First aid guide (part 2)

17. Fever: First aid

Fever is a sign of a variety of medical conditions, including infection. Your normal temperature may differ slightly from the average body temperature of 98.6 F (37 C).

For young children and infants, even slightly elevated temperatures may indicate a serious infection. In newborns, either a subnormal temperature or a fever may be a sign of serious illness. For adults, a fever usually isn't dangerous until it reaches 103 F (39.4 C) or higher.

Don't treat fevers below 102 F (38.9 C) with any medications unless your doctor tells you to. If you have a fever of 102 F (38.9 C) or higher, your doctor may suggest taking an over-the-counter medication, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others).

Adults also may use aspirin, but don't give aspirin to children. It may trigger a rare, but potentially fatal, disorder known as Reye's syndrome. Also, don't give ibuprofen to infants younger than 6 months of age.

How to take a temperature
Today most thermometers have digital readouts. Some take the temperature quickly from the ear canal and can be especially useful for young children and older adults. Other thermometers can be used rectally, orally or under the arm.

If you use a digital thermometer, be sure to read the instructions so that you know what the beeps mean and when to read the thermometer. Under normal circumstances, temperatures tend to be highest around 4 p.m. and lowest around 4 a.m.

Because of the potential for mercury exposure or ingestion, glass mercury thermometers have been phased out and are no longer recommended.

Rectally (for infants)
To take your child's temperature rectally:

• Place a dab of petroleum jelly or other lubricant on the bulb.
• Lay your child on his or her stomach.
• Carefully insert the bulb one-half inch to one inch into the rectum.
• Hold the bulb and child still for three minutes. To avoid injury, don't let go of the thermometer while it's inside your child.
• Remove the thermometer and read the temperature as recommended by the manufacturer.

Taking a rectal temperature is also an option for older adults when taking an oral temperature is not possible.

A rectal temperature reading is generally 1 degree Fahrenheit (about 0.5 degree Celsius) higher than an oral reading.

Orally
To take your temperature orally:

• Place the bulb under your tongue
• Close your mouth for the recommended amount of time, usually three minutes

Under the arm (axillary)
Although it's not the most accurate way to take a temperature, you can also use an oral thermometer for an armpit reading:

• Place the thermometer under your arm with your arm down.
• Hold your arms across your chest.
• Wait five minutes or as recommended by your thermometer's manufacturer.
• Remove the thermometer and read the temperature.

To take your child's axillary temperature, have the child sit in your lap, facing to the side. Place the thermometer under your child's near arm, which should be against your chest.

An axillary reading is generally 1 degree Fahrenheit (about 0.5 degree Celsius) lower than an oral reading.

Get medical help for a fever if:

• A baby younger than 3 months has a rectal temperature of 100.4 F (38 C) or higher, even if your baby doesn't have other signs or symptoms
• A baby older than 3 months has a temperature of 102 F (38.9 C) or higher
• A newborn has a lower than normal temperature — less than 97 F (36.1 C) rectally
• A child younger than age 2 has a fever longer than one day, or a child age 2 or older has a fever longer than three days
• An adult has a temperature of more than 103 F (39.4 C) or has had a fever for more than three days

Call your doctor immediately if your child has a fever after being left in a hot car or if a child or adult has any of these signs or symptoms with a fever:

• A severe headache
• Severe swelling of the throat
• Unusual skin rash
• Unusual eye sensitivity to bright light
• A stiff neck and pain when the head is bent forward
• Mental confusion
• Persistent vomiting
• Difficulty breathing or chest pain
• Extreme listlessness or irritability
• Abdominal pain or pain when urinating
• Other unexplained symptoms

18. Food-borne illness: First aid

All foods naturally contain small amounts of bacteria. But poor handling of food, improper cooking or inadequate storage can result in bacteria multiplying in large enough numbers to cause illness. Parasites, viruses, toxins and chemicals also can contaminate food and cause illness.

Signs and symptoms of food poisoning vary with the source of contamination, and whether you're dehydrated or have low blood pressure. Generally they include:

• Diarrhea
• Nausea
• Abdominal pain
• Vomiting (sometimes)
• Dehydration (sometimes)

With significant dehydration, you might feel:

• Lightheaded or faint, especially on standing
• A rapid heartbeat

Whether you become ill after eating contaminated food depends on the organism, the amount of exposure, your age and your health. High-risk groups include:

• Older adults. As you get older, your immune system may not respond as quickly and as effectively to infectious organisms as when you were younger.
• Infants and young children. Their immune systems haven't fully developed.
• People with chronic diseases. Having a chronic condition, such as diabetes or AIDS, or receiving chemotherapy or radiation therapy for cancer reduces your immune response.

If you develop food poisoning:

• Rest and drink plenty of liquids.
• Don't use anti-diarrheal medications because they may slow elimination of bacteria from your system.

Foodborne illness often improves on its own within 48 hours. Call your doctor if you feel ill for longer than two or three days or if blood appears in your stools.

Call 911 or call for emergency medical assistance if:

• You have severe symptoms, such as watery diarrhea that turns very bloody within 24 hours.
• You belong to a high-risk group.
• You suspect botulism poisoning. Botulism is a potentially fatal food poisoning that results from the ingestion of a toxin formed by certain spores in food. Botulism toxin is most often found in home-canned foods, especially green beans and tomatoes. Signs and symptoms of botulism usually begin 12 to 36 hours after eating the contaminated food and may include headache, blurred vision, muscle weakness and eventual paralysis. Some people also have nausea and vomiting, constipation, urinary retention, difficulty breathing, and dry mouth. These signs and symptoms require immediate medical attention.

19. Foreign object in the ear: First aid

A foreign object in the ear can cause pain and hearing loss. Usually you know if an object is stuck in your ear, but small children may not be aware of it.

If an object becomes lodged in the ear, follow these steps:

• Don't probe the ear with a tool. Don't attempt to remove the foreign object by probing with a cotton swab, matchstick or any other tool. To do so is to risk pushing the object farther into the ear and damaging the fragile structures of the middle ear.
• Remove the object if possible. If the object is clearly visible, pliable and can be grasped easily with tweezers, gently remove it.
• Try using gravity. Tilt the head to the affected side to try to dislodge the object.
• Try using oil for an insect. If the foreign object is an insect, tilt the person's head so that the ear with the offending insect is upward. Try to float the insect out by pouring mineral oil, olive oil or baby oil into the ear. The oil should be warm but not hot. As you pour the oil, you can ease the entry of the oil by straightening the ear canal. Pull the earlobe gently backward and upward for an adult, backward and downward for a child. The insect should suffocate and may float out in the oil bath. Don't use oil to remove any object other than an insect. Do not use this method if the child has ear tubes in place or if there is any suspicion of a perforation in the eardrum — pain, bleeding or discharge from the ear.

If these methods fail or the person continues to experience pain in the ear, reduced hearing or a sensation of something lohttp://www.blogger.com/post-create.g?blogID=4911570937085127314dged in the ear, seek medical assistance.

20. Foreign object in the eye: First aid

If you get a foreign object in your eye:

• Wash your hands.
• Try to flush the object out of your eye with clean water or saline solution. Use an eyecup or a small, clean drinking glass positioned with its rim resting on the bone at the base of your eye socket.
• Another way to flush a foreign object from your eye is to get into a shower and aim a gentle stream of lukewarm water on your forehead over the affected eye while holding your eyelid open.

To help someone else:

1. Wash your hands.
2. Seat the person in a well-lighted area.
3. Gently examine the eye to find the object. Pull the lower lid down and ask the person to look up. Then hold the upper lid while the person looks down.
4. If the object is floating in the tear film on the surface of the eye, try using a medicine dropper filled with saline solution or clean, lukewarm water to flush it out. If a medicine dropper isn't available, use a glass of water or hold the person's head under a gentle stream of water.

Caution

• Don't try to remove an object that's embedded in the eyeball.
• Don't rub the eye.
• Don't try to remove a large object that makes closing the eye difficult.

When to call for help
Call 911 or your local emergency number when:

• You can't remove the object.
• The object is embedded in the eyeball.
• The person with the object in the eye is experiencing abnormal vision.
• Pain, redness or the sensation of an object in the eye persists after the object is removed.

21. Foreign object in the nose: First aid

If a foreign object becomes lodged in your nose:

• Don't probe at the object with a cotton swab or other tool.
• Don't try to inhale the object by forcefully breathing in. Instead, breathe through your mouth until the object is removed.
• Blow out of your nose gently to try to free the object, but don't blow hard or repeatedly. If only one nostril is affected, close the opposite nostril by applying gentle pressure and then blow out gently through the affected nostril.
• Gently remove the object if it's visible and you can easily grasp it with tweezers. Don't try to remove an object that isn't visible or easily grasped.
• Call for emergency medical assistance or go to your local emergency room if these methods fail.

22. Foreign object in the skin: First aid

If a foreign object is projecting from the skin:

• Wash your hands and clean the area well with soap and water.
• Use tweezers to remove splinters of wood or fiberglass, small pieces of glass, or other foreign objects. A magnifying glass may help you see the object better.
• Squeeze the wound gently to allow bleeding to wash out germs.
• Wash the area again and pat dry. Apply antibiotic ointment.

If the object is completely embedded in your skin:

• Wash your hands and clean the area well with soap and water.
• Sterilize a clean, sharp needle by wiping it with rubbing alcohol. If rubbing alcohol isn't available, clean the needle with soap and water.
• Use the needle to break the skin over the object and gently lift the tip of the object out. A magnifying glass may help you see the object better.
• Use tweezers to remove the object.
• Squeeze the wound gently to allow bleeding to wash out germs.
• Wash the area again and pat dry. Apply antibiotic ointment.

Seek medical help if:

• The particle doesn't come out easily.
• The particle is close to an eye.

Check your immunization record to be sure you're current on your tetanus shot (within 10 years unless the wound is deep or dirty). The immunization may be listed as Td, DTaP or Tdap.

23. Foreign object inhaled: First aid

If you or your child inhales a foreign object, see your doctor. If an inhaled foreign object causes choking, the American Red Cross recommends the "five-and-five" approach to delivering first aid:

• Give 5 back blows. First, deliver five back blows between the choking person's shoulder blades with the heel of your hand.
• Give 5 abdominal thrusts. Perform five abdominal thrusts (also known as the Heimlich maneuver).
• Alternate between 5 blows and 5 thrusts until the blockage is dislodged.

If you're the only rescuer, perform back blows and abdominal thrusts before calling 911 or your local emergency number for help. If another person is available, have that person call for help while you perform first aid.

The American Heart Association does not teach the back-blow technique, only the abdominal thrust procedures. It's OK not to use back blows if you have not learned the back-blow technique. Both approaches are acceptable.

To perform the Heimlich maneuver on someone else

• Stand behind the person. Wrap your arms around the waist. Tip the person forward slightly.
• Make a fist with one hand. Position it slightly above the person's navel.
• Grasp the fist with the other hand. Press hard into the abdomen with a quick, upward thrust — as if trying to lift the person up.
• Perform a total of 5 abdominal thrusts, if needed. If the blockage still isn't dislodged, repeat the five-and-five cycle.

A modified version of the technique is sometimes taught for use with pregnant or obese people. The rescuer places his or her hand in the center of the chest to compress, rather than in the abdomen.

To perform the Heimlich maneuver on yourself
If you're alone and choking and you have a landline phone, call 911 or your local emergency number immediately. Then, although you'll be unable to effectively deliver back blows to yourself, you can still perform abdominal thrusts to dislodge the item.

• Place a fist slightly above your navel.
• Grasp your fist with the other hand and bend over a hard surface — a countertop or chair.
• Shove your fist inward and upward.

24. Foreign object swallowed: First aid

If you swallow a foreign object, it will usually pass through your digestive system uneventfully. But some objects can lodge in your esophagus, the tube that connects your throat and stomach. If an object is stuck in your esophagus, you may need to remove it, especially if it is:

• A pointed object, which should be removed as quickly as possible to avoid further injury to the esophageal lining
• A tiny watch- or calculator-type button battery, which can rapidly cause nearby tissue injury and should be removed from the esophagus without delay

If a person who has swallowed an object is coughing forcefully, encourage him or her to continue coughing and do not interfere. If a swallowed object blocks the airway and the person's condition worsens (the cough becomes silent or their breathing becomes more difficult), the American Red Cross recommends the "five-and-five" approach to first aid:

• Give 5 back blows. First, deliver five back blows between the victim's shoulder blades with the heel of your hand.
• Give 5 abdominal thrusts. Perform five abdominal thrusts (also known as the Heimlich maneuver). Abdominal thrusts may injure infants. Use chest compressions instead.
• Alternate between 5 back blows and 5 abdominal thrusts until the blockage is dislodged.

If you're the only rescuer, perform back blows and abdominal thrusts before calling 911 or your local emergency number for help. If another person is available, have that person call for help while you perform first aid.

If the person becomes unconscious, help him or her to the ground and begin CPR. With attempted breaths, check the mouth for an object and if visible remove it. Do not perform a "blind finger sweep" because this could push an object farther into the airway.

The American Heart Association does not teach the back-blow technique, only the abdominal thrust procedures. It's OK not to use back blows if you have not learned the back-blow technique. Both approaches are acceptable.

To perform abdominal thrusts (the Heimlich maneuver) on someone else:

• Stand behind the person. Wrap your arms around the waist. Tip the person forward slightly.
• Make a fist with one hand. Position it slightly above the person's navel.
• Grasp the fist with the other hand. Press hard into the abdomen with a quick, upward thrust — as if trying to lift the person up.
• Perform a total of 5 abdominal thrusts, if needed. If the blockage still isn't dislodged, repeat the five-and-five cycle.

A modified version of the technique is sometimes taught for use with pregnant or obese people. The rescuer places his or her hand in the center of the chest to compress, rather than in the abdomen.

To perform abdominal thrusts (the Heimlich maneuver) on yourself:
If you're choking and alone and have a land-line phone, call 911 or your local emergency number immediately. You can't perform back blows on yourself. But you can perform abdominal thrusts.

• Place a fist slightly above your navel.
• Grasp your fist with the other hand and bend over a hard surface — a countertop or chair will do.
• Shove your fist inward and upward.

25. Fractures (broken bones): First aid

A fracture is a broken bone. It requires medical attention. If the broken bone is the result of major trauma or injury, call 911 or your local emergency number. Also call for emergency help if:

• The person is unresponsive, isn't breathing or isn't moving. Begin cardiopulmonary resuscitation (CPR) if there's no respiration or heartbeat.
• There is heavy bleeding.
• Even gentle pressure or movement causes pain.
• The limb or joint appears deformed.
• The bone has pierced the skin.
• The extremity of the injured arm or leg, such as a toe or finger, is numb or bluish at the tip.
• You suspect a bone is broken in the neck, head or back.
• You suspect a bone is broken in the hip, pelvis or upper leg (for example, the leg and foot turn outward abnormally).

Don't move the person except if necessary to avoid further injury. Take these actions immediately while waiting for medical help:

• Stop any bleeding. Apply pressure to the wound with a sterile bandage, a clean cloth or a clean piece of clothing.
• Immobilize the injured area. Don't try to realign the bone or push a bone that's sticking out back in. If you've been trained in how to splint and professional help isn't readily available, apply a splint to the area above and below the fracture sites. Padding the splints can help reduce discomfort.
• Apply ice packs to limit swelling and help relieve pain until emergency personnel arrive. Don't apply ice directly to the skin — wrap the ice in a towel, piece of cloth or some other material.
• Treat for shock. If the person feels faint or is breathing in short, rapid breaths, lay the person down with the head slightly lower than the trunk and, if possible, elevate the legs.

26. Frostbite: First aid

When exposed to very cold temperatures, skin and underlying tissues may freeze, resulting in frostbite. The areas most likely to be affected by frostbite are your hands, feet, nose and ears.

If your skin looks white or grayish-yellow, is very cold and has a hard or waxy feel, you may have frostbite. Your skin may also itch, burn or feel numb. Severe or deep frostbite can cause blistering and hardening. As the area thaws, the flesh becomes red and painful.

Gradually warming the affected skin is key to treating frostbite. To do so:

• Protect your skin from further exposure. If you're outside, warm frostbitten hands by tucking them into your armpits. Protect your face, nose or ears by covering the area with dry, gloved hands. Don't rub the affected area and never rub snow on frostbitten skin.
• Get out of the cold. Once you're indoors, remove wet clothes.
• Gradually warm frostbitten areas. Put frostbitten hands or feet in warm water — 104 to 107.6 F (40 to 42 C). Wrap or cover other areas in a warm blanket. Don't use direct heat, such as a stove, heat lamp, fireplace or heating pad, because these can cause burns before you feel them on your numb skin.
• Don't walk on frostbitten feet or toes if possible. This further damages the tissue.
• If there's any chance the affected areas will freeze again, don't thaw them. If they're already thawed, wrap them up so that they don't become frozen again.
• Get emergency medical help. If numbness or sustained pain remains during warming or if blisters develop, seek medical attention.

27. Gastroenteritis: First aid

Gastroenteritis is an inflammation of your stomach and intestines. Common causes are:

• Viruses.
• Food or water contaminated by bacteria or parasites.
• Reaction to a new food. Young children may develop signs and symptoms for this reason. Infants who are breast-fed may even react to a change in their mothers' diets.
• Side effect from medications.

Characteristic signs and symptoms include:

• Nausea or vomiting
• Diarrhea
• Abdominal cramps
• Low-grade fever (sometimes)

Depending on the cause of the inflammation, symptoms may last from one day to more than a week.

If you suspect gastroenteritis in yourself:

• Stop eating for a few hours to let your stomach settle.
• Drink plenty of liquids, such as a sports drink or water, to prevent dehydration. If you have trouble tolerating liquids, take them in frequent sips. Make sure that you're urinating normally, and that your urine is light and clear and not dark. Infrequent passage of dark urine is a sign of dehydration. Dizziness and lightheadedness also are signs of dehydration. If any of these symptoms occur and you can't drink enough fluids, seek medical attention.
• Ease back into eating. Gradually begin to eat bland, easy-to-digest foods, such as soda crackers, toast, gelatin, bananas, rice and chicken. Stop eating if your nausea returns. Avoid milk and dairy products, caffeine, alcohol, nicotine, and fatty or highly seasoned foods for a few days.
• Consider acetaminophen (Tylenol, others) for relief of discomfort, unless you have liver disease.
• Get plenty of rest. The illness and dehydration can make you weak and tired.

Get medical help if:

• Vomiting persists more than two days
• Diarrhea persists more than several days
• Diarrhea turns bloody
• Fever is 101 F (38.3 C) or higher
• Lightheadedness or fainting occurs with standing
• Confusion develops
• Worrisome abdominal pain develops

If you suspect gastroenteritis in your child:

• Allow your child to rest.
• When your child's vomiting stops, begin to offer small amounts of an oral rehydration solution (CeraLyte, Enfalyte, Pedialyte). Don't use only water or only apple juice.
• Gradually introduce bland, easy-to-digest foods, such as toast, rice, bananas and potatoes. Avoid giving your child full-fat dairy products, such as whole milk and ice cream, and sugary foods, such as sodas and candy. These can make diarrhea worse.
• Consider acetaminophen (Tylenol, others) for relief of discomfort, unless your child has liver disease. Don't give your child aspirin.
• If you're breast-feeding, let your baby nurse. If your baby is bottle-fed, offer a small amount of an oral rehydration solution (CeraLyte, Enfalyte, Pedialyte) or regular formula.

Get medical help if your child:

• Becomes unusually drowsy.
• Vomits blood.
• Has bloody diarrhea.
• Shows signs of dehydration, such as dry mouth and skin, marked thirst, sunken eyes, or crying without tears. In an infant, be alert to the soft spot on the top of the head becoming sunken and to diapers that remain dry for more than three hours.
• Is younger than age 2 and has a fever that lasts more than one day or is age 2 or older and has a fever that lasts more than three days.

28. Head pain: First aid

Most headaches are minor, and you can treat them with a pain reliever. Some head pain, however, signals a dangerous or serious medical problem. Don't ignore unexplained head pain or head pain that steadily worsens.

Get immediate medical attention if your head pain:

• Develops suddenly and severely
• Accompanies a fever; stiff neck; rash; mental confusion; loss of consciousness; seizures; changes in vision, such as blurring or seeing halos around lights; dizziness; weakness or paralysis, such as in the arms or legs; loss of balance; a reddened eye; numbness; or difficulty speaking
• Is severe and follows a recent sore throat or respiratory infection
• Begins or worsens after a head injury, fall or bump
• Is a different type of headache from your usual and you're older than 50
• Progressively worsens over the course of a single day or persists for several days

29. Head trauma: First aid

Post head trauma involves injuries that are minor and don't require hospitalization. However, call 911 or your local emergency number if any of the following signs or symptoms are apparent.

Adults

• Severe head or facial bleeding
• Bleeding or fluid leakage from the nose or ears
• Severe headache
• Change in level of consciousness for more than a few seconds
• Black-and-blue discoloration below the eyes or behind the ears
• Cessation of breathing
• Confusion
• Loss of balance
• Weakness or an inability to use an arm or leg
• Unequal pupil size
• Slurred speech
• Seizures

Children

• Any of the signs or symptoms for adults
• Persistent crying
• Refusal to eat
• Bulging in the soft spot on the front of the head (infants)
• Repeated vomiting

If severe head trauma occurs

• Keep the person still. Until medical help arrives, keep the injured person lying down and quiet, with the head and shoulders slightly elevated. Don't move the person unless necessary, and avoid moving the person's neck. If the person is wearing a helmet, don't remove it.
• Stop any bleeding. Apply firm pressure to the wound with sterile gauze or a clean cloth. But don't apply direct pressure to the wound if you suspect a skull fracture.
• Watch for changes in breathing and alertness. If the person shows no signs of circulation (breathing, coughing or movement), begin CPR.

30. Heart attack: First aid

Someone having a heart attack may experience any or all of the following:

• Uncomfortable pressure, fullness or squeezing pain in the center of the chest
• Prolonged pain in the upper abdomen
• Discomfort or pain spreading beyond the chest to the shoulders, neck, jaw, teeth, or one or both arms
• Shortness of breath
• Lightheadedness, dizziness, fainting
• Sweating
• Nausea

A heart attack generally causes chest pain for more than 15 minutes, but it can also have no symptoms at all. Many people who experience a heart attack have warning signs hours, days or weeks in advance.

If you or someone else may be having a heart attack

• Call 911 or your local emergency medical assistance number. Don't tough out the symptoms of a heart attack for more than five minutes. If you don't have access to emergency medical services, have a neighbor or a friend drive you to the nearest hospital. Drive yourself only as a last resort, if there are absolutely no other options, and realize that it places you and others at risk when you drive under these circumstances.
• Chew and swallow an aspirin, unless you're allergic to aspirin or have been told by your doctor never to take aspirin. But seek emergency help first, such as calling 911.
• Take nitroglycerin, if prescribed. If you think you're having a heart attack and your doctor has previously prescribed nitroglycerin for you, take it as directed. Do not take anyone else's nitroglycerin, because that could put you in more danger.
• Begin CPR if the person is unconscious. If you're with a person who might be having a heart attack and he or she is unconscious, tell the 911 dispatcher or another emergency medical specialist. You may be advised to begin cardiopulmonary resuscitation (CPR). If you haven't received CPR training, doctors recommend skipping mouth-to-mouth rescue breathing and performing only chest compressions (about 100 per minute). The dispatcher can instruct you in the proper procedures until help arrives.

31. Heat cramps: First aid

Bring heavy exercise in hot environments. The spasms may be more intense and more prolonged than are typical nighttime leg cramps. Inadequate fluid intake often contributes to heat cramps.

Muscles most often affected include those of your calves, arms, abdominal wall and back, although heat cramps may involve any muscle group involved in exercise.

If you suspect heat cramps:

• Rest briefly and cool down
• Drink clear juice or an electrolyte-containing sports drink
• Practice gentle, range-of-motion stretching and gentle massage of the affected muscle group
• Don't resume strenuous activity for several hours or longer after heat cramps go away
• Call your doctor if your cramps don't go away within one hour or so

32. Heat exhaustion: First aid

Heat exhaustion is one of the heat-related syndromes, which range in severity from mild heat cramps to heat exhaustion to potentially life-threatening heatstroke.

Signs and symptoms of heat exhaustion often begin suddenly, sometimes after excessive exercise, heavy perspiration, and inadequate fluid or salt intake. Signs and symptoms resemble those of shock and may include:

• Feeling faint or dizzy
• Nausea
• Heavy sweating
• Rapid, weak heartbeat
• Low blood pressure
• Cool, moist, pale skin
• Low-grade fever
• Heat cramps
• Headache
• Fatigue
• Dark-colored urine

If you suspect heat exhaustion:

• Get the person out of the sun and into a shady or air-conditioned location.
• Lay the person down and elevate the legs and feet slightly.
• Loosen or remove the person's clothing.
• Have the person drink cool water or other nonalcoholic beverage without caffeine.
• Cool the person by spraying or sponging him or her with cool water and fanning.
• Monitor the person carefully. Heat exhaustion can quickly become heatstroke.

If fever greater than 102 F (38.9 C), fainting, confusion or seizures occur, call 911 or emergency medical help.

33.Heatstroke: First aid

Heatstroke is the most severe of the heat-related problems, often resulting from exercise or heavy work in hot environments combined with inadequate fluid intake.

Young children, older adults, people who are obese and people born with an impaired ability to sweat are at high risk of heatstroke. Other risk factors include dehydration, alcohol use, cardiovascular disease and certain medications.

What makes heatstroke severe and potentially life-threatening is that the body's normal mechanisms for dealing with heat stress, such as sweating and temperature control, are inadequate. The main sign of heatstroke is a markedly elevated body temperature — generally greater than 104 F (40 C) — with changes in mental status ranging from personality changes to confusion and coma. Skin may be hot and dry — although if heatstroke is caused by exertion, the skin may be moist.

Other signs and symptoms may include:

• Rapid heartbeat
• Rapid and shallow breathing
• Elevated or lowered blood pressure
• Cessation of sweating
• Irritability, confusion or unconsciousness
• Feeling dizzy or lightheaded
• Headache
• Nausea
• Fainting, which may be the first sign in older adults

If you suspect heatstroke:

• Move the person out of the sun and into a shady or air-conditioned space.
• Call 911 or emergency medical help.
• Cool the person by covering him or her with damp sheets or by spraying with cool water. Direct air onto the person with a fan or newspaper.
• Have the person drink cool water or other nonalcoholic beverage without caffeine, if he or she is able.

34. Human bites: First aid

Human bites can be as dangerous as or even more dangerous than animal bites because of the types of bacteria and viruses contained in the human mouth. If someone cuts his or her knuckles on another person's teeth, as might happen in a fight, this is also considered a human bite.

If you sustain a human bite that breaks the skin:

1. Stop the bleeding by applying pressure with a clean, dry cloth.
2. Wash the wound thoroughly with soap and water.
3. Apply an antibiotic cream to prevent infection.
4. Apply a clean bandage. Cover the affected area with a nonstick bandage.
5. Seek emergency medical care.

If you haven't had a tetanus shot within five years, your doctor may recommend a booster. In this case, you should have the booster within 48 hours of the injury.

35. Hypothermia: First aid

Under most conditions your body maintains a healthy temperature. However, when exposed to cold temperatures, especially with a high wind chill factor and high humidity, or to a cool, damp environment for prolonged periods, your body's control mechanisms may fail to keep your body temperature normal. When more heat is lost than your body can generate, hypothermia, defined as an internal body temperature less than 95 F (35 C), can result.

Wet or inadequate clothing, falling into cold water and even not covering your head during cold weather can increase your chances of hypothermia.

Signs and symptoms include:

• Shivering
• Slurred speech
• Abnormally slow breathing
• Cold, pale skin
• Loss of coordination
• Fatigue, lethargy or apathy
• Confusion or memory loss
• Bright red, cold skin (infants)

Signs and symptoms usually develop slowly. People with hypothermia typically experience gradual loss of mental acuity and physical ability, so they may be unaware that they need emergency medical treatment.

Older adults, infants, young children and people who are very lean are at particular risk. Other people at higher risk of hypothermia include those whose judgment may be impaired by mental illness or Alzheimer's disease and people who are intoxicated, homeless or caught in cold weather because their vehicles have broken down. Other conditions that may predispose people to hypothermia are malnutrition, cardiovascular disease and an underactive thyroid (hypothyroidism).

To care for someone with hypothermia:

• Call 911 or emergency medical assistance. While waiting for help to arrive, monitor the person's breathing. If breathing stops or seems dangerously slow or shallow, begin cardiopulmonary resuscitation (CPR) immediately.
• Move the person out of the cold. If going indoors isn't possible, protect the person from the wind, cover his or her head, and insulate his or her body from the cold ground.
• Remove wet clothing. Replace wet things with a warm, dry covering.
• Don't apply direct heat. Don't use hot water, a heating pad or a heating lamp to warm the victim. Instead, apply warm compresses to the center of the body — head, neck, chest wall and groin. Don't attempt to warm the arms and legs. Heat applied to the arms and legs forces cold blood back toward the heart, lungs and brain, causing the core body temperature to drop. This can be fatal.
• Don't give the person alcohol. Offer warm nonalcoholic drinks, unless the person is vomiting.
• Don't massage or rub the person. Handle people with hypothermia gently; their skin may be frostbitten, and rubbing frostbitten tissue can cause severe damage.

http://www.mayoclinic.com/health/FirstAidIndex/FirstAidIndex