The chances that you'll find yourself responding to a medical or first aid emergency at some point in your life are close to 100 percent. Whether it's a fall, a drug overdose, or a home-handyman project gone wrong, all of us will at some point be faced with handling an emergency that could mean life or death.
Yet it's all too common for people to think they know what to do in an accident or other health emergency, then find themselves paralyzed with indecision when seconds count. It's also common for people to follow outdated information or advice that doesn't take into account recent medical advances, says William T. Durkin, Jr., a physician and president of the American Academy of Emergency Medicine. Here's how to avoid the scariest first aid mistakes, and what to do to save the lives of those you love.
First aid mistake #1: Assuming a burn is benign
Some burns can be treated at home, and some can't. Not going to the emergency room when a burn is serious can result in infection, complications, and even death. It's also important to remember that burns don't occur just from fire; they also result from electricity, chemical exposure, and hot liquids. Electrical burns, which can occur from power lines or electrical wires or cords, can cause serious but invisible injuries deeper inside the body that might go unrecognized.
What to do: Run cool water over the burned area or soak in a vat of cool water (without ice). Head to the hospital for any burns to the eyes, mouth, or genital areas, even if mild; any burn that covers an area larger than your hand; and any burn that causes blisters or is followed by a fever. In the case of electrical burn, go to the ER immediately.
What not to do: Don't apply ice, don't apply any ointments, and don't apply butter or any other type of grease to burns. Also, don't cover a burn with a towel, blanket, or other cloth, because loose fibers might attach to the skin. Never break blisters, and if clothing is stuck to the skin, don't try to pull it off.
First aid mistake #2: Mishandling a cut-off body part
Timing and how you care for the cut-off body part are the keys to a successful outcome. Make a few wrong choices and surgeons won't be able to reattach it, whether it's a finger, thumb, or hand -- frequently associated with Halloween pumpkin carving, fireworks, snowblowers, or the use of table saws -- or even a nose, ear, or penis.
What to do: Handle the body part gently, wrapping it in gauze dampened with saline solution if you have some on hand, water if you don't. Seal it in a watertight bag (still wrapped) and submerge it in ice water. Get it to the emergency room -- along with the accident victim, of course -- as soon as possible. A severed arm or leg must be reattached within 6 to 12 hours. A finger can survive for 2 days if refrigerated but only 12 hours or less in a warm environment.
What not to do: Don't assume the cut-off digit or limb can't be reattached, even if it's damaged. No matter how doubtful you are, protect what you can save and transport it. Don't place body parts directly on ice and don't submerge body parts in water, where tissues can suffer frostbite and other damage or be contaminated by bacteria.
First aid mistake #3: Waiting too long to report a drug overdose
It's often scary to take action when someone passes out or becomes seriously ill from a drug overdose, a combination of drugs, or drugs and alcohol. Fearing exposure, legal action, academic probation, or angry parents, many people wait until it's too late to call 911 or take someone to the emergency room. Another mistake: not recognizing that a synthetic version of a "less serious" drug, such as pot, can cause a deadly reaction. Beware, too, that the danger doesn't just come from street drugs; prescription drugs are now the number-one cause of fatal drug overdoses, responsible for more than 26,000 deaths a year.
What to do: If the person is unconscious or not breathing, call 911. Collect the drugs and medications the victim took and bring them with you to the hospital. If breathing is weak, start CPR if you know how, or find someone who does. If the skin has a blue tint, that's an additional indication that depressed breathing is serious. If the person is dizzy, nauseated, incoherent, or hallucinating but still conscious, take him or her to the emergency room.
Overdosing on methamphetamine, speed, or cocaine causes a different set of symptoms, which include rapid or racing heartbeat, rapid breathing or hyperventilation, excessive sweating, acute anxiety, and sudden fluctuations in blood pressure. The result can be a stroke or heart attack, so go to the emergency room if you suspect an overdose of one of these drugs. If the victim is conscious, alert, and relatively stable but you still suspect an overdose, call the poison control center to report what you've observed and ask what to do.
What not to do: Don't call on a friend or neighbor to check if the victim is OK. And don't assume that, just because someone is still conscious, he or she is going to be fine. Don't try to make the person vomit. Don't waste time making repeated attempts to wake an overdose victim, such as pouring cold water over him or her. Don't avoid telling the emergency team exactly what drugs the victim took, even if they were illegal. Misreporting decreases the chance the person can be treated successfully.
More deadly first aid mistakes
First aid mistake #4: Not taking head trauma seriously enough
Only in recent years have doctors begun to fully understand and appreciate the long-term effects of brain injury, on everything from physical mobility to personality. A typical survivor of a severe brain injury will require five to ten years of intensive services and rehabilitation. Someone doesn't need to be knocked out or lose consciousness to sustain a traumatic brain injury, either. And not all head injuries come from physical impact; shaking and whiplash can cause the brain to move around inside the skull, causing traumatic brain injury (TBI).
What to do: Check for signs of concussion, which include confusion, lack of focus, sleepiness, headache, nausea and vomiting, memory loss, "seeing stars" or flashing lights, and loss of consciousness. In the case of suspected concussion, call 911 or go to the emergency room. Also call 911 if the person faints or is less alert, has convulsions or seizures, can't stop vomiting, has unequal pupils or unusual eye movements, or can't walk.
What not to do: Don't assume that because the injured person didn't lose consciousness, he or she is fine. Another common mistake is failing to watch carefully for 24 hours or more for symptoms that may develop later.
First aid mistake #5: Not responding to or reporting alcohol poisoning
There's a fine line between being extremely drunk and having a blood alcohol concentration high enough to kill you. And sadly, there's a great deal of mythology surrounding drinking and what works and doesn't work to "sober up." Very few people know the signs, symptoms, and potential damage that can result from alcohol poisoning. Yet more than 50,000 cases of alcohol poisoning are reported every year, and one in 1,000 of those reported results in death.
What to do: Call 911 if you think there's any chance the person you're worried about has drunk enough alcohol to be in danger -- or has drunk a great deal quickly, such as on a dare. Stay with a friend or family member who's "sleeping it off," checking their breathing regularly to make sure it's not depressed (less than eight breaths per minute.) Also check their body temperature and skin color: Signs of hypothermia include cold, clammy skin; bluish skin; and paleness.
What not to do: Don't try to sober someone up with coffee, a cold shower, or a walk in cold air. The only factors that affect the level of alcohol in the blood are time and the digestive process. The biggest mistake of all: leaving someone alone after he or she has passed out. A person's blood alcohol concentration can continue to rise even after losing consciousness, because the alcohol continues to enter the bloodstream from the stomach and intestines and then circulates throughout the body. Another serious threat is choking after vomiting while sleeping.
First aid mistake #6: Missing the signs of internal bleeding
Internal bleeding occurs when an artery or vein is damaged or leaks. Because it's inside the body or brain, there may be little or no sign that it's happening and, depending on the type of injury, the outside of the body may look fine.
What to do: Be familiar with the kinds of injuries and trauma likely to cause internal bleeding. These include:
- A fall
- A high-impact injury such as a car crash
- Blunt-force trauma
- A hit or impact in the lower back or hip, where the kidneys are located
- Physical contact in sports, particularly to the abdomen
- Impact from a falling object
- A punch to the eye
- A hit from a fast-moving ball, such as in baseball or volleyball
- A "deceleration injury" from shaking, whiplash, or rebound from impact, which can cause organs to shift inside the body
- An ectopic pregnancy, miscarriage, or retained placenta after birth
Call 911 or go to the emergency room if the impact was strong enough to knock someone out, knock the breath out of them, or cause them to be dizzy. If a woman is pregnant, any bleeding is reason to go to the doctor. And after birth, if a woman is weak, woozy, or doesn't seem like herself, ask the nurse or doctor to examine her for retained placenta or another source of internal bleeding.
What not to do: Don't assume that if someone "looks fine" after a fall, a hit in sports, a car accident, or other trauma, there's no need to go to the hospital. Be aware that people who are taking anticlotting medications such as warfarin, or those who regularly take aspirin or who have bleeding disorders, are more prone to any kind of bleeding, external or internal.