Medical Preparedness: First Aid Kits, Supplies, and 15 Emergencies

Signs: Anything from a graze to a deep gash. Blood that spurts, pools, or soaks through a dressing is life-threatening and is treated before anything else. A wound that gapes, shows fat or muscle, or sits over a joint needs closing by a clinician.

Do first

1. Life-threatening limb bleeding: tourniquet 2 to 3 inches above the wound, never over a joint, tightened until the bleeding stops. Write down the time and do not loosen it.
2. Bleeding from the groin, armpit, or neck: pack gauze into the wound and hold hard pressure, at least 3 minutes with hemostatic gauze and 10 with plain gauze.
3. Ordinary bleeding: firm direct pressure with gauze for a full 10 minutes without lifting to look.
4. Flush the wound with a steady stream of clean drinking water or saline until it runs clear. Do not scrub. Keep soap, peroxide, alcohol, and iodine out of the wound itself.
5. Wash the skin around it with soap, or wipe it with an antiseptic wipe or dilute iodine, working away from the wound.
6. Close only a clean, shallow cut with closure strips. Leave bites, punctures, and dirty wounds open. Add a thin layer of antibiotic ointment, cover with a non-adherent pad, and check it daily.

Reach for: Bandages, Leukotape P, Antiseptic Wipes, Gauze, Adhesive Tape, Butterfly Closures, Antibiotic Ointment, How to treat a deep cut

Get help: Call 911 for bleeding that needed a tourniquet or packing. Get to an ER or clinic for bleeding that will not stop after 10 to 15 minutes of firm pressure, a deep, gaping, or puncture wound, an animal or human bite, debris you cannot flush out, numbness or loss of movement, or a dirty wound when the last tetanus shot was more than 5 years ago. Stitches work best within about 6 to 8 hours.

Signs: Pain, swelling, and bruising after a fall or twist. Suspect a break with deformity, a grinding feeling, inability to bear weight or use the limb, or pain directly over the bone. Treat it as broken when unsure.

Do first

1. Stop any bleeding first. Cover an open fracture with a sterile dressing and do not push bone back in.
2. Check color, warmth, feeling, and movement in the fingers or toes beyond the injury.
3. Splint it in the position found, padded, immobilizing the joint above and the joint below. Use a sling and swathe for an arm, shoulder, or collarbone.
4. Recheck circulation after splinting and loosen the wrap if the fingers or toes turn pale, blue, cold, or numb.
5. Sprains: rest, a snug elastic wrap, elevation, and cold packs through a cloth for 20 minutes at a time. Ibuprofen or acetaminophen for pain.

Reach for: Splints, Elastic Bandages, Triangular Bandages, Pain Relievers, Duct Tape

Get help: Call 911 for a suspected neck, back, hip, pelvis, or thigh fracture, bone through the skin, or a limb that is cold, blue, or numb. Do not move someone with a possible spine injury unless they are in danger. Every other suspected break needs an X-ray within a day.

Signs: Red and painful skin is superficial. Blisters mean a partial-thickness burn. White, leathery, charred, or painless skin is a full-thickness burn. Chemical and electrical burns are deeper than they look.

Do first

1. Stop the burning. Remove rings, watches, and clothing that is not stuck to the skin.
2. Cool the burn under cool running water for a full 20 minutes. Never ice, butter, or oil. Cooling still helps up to 3 hours after the burn.
3. Chemical burn: brush off dry powder, then flood with running water for at least 15 minutes. Do not try to neutralize it.
4. After cooling, burn gel can ease a minor burn. Leave blisters intact.
5. Cover loosely with a non-adherent dressing or clean plastic wrap, and keep the person warm.

Reach for: Burn Gel, Sterile Dressings, Non-Adherent Dressings, Sunburn relief with baking soda

Get help: Call 911 or go to an ER for any burn larger than the person's hand, any deep burn, burns to the face, hands, feet, genitals, or across a joint, burns that circle a limb, chemical or electrical burns, and anyone who breathed smoke or hot gas. Children and older adults need care sooner.

Signs: Hypothermia: shivering, fumbling hands, slurred speech, confusion, drowsiness. Shivering that stops while the person gets worse is an emergency. Frostbite: skin that is white or gray-yellow, waxy, hard, and numb, usually fingers, toes, nose, or ears.

Do first

1. Get out of wind and wet. Replace wet clothing with dry layers and insulate the person from the ground.
2. Wrap in blankets or a sleeping bag with a Mylar blanket around the outside as the wind and vapor barrier. Mylar alone does not insulate.
3. Put hand warmers or warm water bottles at the armpits, chest, and groin, over a layer of cloth. Give warm sweet drinks only if fully alert.
4. Handle a very cold person gently and keep them lying flat. Rough movement can stop a cold heart.
5. Frostbite: rewarm only when there is no chance of refreezing, in warm water of about 100 to 104°F for 20 to 30 minutes. No rubbing, no fire, no hand warmers directly on numb skin, and no walking on thawed feet.

Reach for: Thermal Blankets, Hand Warmers

Get help: Call 911 for confusion, drowsiness, slurred speech, shivering that has stopped, or a body temperature under 95°F. Frostbite with blisters, skin that stays numb or hard after rewarming, or any frostbite with hypothermia needs an ER.

Signs: Heat exhaustion: heavy sweating, cool clammy skin, headache, nausea, cramps, weakness. Heat stroke: confusion, slurred speech, collapse, or seizure with a body temperature of 104°F or more, skin hot and either dry or sweaty. Dehydration: dark urine, dry mouth, dizziness on standing.

Do first

1. Heat stroke: call 911, then cool immediately. Cold water immersion is best. Otherwise soak the person with cold water and fan hard, with ice packs at the neck, armpits, and groin. Cool first, transport second.
2. Nothing by mouth for anyone confused or vomiting.
3. Heat exhaustion: move to shade or air conditioning, loosen clothing, apply wet cooling towels, and fan.
4. If alert, sip an electrolyte drink, 1 to 2 ounces every 5 to 10 minutes. Slow sipping prevents nausea.
5. Rest for the remainder of the day. A second bout comes easier than the first.

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Get help: Heat stroke is always 911. Get medical care for heat exhaustion that is no better after 1 hour of cooling, for repeated vomiting, and for dehydration with confusion, a rapid weak pulse, fainting, or no urine in 8 hours.

Signs: Local pain, swelling, redness, and itch are normal. Hives away from the sting, swelling of the lips, tongue, or throat, wheezing, vomiting, or faintness within minutes to 2 hours means anaphylaxis.

Do first

1. Anaphylaxis: inject epinephrine into the outer thigh right away, call 911, and lay the person flat with legs raised, or sitting up if breathing is hard. A second dose can go in after 5 to 15 minutes if there is no improvement.
2. Remove a stinger fast by scraping or pulling it. Speed matters more than method.
3. Wash with soap and water and apply a cold pack through a cloth.
4. Oral antihistamine for itching and swelling, hydrocortisone cream on unbroken skin.
5. Ticks: grip at the head with fine tweezers, close to the skin, and pull straight out with steady pressure. Nothing smeared on the tick makes it back out. Watch the site for about a month.

Reach for: Cetirizine (Antihistamine), Antihistamines, Hydrocortisone Cream, Stainless Steel Tweezers, Epinephrine auto-injector (prescription), Tick Removal and Bite Care, Drawing poultice for bites, stings, and boils

Get help: Call 911 for any sign of anaphylaxis, even if epinephrine worked, because symptoms can return. Get care for stings inside the mouth or throat, dozens of stings at once, a bite with spreading redness or a dark center, and any rash, fever, or aches in the weeks after a tick bite.

Signs: Poison ivy, oak, and sumac leave an oil called urushiol on the skin. An itchy red rash with streaks and blisters appears 12 to 72 hours later. The blister fluid does not spread it. Oil left on clothes, tools, and pets does.

Do first

1. Wash the skin with soap and cool or lukewarm water as fast as possible, 2 or 3 times over. Within 10 minutes is ideal. After about 30 minutes the oil has bonded.
2. Scrub under the fingernails and wash the clothing, tools, gloves, and pets that touched the plant.
3. Calamine lotion and cool compresses for weeping, itchy rash. Hydrocortisone cream on unbroken skin.
4. Oral antihistamines do little for this itch. A sedating one at night can help with sleep.
5. Keep blisters intact and covered loosely if they break.

Reach for: Calamine Lotion, Hydrocortisone Cream, Antihistamines, Poison Ivy & Oak Wash, Baking soda paste, compress and soak for itching

Get help: Call 911 for trouble breathing or throat tightness, especially after breathing smoke from burning plants. See a clinician for a rash on the face, eyes, or genitals, a rash over a large part of the body, or blisters with pus and fever.

Signs: Local infection: redness that spreads, warmth, swelling, increasing pain, pus, red streaks running toward the body, fever. MRSA often starts as a painful red bump mistaken for a spider bite. Sepsis: fever or an abnormally low temperature with a fast heart rate, fast breathing, confusion, extreme pain, or clammy skin.

Do first

1. Draw a pen line around the edge of the redness and write the time. Spread past the line within hours means it is getting worse.
2. Take and record temperature, pulse, and breathing rate.
3. Clean the wound again by flushing with clean water or saline and apply a fresh sterile dressing. Change it at least daily.
4. Warm compresses help a small boil drain on its own. Do not squeeze or cut it.
5. Antibiotics are taken only as prescribed for that infection, at the full dose and for the duration on the label.

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Get help: Sepsis is a 911 emergency and cannot be treated at home. Go to an ER for red streaks, redness that spreads quickly, fever with a wound, an infected bite, infection on the face or hand, or any infection in someone with diabetes or a weak immune system.

Signs: The illness usually passes. The fluid loss is what does harm. Watch for thirst, dark or no urine, dry mouth, dizziness on standing, sunken eyes, and in children no tears and unusual sleepiness.

Do first

1. Start oral rehydration solution early in small, frequent sips, a spoonful every few minutes after vomiting.
2. Use a true ORS with glucose. With no packets on hand, stir 6 level teaspoons of sugar and half a level teaspoon of salt into 1 liter of clean water. A zero sugar electrolyte mix does not do this job.
3. Loperamide can slow watery diarrhea in adults. Do not use it with blood in the stool or a high fever.
4. Anti-nausea medication helps fluids stay down.
5. Return to bland food as appetite comes back, and wash hands with soap after every bathroom trip so it does not go through the house.

Reach for: Anti-diarrheal Medication, Oral Rehydration Salts (packets), Anti-nausea Medication, Activated charcoal for poison ingestion or digestive illness, Clay Binder for Digestive Upset

Get help: Go to an ER for blood in the stool or vomit, black stool, severe belly pain, confusion, fainting, no urine in 8 hours, or fluids that will not stay down for 24 hours. Infants, older adults, and pregnant women need care much sooner. For a suspected poisoning call Poison Control at 1-800-222-1222.

Signs: Asthma attack: wheezing, tight chest, coughing, short sentences. Pneumonia: fever, cough with colored phlegm, fast breathing, chest pain on breathing in, and a pulse oximeter reading that drifts down.

Do first

1. Asthma: sit the person upright and give their own rescue inhaler, through a spacer if they have one, as their action plan directs.
2. Call 911 if the inhaler brings no relief within minutes, or if they cannot finish a sentence or their lips turn blue.
3. Pneumonia: rest, fluids, and a fever reducer for comfort. Record temperature, breathing rate, and oxygen reading twice a day.
4. Do not suppress a wet, productive cough, because it clears the lungs. A spoonful of honey quiets a cough in anyone over one year old.
5. Pneumonia is treated with a clinician's diagnosis and the right antibiotic. It is not a wait and see illness in older adults.

Reach for: Rescue inhaler and spacer (prescription), Cough Suppressants, Fever Reducers, Pulse oximeter and thermometer, Mullein for lung support

Get help: Call 911 for severe trouble breathing, blue lips, confusion, or an asthma attack the inhaler does not break. Get same-day care for fever with shortness of breath, chest pain, coughing blood, or an oxygen reading that stays under 92 percent.

Signs: Chest pressure, squeezing, or pain lasting more than a few minutes, which may spread to the arm, jaw, neck, or back, with shortness of breath, cold sweat, nausea, or lightheadedness. Women, older adults, and diabetics often have little chest pain and more fatigue, nausea, and breathlessness.

Do first

1. Call 911 first. Do not drive yourself.
2. Chew 162 to 324 mg of plain, non-coated aspirin (2 to 4 low dose tablets, or 1 regular), unless the person is allergic, is bleeding, or has been told never to take it.
3. Sit them down, loosen clothing, and keep them calm and still.
4. Nitroglycerin only if it is their own prescription, taken as prescribed, and never within 24 to 48 hours of an erectile dysfunction drug.
5. If they collapse, stop responding, and are not breathing normally, that is cardiac arrest: start CPR, pushing hard and fast in the center of the chest at 100 to 120 per minute and at least 2 inches deep, and send someone for an AED.

Reach for: Aspirin, Nitroglycerin (the patient's own prescription), CPR Mouth Barrier

Get help: Every suspected heart attack is a 911 call, including symptoms that fade. Minutes of delay cost heart muscle.

Signs: Grit or dust, a scratch that feels like sand and waters constantly, a chemical splash, a blow to the eye, or an object stuck in the eye.

Do first

1. Chemical splash: flush immediately with clean running water or sterile eye wash for at least 15 minutes, holding the lids open, then call Poison Control at 1-800-222-1222 or head to an ER while still flushing if you can.
2. Dust or loose debris: do not rub. Blink, then rinse with sterile eye wash.
3. Object stuck in the eye or a cut to the eyeball: do not remove it, rinse it, or press on it. Tape a paper cup or rigid shield over the eye so nothing touches it, and go.
4. A light eye pad is for comfort on a scratched eye only. Never put pressure on an injured eye.
5. Homemade saline and boric acid rinses stay out of any eye that is scratched, punctured, or chemically burned.

Reach for: Sterile Eye Wash, Eye Pads, Adhesive Tape, Boric acid (mild irritation only), Boric Acid Eye Wash for Mild Irritation

Get help: Go to an ER for any chemical splash, embedded object, cut to the eye or lid, blood inside the eye, sudden loss of vision, or severe pain. See an eye doctor within a day for a scratch that is not clearly better.

Signs: Severe toothache, a lost filling or crown, a broken tooth, a knocked-out tooth, or bleeding after an injury or extraction.

Do first

1. Knocked-out adult tooth: pick it up by the crown, rinse it briefly without scrubbing, and push it back into the socket, or carry it in milk or the person's own saliva. A dentist within 30 to 60 minutes gives it the best chance. Do not replant a baby tooth.
2. Bleeding: bite down on folded gauze with steady pressure for 15 to 20 minutes.
3. Lost filling or crown: cover the tooth with temporary filling material from a dental repair kit, and use dental wax over a sharp edge.
4. Pain: ibuprofen and acetaminophen can be alternated within their label limits. Do not hold aspirin against the gum.
5. Rinse with warm salt water. It cleans and soothes, and it does not cure an infection.

Reach for: Dental Repair Kit, Pain Relievers, Gauze, Sore Throat Gargle and Mouth Rinse

Get help: Go to an ER immediately for swelling of the face, jaw, or neck, swelling under the tongue, fever, or trouble swallowing or breathing. An abscess is trapped pus that no rinse reaches, and it needs drainage and usually an antibiotic.

Signs: Mild: localized hives, itching, sneezing, watery eyes. Severe (anaphylaxis): widespread hives with swelling of the lips, tongue, or throat, hoarse voice, wheezing, repeated vomiting, faintness, or a sense of doom after food, a sting, or a medication.

Do first

1. Anaphylaxis: epinephrine into the outer thigh at the first sign. Do not wait to see if it gets worse, and do not reach for an antihistamine first.
2. Call 911 every time epinephrine is used.
3. Lay the person flat with legs raised. Let them sit up if breathing is hard. Do not let them stand or walk.
4. Give a second dose after 5 to 15 minutes if symptoms have not improved.
5. Mild reactions: remove the trigger, take an oral antihistamine, use hydrocortisone cream on itchy unbroken skin, and watch closely for 2 hours.

Reach for: Epinephrine auto-injector (prescription), Cetirizine (Antihistamine), Antihistamines, Hydrocortisone Cream

Get help: Anaphylaxis is always 911, even after the epinephrine works, because a second wave can follow hours later. See a clinician for hives that last days or any reaction to a medication.

Signs: Low blood sugar, under 70 mg/dL: shakiness, sweating, hunger, irritability, confusion, slurred speech that can pass for drunkenness, then seizure or unconsciousness. High blood sugar crisis: extreme thirst, frequent urination, vomiting, deep fast breathing, fruity breath.

Do first

1. If you cannot test and cannot tell high from low, treat it as low. Sugar will not meaningfully harm a high, and it saves a low.
2. Awake and able to swallow: 15 grams of fast sugar. That is 3 to 4 glucose tablets, 1 gel pack, half a cup of juice or regular soda, or 1 tablespoon of honey.
3. Recheck in 15 minutes and repeat if still low. Follow with a snack that has protein and starch.
4. Not able to swallow safely or unresponsive: nothing by mouth, no gel under the tongue. Give prescribed glucagon if available, roll them onto their side, and call 911.
5. Never give insulin as first aid. Insulin keeps 28 days unrefrigerated at 59 to 86°F and is ruined by freezing, so plan cold storage for outages.

Reach for: Glucose Tablets, Glucose Gel Packs, Grade A Honey Packets, Glucagon and insulin (the patient's own prescriptions)

Get help: Call 911 for unconsciousness, seizure, a low that does not respond to two rounds of sugar, or the signs of a high blood sugar crisis: vomiting, deep fast breathing, fruity breath, and drowsiness.