First Aid Guide

S — Send for Help

• Call emergency services immediately or instruct a bystander to call
• Country-specific emergency numbers:
  • United States / Canada: 911
  • European Union: 112
  • United Kingdom: 999 (or 112)
  • Australia: 000
  • China: 120
  • Japan: 119
  • India: 112
  • Brazil: 192 (SAMU)
  • South Korea: 119
  • Mexico: 911
• Provide: location, number of casualties, nature of emergency, your name

A — Airway

• Open the airway using head-tilt, chin-lift maneuver
• Place one hand on the forehead and gently tilt the head back
• Lift the chin with two fingers under the bony part of the jaw
• Check for and remove any visible obstructions (do NOT do a blind finger sweep)
• If spinal injury is suspected, use jaw-thrust maneuver instead

B — Breathing

• Look, listen, and feel for normal breathing for up to 10 seconds
• Look: chest rise and fall
• Listen: breath sounds at nose and mouth
• Feel: air on your cheek
• Occasional gasps are NOT normal breathing (agonal breathing)

C — CPR

• If the person is not breathing normally, begin CPR immediately
• See Section 2 for detailed CPR instructions

D — Defibrillation

• Use an AED (Automated External Defibrillator) as soon as one is available
• Turn on the AED and follow voice prompts
• Attach pads to bare, dry chest as shown on pads
• Ensure no one is touching the person when analyzing or delivering shock
• Resume CPR immediately after shock delivery

2. CPR Instructions

Adult CPR (8+ years)

Compression-to-breath ratio: 30 compressions : 2 rescue breaths

Chest Compressions:

• Hand placement: heel of one hand on the center of the chest (lower half of the sternum), other hand on top, fingers interlocked
• Arms straight, shoulders directly over hands
• Depth: 5–6 cm (2–2.4 inches)
• Rate: 100–120 compressions per minute
• Allow full chest recoil between compressions — do NOT lean on the chest
• Minimize interruptions (pauses should be <10 seconds)

Rescue Breaths:

• Tilt head back, lift chin
• Pinch nose closed
• Create a seal over the mouth
• Give 2 breaths, each over 1 second
• Watch for chest rise
• If chest does not rise, reposition airway and try again

Hands-only CPR:

• If untrained or unwilling to give breaths, continuous chest compressions are still effective
• Push hard and fast in the center of the chest

Continue CPR until:

• Emergency services arrive and take over
• The person starts breathing normally
• An AED is ready to use
• You are physically exhausted and cannot continue

Child CPR (1–8 years)

• Use one or two hands for compressions (depending on child's size)
• Compression depth: approximately 5 cm (2 inches) — about one-third of chest depth
• Rate: 100–120 compressions per minute
• Ratio: 30:2 (single rescuer) or 15:2 (two rescuers)
• Give 2 initial rescue breaths before starting compressions if witnessed arrest
• Use less force than for adults

Infant CPR (under 1 year)

• Use two-finger technique: place two fingers on the sternum, just below the nipple line
• Compression depth: approximately 4 cm (1.5 inches) — about one-third of chest depth
• Rate: 100–120 compressions per minute
• Ratio: 30:2 (single rescuer) or 15:2 (two rescuers)
• Cover infant's mouth AND nose with your mouth for rescue breaths
• Use gentle puffs of air (do NOT use full breaths)
• Give 2 initial rescue breaths before starting compressions

3. Common First Aid Procedures

Burns

Degree Classification:

Treatment:

1. Remove the person from the source of the burn
2. Cool the burn under cool (not cold) running water for at least 20 minutes
3. Remove clothing and jewelry near the burn (unless stuck to skin)
4. Cover loosely with a clean, non-stick dressing or cling wrap
5. Keep the person warm (cool the burn, warm the patient)

Do NOT:

• Apply ice, butter, toothpaste, or any home remedies
• Break blisters
• Remove clothing stuck to the burn
• Use adhesive dressings directly on the burn

Seek Emergency Care When:

• 2nd degree burn larger than 3 inches (7.5 cm) or larger than the person's palm
• 3rd degree burn of any size
• Burns on face, hands, feet, genitals, or major joints
• Chemical or electrical burns
• Burns that encircle a limb
• Burns in children under 5 or adults over 60
• Inhalation injury suspected (singed nose hairs, soot around mouth, hoarse voice)

Bleeding Control

Minor Bleeding:

1. Wash hands or wear gloves
2. Rinse wound gently with clean water
3. Apply direct pressure with a clean cloth or gauze
4. Apply antibiotic ointment if available
5. Cover with a sterile bandage

Severe Bleeding:

1. Call emergency services immediately
2. Apply firm, direct pressure with a clean cloth — do NOT remove the cloth if it soaks through; add more layers on top
3. Elevate the injured area above the heart if possible
4. Keep the person lying down
5. Apply pressure to pressure points if direct pressure alone is insufficient

Tourniquet Use:

• Use ONLY when direct pressure fails to control life-threatening limb bleeding
• Place 2–3 inches (5–7 cm) above the wound, NOT on a joint
• Tighten until bleeding stops
• Note the time of application — write "TK" and time on the person's forehead or the tourniquet
• Do NOT remove once applied — leave for medical professionals
• A belt, tie, or strip of cloth can be improvised if no commercial tourniquet is available

Nosebleed:

• Sit upright and lean slightly forward (NOT backward)
• Pinch the soft part of the nose firmly
• Hold for 10–15 minutes without releasing
• Breathe through the mouth
• Apply ice to the bridge of the nose
• Seek medical help if bleeding persists beyond 20 minutes or follows a head injury

Choking

Conscious Adult or Child (over 1 year):

1. Ask: "Are you choking? Can you cough?"
2. If they can cough forcefully, encourage coughing
3. If they cannot cough, speak, or breathe:
   • Stand behind the person
   • Place the thumb side of your fist just above the navel, below the ribcage
   • Grasp your fist with your other hand
   • Perform quick, upward abdominal thrusts (Heimlich maneuver)
   • Repeat until the object is expelled or the person becomes unconscious

Conscious Infant (under 1 year):

1. Place infant face-down on your forearm, supporting the head
2. Give 5 firm back blows between the shoulder blades with the heel of your hand
3. Turn infant face-up, supporting the head
4. Give 5 chest thrusts using two fingers on the center of the chest, just below the nipple line
5. Repeat cycle of 5 back blows and 5 chest thrusts until object is expelled or infant becomes unconscious

Unconscious Choking (any age):

1. Call emergency services
2. Begin CPR — 30 compressions, then check the mouth for visible objects before giving breaths
3. If you see an object, remove it carefully
4. Do NOT do a blind finger sweep
5. Attempt rescue breaths; if air does not go in, reposition and try again
6. Continue CPR until help arrives

Fractures & Sprains

RICE Protocol (for sprains and minor injuries):

• Rest: Stop using the injured area
• Ice: Apply ice wrapped in cloth for 20 minutes on, 20 minutes off
• Compression: Wrap with elastic bandage (not too tight — check circulation)
• Elevation: Raise above heart level when possible

Suspecting a Fracture vs. Sprain:

Splinting Basics:

1. Immobilize the joint above and below the suspected fracture
2. Use rigid material (board, rolled magazine, stick) padded with soft cloth
3. Secure with bandages, tape, or strips of cloth
4. Check circulation beyond the splint (pulse, color, sensation, movement)
5. Do NOT attempt to straighten or realign the bone

Do NOT:

• Try to push a bone back into place
• Move the person unnecessarily if spinal injury is suspected
• Remove embedded objects
• Apply heat in the first 48 hours

Poisoning

Immediate Actions:

1. Call poison control immediately:
   • US: 1-800-222-1222
   • UK: 111
   • Australia: 13 11 26
   • EU: Check national poison center number
2. Do NOT induce vomiting unless specifically directed by poison control
3. Do NOT give anything by mouth unless directed

Information to Provide:

• Person's age and weight
• Substance name and amount (bring the container if possible)
• Time of exposure
• Symptoms present
• Route of exposure (swallowed, inhaled, skin contact, eye contact)

Common Household Poisons:

• Cleaning products (bleach, ammonia, drain cleaners)
• Medications (acetaminophen/paracetamol, iron supplements, opioids)
• Pesticides and herbicides
• Carbon monoxide
• Plants (oleander, foxglove, certain mushrooms)
• Batteries (button/coin cell — especially dangerous for children)
• Essential oils (in concentrated form)
• Alcohol (especially in children)

If Inhaled:

• Move to fresh air immediately
• Call emergency services
• Begin CPR if not breathing

If on Skin/Eyes:

• Remove contaminated clothing
• Flush skin or eyes with clean water for at least 15–20 minutes

Allergic Reaction / Anaphylaxis

Signs of Anaphylaxis:

• Swelling of face, lips, tongue, throat
• Difficulty breathing, wheezing
• Rapid or weak pulse
• Skin rash, hives, flushing
• Nausea, vomiting, diarrhea
• Dizziness or fainting
• Sense of doom

Treatment:

1. Call emergency services immediately
2. Use an epinephrine auto-injector (EpiPen or equivalent) if available:
   • Remove safety cap
   • Inject into the outer mid-thigh — can be given through clothing
   • Hold in place for 10 seconds (or per device instructions)
   • Note the time of injection
   • A second dose may be given after 5–15 minutes if no improvement
3. Position the person:
   • Breathing difficulty: sit them upright
   • Feeling faint/dizzy: lie them down, elevate legs
   • Vomiting: place in recovery position
4. ALWAYS call emergency services even after using epinephrine — symptoms can return (biphasic reaction)

Do NOT:

• Leave the person alone
• Have them stand or walk
• Give oral antihistamines as a substitute for epinephrine in severe reactions

Heat-Related Illness

Heat Exhaustion:

• Symptoms: heavy sweating, weakness, cold/pale/clammy skin, fast weak pulse, nausea, fainting
• Treatment:
  • Move to a cool place
  • Lie down, loosen clothing
  • Apply cool, wet cloths or fan
  • Sip cool water slowly
  • If vomiting, seek medical attention

Heat Stroke (MEDICAL EMERGENCY):

• Symptoms: body temperature >40°C (104°F), hot/red/dry or damp skin, rapid strong pulse, confusion, loss of consciousness
• Treatment:
  1. Call emergency services immediately
  2. Move to a cooler environment
  3. Cool rapidly: immerse in cold water if possible, or apply ice packs to neck, armpits, groin
  4. Do NOT give fluids if unconscious
  5. Monitor breathing and be prepared to start CPR

Hypothermia

Mild Hypothermia (32–35°C / 90–95°F):

• Symptoms: shivering, cold pale skin, slurred speech, confusion, clumsiness
• Treatment:
  • Move to a warm, dry shelter
  • Remove wet clothing
  • Wrap in warm blankets, focusing on the core (trunk, head, neck)
  • Give warm (not hot) drinks if conscious — no alcohol or caffeine
  • Apply warm compresses to center of body (chest, neck, groin)
  • Keep the person awake

Severe Hypothermia (below 32°C / 90°F):

• Symptoms: shivering may stop, very drowsy or unconscious, weak pulse, slow breathing
• Treatment:
  1. Call emergency services immediately
  2. Handle very gently — rough handling can cause cardiac arrest
  3. Do NOT rub or massage limbs
  4. Do NOT use direct heat (hot water, heating pads)
  5. Rewarm gradually — insulate from the ground, cover with blankets
  6. Monitor breathing — be prepared to start CPR
  7. Do NOT give food or drink if unconscious

Seizures

During a Seizure:

1. Stay calm and time the seizure
2. Clear the area of hard or sharp objects
3. Place something soft under the head
4. Loosen tight clothing around the neck
5. Do NOT restrain the person or hold them down
6. Do NOT put anything in their mouth
7. Do NOT give food, drink, or medication during the seizure

After the Seizure:

1. Place in the recovery position (see Section 6)
2. Stay with them until fully conscious and alert
3. Speak calmly and reassuringly
4. Check for injuries

Call Emergency Services If:

• Seizure lasts more than 5 minutes
• Person does not regain consciousness
• Another seizure follows quickly
• Person is injured
• Person is pregnant or has diabetes
• This is their first seizure
• Seizure occurs in water

Insect Stings and Bites

Bee/Wasp Stings:

1. Remove the stinger by scraping sideways with a flat edge (credit card, fingernail)
   • Do NOT squeeze or use tweezers on the stinger (can release more venom)
2. Wash the area with soap and water
3. Apply a cold pack to reduce swelling (20 minutes on, 20 minutes off)
4. Take an oral antihistamine if available for itching/swelling
5. Monitor for signs of anaphylaxis for at least 30 minutes

Tick Bites:

1. Use fine-tipped tweezers, grasp the tick as close to the skin as possible
2. Pull upward with steady, even pressure — do NOT twist or jerk
3. Clean the area with antiseptic
4. Save the tick in a sealed container (for identification if illness develops)
5. Watch for rash or flu-like symptoms over the next few weeks

Spider Bites:

• Clean with soap and water, apply ice
• Seek medical attention if: severe pain, abdominal cramping, growing wound, difficulty breathing
• Try to identify or photograph the spider if safe to do so

4. Emergency Kit Checklist

Essential Items for Home/Travel First Aid Kit:

Additional Items for Travel/Outdoor Kits:

• Tourniquet (commercial, e.g., CAT)
• Hemostatic gauze
• Oral rehydration salts
• Insect repellent and sting relief
• Sunscreen
• Blister treatment (moleskin)
• SAM splint (moldable)

Maintenance:

• Check kit every 6 months
• Replace expired medications
• Restock used items immediately
• Keep kit in an accessible, known location

5. Emergency Numbers Reference

Note: 112 works on GSM mobile phones in most countries worldwide, even without a SIM card.

6. Recovery Position

Use for an unconscious person who IS breathing normally.

Step-by-Step Instructions:

1. Kneel beside the person, ensure legs are straight
2. Place the arm nearest to you at a right angle to the body, palm facing up
3. Bring the far arm across the chest and hold the back of their hand against the cheek nearest to you
4. With your other hand, grasp the far knee and pull it up so the foot is flat on the ground
5. Keeping their hand against their cheek, pull on the far knee to roll the person toward you onto their side
6. Adjust the top leg so the hip and knee are bent at right angles
7. Tilt the head back gently to keep the airway open
8. Ensure the hand under the cheek keeps the head tilted
9. Check that the person cannot roll forward or backward
10. Monitor breathing continuously until help arrives

Do NOT use if:

• Spinal injury is suspected (keep them still unless airway is compromised)
• Major injury to the side you would roll them onto

Output Format

When responding to first aid queries, use the following formats as appropriate:

Step-by-Step Emergency Guide

For acute emergencies, provide:

1. Immediate action (bold, first line)
2. Numbered steps in order of priority
3. Clear "Call emergency services" instruction with relevant number
4. "Do NOT" warnings in a distinct section
5. "Seek emergency care if" criteria

Quick Reference Card

For general inquiries, provide a condensed summary:

• Condition name
• Key signs/symptoms (bulleted)
• Critical first steps (numbered, max 5)
• When to call for help

Data Persistence

Store user-specific first aid references at: items/first-aid-reference.md

This file can include:

• User's country and local emergency numbers
• Known allergies or medical conditions of household members
• Location of home first aid kit
• Personal emergency contacts
• Specific medication information (e.g., EpiPen location)
• Custom notes from the user

Alerts and Safety

ALWAYS CALL EMERGENCY SERVICES FOR SERIOUS INJURIES

• This guide supplements but does NOT replace formal first aid training. Consider taking a certified course from organizations like the Red Cross, St John Ambulance, or your local equivalent.
• Time-critical emergencies: Call emergency services FIRST, then follow the steps in this guide.
• When in doubt, seek professional medical help. It is always better to call and not need help than to not call and need it.
• Do NOT move a person with suspected spinal injury unless they are in immediate danger.
• Always use personal protective equipment (gloves) when dealing with blood or bodily fluids.
• This guide provides general information only. Treatment may vary based on the person's age, medical history, and specific circumstances.

MEDICAL DISCLAIMER: The information in this skill is provided for educational and informational purposes only. It is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions regarding a medical condition or emergency.