Hesperian Health Guides

Hesperian Health Guides

First Aid

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HealthWiki > New Where There Is No Doctor > First Aid


Establish Calm and Control

Protect yourself

Try to keep blood and body fluids off yourself when you care for people who are bleeding.

  • Wash your hands as often as you can. Flushing out any blood that gets in your eyes or into a cut in your skin can prevent you from getting an infection.
  • Cover your skin and eyes. Wear glasses and clean gloves if you can. Plastic bags worn on your hands work too. See Care for Sick People (in development) for more about protecting yourself from germs.


When an emergency happens, having a step-by-step approach to the problems facing you can help you think clearly and care for the most important problems first.

1. Take a deep breath. Emergencies can be scary. But the calmer you are, the more useful you will be. Being calm will also comfort and help the injured person or people around you.
2. Ask yourself: is this place safe? Move the person and yourself away from fires, busy streets, or other dangers.
(If the person might have a neck or back injury, move him carefully so you do not move his neck.)
3. Treat the most dangerous problems first. No matter what caused the injury, check breathing immediately. It is the most important function needed for life. See about difficulty breathing.
4. After breathing, check for bleeding. Heavy bleeding can kill.
5. When the person is breathing and heavy bleeding is controlled, check the whole body for other injuries and broken bones. Start at the head and check every part of the body, front and back, down to the toes. Gently ask questions, look the person over, and carefully touch the body to see if there are hidden injuries. It is common to have more than one injury, and some are not obvious at first glance.
6. Try to be as gentle and comforting as you can. The injured person is likely scared and in pain. By calming him, you can help his breathing and heart rate return to normal.

Re-check breathing and bleeding often. If you can check his blood pressure, check it often. An injured person may seem fine at first and then suddenly get worse. Regularly re‑check these most important signs of life until you are sure he is OK. Keep talking to him. This will help you see if he is confused or if his confusion gets worse.

a woman speaking to a man in a crowd while she helps an injured man.
Please keep the people back. I'll try to help him.


The people who gather after an accident should be encouraged to help. Ask loud, assertive people to clear a space around you and the injured person. Tell someone to go for medical help or get supplies like cloth (for bandages), or blankets. Give everyone a job to keep them calm and to make sure all the urgent work gets done. If many people have been injured, see Disasters and Displacement (in development) for how to decide who to help first.

The injured person can also help herself. Most bleeding people can put pressure on their own wounds. This can focus the person and allows you to check for other injuries or to care for other injured people.

? Ask if the person has pain, numbness, or difficulty moving.
These are signs of sprains or broken bones. See information on broken ribs and broken bones. If there is numbness or difficulty moving the lower body or the whole body, there may be a spine injury.
Ask or notice if they are having trouble breathing, or if the person is choking.
Stabbing pain with breathing may be a broken rib.
Shortness of breath, chest tightness, and wheezing are signs of asthma (see Problems with Breathing and Coughing—in development).
Trouble breathing can be caused by chemical poisoning or drug overdose.
Notice if they seem confused or have trouble speaking clearly. This can help you to assess how badly injured they are. See what to do if the person is unconscious
Many people become confused after an accident. But unclear speech, losing consciousness, and lasting confusion can be signs of head injury or intoxication from drugs or alcohol.
Slurred or strange speech can also be a sign of stroke. Is one side of their face or body drooping or does it seem weak? See Head and Brain Problems (in development).
Confusion or changes in consciousness can also be a sign of a diabetic emergency. See what to do if the person became ill suddenly.
? Look carefully: Is there bleeding, swelling, bruises, redness, or disfigured body parts? Compare one side of the body to the other. For example, if one leg looks shorter, it may be broken.
See what to do for bleeding.
For possible broken bones, see information on broken ribs and broken bones.
Bruising, swelling, and redness can be signs of bleeding inside the body. Watch for shock.
? Feel gently along the head, face, neck, back, front, arms, and legs. Is there pain, numbness, or bones out of place? If there may be a back or neck injury, feel every vertebra (the knobs of the backbone) from the head to the space between the buttocks.
See what to do for signs of head injury.
If you suspect there may be an injury to the head, neck, or back, see "Spine and Neck Injuries" before you move the person.


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