In Time Of Emergency by Department of Defense
D >>
Department of Defense >> In Time Of Emergency
4. _Don't move the patient immediately_. Unless there is real danger of
the patient receiving further injury where he is, he should not be moved
until breathing is restored, bleeding is stopped, and suspected broken
bones are splinted.
5. _Keep calm, and reassure the patient._ Keep him lying down and
comfortably warm, but do not apply heat to his body, or make him sweat.
6. _Never attempt to give liquids to an unconscious person_. If he is
not able to swallow, he may choke to death or drown. Also, don't give
him any liquids to drink if he has an abdominal injury.
IF THE PATIENT HAS STOPPED BREATHING
Quick action is required. You must get air into his lungs again
immediately or he may die. The best and simplest way of doing this is to
use mouth-to-mouth artificial respiration. Here is how to do it:
1. Place the patient on his back. Loosen his collar.
2. Open his mouth and use your fingers to remove any food or foreign
matter. If he has false teeth or removable dental bridges, take them
out.
3. Tilt the patient's head back so that his chin points upward. Lift his
lower jaw from beneath and behind so that it juts out. This will move
his tongue away from the back of his throat, so it does not block the
air passage to his lungs. Placing a pillow or something else under his
shoulders will help get his head into the right position. Some patients
will start breathing as soon as you take these steps, and no further
help is necessary.
4. Open your mouth as wide as possible, and place it tightly over the
patient's mouth, so his mouth is completely covered by yours. With one
hand, pinch his nostrils shut. With your other hand, hold his lower jaw
in a thrust-forward position and keep his head tilted back. With a baby
or small child, place your mouth over both his nose and mouth, making a
tight seal.
5. Blow a good lungful of air into an adult patient's mouth, continuing
to keep his head tilted back and his jaw jutting out so that the air
passage is kept open. (Air can be blown through an unconscious person's
teeth, even though they may be clenched tightly together.) Watch his
chest as you blow. When you see his chest rise, you will know that you
are getting air into his lungs.
6. Remove your mouth from the patient's mouth, and listen for him to
breathe out the air you breathed into him. You also may feel his breath
on your cheek and see his chest sink as he exhales.
7. Continue your breathing for the patient. If he is an adult, blow a
good breath into his mouth every 5 seconds, or 12 times a minute, and
listen for him to breathe it back out again. _Caution_: If the patient
is an infant or small child, blow _small puffs_ of air into him about 20
times a minute. You may rupture his lung if you blow in too much air at
one time. Watch his chest rise to make sure you are giving him the right
amount of air with each puff.
8. If you are _not_ getting air into the patient's lungs, or if he is
not breathing out the air you blew into him, first make sure that his
head is tilted back and his jaw is jutting out in the proper position.
Then use your fingers to make sure nothing in his mouth or throat is
obstructing the air passage to his lungs. If this does not help, turn
him on his side and strike him sharply with the palm of your hand
several times between his shoulder blades. This should dislodge any
obstruction in the air passage. Then place him again on his back, with
his head tilted back and his jaw jutting out, and resume blowing air
into his mouth. If this doesn't work, try closing his mouth and blowing
air through his nose into his lungs.
9. If you wish to avoid placing your mouth directly on the patient's
face, you may hold a cloth (handkerchief, gauze or other porous
material) over his mouth and breathe through the cloth. But don't waste
precious time looking for a cloth if you don't have one.
10. _Important_: Even if the patient does not respond, continue your
efforts for 1 hour or longer, or until you are completely sure he is
dead. If possible, have this confirmed by at least one other person.
TO STOP SERIOUS BLEEDING
1. Apply firm, even pressure to the wound with a dressing, clean cloth,
or sanitary napkin. If you don't have any of these, use your bare hand
until you can get something better. Remember, you must keep blood from
running out of the patient's body. Loss of 1 or 2 quarts will seriously
endanger his life.
2. Hold the dressing in place with your hand until you can bandage the
dressing in place. In case of an arm or leg wound, make sure the bandage
is not so tight as to cut off circulation; and raise the arm or leg
above the level of the patient's heart. (But if the arm or leg appears
broken, be sure to splint it first.)
3. Treat the patient for shock (see page 62).
4. If blood soaks through the dressing, do _not_ remove the dressing.
Apply more dressings.
5. SPECIAL ADVICE ON TOURNIQUETS: Never use a tourniquet unless you
cannot stop excessive, life-threatening bleeding by any other method.
Using a tourniquet increases the chances that the arm or leg will have
to be amputated later. If you are _forced_ to use a tourniquet to keep
the patient from bleeding to death (for example, when a hand or foot has
been accidentally cut off), follow these instructions carefully:
--Place the tourniquet _as close to the wound as possible_, between the
wound and the patient's heart.
--After the tourniquet has been applied, do not permit it to be loosened
(even temporarily, or even though the bleeding has stopped) by anyone
except a physician, who can control the bleeding by other methods and
replace the blood that the patient has lost.
--Get a physician to treat the patient as soon as possible.
PREVENTING AND TREATING SHOCK
Being "in shock" means that a person's circulatory system is not working
properly, and not enough blood is getting to the vital centers of his
brain and spinal cord.
These are the symptoms of shock: The patient's pulse is weak or rapid,
or he may have no pulse that you can find. His skin may be pale or blue,
cold, or moist. His breathing may be shallow or irregular. He may have
chills. He may be thirsty. He may get sick at his stomach and vomit.
A person can be "in shock" whether he is conscious or unconscious.
_Important: All seriously-injured persons should be treated for shock,
even though they appear normal and alert_. Shock may cause death if not
treated promptly, even though the injuries which brought on shock might
not be serious enough to cause death. In fact, persons may go into shock
without having any physical injuries.
Here is how to treat any person who may be in shock:
1. Keep him lying down and keep him from chilling, but do _not_ apply a
hot water bottle or other heat to his body. Also, loosen his clothing.
2. Keep his head a little lower than his legs and hips. But if he has a
head or chest injury, or has difficulty in breathing, keep his head and
shoulders slightly higher than the rest of his body.
3. Encourage him to drink fluids if he is conscious and not nauseated,
and if he does not have abdominal injuries. Every 15 minutes give him a
half-glass of this solution until he no longer wants it: One teaspoonful
of salt and a half-teaspoonful of baking soda to one quart of water.
4. Do _not_ give him alcohol.
BROKEN BONES
Any break in a bone is called a fracture. If you think a person may have
a fracture, treat it as though it were one. Otherwise, you may cause
further injury. For example, if an arm or leg is injured and bleeding,
splint it as well as bandage it.
With any fracture, first look for bleeding and control it. Keep the
patient comfortably warm and quiet, preferably lying down. If you have
an ice bag, apply it to the fracture to ease the pain. Do not move the
patient (unless his life is in danger where he is) without first
applying a splint or otherwise immobilizing the bone that may be
fractured. Treat the patient for shock.
A FRACTURED ARM OR LEG should be straightened out as much as possible,
preferably by having 2 persons gently stretch it into a normal position.
Then it should be "splinted"--that is, fastened to a board or something
else to prevent motion and keep the ends of the broken bone together. As
a splint, use a board, a trimmed branch from a tree, a broomstick, an
umbrella, a roll of newspapers, or anything else rigid enough to keep
the arm or leg straight. Fasten the arm or leg to the splint with
bandages, strips of cloth, handkerchiefs, neckties, or belts. After
splinting, keep the injured arm or leg a little higher than the rest of
the patient's body. From time to time, make sure that the splint is not
too tight, since the arm or leg may swell, and the blood circulation
might be shut off. If the broken bone is sticking out through the skin
but the exposed part of it is clean, allow it to slip back naturally
under the skin (but don't push it in) when the limb is being
straightened. However, if the exposed part of the bone is dirty, cover
it with a clean cloth and bandage the wound to stop the bleeding. Then
splint the arm or leg without trying to straighten it out, and try to
find a doctor or nurse to treat the patient.
A FRACTURED COLLAR-BONE should also be prevented from moving, until the
patient can get professional medical attention. It can be immobilized by
placing the arm on that side in a sling and then binding the arm close
to the body.
A FRACTURED RIB should be suspected if the patient has received a chest
injury or if he has pain when he moves his chest, breathes, or coughs.
Strap the injured side of his chest with 2-inch adhesive tape if
available, or with a cloth bandage or towel wrapped around and around
his entire chest.
Fractured bones in the NECK OR BACK are very serious, because they may
injure the patient's spinal cord and paralyze him or even kill him. He
should not be moved until a doctor comes (or a person trained in first
aid), unless it is absolutely necessary to move him to prevent further
injury. If a person with a back injury has to be moved, he should be
placed gently on his back on a stiff board, door or stretcher. His head,
back, and legs should be kept in a straight line at all times.
A person with a neck injury should be moved gently with his head, neck,
and shoulders kept in the same position they were when he was found. His
neck should not be allowed to bend when he is being moved.
BURNS
Non-serious or superficial (first degree) burns should not be
covered--in fact, nothing need be done for them. However, if a first
degree burn covers a large area of the body, the patient should be given
fluids to drink as mentioned in item 2 following.
The most important things to do about serious (second or third degree)
burns are: _(a)_ Treat the patient for shock, _(b)_ Prevent infection,
and _(c)_ Relieve pain. These specific actions should be taken:
1. Keep the patient lying down, with his head a little lower than his
legs and hips unless he has a head or chest wound, or has difficulty in
breathing.
2. Have him drink a half-glass every 15 minutes of a salt-and-soda
solution (one teaspoonful of salt and a half-teaspoonful of baking soda
to a quart of water). Give him additional plain water to drink if he
wants it.
3. Cover the burned area with a _dry_, sterile gauze dressing. If gauze
is not available, use a clean cloth, towel or pad.
4. With soap and water, wash the area _around_ the burn (not the burn
itself) for a distance of several inches, wiping _away_ from the burn.
The dressing will help prevent surface washings from getting into the
burned area.
5. Use a bandage to hold the dry dressing firmly in place against the
burned area. This will keep moving air from reaching the burn, and will
lessen the pain. Leave dressings and bandage in place as long as
possible.
6. If adjoining surfaces of skin are burned, separate them with gauze or
cloth to keep them from sticking together (such as between toes or
fingers, ears and head, arms and chest).
7. If the burn was caused by a chemical--or by fallout particles
sticking to the skin or hair--wash the chemical or the fallout particles
away with generous amounts of plain water, then treat the burn as
described above.
_What NOT to do about burns_:
--Don't pull clothing over the burned area (cut it away, if necessary).
--Don't try to remove any pieces of cloth, or bits of dirt or debris,
that may be sticking to the burn.
--Don't try to clean the burn; don't use iodine or other antiseptics on
it; and don't open any blisters that may form on it.
--Don't use grease, butter, ointment, salve, petroleum jelly, or any
type of medication on severe burns. Keeping them dry is best.
--Don't breathe on a burn, and don't touch it with anything except a
sterile or clean dressing.
--Don't change the dressings that were initially applied to the burn,
until absolutely necessary. Dressings may be left in place for a week,
if necessary.
RADIATION SICKNESS
Radiation sickness is caused by the invisible rays given off by
particles of radioactive fallout. If a person has received a large dose
of radiation in a short period of time--generally, less than a week--he
will become seriously ill and probably will die. But if he has received
only a small or medium dose, his body will repair itself and he will get
well. No special clothing can protect a person from gamma radiation, and
no special medicines can protect him or cure him of radiation sickness.
Symptoms of radiation sickness may not be noticed for several days. The
early symptoms are lack of appetite, nausea, vomiting, fatigue, weakness
and headache. Later, the patient may have sore mouth, loss of hair,
bleeding gums, bleeding under the skin, and diarrhea. But these same
symptoms can be caused by other diseases, and not everyone who has
radiation sickness shows all these symptoms, or shows them all at once.
If the patient has headache or general discomfort, give him one or two
aspirin tablets every 3 or 4 hours (half a tablet, for a child under
12). If he is nauseous, give him "motion sickness tablets," if
available. If his mouth is sore or his gums are bleeding, have him use a
mouth wash made up of a half-teaspoonful of salt to 1 quart of water. If
there is vomiting or diarrhea, he should drink slowly several glasses
each day of a salt-and-soda solution (one teaspoonful of salt and
one-half teaspoonful of baking soda to 1 quart of cool water), plus
bouillon or fruit juices. If available, a mixture of kaolin and pectin
should be given for diarrhea. Whatever his symptoms, the patient should
be kept lying down, comfortably warm, and resting.
Remember that radiation sickness is _not_ contagious or infectious, and
one person cannot "catch it" from another person.
* * * * *
PART TWO
MAJOR NATURAL DISASTERS
Many of the actions recommended in Part I of this handbook to help you
prepare for and live through a nuclear attack--such as learning the
warning signals, stocking emergency supplies, taking a course in
emergency skills, and knowing how to fight fires at home--also would
help you in case a major natural disaster occurs in your area. If you
are prepared for nuclear attack, you are also prepared to cope with most
peacetime disasters--disasters that kill hundreds of Americans every
year, injure thousands, inflict widespread suffering and hardship, and
cause great economic loss.
Part II of this handbook (pages 69-86) is intended to help you prepare
for those natural disasters that may occur in your area, and tell you
the right actions to take if they occur. Chapter 1 (pages 71-74) gives
general guidance applicable to various types of natural disasters.
Succeeding chapters give special advice on floods, hurricanes,
tornadoes, winter storms, and earthquakes.
* * * * *
CHAPTER 1
GENERAL GUIDANCE
There are certain things you can learn and do that will help you get
ready for, and cope with, almost any type of natural disaster.
Perhaps the most basic thing to remember is to _keep calm_. This may
mean the difference between life and death. In many disasters, people
have been killed or injured needlessly because they took thoughtless
actions when they should have done something else--or done nothing at
all just then.
In a time of emergency, taking proper action may save your life. _Take
time to think_, and then take the considered action that the situation
calls for. Usually, this will be the action you have planned in advance,
or the action you are instructed to take by responsible authorities.
Here is other guidance that applies to most types of natural disasters.
WARNING
LEARN YOUR COMMUNITY'S WARNING SIGNALS. In most communities having
outdoor warning systems, the Attack Warning Signal is a wavering sound
on the sirens, or a series of short blasts on whistles, horns, or other
devices. This signal will be used only to warn of an attack against the
United States.
Many communities also are using an _Attention or Alert Signal_, usually
a 3- to 5-minute _steady blast_ to get the attention of their people in
a time of threatened or impending peacetime emergency. In most places,
the Attention or Alert Signal means that people should turn on their
radio or television sets to hear important emergency information being
broadcast.
You should find out now, before any emergency occurs, what warning
signals are being used in your community, what they sound like, what
they mean, and what actions you should take when you hear them.
Also, whenever a major storm or other peacetime disaster threatens, keep
your radio or television set turned on to hear Weather Bureau reports
and forecasts (issued by the Environmental Science Services
Administration of the U.S. Department of Commerce), as well as other
information and advice that may be broadcast by your local government.
When you are warned of an emergency, get your information on the radio
or television. Use your telephone only to _report_ important events
(such as fires, flash floods, or tornado sightings) to the local
authorities. If you tie up the telephone lines simply to get
information, you may prevent emergency calls from being completed.
EMERGENCY SUPPLIES
A major disaster of almost any kind may interfere with your normal
supplies of water, food, heat, and other day-to-day necessities. You
should keep on hand, in or around your home, a stock of emergency
supplies sufficient to meet your needs for a few days or preferably for
a week.
If you stayed at home during the disaster, these supplies would help you
live through the period of emergency without hardship. If you had to
evacuate your home and move temporarily to another location, your
emergency supplies could be taken with you and used en route or after
you arrived at the new location (where regular supplies might not be
available). Even if you only had to move to an emergency shelter station
set up by a local agency, these supplies might be helpful to you, or
make your stay easier.
The most important items to keep on hand are water (preferably in
plastic jugs or other stoppered containers); canned or sealed-package
foods that do not require refrigeration or heat for cooking; medicines
needed by family members, and a first aid kit; blankets or sleeping
bags; flashlights or lanterns; a battery-powered radio; and perhaps a
covered container to use as an emergency toilet. In addition, an
automobile in good operating condition with an ample supply of gasoline
may be necessary in case you have to leave your home.
In those parts of the country subject to hurricanes or floods, it is
also wise to keep on hand certain emergency materials you may need to
protect your home from wind and water--such as plywood sheeting or
lumber to board up your windows and doors, and plastic sheeting or
tarpaulins to protect furniture and appliances.
FIRE PROTECTION AND FIRE FIGHTING
Fires are a special hazard in a time of disaster. They may start more
readily, and the help of the fire department may not be available
quickly. Therefore, it is essential that you:
1. Follow the fire prevention rules given on page 52, and be especially
careful not to start fires.
2. Know how to put out small fires yourself. (See pages 52-54.)
3. Have on hand simple tools and equipment needed for fire fighting.
(See page 43.)
AFTER A NATURAL DISASTER
_Use extreme caution in entering or working in buildings_ that may have
been damaged or weakened by the disaster, as they may collapse without
warning. Also, there may be gas leaks or electrical short circuits.
_Don't bring lanterns, torches or lighted cigarettes_ into buildings
that have been flooded or otherwise damaged by a natural disaster, since
there may be leaking gas lines or flammable material present.
_Stay away from fallen or damaged electric wires_, which may still be
dangerous.
_Check for leaking gas pipes in your home_. Do this by _smell only_--
don't use matches or candles. If you smell gas, do this: (1) Open all
windows and doors, (2) Turn off the main gas valve at the meter, (3)
Leave the house immediately, (4) Notify the gas company or the police or
fire department, (5) Don't re-enter the house until you are told it is
safe to do so.
_If any of your electrical appliances are wet_, first turn off the main
power switch in your house, then unplug the wet appliance, dry it out,
reconnect it, and finally, turn on the main power switch. (Caution:
Don't do any of these things while _you_ are wet or standing in water.)
If fuses blow when the electric power is restored, turn off the main
power switch again and then inspect for short circuits in your home
wiring, appliances and equipment.
_Check your food and water supplies before using them_. Foods that
require refrigeration may be spoiled if electric power has been off for
some time. Also, don't eat food that has come in contact with flood
waters. Be sure to follow the instructions of local authorities
concerning the use of food and water supplies.
_If needed, get food, clothing, medical care or shelter_ at Red Cross
stations or from local government authorities.
_Stay away from disaster areas_. Sightseeing could interfere with first
aid or rescue work, and may be dangerous as well.
_Don't drive unless necessary_, and drive with caution. Watch for
hazards to yourself and others, and report them to local authorities.
_Write, telegraph or telephone your relatives_, after the emergency is
over, so they will know you are safe. Otherwise local authorities may
waste time locating you--or if you have evacuated to a safer location,
they may not be able to find you. (However, do not tie up the phone
lines if they are still needed for official emergency calls.)
_Do not pass on rumors_ or exaggerated reports of damage.
_Follow the advice and instructions of your local government_ on ways to
help yourself and your community recover from the emergency.
* * * * *
CHAPTER 2
FLOODS AND HURRICANES
In addition to the general guidance in Chapter 1 of this section, there
are certain emergency actions particularly associated with major floods,
hurricanes, and storm tides or surges. These types of disasters usually
are preceded by extended periods of warning. People living in areas
likely to be most severely affected often are warned to move to safer
locations.
EVACUATION
If you are warned to evacuate your home and move to another location
temporarily, there are certain things to remember and do. Here are the
most important ones:
* FOLLOW THE INSTRUCTIONS AND ADVICE OF YOUR LOCAL GOVERNMENT. If you
are told to evacuate, do so promptly. If you are instructed to move to a
certain location, go there--don't go anywhere else. If certain travel
routes are specified or recommended, use those routes rather than trying
to find short cuts of your own. (It will help if you have previously
become familiar with the routes likely to be used.) If you are told to
shut off your water, gas or electric service before leaving home, do so.
Also find out on the radio where emergency housing and mass feeding
stations are located, in case you need to use them.
* SECURE YOUR HOME BEFORE LEAVING. If you have time, and if you have not
received other instructions from your local government, you should take
the following actions before leaving your home:
--Bring outside possessions inside the house, or tie them down securely.
This includes outdoor furniture, garbage cans, garden tools, signs, and
other movable objects that might be blown or washed away.
--Board up your windows so they won't be broken by high winds, water,
flying objects or debris.
--If flooding is likely, move furniture and other movable objects to the
upper floor of your house. Disconnect any electrical appliances or
equipment that cannot be moved--but don't touch them if you are wet or
are standing in water.
--Do _not_ stack sandbags around the outside walls of your house to keep
flood waters out of your basement. Water seeping downward through the
earth (either beyond the sandbags or over them) may collect around the
basement walls and under the floor, creating pressure that could damage
the walls or else raise the entire basement and cause it to "float" out
of the ground. In most cases it is better to permit the flood waters to
flow freely into the basement (or flood the basement yourself with clean
water, if you feel sure it will be flooded anyway). This will equalize
the water pressure on the inside and outside of the basement walls and
floor, and thus avoid structural damage to the foundation and the house.