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When Minutes Count.....
 When Minutes Count - A citizen's guide to medical emergencies. This is a guide to management of common emergencies in your community. Using these simple guidelines developed by the Texas Department of Health may enable you to save the life of an ill or injured person. Your intervention, before EMS arrives, may mean the difference between life and death for a friend, relative or fellow citizen.Submitted by Karla Rushing, RN - MCH Trauma Coordinator
Recognizing medical emergencies:
Call 9-1-1 immediately if any of these conditions are present:
• | Serious bleeding |  | • | Not breathing |
• | Unconsciousness | | • | Choking |
• | Signs of a heart attack | | • | Broken bones |
• | Burns | | • | Head, chest or abdominal |
• | Neck or spine injuries | | | |
These are all obvious reasons to call 9-1-1
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Calling 9-1-1:
1. Remain calm or have a calmer person make the call.
2. Give the 9-1-1 dispatcher whatever information is asked for, usually:
• the address of where the emergency or victim is, and a nearby cross street
• your name and the telephone number of the location where you are.
• the name of the ill or injured person, and what is wrong with them.
3. Have someone wait out near the street or in the parking lot to direct EMS to the victim.
Stay on the line until the dispatcher tells you to hang up—this is important!
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Emergency Care Rules:
1. Do not move the ill or injured person unless they are in immediate danger.
2. Call 9-1-1 immediately. Send someone else to call for help if you can, so that you can stay with the person.
3. Do not give the person anything to eat or drink or allow them to smoke.
4. Keep the person calm and still.
5. Apply the following emergency care measures until the ambulance arrives.
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How to check breathing and heart beat:
If someone is not breathing or their heart is not beating, the person may die or suffer permanent damage before EMS arrives. Always check for breathing and
heartbeat (pulse) in a medical emergency, and be sure to give that information to EMS when you call.
1. If the person has collapsed, try to wake the person up by shaking the shoulder and shouting at them.
• If there is no response, gently lay the person flat on his or her back on a firm surface.
• Call for help or send someone for help.
• Gently lift the person’s chin forward with one hand while pushing down on the forehead to tilt the head back. The mouth should be open.
2. Put your ear to the person’s face and listen for breathing sounds; feel for warm breath on your cheek. Also, watch for the rise and fall of their chest.
• If the person is breathing, the heart is beating.
• If the person is not breathing: pinch the nose closed, cover the entire mouth area with your mouth, and blow two deep breaths into the mouth.
• Watch for the chest to rise.
• Check for pulse. Put two fingers on the person’s neck in the groove just to the side of the Adam’s apple; feel for a pulse for 10 seconds.
3. If there is a pulse, but still no breathing, begin rescue breathing.
• Give one breath every five seconds for an adult or 1 breath every 3 seconds for an infant or child.
• Recheck the pulse after every minute of rescue breathing. (12 breaths for an adult or 20 breaths for a child)
4. If you are sure there is no pulse, begin CPR, if you are trained.
Remember: Your care may make the difference between life and death.
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Bleeding:
1. Call 9-1-1 immediately for serious or spurting bleeding.
2. Have the person lie down.
3. Apply firm, direct pressure over the wound to stop bleeding. Use the cleanest available pad. Use a cloth, handkerchief, or clothing if necessary. If pad becomes blood-soaked, leave it on and put another one on top of it.
* DO NOT USE TOURNIQUETS. Be certain to avoid coming into contact with another person’s blood.
4. Elevate the injured limb, unless a fracture is involved.
5. Maintain the pressure until EMS arrives.
6. Raise the person’s feet higher than the head.
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Heart Attack/Chest Pain:
1. Call 9-1-1 immediately.
The person may have pain or feel pressure in the chest area or in the jaw, shoulder or arms, or report having a feeling of indigestion. The person may sweat, vomit, or have trouble breathing. Sometimes the person may deny feeling ill. DO NOT wait to see if the pain/discomfort goes away.
2. Have the person sit or recline, whichever is most comfortable.
3. Loosen the clothing at neck, chest and waist.
4. If the person collapses and loses consciousness, try to awaken them.
5. If there is no breathing and no pulse in the neck, begin CPR, if you are trained.
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Broken Bones:
1. For a serious injury of a broken or dislocated bone, call 9-1-1.
2. Keep the injured limb from moving.
3. If there is reason to suspect multiple broken bones, or the bone protrudes through the skin, or when the neck, back, pelvis or thigh might be broken, DO NOT attempt to move the person unless they are in immediate danger.
4. Apply cold (not ice) packs to minimize swelling.
5. If a broken bone protrudes through the skin, cover it with a dressing, but DO NOT try to push it back in. If there is excessive bleeding, use
direct pressure around the area to try to stop the bleeding.
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Burns:
1. Remove person from danger and source of the burn if it is safe to do so.
2. For serious burns, call 9-1-1 immediately.
3. Cover burned area with a cool, wet cloth, but do not over-cool.
4. Raise burned arms or legs higher than the person’s heart.
5. DO NOT break blisters or remove burned skin.
6. DO NOT use butter, ointments, or home remedies.
7. For small or minor burns, immerse in cool water.
8. Preserve normal body temperature—cover the person lightly if necessary.
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Choking:
If the adult can speak or cough, then they are able to breathe and the airway is not totally blocked. Encourage the person to cough out the object. DO NOT
interfere with efforts to do so.
If the adult cannot speak or breath, but is still conscious:
Ask the person “Are you choking?” If you are trained, perform the Heimlich maneuver. If the person loses consciousness, help them to the ground. Protect the head and neck.
If the person is choking and becomes unconscious:
• Call 9-1-1 immediately.
• Place the person on his or her back, keeping the face up. Open the mouth by lifting the lower jaw up and forward.
• Use your index finger to sweep out the mouth.
• Attempt rescue breathing. Pull the head back and pinch the nose closed. Cover entire mouth and blow into their mouth. If the air enters, they are no longer choking. Continue rescue breathing, if needed, until EMS arrives. If air does not go in, re-tilt the head and try again. If air still does not go in, perform five abdominal thrusts.
• Continue finger sweep-rescue breathing-abdominal thrust cycle until EMS arrives.
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If an infant chokes and is conscious:
Place the child face down over the lower part of your arm. With the baby’s head angled down, rest your arm over your thigh. Using the heel of your hand, give five quick, firm blows between the shoulder blades. If the object does not dislodge, turn child over, support with your arm resting on your thigh, and with the baby’s head angled down, use two fingers to press the breastbone five times.
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If an infant chokes and becomes unconscious:
1. Call 9-1-1 immediately.
2. If you can see the object in the infant’s mouth, perform a finger sweep to remove it. DO NOT perform sweeps in an infant’s mouth for objects that can not be seen.
3. Attempt rescue breathing. Very slightly tilt the head and lift the chin. Make a tight seal on infant’s mouth and nose with rescuer’s mouth. Ventilate two times with puffs from the rescuer’s cheeks or until the chest rises. If air does not go in, retilt the head and try again, if air is still not going in:
• Place the child face down over the lower part of your arm.
• With the baby’s head angled down, rest your arm over your thigh.
• Using the heel of your hand, give five quick, firm blows between the shoulder blades. If the object does not dislodge, turn child over, support with your arm resting on your thigh, and with the baby’s head angled down, use two fingers to press the breastbone five times. Check for object, finger sweep is necessary, try breaths again.
4. Repeat the procedure as often as necessary until EMS arrives.
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Convulsions/Seizures:
Call 9-1-1 immediately. Protect the person from further injury by removing obstacles. Turn the person onto one side and do not try to restrain movements. If the person has fallen or shows evidence of injury, do not move the person unless he or she is in immediate danger. Do not prop up the head. DO NOT put anything into the person’s mouth.
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Insect Bites:
Remove stinger if possible by scraping (not pinching). Apply cold compresses. If there is any reaction, such as breathing problems, call 9-1-1 immediately.
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Snake Bites:
Keep the person calm, have them sit quietly, and call 9-1-1 immediately. Try to identify or describe the snake without endangering yourself.
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Eyes:
For an object in the eye, try to wash it out by flushing the eye with lots of clear water. If the object cannot be easily washed out, cover both eyes lightly with a cloth, keep the person quiet and call 9-1-1 immediately. If chemicals get in the eye, flush eyes with lots of clear water. Continue flushing until EMS arrives. DO
NOT use drops or ointments.
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Fainting:
If a person is “feeling faint,” have the person lie down on his or her back until feeling better. Raise the person’s feet higher than the head. Check breathing and heartbeat. Apply cold compresses to the person’s forehead. If fainting is associated with chest pains, convulsions, or severe headache, or if it lasts more than one minute, call 9-1-1 immediately.
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Head, Neck or Back Injuries:
Call 9-1-1 immediately. DO NOT wait to see if the pain/discomfort goes away. Tell the person to remain absolutely still and calm. Severe, deep cuts should not be cleaned. Cover cuts with a clean cloth. Do not apply heavy presure to bleeding area. Do not attempt to stop bleeding from the ears, nose, or mouth.
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Poisoning/Overdose:
Call 9-1-1 immediately. Then call the Texas Poison Control Center Network at 1-800-POISON-1 and describe the product, the amount swallowed, and the time
it was taken.
1. Look inside the person’s mouth for burns that might indicate the ingestion of an acid or alkali. If present, DO NOT induce vomiting.
2. Send the container of the suspected poison to the hospital with the person.
DO NOT use syrup of ipecac unless the poison center has told you to use it. Every household should have syrup of ipecac on hand. The poison center will tell you when to use it.
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Unconsciousness:
1. Call 9-1-1 immediately.
2. Check for breathing and a heartbeat. If there is no breathing and no pulse in the neck, begin CPR if you are trained. If the person cannot be roused but is breathing well and has a good pulse, place the person on his or her side unless you suspect a neck injury.
DO NOT give the person anything to drink. If drug overdose or poison is suspected, the container of the suspected toxin.
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