Old Tappan First Aid Corps

First Aid Heat or Cold

Emergencies Due to Excessive Heat or Cold

Heat Related Emergencies

The body's chemical activities take place in a limited temperature range. They cannot occur with the efficiency needed for life if the body temperature is too high or too low. Heat is generated as a result of the constant chemical processes within the body. A certain amount of this heat is required to maintain normal body temperature. Any heat that is not needed for temperature maintenance must be lost from the body or hyperthermia (HI-per-THUR-mi-ah), an abnormally high body temperature, will be created. If allowed to go unchecked, this will lead to death. Limiting physical exertion, drinking non-alcoholic fluids, and limiting exposure to excessive heat may help to prevent heat-related injuries.

There are three common emergencies brought about by exposure to excessive heat:

HEAT CRAMPS-brought about by long exposure to heat. The scene temperature does not have to be much greater than what would be considered "normal" environmental temperature. The individual perspires heavily, often drinking large quantities of water. As the sweating continues, salts are lost by the body, bringing on painful muscle cramps. Some  medical authorities question whether heat cramps are associated with salt loss.

Heat Cramps Symptoms and Signs:  Severe muscle cramps (usually in the legs and abdomen), exhaustion, sometimes dizziness or periods of faintness.

               Heat Cramps Emergency Care Procedure:

• Move patient to a nearby cool place
• Massage (with pressure) the "cramped" muscle to help ease discomfort
• Apply warm, moist towels over cramped muscles for added relief
• If cramps persist, or if more serious signs and symptoms develop, call for medical transport

HEAT EXHAUSTION-the typical heat exhaustion patient is a healthy individual who has been exposed to excessive heat while working or exercising. This is a mild form of shock brought about by fluid and salt loss. Blood will pool in the skin as the body attempts to rid itself of excess heat. Heat exhaustion is  more of a problem during the summer and reaches a peak during prolonged heat waves. The condition may develop into heat stroke.

Heat Exhaustion Symptoms and Signs:  rapid and shallow breath, weak pulse, cold and clammy skin, heavy perspiration, total body weakness, and dizziness that sometimes leads to unconsciousness

 Heat Exhaustion Emergency Care Procedures:

• Call for medical assistance
• Move the patient to a nearby cool place
• Keep the patient at rest
• Remove enough clothing to cool the patient without chilling him
• Fan the patient's skin
• Give the patient water. NEVER try to give fluids to an unconscious patient
• Treat for shock, but do not cover to the point of overheating

HEAT STROKE-this is a TRUE EMERGENCY, brought about when a person's temperature-regulating mechanisms fail and his body cannot rid itself of excess heat. The problem is compounded when the patient fails to sweat in response to fluid and salt loss due to heat. Athletes, laborers, and others who exercise in hot environments are common victims.

 More cases of heat stroke are reported on hot, humid days. Even though heat stroke is commonly called "sun stroke," it can be caused by excessive heat other than from the sun. ALL cases of heat stroke are serious and require sending the patient to a medical facility as soon as possible.

Heat Stroke Symptoms and Signs:  deep breaths, then shallow breathing; rapid, strong pulse, then rapid weak pulse; dry hot skin; dilated pupils; loss of consciousness; seizures or muscular twitching may be seen.

Heat Stroke Emergency Care Procedures:

• Call 911 for immediate medical assistance
• Cool the patient -- in any manner -- rapidly. Move the patient out of the sun or away from the heat source. May put victim in water up to face (constantly monitor to prevent drowning). May wrap in wet towels or sheets and pour cold water over these. Body heat must be lowered rapidly or brain cells will die.
• Treat for shock
• Monitor breathing

Cold Related Emergencies

As noted, the body generates heat, trying to keep a core temperature of 98.6 degrees F. This involved a balance of the heat being generated, the heat lost, and the heat absorbed from the environment. If the environment is too cold, body heat can be lost faster than it can be generated. The body attempts to adjust be reducing respirations, perspiration, and circulation to the skin. Muscular activity will increase in the from of shivering to generate more heat. The rate at which foods that serve as fuel are burned within the body increases to produce more heat. At a certain point, enough heat will not be available to all parts of the body, leading to a general reduction or stopping of vital body functions. Hypothermia is a generalized cooling that may reduce the body temperature to a point at which the body can no longer generate enough heat to support life.

 The body can lose heat by conduction. This is a direct transfer of heat from the warm body into the cold environment. Heat also can be lost by convection as cool air passes over the body surface and carries away body heat. If a person's body or clothing becomes wet, water chill becomes a problem. Water conducts heat away from the body 240 times faster than still air. The effects of a cold environment also can be made worse by wind child. The more wind, the more heat loss by the body. Wind increases the effects of cold temperatures.

Patients with injuries or chronic illnesses will show the affects of cold much sooner than healthy persons. Those under the influence of alcohol or other substances tend to be affected more rapidly and more severely than the average person.

First Aid Bleeding

Bleeding

Listed below are some general principles of emergency care that apply to the majority of open wounds. If possibly serious, seek medical attention immediately.

Note: (In order to avoid health risks, please be sure to put on latex or rubber gloves.  If either is not available, try to find a clean, plastic bag to cover your hands.)

• Control Bleeding - Start with direct pressure of direct pressure and elevation. When necessary, use pressure points. Do NOT use a tourniquet 
• Clear the wound surface. You may need to expose the wound (cut the clothing if needed). (Do not clean the wound; simply remove foreign matter from its surface. Proper wound cleaning often is best done by medical staff.) Brush large debris away with a sterile dressing. 
• Prevent Further Contamination - Use a sterile dressing, if possible. When none is available, use the cleanest cloth material at the scene 
• Bandage the Dressing in Place  - Do not remove blood-soaked cloth. Put additional material over it. 
• Reassure the patient - will decrease patient's pulse rate and blood pressure and may reduce bleeding rate. 
• Treat for shock
  Ensure an adequate airway, control bleeding, reassure the patient, have the patient lie down with feet elevated, prevent loss of body heat (but do not overheat), give nothing by mouth, monitor patient

First Aid Bites

Bites

Animals and insects do not usually attack unless injured or provoked.  Many bites and stings can be prevented by using common sense.  For example, take sensible precautions before attempting to rescue a casualty from an angry dog or a swarm of bees.  Call help or contact the emergency service, if needed.

Insect and marine stings are often minor injuries that can usually be treated with first aid alone.  However, animal and human bites always require medical attention, as germs are harbored in the mouths of all animals.  Snake bites carry the additional risk of poisoning.  In cases of bite wounds, the casualty must be protected from serious infections such as tetanus and rabies.

Animal Bites

Germs are harbored in the mouths of all animals and humans.  Bites from sharp, pointed teeth cause deep puncture wounds that carry germs deep into the tissues.  Human bites also crush the tissues.  Serious wounds require hospital treatment.  Any bite in which the skin is broken requires immediate first aid, followed by medical attention.  These wounds are very susceptible to infection.

Treatment of Superficial Bites

• Wash the wound thoroughly with soap and warm water. 
• Pat dry and cover with an adhesive dressing or a small sterile dressing. 
• Advise the casualty to see their own medical practitioner. 

Treatment of Serious Wounds

• Control bleeding by applying direct pressure and raising the injured part. 
• Cover the wound with a sterile dressing or clean pad bandaged in place. 
• The casualty should be taken or sent to hospital. 

Insect Stings

Bee, wasp and hornet stings are usually more painful and alarming than dangerous.  An initial sharp pain is followed by mild swelling and soreness, which can be relieved by first aid.  However, some people are allergic to these poisons, and can rapidly develop anaphylactic shock, a very serious condition.  Multiple stings can have a dangerous cumulative effect.  Stings in the mouth or throat, causing swelling which may obstruct the airway, should be taken very seriously.

Treatment of a Sting in the Skin

• Remove the sting, if still present, with tweezers. 
• Apply a cold compress to relieve pain and minimize swelling. 
• Advise the casualty to see their own medical practitioner if pain and swelling persist or increase over the following 24 to 48 hours. 

Treatment of a Sting in the Mouth

• Give the casualty ice to suck to minimize swelling.
• Contact the emergency service, reassuring the casualty until help arrives.

Injuries by Marine Creatures

Sea creatures can cause various injuries.  Jellyfish, Portuguese man-of-war, corals and sea anemones can cause stings.  Their venom is contained in stinging cells (nematocysts) that stick to the victims skin, and this is released when the cell ruptures.  The spines of sea urchins or weever fish may puncture the skin, if trodden on, and become embedded in the foot, usually causing a painful local reaction, though serious general effects are rare.  In some parts of the world, sever degrees of poisoning can occur, giving rise to sever allergic reaction (anaphylactic shock), or paralysis of the chest muscle.  These cases, rarely, may be fatal.

Treatment of Marine Stings

• Pour alcohol or household vinegar over the injury for several minutes to incapacitate stinging cells that have not yet ruptured.
• Apply to the wound a paste of equal parts of sodium bicarbonate (baking soda) and water.
• Dust a dry powder such as talcum powder or meat tenderizer over the skin around the injury so that remaining cells stick together.
• In case of severe injuries or a serious generalized reaction, contact the emergency service. 

Snake Bites

A snake bite is often not a serious injury, but can be very frightening.  It is vital to reassure the casualty, as the spread of venom by be delayed if the casualty keeps still and calm.  The snake, or a note of its appearance, should be kept, so that that correct anti-venom can be given, if necessary.  The police should be notified if an escaped snake remains at large.

Treatment of Snake Bites

• Lay the casualty down, telling them to keep calm and still.

• Wash the wound thoroughly with soap and water, if possible.

• Secure and support the injured part.  Contact the emergency service.

 DO NOT apply a tourniquet, cut the wound with a knife, or attempt to suck out the venom.

The nearest Poison Control Center is located at:

NJ Poison Info & Education System
65 Bergen StreetNewark, NJ 07107-3001

Phone: (973)972-9280
Fax: (973)643-2679

http://www.njpies.org

Broken Bones (Fractures)

For fractured limbs, take the following precautions until emergency help arrives.

• Place the injured part in as natural a position as possible without causing discomfort to the patient. If the patient must be moved to a medical facility, protect the injured part from further injury by applying splints long enough to extend well beyond the joints above and below the fracture.

• Use firm material, such as a board, pole or metal rod, as a splint.

• Pad the splints with clothing or other soft material o prevent skin injury.

• Fasten splints with a bandage or cloth at the break and at points along the splint above and below the break.

• Use a pressure bandage to control any bleeding.

For very serious fractures involving injuries to the body, neck or back, observe the following:

• Do not move the victim without medical supervision, unless absolutely necessary, and then only if the proper splints have been applied.

• If a victim with a suspected neck or back injury must be moved, keep the back, head and neck in a straight line, preventing them from being twisted or bent during movement.

• Use a board or stretcher to support the victim, if available.