Think you’d know what to do if you found yourself in the middle of a medical emergency? The key to keeping your head in a crisis is to take a few seconds to assess the situation, says Richard K. Turner, M.D., an emergency physician at the Doctors Medical Center in San Pablo, Calif. Once you’ve done that, call 911. Read on for how to improvise in the most common emergency situations.
These are the classic signs: “Chest pain or pressure radiating to the jaw or neck and down the arm, along with shortness of breath and nausea,” Turner said. What to do? “Dial 911," he said. "Then give the person an aspirin to chew if they’re not allergic to it.” (It’s best to give 325 milligrams.) If she’s unconscious, you can check that her airway is clear and that she’s breathing. If there are no signs of life, and you know cardiopulmonary resuscitation, begin chest compressions right away. CPR can more than double a person’s chances of survival, according to the American Heart Association. Not sure how to do it? Watch this quick video refresher on the AHA website.
“Direct pressure stops bleeding,” said Jeffrey Pellegrino, Ph.D., a member of the American Red Cross Scientific Advisory Council. Put your hand on the wound or, if possible, direct the victim to put his hands firmly on it. That frees you up to call 911 if necessary and find a bandage or cloth to apply to the wound. If the bleeding continues after direct pressure is applied, add more layers of absorbent material, then call 911. As for using a tourniquet, the American Red Cross recommends it only when pressure hasn’t stemmed the bleeding and the blood loss is life-threatening. “Use whatever is at hand—a belt, or fabric, preferably 4 inches wide, with padding put underneath,” Turner said. “You will also need a tool—like a stick—to use as a lever to turn the tourniquet very tight, until the bleeding is controlled.”
If he can’t get up, he’s in extreme pain, or he lacks sensation in a limb, call 911. Unless he’s in a dangerous place—near traffic, for example—keep him still while you check for injuries. If there’s any sign of a head, neck, or back injury, make sure he stays still until medical help arrives. “Make the position he’s in stable by using whatever you have—a pillow, a rolled-up jacket—around the legs and arms,” Turner said. Even if he’s able to walk away from the accident, that doesn’t mean he escaped injury. Symptoms of head trauma, including a severe headache, dizziness, nausea, and confusion, can take hours or days to appear. Be sure there’s someone who stays with him to observe and to call 911 if necessary.
A blocked airway quickly cuts off oxygen to the brain, so fast action is critical (see illustrations). The surest clue? The person can’t speak. If she’s choking on something that’s visible, reach in and pull it out. But, says Turner, “Never put fingers in the person’s mouth if you don’t see the object.” If her airway is only partly blocked (you’ll know it if she can still speak or cough), encourage her to cough until the blockage is cleared. “Only perform the Heimlich,” Turner said, “if she can’t cough or can’t speak.”
On yourself
If you’re alone and choking, call 911 immediately. Even if you can’t talk, an operator will respond. Try to go outside or into a public place for help. Make a fist and place your thumb below your rib cage and above your navel. Grasp your fist with your other hand. Press it into the area and throw yourself over a chair, railing, or table edge. Quickly thrust your upper belly area against the edge.
On an adult
Don’t do anything if he’s able to speak (or is coughing, since that can dislodge the object). If not, give five back blows between the shoulder blades, alternating with five abdominal thrusts done this way: Wrap your arms around his waist. Make a fist with one hand. Place the thumb side of your fist just above the navel. Grasp your fist with your other hand. Do quick, upward and inward thrusts until the object is dislodged. If he becomes unconscious, call 911 and start CPR.
On a child
If he can’t speak and you can see the blockage, you can try to remove it with your fingers, but don’t let him bite you. If you can’t see or reach it, give five back blows (between his shoulder blades) with the heel of your hand, alternating with five abdominal thrusts. Don’t thrust hard enough to lift him off his feet. Continue until the object is dislodged. If he becomes unconscious, lower him to the floor, call 911, and begin CPR.
Sources for the information in this section are the National Institutes of Health, the Mayo Clinic, and Jeffrey Pellegrino, Ph.D.
This article appeared in the December 2013 issue of Consumer Reports on Health.
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