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Shell Answer Book

 

Shell Answer Series #8 - 1992 By Fred Windisch, Health and Safety Specialist, Shell Oil Company

 

The information in this booklet could be a lifesaver - but it's only a beginning. To learn more, call your local chapter of the American Red Cross and enroll in a first-aid course. Although it will cost a few hours and a few dollars, the skills you'll learn are invaluable.


Q. I'm the first to arrive at a bad accident. What should I do? Q. How do I control severe bleeding?
Q. Do I have to stop? Q. Should I use my belt for a tourniquet?
Q. I'm no doctor. How can I help? Q. What are the symptoms of shock?
Q. Somebody's hurt! Do I move him? Q. What are the symptoms of shock?
Q. What's in a first-aid kit? Q. Can first aid give me AIDS?
Q. I don't think this person is breathing. What now?

 

Q.  I'm the first to arrive at a bad accident. What should I do?
A. Don't make things worse. Avoid another collision by pulling up well beyond the accident. Turn on your emergency flashers. And make sure it's safe to approach the scene: look for things such as downed power lines and spilled gasoline. 

If you can do so safely, turn off the ignitions in the wrecked cars to reduce the chance of fire. Check to see who's injured. But don't move the victims unless they're in immediate danger.

Get help. In many cases, the best thing you can do is call or send for medical help. If you're too busy administering first aid, assign someone else and be specific: "You in the blue shirt, please call 9-1-1." In many parts of the country, 9-1-1 is all you need to dial for emergency medical service. If that doesn't work, call the operator.  

Be ready to describe the location of the accident, including cross streets if possible. Explain what happened and how many people need help. Is anyone bleeding severely, unable to breathe, or without a pulse? What first aid is being given? Pen and paper are invaluable should you need to take down instructions. And don't be the first one to hang up! Make sure that you've answered all the emergency dispatcher's questions. 

Carry at least four or five flares (or reflective triangles) in your car and know how to use them. First, make sure there is no spilled gasoline. Then place the flares behind the accident, about 15-20 paces apart. Angle them toward the side of the road to form a safety zone behind the accident. This will guide approaching traffic around the wreck. 

 
Q.  Do I have to stop?
A. If you're involved in the accident, yes. All states impose severe penalties on drivers who don't stop. And remember that you can be "involved" in an accident even if your car never comes into contact with anything. You're involved if you contribute in any way to a crash. 

Whatever the situation, stopping could save a life. And you should be aware that most states have laws to protect citizens from being held liable for damages when they stop and, in good faith, try to help an injured person. The scope of protection does vary, so know your state's laws. 

 
Q.  I'm no doctor. How can I help?
A. By remembering your ABCs: Airway, Breathing and Circulation. They help you check for life-threatening conditions.  

Open the Airway. With one hand flat on the forehead and two fingers of the other hand placed under the bony part of the chin, tilt the head back and lift the jaw. (Don't do this if you believe there might be a spinal injury*) For small children, slightly tilt the head so you don't close off the airway. 

Check Breathing. With your cheek next to the victim's mouth, look for the chest to rise and fall; listen for breathing; and feel for air coming out of the mouth and nose. 

* A spinal injury might occur in high-impact accidents, such as a motor vehicle collision or a fall.  

Airway Tilt the head back and lift the jaw. 

Breathing Look, listen and feel for about 5 seconds. 

Circulation The carotid artery is a good checkpoint for pulse. 

Check Circulation. A pulse means that the heart is beating. To find the pulse, place two fingers alongside the Adam's apple and press down, gradually and firmly. Feel for at least five seconds. 

 
Q.  Somebody's hurt! Do I move him?
A. It all depends. A good rule of thumb is, don't move the victim unless absolutely necessary. Many car accidents inflict neck or spine injuries, and movement could make things worse. Never move the victim unless there is some immediate danger and you can do so without endangering yourself. 

If you must move the victim, avoid bending and twisting the neck, body or limbs. For example, if you find a victim lying with legs crossed, move him with legs crossed. The sharp edges of broken bones can cause internal damage if they move around. Dragging is better than trying to lift by yourself, as long as you grasp the victim by the clothes above the shoulders or by the ankles. Never pull the person sideways. 

 
Q.  What's in a first-aid kit?
A. Change for pay phone. Chemical cold packs (great to help control swelling). Sterile bandages and gauze pads. Gauze roller bandages, for holding dressings in place and , _ wrapping wounds. Large box of assorted adhesive bandages. Roll of adhesive tape. Scissors. Safety pins. Blanket. Double-bed-size sheet, which to make bandages, slings, etc. Cleansing wipes and alcohol swabs Two pairs of latex gloves. 
 
Q.  I don't think this person is breathing. What now?
A. If the victim is not breathing but does have a pulse, immediately begin rescue breathing (artificial respiration) Don't wait! Someone who has stopped breathing can die in minutes. 

1) To make sure the airway is open, gently tilt the head back in the manner already described (see "Check Airway" ). Again, don't do this if you believe there might be a spinal injury. 

2) With your thumb and index finger, pinch the victim's nose shut. Open your mouth wide, take a deep breath, and put your mouth tightly over the victim's mouth. Blow two full breaths, pausing between the two to take a breath yourself. Watch for the chest to rise and fall. 

3) If the victim does not start breathing on his or her own, blow one full breath every five seconds. 

4) Between breaths, turn your head toward the victim's chest. Listen for air being exhaled. Watch for the victim's chest to fall. Then blow again - every five seconds. 

CPR (cardiopulmonary resuscitation) is used when the heart has stopped. It's a combination of rescue breathing and chest compressions to keep blood circulating, and it's taught in most first aid courses. 

 
Q.  How do I control severe bleeding?
A. Press firmly against the wound with some kind of dressing, such as a thick pad of cloth. This will help absorb the blood and allow it to clot. If possible, use a barrier between you, and the victim's blood (several dressings, latex gloves, a plastic bag). If blood soaks through the cloth, don't remove it. That could make the bleeding worse. Instead, add more thick layers of cloth and apply pressure even more firmly. 

Still bleeding? Unless there is evidence of a broken bone, the next step is to elevate the wound so it's above the level of the heart. This uses gravity to reduce blood pressure at the wound. Keep the hand pressure on, too. If direct hand pressure and elevation aren't enough, then try the pressure point technique, described in the next answer. 

 
Q.  Should I use my belt for a tourniquet?
A. Probably not. A tourniquet completely cuts off the blood flow and can mean the loss of a limb. Instead, find the appropriate pressure point (brachial artery for arm wound, femoral artery for leg wound) and squeeze the artery against the bone to slow the blood flow. For the arm, use the flats of your fingers, not fingertips. The leg pressure point is where leg meets body, not on the leg itself. Press here with the heel of your hand. Continue the direct pressure on the wound, too. 
 
Q.  What are the symptoms of shock?
A. Skin that is pale, moist, clammy, or cool. A weak and rapid pulse. Dilated pupils. Weakness. Shivering. Thirst. Nausea and vomiting. Shallow, at times rapid, breathing. A vacant expression and an offhand, "so what" attitude. 

Shock occurs when the victim's circulatory system fails to provide enough blood to the body - especially the brain. Any serious injury can throw a person into shock. And shock can kill - even when the injury itself isn't all that bad. 

 
Q.  How can I help a victim in shock?
A. Have the victim lie down and raise the feet slightly. That's good for circulation. But don t move him if you believe there might be a spinal injury. In cool weather, place blankets or coats under and over the person to conserve body heat. Make sure the airway is open for breathing. Reassure the victim. Gentleness, kindness, and understanding play an important role in the treatment of shock. 
 
Q.  Can first aid give me AIDS?
A. According to the American Medical Association, "it is extremely unlikely that you - as a first-aider providing emergency care- will contract AIDS from a victim who is bleeding or from the saliva of a victim who may require mouth-to-mouth resuscitation or CPR." The Surgeon General explains why it's so unlikely: "The AIDS virus is transmitted through sexual intercourse, sharing drug needles, or to babies of infected mothers before or during birth." For more information, call CDC National AIDS Hotline: 1 -800-342-AIDS. 
 

 

About the Author . . . 
Author Fred Windisch is a Health and Safety Specialist at Shell Oil Company's Westhollow Research Center in Houston, Texas. A certified Emergency Medical Technician, Fred is also Fire Chief of the Ponderosa Volunteer Fire Department in suburban Houston. He's been with Shell for 22 years. 

Shell Answer Series book #8 was published by Shell in 1992 and is no longer in print. 


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