EMERGENCY CARE OF THE SICK AND INJURED
SUMMARY
BEFORE AN EMERGENCY
1. Take the Medical Self-Help course, or a First Aid course.
2. If this is not possible, obtain a good first aid manual, study it, and keep it at home; or study the emergency medical instructions given in this chapter, and keep this handbook at home.
3. Obtain a good first aid kit, and keep your home medicine chest well stocked with supplies you may need in a time of emergency.
DURING AN EMERGENCY
1. Try to get a doctor or nurse (or at least a person trained in first aid) to treat anyone who is injured or sick.
2. If no one better qualified is available, take charge yourself.
EMERGENCY CARE OF THE SICK AND INJURED
A nuclear attack on the United States would cause great numbers of casualties, and there would be fewer doctors, nurses and hospitals available to care for them. Even in areas where no nuclear weapons exploded, radioactive fallout could prevent doctors and nurses from reaching injured or sick persons for a considerable period of time.
People would have to help each other during the emergency. Those in a stocked public fallout shelter would have available the basic medical kit stored there, and perhaps one or more shelter occupants might be a doctor, nurse, or trained first-aider. But persons in a home shelter would have only the medical supplies available at home, and would have to depend on their own knowledge of first aid and emergency medical care.
Both adults and teenagers can acquire these valuable skills now by taking free courses that are offered in many communities, such as the Medical Self-Help course or a First Aid course.
The following information is no subst.i.tute for one of these courses.
This basic guidance may save lives during a nuclear emergency, however, by helping untrained persons take care of the sick and injured when professional medical a.s.sistance may not be immediately available.
GENERAL RULES FOR ANY MEDICAL EMERGENCY
1. First of all, _do no harm_. Often, well-meaning but untrained persons worsen the injury or illness in their attempts to help. Get competent medical a.s.sistance, if possible. Do not a.s.sume responsibility for a patient if you can get the help of a doctor, nurse, or experienced first-aid worker. But if no one better qualified is available, take charge yourself.
2. _Look for stoppage of breathing, and for serious bleeding._ These are the two most life-threatening conditions you can do something about.
They demand _immediate_ treatment (see pages 58 and 61).
8. _Prevent shock, or treat it._ Shock, a serious condition of acute circulatory failure, usually accompanies a severe or painful injury, a serious loss of blood, or a severe emotional upset. If you _expect_ shock, and take prompt action, you can prevent it or lessen its severity. This may save the patient"s life. (Treatment of shock is discussed on page 62).
4. _Don"t move the patient immediately_. Unless there is real danger of the patient receiving further injury where he is, he should not be moved until breathing is restored, bleeding is stopped, and suspected broken bones are splinted.
5. _Keep calm, and rea.s.sure the patient._ Keep him lying down and comfortably warm, but do not apply heat to his body, or make him sweat.
6. _Never attempt to give liquids to an unconscious person_. If he is not able to swallow, he may choke to death or drown. Also, don"t give him any liquids to drink if he has an abdominal injury.
IF THE PATIENT HAS STOPPED BREATHING
Quick action is required. You must get air into his lungs again immediately or he may die. The best and simplest way of doing this is to use mouth-to-mouth artificial respiration. Here is how to do it:
1. Place the patient on his back. Loosen his collar.
2. Open his mouth and use your fingers to remove any food or foreign matter. If he has false teeth or removable dental bridges, take them out.
3. Tilt the patient"s head back so that his chin points upward. Lift his lower jaw from beneath and behind so that it juts out. This will move his tongue away from the back of his throat, so it does not block the air pa.s.sage to his lungs. Placing a pillow or something else under his shoulders will help get his head into the right position. Some patients will start breathing as soon as you take these steps, and no further help is necessary.
4. Open your mouth as wide as possible, and place it tightly over the patient"s mouth, so his mouth is completely covered by yours. With one hand, pinch his nostrils shut. With your other hand, hold his lower jaw in a thrust-forward position and keep his head tilted back. With a baby or small child, place your mouth over both his nose and mouth, making a tight seal.
5. Blow a good lungful of air into an adult patient"s mouth, continuing to keep his head tilted back and his jaw jutting out so that the air pa.s.sage is kept open. (Air can be blown through an unconscious person"s teeth, even though they may be clenched tightly together.) Watch his chest as you blow. When you see his chest rise, you will know that you are getting air into his lungs.
6. Remove your mouth from the patient"s mouth, and listen for him to breathe out the air you breathed into him. You also may feel his breath on your cheek and see his chest sink as he exhales.
7. Continue your breathing for the patient. If he is an adult, blow a good breath into his mouth every 5 seconds, or 12 times a minute, and listen for him to breathe it back out again. _Caution_: If the patient is an infant or small child, blow _small puffs_ of air into him about 20 times a minute. You may rupture his lung if you blow in too much air at one time. Watch his chest rise to make sure you are giving him the right amount of air with each puff.
8. If you are _not_ getting air into the patient"s lungs, or if he is not breathing out the air you blew into him, first make sure that his head is tilted back and his jaw is jutting out in the proper position.
Then use your fingers to make sure nothing in his mouth or throat is obstructing the air pa.s.sage to his lungs. If this does not help, turn him on his side and strike him sharply with the palm of your hand several times between his shoulder blades. This should dislodge any obstruction in the air pa.s.sage. Then place him again on his back, with his head tilted back and his jaw jutting out, and resume blowing air into his mouth. If this doesn"t work, try closing his mouth and blowing air through his nose into his lungs.
9. If you wish to avoid placing your mouth directly on the patient"s face, you may hold a cloth (handkerchief, gauze or other porous material) over his mouth and breathe through the cloth. But don"t waste precious time looking for a cloth if you don"t have one.
10. _Important_: Even if the patient does not respond, continue your efforts for 1 hour or longer, or until you are completely sure he is dead. If possible, have this confirmed by at least one other person.
TO STOP SERIOUS BLEEDING
1. Apply firm, even pressure to the wound with a dressing, clean cloth, or sanitary napkin. If you don"t have any of these, use your bare hand until you can get something better. Remember, you must keep blood from running out of the patient"s body. Loss of 1 or 2 quarts will seriously endanger his life.
2. Hold the dressing in place with your hand until you can bandage the dressing in place. In case of an arm or leg wound, make sure the bandage is not so tight as to cut off circulation; and raise the arm or leg above the level of the patient"s heart. (But if the arm or leg appears broken, be sure to splint it first.)
3. Treat the patient for shock (see page 62).
4. If blood soaks through the dressing, do _not_ remove the dressing.
Apply more dressings.
5. SPECIAL ADVICE ON TOURNIQUETS: Never use a tourniquet unless you cannot stop excessive, life-threatening bleeding by any other method.
Using a tourniquet increases the chances that the arm or leg will have to be amputated later. If you are _forced_ to use a tourniquet to keep the patient from bleeding to death (for example, when a hand or foot has been accidentally cut off), follow these instructions carefully:
--Place the tourniquet _as close to the wound as possible_, between the wound and the patient"s heart.
--After the tourniquet has been applied, do not permit it to be loosened (even temporarily, or even though the bleeding has stopped) by anyone except a physician, who can control the bleeding by other methods and replace the blood that the patient has lost.
--Get a physician to treat the patient as soon as possible.
PREVENTING AND TREATING SHOCK
Being "in shock" means that a person"s circulatory system is not working properly, and not enough blood is getting to the vital centers of his brain and spinal cord.