Injuries are a painful reality for most at some point in most people's lives. Broken bones, cuts, black eyes, concussions all await those who are unlucky, careless, or stupid. Many folks are at a loss of what to do, but since you are reading Free Medical Care, you can be a revolutionary first aid medic.
NOT Getting Injured
A ounce of prevention is worth a pound of cure.
- Falls are the #1 cause of injury. Watch your step for slippery stuff and hidden obstacles (especially if you are an elder or care for one - falls and old folks is like Colonel Sanders is to chicken. Most die or start going way downhill shortly after if they are frail.)
- Do not be drunk and high or be a dumb ass around heavy machinery, weapons, or vehicles.
- Avoid stupid fights (if you CAN avoid them)and situations that may put you in fights.
- Buckle your seat belt and be certain it's correctly fastened!.
- Be careful around workplace hazards like hot fryer grease, chemicals, dangerous equipment, heights, and unsafe conditions. Make sure all equipment is safe and in working order! No paycheck is worth your life. Especially, if the job is not paying your insurance.
Cuts, Punctures, and Lacerations
Good news is that most minor cuts do not need a doctor. Good sized cuts probably need stitches to keep the wound closed and keep infection from getting into the deep tissues. However, for deep lacerations and punctures like knife wounds, you may need surgery if any damage is done to internal organs.
Cuts and Lacerations in general:
- Stop that bleeding!! Most minor cuts will usually stop by themselves. However, sometimes they do not if the cut is across a vein, the patient is diabetic, or the patient has thin blood or low blood platelet count. Apply gentle pressure continuously for 20 to 30 minutes. Elevate the wound, if you can. Don't keep checking to see if the bleeding has stopped as this may damage or dislodge the clot that's forming and cause bleeding to resume. If you see blood spurting out or the bleeding continues even after maintaining pressure, seek a doctor immediately! This may mean a good sized blood vessel or even (in worst cases) organ is hit and requires someone who knows what the hell they are doing with special equipment to go in there (and is out of the scope of Free Medical Care). Never tourniquet especially with improvised things like belts, rags, or cord this could lead to vascular damage and loss of the whole limb, instead apply pressure to the arterial area of the arm or leg if direct pressure is inefective. Bleeding all over the place is not only messy and inconvenient, it can lead to loss of consciousness, low blood pressure and high heart rate, difficulty breathing, and ultimately death. If there is a lot of blood lost, the patient may need a transfusion as soon as possible.
- Clean the wound. Once it is sure that no one is going to die in a pool of blood, you need to clean it. Get a sterile cloth and rinse out the wound with clear water. Do not use soap as this can irritate the wound. Never use hydrogen peroxide on a fresh open cut because while it may kill bacteria, it will also kill living cell tissue and may dissolve the clot. If dirt or debris remains in the wound after washing, use sterile tweezers cleaned with alcohol to remove the particles. If you still can not get debris out, or if the debris is something like broken glass, get a doctor. Stuff like that left in after the wound closes can lead to deep infections or worse. Be sure to clean around the wound as well.
- Apply an antibiotic. Neosporin is awesome. As we mentioned in The Free Pharmacy, every serious revolutionary medic should have this in their first aid kit. Contrary to advertisements, neosporin does not make the wound heal faster, but merely kills infection.. Never put any ointments inside a wound or on a deep puncture wound!! We have seen allergic reactions to ointments in the past, but it is rare. If you see a rash, discontinue use.
- Bandage. Apply the right sized bandage to the wound. Of course, if no bandage is available, you can wrap it with the cleanest cloth or towel whatever you can find. However, if you do use improvised "bandages", switch to sterile bandages and clean the area again as soon as possible to avoid infection. Try to change the bandage every other day. If it is a newer bad cut or recent surgery, try not to get it wet in the bathtub. Wrap the area up with waterproof plastic as tap water contains numerous bacteria if you absolutely need to bathe. Like with tourniquets never wrap tightly with tape or even tape all the way around an arm or leg, swelling can make this very tight cutting off blood and causing damage or even loss of a limb.
- Get stitches if the cut is deep. Deep lacerations often will not close without help. The skin is your best defense against infection and an open wound lets nasty things bypass this. If you cant get stitches right away butterfly bandages available in the same area of the store as bandages will hold many lacerations closed until you get to a doctor, if they wont stick try cleaning the area near the wound with alcohol swabs, you can superglue the edges of a butterfly dressing away from the wound if it will be in use for a few days or it just wont stick.
- Watch out for infection. Sometimes even with the best precautions, nasty bugs can get inside the wound. If you see any redness, increasing pain, drainage, warmth, or swelling see a doctor. If the wound is not healing, see a doctor as well.
- You may need a tetanus shot. Deep wounds or dirty wounds like stepping on rusty nails are particularly bad for this. Even if you may have had this earlier in life, medical professionals recommend you get boosters every 10 years or so. Try to get this as soon as you can after the wound.
The medical term for broken bones is fractures. It is recommended, that a doctor with access to X-rays, appliances and prosthetic devices (if the fracture is really bad), and experience in bone setting is reached as soon as possible. Bones can be broken any number of ways. Sometimes, it is just one clean break in one area which may or may not stick out of the skin. Breaks that stick out of the skin are complex fractures and those that do not are called simple fractures. More serious cases involve where bones can be shattered into many pieces, chipped off into the body or a joint, and even driven into one another!
- Of course, if the person is not breathing or there is no heartbeat - begin CPR.
- Stop that Bleeding! As we mentioned in Cuts, Punctures, and Lacerations bleeding to death sucks. Sometimes bones can penetrate the skin and cause bleeding. Other times, the patient will have cuts as well as broken bones. Apply a tourniquet if you need to. Light pressure can be used if there is a bone sticking out but be careful.. this hurts like hell.
- Avoid moving the patient to prevent further injury. This is very important if a back or neck has been broken. If the back or neck is broken, you need special equipment like neck braces or back braces to safely move the patient. Otherwise, you may increase the chance of permanent paralysis.
- Splints. These can help immobilize some fractures, particularly limb fractures. Grab two thin pieces of wood or whatever and a string or a store bought emergency splint. Apply this splint to the area above and below the fracture sites. Padding the splints can help reduce discomfort. Only do this if there is no professional help, because if done wrong, you can mess someone up.
- Get ice packs. This reduces swelling and some discomfort. Plastic zip-lock bags or even grocery store bags can make quick ice packs. Wrap these in a towel, though, because if it touches the skin too long it is painful.
- Shock. Many times, breaking bones induces shock in patients. You can tell they are in shock because they are feeling faint and breathing rapid, short breaths. lay the patient down with the head slightly lower than the rest of the body. Elevate the legs, if you can.
- Traction. If you break a hip, you may need traction to separate the thigh bone from the hip to let it heal.
The time needed for bones to heal varies. With small hairline cracks, this can be a few weeks. For serious stuff like broken hips or shattered bones, you could be looking at months to a year. Even when a serious fracture like that heals, you can still be looking at a limp or arthritis much later in life. Just be careful and try not to let your bones hit anything harder than it.
Burns come from fire, hot grease, and chemicals. The more serious ones can be permanently scarring and life-threatening. Burns are categorized according to how much flesh is consumed.
- First Degree Burns. This is where just the top layer of the skin is singed. Usually, all the patient has to go through is a bit of redness, some pain and swelling, and being hypersensitive to touching stuff. With minor burns, all that needs to be done is to cool the burn under cold, running water. Then, just bandage it loosely and take an Alleve or aspirin if you need to. There is a slight chance for pigment changes on those with dark skin. If the first degree burn takes up large areas of the body, though... you still need a doctor.
- Second Degree Burns. This is where the second layer of skin gets burned into. With second degree, you will start seeing blisters and may have even more pain. Use cold water and bandage just like first degree burns. With these burns, though, your skin which protects you from infections is compromised. You need to look out for signs of infections, too. Also, if it covers large areas of the body, seek help.
- Third Degree Burns. This results from extended contact with fire and being nearly burnt alive. Not only is the skin gone, but entire parts of muscles, nerves, and veins may be nothing but black soot and ash. If someone gets this badly burned, they need a doctor immediately! But, until then, remember this:
- Make sure nothing is still smoldering on the person like burning clothes. Wet them down or use a fire extinguisher.
- Do not pull off the burnt clothing! You could very well pull off pieces of flesh that can be saved. Let a doctor with steady hands and equipment do this.
- Unlike with lesser burns, you do not want to soak this in cold water. Doing so can result in hypothermia and shock!
- Of course, check for breathing and pulse. If none of these are present, use CPR.
- Raise the burnt parts of the body above heart level.
- Use cool, moist towels or bandages to cover the burn area.
- Do not use creams like neopsporin or aloe vera on a second or third degree burn.
Affected feet become numb and then turn red or blue. As the condition worsens, they may swell. Advanced immersion foot often involves blisters and open sores, which lead to fungal infections; this is sometimes called jungle rot. If left untreated, immersion foot usually results in gangrene, which can require amputation. If immersion foot is treated properly, complete recovery is normal, though it is marked by severe short-term pain when feeling is returning. Be careful in cold conditions if your feet get wet constantly because this can combine with frostbite and really mess a patient up. Immersion of the foot is easily prevented by keeping the feet warm and dry, and changing socks three to four times a day when the feet cannot be kept dry. As quickly as possible get to a warm dry place where you can keep the feet elevated.
Frost bite is the result of freezing fluids in the body. Most at risk are the fingers toes and ears followed by other parts of the extremities. DO NOT RUB OR SLAP FROZEN EXTREMITIES this will greatly reduce the chance of successful recovery. Get to a hospital for treatment. If there is no possibility of proper hospital care thaw the frozen areas in lukewarm water only if there is no chance of refreezing, this will be very painful. There is a danger of gangrene and some damage might need to be amputated. There has been some recent clinical success in using leaches to draw blood through damaged capillaries to the finger and toe tips.
Pepper Spray and Tear Gas
Capsaicin is not soluble in water, and even large volumes of water will not wash it off. Victims are generally encouraged to blink vigorously in order to encourage tears, which will help flush the irritant from the eyes.
A formal study of five often-recommended treatments for skin pain (Maalox, 2% lidocaine gel, baby shampoo, milk, or water) concluded that "...there was no significant difference in pain relief provided by five different treatment regimens. Time after exposure appeared to be the best predictor for decrease in pain..."
To avoid rubbing the spray into the skin, thereby prolonging the burning sensation, and in order to not spread the compound to other parts of the body, victims should try to avoid touching affected areas. There are also wipes, manufactured for the express purpose of serving to decontaminate such as sudecon for someone who has received a dose of pepper spray, it can often be swiped from a cart or drawer in the ER, but is likely not worth the money except as an expensive placebo(sugar pill). Many ambulance services and emergency departments use baby shampoo to remove the spray and with generally good effect. Some of the OC and CS will remain in the respiratory system, but a recovery of vision and the coordination of the eyes can be expected within 7 to 15 minutes.
Some "triple-action" pepper sprays also contain "tear gas" (CS gas), which can be neutralized with sodium metabisulfite (Campden tablets, used in homebrewing), though it, too, is not water soluble and needs to be washed off using the same procedure as for pepper spray. (courtesy of our friends at wikipedia also GNU FDL)