Can be the result of any severe injury to the body. Shock is caused by bodily reactions, which slow or stop the circulatory mechanisms, and the symptoms are those of insufficient blood supply to vital organs.

Signs and symptoms---weakness, rapid but weak pulse, pale face, cold and clammy skin with perspiration of forehead and palms, chills, thirst, nausea, shallow irregular breathing, low blood pressure.

Emergency treatment---Have victim lie flat with head level or lower then rest of body (elevate legs 12-18 inches above head). Cover victim to keep him off the ground and to prevent loss of body heat. Objective is not to heat victim, but to keep him from cooling. If victim is conscious, not vomiting, and does not have an abdominal injury, give small sips of "shock solution"—(1 tsp. table salt, ½ tsp. baking soda to 1 qt. water). Give by the spoonful, and as much as the victim will take. Small sips of black coffee or tea are helpful, but no alcohol. Get medical attention as soon as possible.

Continuous steady oozing indicates venous flow while spurting blood indicates arterial flow. Some degree of shock will usually be present in any case of severe bleeding. Internal bleeding may show no outward signs of blood, but victim will exhibit restlessness, anxiety, thirst, pallor, weakness, rapid but weak and thready pulse. Bleeding from the chest may produce spitting up of blood which will be bright red and frothy. Bleeding from the stomach or upper intestines will produce a black and tarry stool. Bleeding from the lower intestines will be bright red.

Emergency treatment---use immediate and continuous pressure over the wound with any clean cloth available. Continue as long as necessary to stop the bleeding, then use a comfortable pressure dressing. Do not use a tourniquet as they can quickly produce gangrene if improperly used. If bleeding is from the arms or legs, elevate the part above heart level.

Pressure points may be helpful as well as manual pressure over the wound. A pressure point may be anywhere that a blood vessel passes over a bone. Remember that if the blood is venous (not spurting), it is being carried back to the heart, and that pressure should be applied distal to the wound. The opposite is true of arterial blood.

Emergency treatment for internal bleeding should be directed toward keeping the victim warm and quiet, preferably lying on his back. Turn the head to minimize any chance of aspirating blood or vomit. If bleeding is from the lungs, the victim may need to be propped up to enhance breathing.

Assume that any severe blow to the head, whether or not the patient has lost consciousness or is dizzy, even for a short spell, is a skull fracture or a concussion.

Immediate first aid: Keep patient lying down and warm. Do not allow patient to sit up or walk. If face is flushed, raise head slightly with a pillow. If face is pale, keep head level with a pillow or slightly lower. Do not give anything by mouth. Apply cold cloths to head, and turn head to side, so secretions can escape from mouth. If scalp is bleeding, use compression lightly. Do not press hard in case there are skull fragments which can be depressed into the brain tissue. Transport patient lying down with head supported on both sides to prevent jarring.

Extent of head injury may be assessed by holding one hand over each eye in turn for a few seconds, then quickly removing hand to see if the pupil reacts by contracting to the light. Fixed pupils indicate a more serious head injury.

Utter tragedy can result if a victim of spinal injury is moved by well-intended but uninformed persons. Slight movement of head or back may sever nerves and cause paralysis or death. What you don’t do in the first few minutes is more important than what you do.

DO NOT move or lift patient from where he lies until trained medical help arrives.

DO NOT bend or twist the head or body in any direction.

DO NOT put a pillow under the head or give water or a cigarette.

DO NOT remove him from under a fallen object, but remove the object if it can be done without moving the patient.

Suspect a broken neck or back in any bad fall or impact injury to the neck or spine.

If patient is conscious, ask him to move hands or fingers. If he cannot, suspect neck fracture. If he cannot move feet or toes, suspect back fracture. Keep patient warm and covered. Do not move or lift him. Get medical help as soon as possible.

Suspect a broken bone if:

• Victim cannot move injured part
• Part is deformed or misshapen
• Pain when trying to move
• Lack of feeling when part is touched
• There is swelling and blueness of the skin

If in doubt, treat as a fracture.

A simple fracture exists under unbroken skin; these can be displaced or undisplaced.

A compound fracture is one in which the bone is protruding through the skin.

General principles of first aid for fractures

1. Do not move or disturb patient unless necessary

2. If victim must be moved, pull at legs or armpits along axis of body

3. Stop serious bleeding

4. Keep airway open if patient is unconscious---use CPR

5. Keep patient warm and lying down

6. Do not put pillow under head if neck or head is injured but block head on either side to prevent movement.

7. Use splints before moving patient—(almost anything rigid can serve as a splint in an emergency, i.e.: boards, sticks, cane, umbrella, tightly rolled magazines or newspapers.) Try to extend splint above and below the adjacent joints to prevent motion.

For major wounds

1. Stop bleeding
2. Combat shock
3. Keep breathing passages clear
4. Give CPR if necessary
5. Keep victim warm and covered

Crushing blows, punctures, stab wounds, or gunshot wounds may create an opening from the lungs to the outside air. Air may enter and blow out of the wound with a sucking or hissing sound. Froth or bubbles may be seen. Stop this opening IMMEDIATELY. Put your hands on either side of the wound and push together as the patient exhales to plug the opening. Cover the wound with a compress and bandage to make it airtight. Bind chest firmly. Have patient lie down, but keep shoulders slightly raised. Give nothing by mouth.

Closed wounds---suspect serious abdominal injury if patient has experienced a crushing blow to the abdomen. There may be internal bleeding. Keep patient lying on back and keep patient warm. Give nothing by mouth, not even water.

Open wounds---for stab wound, cut, or gunshot, put sterile dressing or clean cloth over wound to draw edges together. Stop the bleeding. Keep patient lying on back and keep patient warm. If intestines are exposed, they must not be allowed to dry out. Keep moist with warm salt water solution (1 tsp. to 1 pint). Intestines must not dry out even for an instant. Do not try to put intestines back in place. Give nothing by mouth. Keep patient warm and on back with knees bent.

Apply Heimlich maneuver---in general, clear air passage—turn head to one side. Use finger or cloth to clear air passage of any fluid. Give CPR.

Minor burns--- (skin is reddened, unbroken, no blisters)

Hold immediately under cool water for several minutes until no pain is felt when affected part is removed

Moderate burns—Apply a paste of wet baking soda or a dressing with a mild burn ointment. Cover with a sterile bandage. Immediate exclusion of air gives the greatest pain relief.

Major burns---blisters, broken skin, fair amount of skin burned.

If possible, wrap patient carefully in a sheet or blanket and get to hospital as soon as possible. If this is not possible, immerse burned part in warm (not hot) water. If burn is extensive or involves the trunk, thighs or other large skin areas, put patient, clothes and all, into a tub full of warm running water. This excludes air from the burn and helps prevent shock. Stir some baking soda into the water. Try to cut away any clothing not adhered to the burn area. After removing patient from tub, wrap in a clean dry sheet and cover with a blanket.

Do not open large blisters

Do not apply antiseptic

Do not apply greases, ointments, butter, fluffy cotton or any dressing the doctor will find hard to remove.

The major threat of major burns is shock. Give immediate fluids. Use the shock solution: 1 tsp. salt, ½ tsp. baking soda dissolved in 1 qt. warm water. Give fluids slowly.

FAINTING

Lack of oxygen to the brain---place patient in a sitting position with his head lowered between his knees. After patient feels better, coffee or tea may be given.

STROKE

Caused by a break or seepage of blood within the skull. Face may be red but sometimes pale gray. Strong, slow pulse. One eye pupil often larger than the other. One side of the body may become limp or paralyzed. One corner of the mouth may droop.

Keep patient warm, but not hot. Apply cool cloths to the head. Transport patient in lying position.

Characterized most often by intense pain under the sternum, often radiating down left arm.

First aid measures are limited. Victim should not move about as this causes extra work for the heart. Victim should be lying down, but may have upper back and head elevated if it makes breathing easier. Give an aspirin immediately if victim is conscious, and allow them to take any heart medication prescribed for them such as nitroglycerin. Give oxygen if available.

Scraped skin surfaces bleed or ooze. If coarse pieces of dirt are in the wound, wash with warm saline solution, hydrogen peroxide or warm soap and water. Cover with a sterile dressing after applying a liquid antiseptic such as betadine.

Do not attempt to remove the top off a blister. Use a sterile needle to puncture the lower edge of a blister, and with a sterile gauze pad, press all the fluid from the blister. Cover with a sterile dressing or band-aid. If the blister top has been worn off, clean with warm soap and water and use an antiseptic ointment. Cover with a sterile dressing. Watch for signs of infection. Start antibiotics if necessary.

Give immediate first aid. Don’t worry about a specific poison antidote. Start by forcing large amounts of fluids. This will help to dilute the poison and cause vomiting which should be encouraged.

Emetics to induce vomiting:

Glass of milk immediately, followed by either: warm tap water, warm salt water (1tsp. per glass), or 1tsp. dry mustard to 1 glass water.

Press down on shank of hook until barbed end pushes through the skin. Cut off barb with wire cutters and remove shaft of hook. Wash wound with soap and water. Encourage bleeding. Do not try to remove a hook from a dangerous area such as the eye. Seek professional help as soon as possible.

INFORMATION ON THESE FOLLOWING TWO CONDITIONS HAS BEEN PREVIOUSLY DISTRIBUTED, BUT BECAUSE OF THEIR FREQUENT OCCURENCE DURING OUR HOT SUMMER MONTHS, I AM INCLUDING THEM AGAIN IN THESE PAPERS.

HEATSTROKE (SUNSTROKE): Grave emergency---often fatal---Act quickly to cool victim.

Symptoms:

Victim’s skin is very hot and dry. Body temp may be 104 to 110 degrees F.

Weakness, dizziness, rapid breathing, nausea, mental confusion, unconsciousness.

Treatment: 1. Cool victim rapidly, ice bags, drench clothes in cold water, spray from showerhead with cold water.

1. Strip clothing and wrap in sheet. Keep sheet wet with cold water.
2. Check body temperature every 10 minutes. Keep repeating applications of cold water or ice until temp drops to 101 to 102 degrees F. If temperature rises, repeat above treatment.
3. Summon physician.

Symptoms:

Victim’s skin is moist and clammy (as opposed to hot and dry as in heatstroke). There is profuse sweating. Body temp is about normal. Nausea likely, and victim may feel dizzy and fain

Treatment:

• Remove victim from the sun.
• Loosen clothing.
• Give sips of slightly salted water (1 tsp. to 1 pint)
• Give stimulants—coffee, tea
• Try to place victim in path of circulating air--- (i.e.: a fan)