Emergencies & First Aid

Part 1

The first thirty seconds, whatever has happened

The same opening sequence works for nearly every emergency, and having it automatic is what stops the freeze.

1. 1

   Check the scene is safe

   Look before you move. Traffic, fire, live electricity, gas, water. A second casualty helps nobody, and rescuers becoming casualties is a genuinely common pattern. If the scene is not safe, stay back and call.

2. 2

   Check responsiveness

   Tap the shoulder firmly and shout. If they respond and can talk, they are breathing and have a pulse — that already tells you a great deal.

3. 3

   Call 911, and be specific

   Say the location first, before anything else, in case the call drops. Then what happened, how many people, and whether they are conscious and breathing. Do not hang up — dispatchers talk you through what to do, and that coaching is genuinely effective.

4. 4

   Send someone for the specific thing you need

   Never shout for general help. Point at one person and give them one job: 'You, in the blue shirt, get the AED from the wall by the entrance.' Named, specific instructions get done; a crowd request does not.

5. 5

   Then treat, worst first

   Breathing, then severe bleeding, then everything else. A broken arm can wait; an airway cannot.

Part 2

Severe bleeding — the one where minutes matter most

This is the most survivable serious emergency for a bystander to affect, and the actions are simple.

1. 1

   Press hard, directly on it

   Gloves if you have them, then firm direct pressure straight onto the wound with a clean cloth or dressing. Hard. Much harder than feels polite. Pressure is what stops bleeding.

2. 2

   Do not keep looking

   Lifting the dressing to check disturbs the clot that is forming. If blood soaks through, add another layer on top and keep pressing — never remove the first one.

3. 3

   Keep pressing until help arrives

   Ten minutes of unrelieved pressure feels like a long time. Do not stop early. If you tire, have someone take over with hands already in place.

4. 4

   Tourniquet, only for life-threatening limb bleeding

   If an arm or leg is bleeding in a way that pressure will not control and life is clearly at risk, a tourniquet goes two to three inches above the wound, never on a joint, tightened until the bleeding stops. It will hurt a great deal — that is expected. Note the time it went on and tell the paramedics. Never loosen it once applied.

5. 5

   Embedded objects stay in

   If something is stuck in the wound, leave it. It may be the only thing preventing much worse bleeding. Pad around it to stabilise it and let the hospital remove it.

Part 3

Choking, and hands-only CPR

Two situations where a bystander who acts changes the outcome more than anything a hospital can do later.

1. 1

   Choking — can they cough?

   If they are coughing forcefully, encourage them and do nothing else — coughing is more effective than anything you can do. If they cannot cough, speak or breathe, and are clutching their throat, act now.

2. 2

   Back blows and abdominal thrusts

   Five firm blows between the shoulder blades with the heel of your hand, leaning them forward. If that fails, stand behind, fist just above the navel, grasp it with the other hand and pull sharply inward and upward, five times. Alternate. Keep going until it clears or they go unconscious — at which point lower them and start CPR, and tell 911.

3. 3

   Choking alone

   Thrust your own abdomen hard over the back of a chair or a counter edge. People have saved themselves this way. Call 911 first if you can, even if you cannot speak — an open line with no voice gets a response.

4. 4

   Hands-only CPR — when to start

   If someone is unresponsive and not breathing normally (gasping is not breathing), call 911, then start compressions. You cannot make a dead person worse, and hesitation is what costs lives.

5. 5

   How to do compressions

   Heel of the hand in the center of the chest, other hand on top, fingers interlocked, arms straight, shoulders directly over your hands. Push hard and fast — about two inches deep, roughly 100–120 per minute. The beat of 'Stayin' Alive' is genuinely the right tempo. Let the chest come fully back up between compressions. Do not stop until help takes over.

6. 6

   Use the AED as soon as one arrives

   It talks you through it in plain language and will not shock someone who does not need it. Turn it on, put the pads where the pictures show, and follow the voice. Early defibrillation is the single biggest factor in surviving cardiac arrest.

Part 4

Recognizing the ones people miss

These kill people who waited because they were not sure. Being wrong and calling is fine.

• STROKE — remember FAST. Face drooping, Arm weakness, Speech slurred, Time to call 911. Note the time symptoms started; treatment options depend on it.
• HEART ATTACK — chest pressure or squeezing, possibly spreading to arm, jaw or back, with sweating, nausea or breathlessness. Women, older people and diabetics often present with fatigue, nausea or jaw pain rather than classic chest pain, and are frequently missed for exactly that reason.
• HEAT STROKE — a genuine Texas killer. Hot, red skin, confusion, and often no sweating. Call 911, move to shade, cool aggressively with wet cloths and fanning. Confusion is the line between heat exhaustion and something life-threatening.
• CARBON MONOXIDE — headache, dizziness and nausea that improve when you leave the house and return when you come back, in several people at once. Get out, then call. Fit detectors; it is odorless and colorless.
• SEVERE ALLERGIC REACTION — swelling of face or throat, difficulty breathing, widespread hives. If they carry an auto-injector, help them use it, then call 911 regardless — symptoms can return.
• A HEAD INJURY WITH confusion, repeated vomiting, worsening headache, unequal pupils or drowsiness needs assessment now, not in the morning.

Part 5

Being ready for a North Texas storm

This region gets tornadoes, ice storms, prolonged power cuts and extreme heat. Preparation is a one-afternoon job that pays off every few years.

• Water: one gallon per person per day, three days minimum. Two weeks is better and costs very little.
• Food that needs no cooking or refrigeration, and a manual tin opener — the item everyone forgets.
• Torches, not candles. Candles during power cuts are a leading cause of house fires.
• Power banks charged, and a car charger. Charge everything when a storm is forecast, not after.
• TORNADO: lowest floor, most interior room, no windows, cover your head. A bathroom or closet under the stairs. In a mobile home, leave for a solid building before it arrives.
• ICE STORM: know how to shut off your water, keep taps dripping, and never run a generator or grill indoors or in a garage — carbon monoxide from generators kills people every single winter.
• Keep half a tank of fuel in the car through winter and hurricane season. Pumps need electricity.
• Cash in small notes. Card machines and ATMs both fail in a power cut.
• Photograph your documents and insurance policies and store them somewhere online you can reach from a phone.
• Agree a meeting point and an out-of-state contact everyone can text. Local networks jam; long-distance texts often still get through.