First Aid Procedures
Appendix XIII (adapted from NMSU Lab Guide - dls 06/00)

FIRST AID

First aid is the immediate care of a person who has been injured or has suddenly taken ill. It is intended to prevent death or further illness and injury and to relieve pain until medical aid can be obtained. The objectives of first aid are (1) to control conditions that might endanger life; (2) to prevent further injury; (3) to relieve pain, prevent contamination, and treat for shock; and (4) to make the patient as comfortable as possible.

The initial responsibility for first aid rests with the first person(s) at the scene, who should react quickly but in a calm and reassuring manner. The person assuming responsibility should immediately summon medical help by calling 911 (be explicit in reporting suspected types of injury or illness and requesting assistance). The injured person should not be moved except when they are in significant danger of further injury/death. Laboratory workers should be encouraged to obtain training in first aid and cardiopulmonary resuscitation (CPR). Do not attempt to administer first aid unless you have had proper training.

PULMONARY RESUSCITATION

The following procedures are presented to help guide trained personnel in the event of an emergency and should not be attempted except by trained personnel. In any event the rescuer should call 911 at the earliest possible time to obtain advanced life support assistance from EMS (Emergency Medical Service) personnel. If the patient is unresponsive and not breathing mouth-to-mouth resuscitation should begin immediately. Any delay increases the risk of serious disability or death.

1. Place the patient flat on his or her back on the floor and kneel at the side.

2. Establish an airway. Check the patient's mouth with your finger to be sure that no obstruction is present and then tip the patient's head back by placing one hand on the forehead and the other hand under the chin.

3. Place your ear near the patients mouth and listen for any sound of air exchange. If the person is breathing keep the head tilted until EMS arrives. If the person is NOT breathing continue to step #4.

4. Pinch the patient's nostrils, and begin mouth-to-mouth resuscitation by taking a deep breath and placing your mouth over the patient's mouth so as to make a leakproof seal. Blow your breath into the patient's mouth until you see the chest rise.

5. Remove your mouth and allow the patient to exhale.

6. Repeat the procedure at a rate of once every 4 to 5 seconds.

HEART (CARDIAC) RESUSCITATION

Only administer CPR if you are certified. Summon medical personnel immediately.

HEAVY BLEEDING

Heavy bleeding is caused by injury to one or more large blood vessels. Lay the patient down. Control bleeding by applying firm pressure directly over the wound with a clean handkerchief, cloth, or your hand. If the injury is on an arm or leg, elevate the appendage above the level of the heart. Keep direct pressure on the wound for at least five (5) minutes. If direct pressure does not work, use a pressure point. A tourniquet should not be applied unless amputation or death is certain. EMS personnel should be called (dial 911) as soon as possible for any serious bleeding.

SHOCK

Shock usually accompanies severe injury. The signs of shock include less color in the face, a cold and clammy skin, weakness, nausea or vomiting, shallow breathing, and a rapid pulse that may be too faint to be felt at the wrist. The following procedures for the treatment of shock should be followed:

1. Correct the cause, if possible (e.g., control bleeding).

2. Keep the patient lying down; if there are no contraindications (e.g., a head injury) elevate the patient's feet.

3. Keep the patient's airway open. If he or she is about to vomit, turn the head to the side.

4. Keep the patient at body temperature or warm enough to avoid chilling.

SEIZURES/CONVULSIONS

Seizures may occur for a number of reason, if a person starts to convulse, do not attempt to restrain them. Move any objects they may injure themselves on out of the way or pad them with clothing or paper. Place padding under the patients head and notify E.M.S. (by calling 911). Never try to open the person's mouth or place items between their teeth. Allow the seizure to take its course and then monitor the person's breathing and pulse. It will also be helpful if you can look for a medic-alert bracelet or necklace. If there are other people around, ask them to move away from the area once the seizure is over to offer the patient some privacy.

MISCELLANEOUS ILLNESSES AND INJURIES

After requesting medical aid, the following points should be addressed in specific emergencies:

1. Abdominal pain - Keep the patient quiet. Give nothing by mouth.

2. Back and neck injuries - Keep the patient absolutely quiet. Do not move the patient or lift the head unless absolutely necessary.

3. Chest pain - Keep the patient calm and quiet. Place the patient in the most comfortable position (usually half sitting).

4. Electric shock - Turn off the current. Do not touch the victim until he or she is separated from the current source. Begin mouth-to-mouth resuscitation if respiration has ceased.

5. Fainting - Simple fainting can usually be ended quickly by laying the victim down.

6. Unexplained unconsciousness - Look for emergency medical identification around the victim's neck or wrist or in his or her wallet. Keep the victim warm, lying down, and quiet until he or she regains consciousness. If there is drainage from the nose, mouth, or ears let it drain freely. Do not give the victim anything by mouth. Keep the victim's airway open to aid breathing. Do not cramp the neck with a pillow.

CHEMICAL INGESTION OR CONTAMINATION

A. Ingestion of Chemicals

Encourage the victim to drink large amounts of milk or water while in route to medical assistance. Attempt to learn exactly what substances were ingested and inform the EMS (while the victim is in route, if possible) and the poison control center.

B. Chemicals Spilled on the Body over a Large Area

Quickly remove all contaminated clothing while using the safety shower; seconds count and no time should be wasted because of modesty. Immediately flood the affected body area with cool water for at least 15 min; resume if pain returns. Wash off chemicals by using a mild detergent or soap (preferred) and water; do not use neutralizing chemicals, unguents or salves.

C. Chemicals on the Skin in a Confined Area

Immediately flush with cool water and gently wash by using a mild detergent or soap (preferred) and water, soap, removing any jewelry in the affected area. If a delayed action [the physiological effects of some chemicals (e.g., methyl and ethyl bromides) may be delayed as much as 48 hours] is noted, obtain medical attention promptly and explain carefully what chemicals were involved.