First Aid – Page 3

Although most black eye injuries aren’t serious, bleeding within the eye, called a hyphema, is serious and can reduce vision and damage the cornea — the clear, protective "window" at the front of the eye. In some cases, abnormally high pressure inside the eyeball (glaucoma) also can result.

To take care of a black eye:

• Using gentle pressure, apply a cold pack or a cloth filled with ice to the area around the eye. Take care not to press on the eye itself. Apply cold as soon as possible after the injury to reduce swelling, and continue using ice or cold packs for 24 to 48 hours.
• Be sure there’s no blood within the white and colored parts of the eye.

Seek medical care immediately if you experience vision problems (double vision, blurring), severe pain, or bleeding in the eye or from the nose.
 

Everyday activities can lead to corneal abrasions. Examples are playing sports, doing home repairs or being scratched by children who accidentally brush your cornea with a fingernail. Other common injuries to the cornea include splash accidents — contact with chemicals ranging from antifreeze to household cleaners.

Because the cornea is extremely sensitive, abrasions can be painful. If your cornea is scratched, you might feel like you have sand in your eye. Tears, blurred vision, increased sensitivity or redness around the eye can suggest a corneal abrasion. You may get a headache.

In case of injury, seek prompt medical attention. Other immediate steps you can take for a corneal abrasion are to:

• Use saline solution, if available, or clean water to rinse the eye. Use an eyecup or small, clean glass positioned with its rim resting on the bone at the base of your eye socket. If your work site has an eye-rinse station, use it. Rinsing the eye may wash out an offending foreign body.
• Blink several times. This movement may remove small particles of dust or sand.
• Pull the upper eyelid over the lower eyelid. The lashes of your lower eyelid can brush a foreign body from the undersurface of your upper eyelid.

Take caution to avoid certain actions that may aggravate the injury:

• Don’t try to remove an object that’s embedded in your eyeball. Also avoid trying to remove a large object that makes closing the eye difficult.
• Don’t rub your eye after an injury. Touching or pressing on your eye can worsen a corneal abrasion.
• Don’t touch your eyeball with tweezers, cotton swabs or other instruments. This can aggravate a corneal abrasion.
   

1. Flush your eye with water. Use clean, lukewarm tap water for at least 20 minutes, and use whichever of these approaches is quickest:
   • Get into the shower and aim a gentle stream of lukewarm water on the forehead over the affected eye. Or, aim the stream on the bridge of the nose if both eyes are affected.
   • Or, put your head down and turn it to the side. Then hold your affected eye open under a gently running faucet.
   • Young children may do best if they lie down in the bathtub or lean back over a sink while you pour a gentle stream of water on the forehead over the affected eye or on the bridge of the nose for both eyes. Remember to flush for at least 20 minutes no matter which method you choose.
2. Wash your hands with soap and water. Thoroughly rinse your hands to be sure no chemical or soap is left on them. Your first goal is to get the chemical off the surface of your eye, but then you need to make sure to remove the chemical from your hands.
3. Remove contact lenses. If they didn’t come out during the flush, then take them out.

Caution:

• Don’t rub the eye — this may cause further damage.
• Don’t put anything except water or contact lens saline rinse in the eye, and don’t use eyedrops unless emergency personnel tell you to do so.

Seek emergency medical assistance
After following the above steps, seek emergency care or, if necessary, call 911 or your local emergency number. Take the chemical container or the name of the chemical with you to the emergency department. If readily available, wear sunglasses because your eyes will be sensitive to light.
 

To help someone else:

1. Wash your hands.
2. Seat the person in a well-lighted area.
3. Gently examine the eye to find the object. Pull the lower lid down and ask the person to look up. Then hold the upper lid while the person looks down.
4. If the object is floating in the tear film on the surface of the eye, try flushing it out. If you’re able to remove the object, flush the eye with a saline solution or clean, lukewarm water.

Caution

• Don’t try to remove an object that’s imbedded in the eyeball.
• Don’t rub the eye.
• Don’t try to remove a large object that makes closing the eye difficult.

When to call for help
Seek emergency medical assistance when:

• You can’t remove the object.
• The object is imbedded in the eyeball.
• The person with the object in the eye is experiencing abnormal vision.
• Pain, redness or the sensation of a foreign body in the eye persists after the object is removed.

If an object becomes lodged in the ear, follow these steps:

• Don’t probe the ear with a tool. Don’t attempt to remove the foreign object by probing with a cotton swab, matchstick or any other tool. To do so is to risk pushing the object farther into the ear and damaging the fragile structures of the middle ear.
• Remove the object if possible. If the object is clearly visible, pliable and can be grasped easily with tweezers, gently remove it.
• Try using gravity. Tilt the head to the affected side to try to dislodge the object.
• Try using oil for an insect. If the foreign object is an insect, tilt the person’s head so that the ear with the offending insect is upward. Try to float the insect out by pouring mineral oil, olive oil or baby oil into the ear. The oil should be warm but not hot. As you pour the oil, you can ease the entry of the oil by straightening the ear canal. Pull the earlobe gently backward and upward for an adult, backward and downward for a child. The insect should suffocate and may float out in the oil bath.
• Don’t use oil to remove any object other than an insect. Do not use this method if there is any suspicion of a perforation in the eardrum — pain, bleeding or discharge from the ear.

If these methods fail or the person continues to experience pain in the ear, reduced hearing or a sensation of something lodged in the ear, seek medical assistance.
 

• Don’t probe at the object with a cotton swab or other tool.
• Don’t try to inhale the object by forcefully breathing in. Instead, breathe through your mouth until the object is removed.
• Blow your nose gently to try to free the object, but don’t blow hard or repeatedly. If only one nostril is affected, close the opposite nostril by applying gentle pressure and then blow out gently through the affected nostril.
• Gently remove the object if it’s visible and you can easily grasp it with tweezers. Don’t try to remove an object that isn’t visible or easily grasped.
• Call for emergency medical assistance or go to your local emergency room if these methods fail.
   

• Wash your hands and clean the area well with soap and water.
• Use tweezers to remove splinters of wood or fiberglass, small pieces of glass or other foreign objects.

If the object is completely embedded in your skin:

• Wash your hands and clean the area well with soap and water.
• Sterilize a clean, sharp needle by wiping it with rubbing alcohol. If rubbing alcohol isn’t available, clean the needle with soap and water.
• Use the needle to break the skin over the object and gently lift the tip of the object out.
• Use tweezers to remove the object. A magnifying glass may help you see the object better.
• Wash and pat-dry the area. Follow by applying antibiotic ointment.
• Seek medical help if the particle doesn’t come out easily or is close to your eye.
   

• First, deliver five back blows between the victim’s shoulder blades with the heel of your hand.
• Next, perform five abdominal thrusts (also known as the Heimlich maneuver).
• Alternate between five back blows and five abdominal thrusts until the blockage is dislodged.

If you’re the only rescuer, perform back blows and abdominal thrusts before calling 911 or your local emergency number for help. If another person is available, have that person call for help while you perform first aid.

To perform the Heimlich maneuver on someone else:

• Stand behind the person. Wrap your arms around the waist. Tip the person forward slightly.
• Make a fist with one hand. Position it slightly above the person’s navel.
• Grasp the fist with the other hand. Press hard into the abdomen with a quick, upward thrust — as if trying to lift the person up.
• Perform a total of five abdominal thrusts, if needed. If the blockage still isn’t dislodged, repeat the five-and-five cycle.

To perform the Heimlich maneuver on yourself:

• Place a fist slightly above your navel.
• Grasp your fist with the other hand and bend over a hard surface — a countertop or chair will do.
• Shove your fist inward and upward.
   

• A pointed object, which should be removed as quickly as possible to avoid further injury to the esophageal lining
• A tiny watch- or calculator-type button battery, which can rapidly cause local tissue injury and should be removed from the esophagus without delay

If a swallowed object blocks the airway, the American Red Cross recommends the "five-and-five" approach to first aid:

• First, deliver five back blows between the victim’s shoulder blades with the heel of your hand.
• Next, perform five abdominal thrusts (also known as the Heimlich maneuver).
• Alternate between five back blows and five abdominal thrusts until the blockage is dislodged.

Call 911 or your local emergency number for help.

To perform abdominal thrusts (the Heimlich maneuver) on someone else:

• Stand behind the person. Wrap your arms around the waist. Tip the person forward slightly.
• Make a fist with one hand. Position it slightly above the person’s navel.
• Grasp the fist with the other hand. Press hard into the abdomen with a quick, upward thrust — as if trying to lift the person up.
• Perform a total of five abdominal thrusts, if needed. If the blockage still isn’t dislodged, repeat the five-and-five cycle.

You can’t perform back blows on yourself. But you can perform abdominal thrusts.

To perform abdominal thrusts (the Heimlich maneuver) on yourself:

• Place a fist slightly above your navel.
• Grasp your fist with the other hand and bend over a hard surface — a countertop or chair will do.
• Shove your fist inward and upward.
   

• Develops suddenly and severely
• Accompanies a fever, stiff neck, rash, mental confusion, seizures, changes in vision, dizziness, weakness, loss of balance, numbness or difficulty speaking
• Is severe and follows a recent sore throat or respiratory infection
• Begins or worsens after a head injury, fall or bump
• Is a new pain, and you’re older than 50
• Is excruciating and affects just one, reddened eye
• Progressively worsens over the course of a single day, or persists for several days
   

• Severe head or facial bleeding
• Bleeding from the nose or ears
• Severe headache
• Change in level of consciousness for more than a few seconds
• Black-and-blue discoloration below the eyes or behind the ears
• Cessation of breathing
• Confusion
• Loss of balance
• Weakness or an inability to use an arm or leg
• Unequal pupil size
• Repeated vomiting
• Slurred speech
• Seizures

If severe head trauma occurs:

• Keep the person still. Until medical help arrives, keep the injured person lying down and quiet in a darkened room, with the head and shoulders slightly elevated. Don’t move the person unless necessary and avoid moving the person’s neck.
• Stop any bleeding. Apply firm pressure to the wound with sterile gauze or a clean cloth. But don’t apply direct pressure to the wound if you suspect a skull fracture.
• Watch for changes in breathing and alertness. If the person shows no signs of circulation (breathing, coughing or movement), begin CPR.
   

Among children and young adults, nosebleeds usually originate from the septum, just inside the nose. The septum separates your nasal chambers.

In middle-aged and older adults, nosebleeds can begin from the septum, but they may also begin deeper in the nose’s interior. This latter origin of nosebleed is much less common. It may be caused by hardened arteries or high blood pressure. These nosebleeds begin spontaneously and are often difficult to stop. They require a specialist’s help.

To take care of a nosebleed:

• Sit upright and lean forward. By remaining upright, you reduce blood pressure in the veins of your nose. This discourages further bleeding. Sitting forward will help you avoid swallowing blood, which can irritate your stomach.
• Pinch your nose. Use your thumb and index finger and breathe through your mouth. Continue to pinch for five to 10 minutes. This maneuver sends pressure to the bleeding point on the nasal septum and often stops the flow of blood.
• To prevent re-bleeding after bleeding has stopped, don’t pick or blow your nose and don’t bend down until several hours after the bleeding episode. Keep your head higher than the level of your heart.
• If re-bleeding occurs, blow out forcefully to clear your nose of blood clots and spray both sides of your nose with a decongestant nasal spray containing oxymetazoline (Afrin, Neo-Synephrine, others). Pinch your nose in the technique described above and call your doctor.

Seek medical care immediately if:

• The bleeding lasts for more than 20 minutes
• The nosebleed follows an accident, a fall or an injury to your head, including a punch in the face that may have broken your nose

For frequent nosebleeds
If you experience frequent nosebleeds, make an appointment with your doctor. You may need to have the blood vessel that’s causing your problem cauterized. Cautery is a technique in which the blood vessel is burned with electric current, silver nitrate or a laser. Sometimes your doctor may pack your nose with special gauze or an inflatable latex balloon to put pressure on the blood vessel and stop the bleeding.

Also call your doctor if you are experiencing nasal bleeding and are taking blood thinners, such as aspirin or warfarin (Coumadin). Your doctor may advise adjusting your medication intake.

Using supplemental oxygen administered with a nasal tube (cannula) may increase your risk of nosebleeds. Apply a water-based lubricant to your nostrils and increase the humidity in your home to help relieve nasal bleeding.
 

A stroke is a true emergency. Seek immediate medical assistance. The sooner treatment is given, the more likely it is that damage can be minimized. Every moment counts.

If you notice a sudden onset of one or more of the following signs or symptoms, call 911 or your local emergency number immediately:

• Sudden weakness or numbness in your face, arm or leg on one side of your body
• Sudden dimness, blurring or loss of vision, particularly in one eye
• Loss of speech or trouble talking or understanding speech
• Sudden, severe headache — a bolt out of the blue — with no apparent cause
• Unexplained dizziness, unsteadiness or a sudden fall, especially if accompanied by any of the other symptoms

Risk factors for stroke include having high blood pressure, having had a previous stroke, smoking, having diabetes and having heart disease. Your risk of stroke increases as you age.