First Aid for Halloween

Halloween and Bonfire Night are soon approaching and preparations have already begun with pumpkin-carving, costume-making and bonfire building! But amongst all of these festivities it’s easy to get carried away and inevitably injuries will occur. St. John Ambulance advises on keeping a well-stocked First Aid kit to hand and offers some tips and hints on how to deal with any disasters on the night.

How to treat Bleeding

Minor cuts, scratches and grazes

Treatment

• Wash and dry your own hands.
• Cover any cuts on your own hands and put on disposable gloves.
• Clean the cut, if dirty, under running water.
• Pat dry with a sterile dressing or clean lint-free material.
• If possible, raise affected area above the heart.
• Cover the cut temporarily while you clean the surrounding skin with soap and water and pat the surrounding skin dry.
• Cover the cut completely with a sterile dressing or plaster.

Severe bleeding

Treatment

• Put on disposable gloves.
• Apply direct pressure to the wound with a pad (e.g. a clean cloth) or fingers until a sterile dressing is available.
• Raise and support the injured limb. Take particular care if you suspect a bone has been broken.
• Lay the casualty down to treat for shock.
• Bandage the pad or dressing firmly to control bleeding, but not so tightly that it stops the circulation to fingers or toes. If bleeding seeps through first bandage, cover with a second bandage. If bleeding continues to seep through bandage, remove it and reapply.
• Treat for shock.
• Dial 999 for an ambulance.
• Remember: Protect yourself from infection by wearing disposable gloves and covering any wounds on your hands.
• If blood comes through the dressing DO NOT remove it – bandage another over the original. If blood seeps through BOTH dressings, remove them both and replace with a fresh dressing, applying pressure over the site of bleeding.

Objects in wounds

Where possible, swab or wash small objects out of the wound with clean water. If there is a large object embedded:

Treatment

• Leave it in place.
• Apply firm pressure on either side of the object.
• Raise and support the wounded limb or part.
• Lay the casualty down to treat for shock.
• Gently cover the wound and object with a sterile dressing.
• Build up padding around the object until the padding is higher than the object, then bandage over the object without pressing on it.
• Depending on the severity of the bleeding, dial 999 for an ambulance or take the casualty to hospital.

How to treat – Burns and Scalds

Around 50,000 children a year are treated in hospital for burns and scalds and 100 children a year will die this way. It is the second most common cause of accidental death after road accidents. Remember Fit smoke alarms in your home. Be safety conscious by using coiled kettle flexes or cordless kettles, etc. to avoid hanging flexes. Turn pan handles away from the
front of the cooker. Keep matches, cigarettes, inflammable substances, chemicals and powerful cleaning materials out of reach. Beware of bonfires and barbecues as well as any indoor fires – use fireguards. Keep domestic water temperatures under 55°c. Treat burns and scalds in exactly the same way.

Minor Burns

Treatment

For minor burns, hold the affected area under cold water for at least 10 minutes. Remove jewellery etc. and cover the burn as detailed above. If the burn is larger than the palm of the casualty’s hand it requires medical attention. All deep burns of any size require urgent hospital treatment.

Severe Burns

Treatment

• Start cooling the burn immediately under running water for at least 10 minutes
• Dial 999 for an ambulance.
• Make the casualty as comfortable as possible, lie them down.
• Continue to pour copious amounts of cold water over the burn for at least ten minutes or until the pain is relieved.
• Whilst wearing disposable gloves, if available, remove jewellery, watch or clothing from the affected area – unless it is sticking to the skin.
• Cover the burn with clean, non-fluffy material to protect from infection. Cloth, a clean plastic bag or kitchen film all make good dressings.
• Treat for shock.

Clothing on fire

Treatment

• Stop, Drop and Roll.
• Stop the casualty panicking or running – any movement or breeze will fan the flames.
• Drop the casualty to the ground.
• If possible, wrap the casualty tightly in a coat, curtain or blanket (not the nylon or cellular type), rug or other heavy-duty fabric. The best fabric is wool.
• Roll the casualty along the ground until the flames have been smothered.

On ALL burns DO NOT

• Use lotions, ointments and creams
• Use adhesive dressings
• Break blisters

Fractures – How to treat

Treatment

• Give lots of comfort and reassurance and persuade them to stay still.
• Do not move the casualty unless you have to.
• Steady and support the injured limb with your hands to stop any movement.
• If there is bleeding, press a clean pad over the wound to control the flow of blood. Then bandage on and around the wound.
• If you suspect a broken leg, put padding between the knees and ankles. Form a splint (to immobilise the leg further) by gently, but firmly, bandaging the good leg to the bad one at the knees and ankles, then above and below the injury. If it is an arm that is broken, improvise a sling to support the arm close to the body.
• Dial 999 for an ambulance.
• If it does not distress the casualty too much, raise and support the injured limb.
• Do not give the casualty anything to eat or drink in case an operation is necessary. Watch out for signs of shock.
• If the casualty becomes unconscious, follow the Resuscitation Sequence - DRABC.

Choking – How to treat

Recognition

• Difficulty in speaking and breathing.
• There may also be: Congested face initially.
• Grey-blue skin (cyanosis) later.
• Distressed signs from the casualty, who may point to the throat, or grasp the neck.

Treatment (conscious adult)

• 1 Ask the casualty to cough, but if the casualty becomes weak or stops coughing go to step 2.
• 2 Bend the casualty well forwards and give up to 5 sharp slaps between the shoulder blades with the flat of your hand.
• 3 If back slaps fail, check the mouth, then try up to 5 abdominal thrusts. Put your arms around the casualty’s trunk. Link your hands below their ribcage and pull sharply inwards and upwards.
• 4 If the obstruction does not clear after 3 cycles of back slaps and abdominal thrusts dial 999 for an Ambulance. Repeat steps 1-4 until obstruction clears.

Treatment (unconscious adult)

• If the casualty becomes unconscious, check breathing and give Rescue Breaths. If you cannot achieve effective Rescue Breaths, give Chest Compressions immediately to try to relieve the obstruction.
• Loss of consciousness may relieve any muscle spasm in the throat.
  Check the casualty’s condition:
• If the casualty is breathing, place them in the Recovery Position.
• If the casualty is not breathing attempt two Rescue Breaths. If these ventilations are effective, check for circulation and carry out Rescue Breaths/CPR as appropriate.
• If these first two Rescue Breaths do NOT make the chest rise check that the airway is open, by head tilt and chin lift, and the mouth is clear and then try again.
• If you cannot achieve effective Rescue Breaths after 5 attempts, commence CPR immediately, as this may clear the obstruction.
• If at any stage the casualty begins to breathe normally, place them in the recovery position and dial 999 for an ambulance.
• Monitor and record the breathing, pulse and level of response every 10 minutes.

Treatment (conscious baby)

• 1 Lay the baby face down on your forearm, supporting his back and chin. Give up to 5 sharp slaps on the baby’s back.
• 2 Check the baby’s mouth; remove any obvious obstruction with one finger. Do not feel blindly down the throat.
• 3 If this fails turn the baby face up on your arm or lap. Give up to 5 sharp thrusts into the baby’s chest.
• 4 Check the baby’s mouth again and remove any obvious obstruction. Do not use abdominal thrusts on a baby.
• If the obstruction still has not cleared, repeat steps 1-4 two times, then take the baby with you to dial 999 for an ambulance.
• Repeat steps 1-4 until help arrives.

If the baby becomes unconscious follow the Resuscitation Sequence – DRABC.

• D- Danger
• R- Response
• A- Airway
• B- Breathing
• C-Circulation

Treatment (conscious child)

• 1 Encourage the child to cough. Only if they become weak or unable to cough, go to step 2.
• 2 Bend the child forwards with their head lower than their chest. Give up to 5 back slaps firmly between the shoulders.
• 3 Check the child’s mouth; remove any obvious obstruction with one
  finger.
• 4 If this fails, stand or kneel behind the child. Make a fist and place it against their lower breastbone. Grasp it with your other hand. Press into the chest with a sharp inward thrust. Give up to 5 of these chest thrusts at a rate of about 1 every 3 seconds.
• 5 Check the child’s mouth and proceed to step 6 if choking persists.
• 6 Make a fist and place it against the child’s central upper abdomen. Grasp it with your hand. Press into their abdomen with a sharp upward thrust up to 5 times. Check the mouth. Repeat steps 2-6 three times.
• 7 Dial 999 for an ambulance. Repeat steps 2-6 until help arrives.
• If the child becomes unconscious, follow the Resuscitation Sequence - DRABC.

Heart Attack – How to Treat

Recognition

• The casualty may have some or all of the following symptoms:
• Tight, constricting pain in the chest (may feel like severe indigestion).
• Pain may spread to the arms, throat, jaw, abdomen, or back.
• Lips may be blue.
• Skin may appear ‘ashen’, sweaty and clammy.
• Casualty may become dizzy or breathless with fast or irregular pulse
  (normal rate 60-80 per minute).

Treatment

If the casualty is conscious:

• Make as comfortable as possible in half-sitting position.
• If available, get the casualty to chew one 300mg aspirin slowly.

If the casualty becomes unconscious:

• Follow the Resuscitation Sequence – DRABC.
• Telephone for an ambulance. 999
• Dial 999, and ask for an Ambulance make sure you information vital for the Ambulance service for e.g. The full address of your location

Fainting (Unconsciousness) – How to treat

Recognition

• Collapse.
• Brief loss of consciousness, pale, cold & clammy skin.
• Slow pulse – this will increase as the casualty recovers.

Treatment

• Lay the casualty down.
• Loosen tight clothing e.g. Neck & Waist
• Kneel down and raise casualty’s legs to improve the blood flow to the brain. If nothing else available then support the casualty’s ankles on your shoulder.
• Provide a source of fresh air by asking someone to open a door or window. As the casualty recovers plenty of reassurance will be required. Sit them up slowly; if they sit up too quickly they may faint again.
• Often someone will feel faint but not actually faint. You should encourage them to lie down and raise their legs, as this is the safest position for someone who could still collapse. If they do feel faint then lay them down again.
• If the casualty does not regain consciousness quickly then reassess DRABC, place in the recovery position and dial 999 for an ambulance.

• D- Danger
• R- Response
• A- Airway
• B- Breathing
• C- Circulation