointing down. Remove the blue cap by pulling straight up- do not bend or twist. Push the orange tip firmly into the mid-outer thigh. You will hear a click- hold firmly in place for several seconds.
• Lie the victim down with the legs and feet elevated, loosen tight clothing and keep them warm.
• Monitor the patient closely. If the patient stops breathing or loses their pulse, start CPR and continue until help arrives.

The medication contained in EpiPens is potent but wears off quickly. Even if the victim feels better after receiving the injection of epinephrine, they must go to the hospital in case symptoms return.

Bites and Stings

Animal bites can be dangerous for several reasons. Animal bites can be deep and there is a high risk of infection.

• If the bite is minor, clean the wound thoroughly with soap and water and apply a thin layer of antibiotic cream. Cover with a bandage.
• For deeper wounds, apply pressure to stop any bleeding and seek medical attention. If medical help is not readily available, stop any bleeding, clean the wound well and apply a clean dressing until medical attention is available.

Any time the skin is broken, there is risk of infection. Signs of infection (redness, swelling, pain that is getting worse instead of better, warmth, red streaks moving out from the wound) require medical help immediately. A tetanus shot is required if tetanus is not up to date.

If there is a chance that the animal carried rabies, it is critical that medical help be sought immediately. If possible, cage the animal that bit the victim, but do not risk a second bite to yourself. Remember that unimmunized domesticated animals can also carry rabies. In many areas of the US, a large proportion of the populations of bats and skunks are rabid. Any wild animal that is acting unusually (i.e. it lets you get close to it) may be ill with rabies.

Traumatic Tooth Loss

Losing a tooth due to trauma does not always mean that a tooth is lost forever. If a tooth is lost due to trauma you should:

• Avoid touching the roots of the tooth- handle it by the crown only.
• Avoid rubbing the tooth in an effort to clean it of debris.
• If debris is present, gently swish the tooth around for less than 10 seconds in a bowl of lukewarm water-do NOT rinse the tooth under running water.
• Attempt to place the tooth back in its socket. Bite down gently on a piece of gauze or moistened paper towel if it will not go all the way in.
• If the tooth will not go back into the socket, place it in some milk or a mild saltwater solution.
• See a dentist as soon as possible- the sooner a dentist is consulted, the better the chance of successful reimplantation.

Frostbite

Frostbite is caused by exposure to cold temperatures for prolonged periods, which causes damage to the skin and underlying tissues.

Symptoms of frostbite may include:

• Pins and needles sensation, followed by numbness
• Pale and hard skin
• Aching, throbbing or lack of sensation in the affected area
• Red and very painful skin/tissue as unthawing occurs
• Blisters and blackened, dead tissue (severe frostbite)

Areas with poorer circulation are most prone to frostbite, such as the nose, ears, hands and feet. When frostbite extends to the blood vessels and damages them, the affected area may not recover and amputation is often necessary.

To treat frostbite:

• Look for signs and symptoms of hypothermia and treat first (see section on Hypothermia above). Call 9-1-1 immediately if frostbite is severe or if there are signs and symptoms of hypothermia.
• Bring the victim into a warm, dry place.
• Remove tight jewellery if fingers are affected, or socks and boots if feet are affected. Remove any wet clothing to prevent further cooling.
• If medical assistance is close by: wrap the affected area with dry gauze, separating fingers and toes.
• If medical assistance is not close by, you will need to rewarm the affected areas.
• Soak affected areas in warm water for 20 to 30 minutes (do NOT use hot water). Keep changing the water as it cools. If the victim’s face is affected, apply warm compresses one after another. Pain, color changes and changes in sensation will occur as the tissue warms. Warming is complete when the affected tissue is soft again and full feeling returns.
• Once fingers and toes have thawed, wrap them in dry gauze, being careful to separate the digits.
• Move the injured tissue as little as possible.
• If the frostbite is severe and affects more than one area, give warm fluids (NOT alcohol) to warm the victim and replenish fluids.
• Do NOT break any blisters that form
• Do NOT rewarm if there is a risk of refreezing- wait until you can get medical assistance)
• Do NOT use direct heat to thaw damaged tissue (i.e. hair dryer, heating pad)
• Do NOT massage the affected area

Foreign Bodies

A foreign object in any part of the body can cause pain, infection, and other problems. Most commonly, foreign bodies are found in the ear, eye, nose or skin.

Ear

Foreign bodies in the ear can lead to hearing loss, pain, and infection. The important thing to remember is to NEVER stick anything in the ear in an attempt to remove an object. Doing so may push the foreign body deeper into the ear and may result in damage to the ear. If you can see the object and grab it with a pair of tweezers, remove it. Use gravity by having the person tilt their head toward the ear with the foreign body.

Many times, an insect will crawl into an ear seeking the warmth and confined space. If you know that an insect is in the ear, you may be able to remove it by warming some baby oil and pouring it into the ear. The oil will serve to drown the insect and may allow the insect to float out of the ear. Do NOT use this method if there is any drainage from the ear that might indicate a ruptured eardrum. You should not use this method in any child who has tubes in his ears for recurrent ear infections.

Whether or not these methods are successful in removing the foreign body from the ear, a licensed practitioner should check the affected ear as soon as possible.

Eye

Foreign bodies in the eye can lead to vision loss, pain and infection. Be sure your hands are clean before you start working with the eyes. Many times, it may be possible to remove the foreign object by flushing the eye with saline solution or clean water while holding your eyelid open.

If the object is embedded in the eyeball, do NOT remove it. Instead, cover the eye loosely with a gauze pad and get immediate medical attention. An object deeply embedded in the eyeball must be removed surgically to prevent further damage to the eye.

If you flush a foreign body from the eye but the victim continues to have pain or redness, or if the victim cannot see normally, medical attention is immediately required.

Nose

Foreign bodies in the nose can lead to pain and infection. The important thing to remember is to NEVER stick anything in the nose in an attempt to remove an object. Doing so may push the foreign body deeper into the nose and may result in damage to the structures of the nose. If you can see the object and grab it with a pair of tweezers, remove it.

Instruct the victim to breathe through his mouth until the foreign body is removed. Breathing through his nose may cause the object to enter the victim’s windpipe or lungs. Instead, have him blow his nose gently in an attempt to remove the object. If the object is not removed using these methods, seek medical help for professional removal.

Skin

Foreign bodies in the skin can lead to infection and pain. Before attempting to remove an object from the skin, make sure your hands are clean. If the object in the skin is wood, do NOT soak the extremity. Getting the wood wet will cause it to swell and fragment, making the removal more difficult. If enough of the foreign body is above the skin, you may be able to grasp it with tweezers and pull it out. After removal, gently squeeze the area around the wound to encourage bleeding to wash out any fragments that might be left behind. Apply some antibiotic ointment and cover the area if it is likely to get dirty. Be sure to consult with your healthcare provider to determine if you should receive a tetanus shot.

Occasionally, the foreign body will be completely under the top layer of skin. If you feel comfortable using a sharp needle to remove the object, you must first clean the needle as well as possible using rubbing alcohol or soap and water. If you can see the point of entry for the object, use the needle to lift the skin above the object and move the point of the needle to lift the tip of the foreign body out above the level of the skin. Use the tweezers to grasp the object and pull it out. Cleanse the wound thoroughly, apply a topical antibiotic ointment, and cover the wound if it is likely to get dirty. Again, be sure to check on the status of your tetanus immunization.

Frostbite

Frostbite is caused by exposure to cold temperatures for prolonged periods, which causes damage to the skin and underlying tissues.

Symptoms of frostbite may include:

• Pins and needles sensation, followed by numbness
• Pale and hard skin
• Aching, throbbing or lack of sensation in the affected area
• Red and very painful skin/tissue as unthawing occurs
• Blisters and blackened, dead tissue (severe frostbite)

Areas with poorer circulation are most prone to frostbite, such as the nose, ears, hands and feet. When frostbite extends to the blood vessels and damages them, the affected area may not recover and amputation is often necessary.

To treat frostbite:

• Look for signs and symptoms of hypothermia and treat first (see section on Hypothermia above). Call 9-1-1 immediately if frostbite is severe or if there are signs and symptoms of hypothermia.
• Bring the victim into a warm, dry place.
• Remove tight jewellery if fingers are affected, or socks and boots if feet are affected. Remove any wet clothing to prevent further cooling.
• If medical assistance is close by: wrap the affected area with dry gauze, separating fingers and toes.
• If medical assistance is not close by, you will need to rewarm the affected areas.
• Soak affected areas in warm water for 20 to 30 minutes (do NOT use hot water). Keep changing the water as it cools. If the victim’s face is affected, apply warm compresses one after another. Pain, color changes and changes in sensation will occur as the tissue warms. Warming is complete when the affected tissue is soft again and full feeling returns.
• Once fingers and toes have thawed, wrap them in dry gauze, being careful to separate the digits.
• Move the injured tissue as little as possible.
• If the frostbite is severe and affects more than one area, give warm fluids (NOT alcohol) to warm the victim and replenish fluids.
• Do NOT break any blisters that form
• Do NOT rewarm if there is a risk of refreezing- wait until you can get medical assistance)
• Do NOT use direct heat to thaw damaged tissue (i.e. hair dryer, heating pad)
• Do NOT massage the affected area

Hyperthermia (Heat Exposure)

Heat related injuries include heat cramps, heat exhaustion and heat stroke. Heat stroke is the most severe of these injuries and typically happens when the victim has been performing heavy work or engaging in sports in a very hot environment. The victim usually has been sweating heavily and not replenishing fluids lost to sweating. In addition, some medications and alcohol use may predispose an individual to heat stroke. The main symptoms of heat stroke include:

• Faintness/dizziness
• Headache
• Nausea/vomiting
• Hot, dry skin or cool, clammy skin
• Rapid and weak pulse
• Weakness
• Altered level of unconsciousness (may lose consciousness)

Untreated heat exhaustion or heat stroke can cause death. Act quickly if you suspect either condition. If you suspect a person has hyperthermia, there are several things you can do to help the victim:

• Call 9-1-1
• Move the person to a cooler environment, out of the sun and into a shady or air-conditioned space.
• Lie the victim down and elevate their legs and feet.
• Remove restrictive or tight clothing.
• Begin to actively cool the victim by fanning the person and applying cool compresses to the armpits, neck and groin areas.
• If the victim is awake enough to drink and is not vomiting, try giving cool liquids to drink. Do NOT give the person alcohol or beverages containing caffeine. Move the person out of the sun and into a shady or air-conditioned space.
• If the victim loses consciousness, monitor airway, breathing and circulation and prepare to perform CPR if necessary.