FIRST AID

If your tooth is knocked out, get emergency dental care. It's sometimes possible to successfully reimplant permanent teeth that have been knocked out. But this is an option only if you follow the steps below immediately — before you see a dentist.


If your tooth is knocked out:

* Handle your tooth by the top only, not the roots.

* Don't rub it or scrape it to remove debris. This damages the root surface, making the tooth less likely to survive.

* Gently rinse your tooth in a bowl of tap water. Don't hold it under running water.

* Try to replace your tooth in the socket. If it doesn't go all the way into place, bite down gently on gauze or a moistened tea bag to help keep it in place. Hold the tooth in place until you see your dentist.

* If you can't replace your tooth in the socket, immediately place it in whole milk, your own saliva or a warm, mild saltwater solution — 1/4 teaspoon salt to 1 quart water (1.2 milliliters salt to about 1 liter water).

* Get medical attention from a dentist or emergency room immediately.

If you participate in contact sports, you can often prevent tooth loss by wearing a mouth guard, fitted by your dentist.

Nosebleeds are common. Most often they are a nuisance and not a true medical problem. But they can be both.

Among children and young adults, nosebleeds usually originate from the septum, just inside the nose. The septum separates your nasal chambers.

In middle-aged and older adults, nosebleeds can begin from the septum, but they may also begin deeper in the nose's interior. This latter origin of nosebleed is much less common. It may be caused by hardened arteries or high blood pressure. These nosebleeds begin spontaneously and are often difficult to stop. They require a specialist's help.

To take care of a nosebleed:


* Sit upright and lean forward. By remaining upright, you reduce blood pressure in the veins of your nose. This discourages further bleeding. Sitting forward will help you avoid swallowing blood, which can irritate your stomach.

* Pinch your nose. Use your thumb and index finger and breathe through your mouth. Continue to pinch for five to 10 minutes. This maneuver sends pressure to the bleeding point on the nasal septum and often stops the flow of blood.

* To prevent re-bleeding after bleeding has stopped, don't pick or blow your nose and don't bend down until several hours after the bleeding episode. Keep your head higher than the level of your heart.

* If re-bleeding occurs, blow out forcefully to clear your nose of blood clots and spray both sides of your nose with a decongestant nasal spray containing oxymetazoline (Afrin, Neo-Synephrine, others). Pinch your nose in the technique described above and call your doctor.

Seek medical care immediately if:

* The bleeding lasts for more than 20 minutes

* The nosebleed follows an accident, a fall or an injury to your head, including a punch in the face that may have broken your nose

For frequent nosebleeds

If you experience frequent nosebleeds, make an appointment with your doctor. You may need to have the blood vessel that's causing your problem cauterized. Cautery is a technique in which the blood vessel is burned with electric current, silver nitrate or a laser. Sometimes your doctor may pack your nose with special gauze or an inflatable latex balloon to put pressure on the blood vessel and stop the bleeding.

Also call your doctor if you are experiencing nasal bleeding and are taking blood thinners, such as aspirin or warfarin (Coumadin). Your doctor may advise adjusting your medication intake.

Using supplemental oxygen administered with a nasal tube (cannula) may increase your risk of nosebleeds. Apply a water-based lubricant to your nostrils and increase the humidity in your home to help relieve nasal bleeding.

Here are the rules of first aid emergency care in nutshell. If time's a'wastin', don't worry. Just look over this Top 10 checklist, and you'll be prepared to begin your first aid care for real!

1. Shout for help! Don't be afraid to use your lungs and shout for help as soon as you begin first aid measures. Keep shouting for help until you know you've been heard and action has been taken. Professional help can't come soon enough—if it's needed!

2. Assess the situation and scout the territory. If possible, ask the injured person what happened. Can she speak? Can she tell you how serious the accident is? Also, look around and make sure that performing first aid isn't going to be hazardous to your health. Are there any exposed wires near the injured person? Are there toxic fumes or flames? Is the ice hard enough for you to walk on or the water calm enough to jump in? In short, make sure you aren't in any danger before you start first aid. You won't be much help if you get injured, too.

3. Determine if the accident warrants a visit to a hospital—or simply a cleansing and a Band-Aid. If the injured person can talk, great. If the person simply needs stitches, don't call for an ambulance, just make a trip to the emergency room. But if he or she is unconscious, you need to make that 911 call. Check those important ABCs: Are the airways clear? Is he or she breathing? What about circulation? Is there a pulse? And, most importantly, it's up to you to decide whether or not to move the injured person. Sometimes this can't be helped. Once you've decided that you can safely walk on the ice or run past the flames, you might have to save the person in jeopardy by pulling or carrying them to safety, away from flames, thin ice, or toxic fumes. Here's a good rule to remember: don't move a person if there isn't a life-or-death reason to do so. You might cause more harm than good.



4.Ouch!

Don't move an injured person if you don't have to. As long as you're not in a burning building or drowning at sea, it is best to let a person lie where he or she is. If the victim has back, head, or neck injuries, moving him or her can make the injuries worse or even cause permanent damage or death.

#5 IF you are trained and certified in CPR and a person is choking or cannot breathe, begin CPR right away. If you are not trained in CPR, do not attempt to resuscitate. You can break the ribs or puncture the lungs, for example, and if the person is choking, you can actually force the object further down his or her throat! If you don't know CPR, use mouth-to-mouth resuscitation techniques or for choking, use the Heimlich Maneuver. Also, take the injured person's pulse and loosen his or her clothes to make breathing easier.

#6 Stop the bleeding. If the injured person is bleeding, apply direct, even pressure with a cloth and your hands to slow the flow. (To protect yourself against HIV and other infections while in direct contact with blood, don't forget to practice the universal guidelines for preventing infection.) Lift up a bleeding limb if it doesn't cause substantial additional pain. Make and apply a tourniquet only as a last resort. (See How to Treat Wounds and Stop Bleeding for details on using a tourniquet.)

#7 Treat any symptoms of shock. If the victim is chilled, breathing harshly, nauseous, clammy, and pale, it is possible he or she is in shock and might become unconscious at any time. Vomiting can also be a sign of shock, and you want to keep airways clear. If no back or neck injury is suspected, gently roll your the victim's whole body to the side to keep airways open and prevent vomit from pooling in the back of the throat (which can cause choking). Cover the victim with a blanket if you see any signs of shock. Use the universal guidelines to prevent transmittal of HIV or any other infection if you come in contact with bodily fluids.

#8 Look for a Medic Alert medallion like this on either a necklace or bracelet.





#8 medic alert identification tag bears the name “Medic Alert” and displays the Greek symbol for medical care (a snake twisted around a staff). This bracelet provides medical and emergency personnel with life-sustaining information about the patient's medical history and special needs. The Medic Alert tag tells you if the victim is diabetic, epileptic, or allergic to any medications—all of which can make a tremendous difference in the course of treatment. If there is no Medic Alert bracelet or necklace, check the injured person's wallet. Sometimes medical warnings are written on an ID card or driver's license.

#9 Seek trained medical assistance. At this point, you can leave the injured person for a moment if necessary to summon help. In this world of cellular phones, it's nice to know we're only an arm's length away from 911. But what if an injury takes place where there isn't a portable phone? Or what if you don't own one yourself? Shout for help or as a last resort, run to the nearest phone. When you call for help, tell the police you want an ambulance with an EMT staff. Only trained personnel can help you with cardiac or respiratory problems, head traumas, poisoning, or fractures.

With or without medical alert information, you can make your call to 911 more efficient if you begin with your name and location and the nature of the problem. If you've performed steps 1 through 7, you can also inform them of such additional things as potential dangers in the locale, whether or not the patient is breathing or bleeding or appears to have broken bones. All of these things help the EMTs prepare themselves before they arrive on the scene.

#10 Never give an injured unconscious person anything by mouth. This means no pills, no liquids—nothing! When a person is unconscious, even water (which you might think will ease the pain) can interfere with breathing and choke him or her.

#11 Wait. This is the hardest part of administering first aid care. When you've followed the steps above and done everything you can, all that's left is to wait for the ambulance to arrive. Unfortunately, minutes can feel like hours. While you're waiting, try to keep the injured person calm. You can provide comfort with a soothing voice or a gentle touch. The “Ssh. Don't worry. Help is almost here…” will help you cope as much as it will help the person you're treating.

Fever is one of your body's reactions to infection. What's normal for you may be a little higher or lower than the average temperature of 98.6 F (37 C). But a rectal temperature higher than 100.4 F (38 C) is always considered a fever. A rectal temperature reading is generally 1 degree F (about 0.5 degree C) higher than an oral reading.

For very young children and infants, even slightly elevated temperatures may indicate a serious infection. In newborns, a subnormal temperature — rather than a fever — also may be a sign of serious illness.

Don't treat fevers below 102 F (38.9 C) with any medications unless advised to do so by your doctor. If you have a fever of 102 F (38.9 C) or higher, your doctor may suggest taking an over-the-counter medication, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others). Adults may also use aspirin. But don't give aspirin to children. It may trigger a rare, but potentially fatal, disorder known as Reye's syndrome. Also, don't give ibuprofen to infants younger than 6 months of age.




Temperature conversion table



How to take a temperature

You can choose from several types of thermometers. Today most have digital readouts. Some take the temperature quickly from the ear canal and can be especially useful for young children and older adults. Other thermometers can be used rectally, orally or under the arm. If you use a digital thermometer, be sure to read the instructions so you know what the beeps mean and when to read the thermometer. Under normal circumstances, temperatures tend to be highest around 4 p.m. and lowest around 4 a.m.

Because of the potential for mercury exposure or ingestion, glass mercury thermometers have been phased out and are no longer recommended.

Because of the potential for mercury exposure or ingestion, glass mercury thermometers have been phased out and are no longer recommended.

Rectally (for infants)
To take your child's temperature rectally:

* Place a dab of petroleum jelly or other lubricant on the bulb.

* Lay your child on his or her stomach.

* Carefully insert the bulb one-half inch to one inch into the rectum.

* Hold the bulb and child still for three minutes. To avoid injury, don't let go of the thermometer while it's inside your child.

* Remove and read the temperature as recommended by the manufacturer.

* A rectal temperature reading is generally 1 degree F (about 0.5 degree C) higher than a simultaneously taken oral reading.

Taking a rectal temperature is also an option for older adults when taking an oral temperature is not possible.

Orally
To take your temperature orally:

* Place the bulb under your tongue.

* Close your mouth for the recommended amount of time, usually three minutes.

Under the arm (axillary)
Although it's not the most accurate way to take a temperature, you can also use an oral thermometer for an armpit reading:

* Place the thermometer under your arm with your arm down.

* Hold your arms across your chest.

* Wait five minutes or as recommended by your thermometer's manufacturer. Then remove the thermometer and read the temperature.

* An axillary reading is generally 1 degree F (about 0.5 degree C) less than an oral reading.

To take your child's axillary temperature, sit your child in your lap with your child facing to the side. Place the thermometer under your child's near arm, which should be against your chest.

Get medical help for a fever in these cases:

* If a baby is younger than 3 months of age and has a rectal temperature of 100.4 F (38 C) or higher. Even if your baby doesn't have other signs or symptoms, call your doctor just to be safe.

* If a baby is older than 3 months of age and has a temperature of 102 F (38.9 C) or higher.

* If a newborn has a lower than normal temperature — less than 97 F (36.1 C) rectally.

* If a child younger than age 2 has a fever for more than one day, or a child age 2 or older has a fever for more than three days. If your child has a fever after being left in a very hot car, seek medical care immediately.

* If an adult has a temperature of more than 103 F (39.4 C) or has had a fever for more than three days.

Call your doctor immediately if any of these signs or symptoms accompanies a fever:

* A severe headache
* Severe swelling of the throat
* Unusual skin rash
* Unusual eye sensitivity to bright light
* A stiff neck and pain when the head is bent forward
* Mental confusion
* Persistent vomiting
* Difficulty breathing or chest pain
* Extreme listlessness or irritability
* Abdominal pain or pain when urinating
* Any other unexplained symptoms

When reporting a fever to your doctor, don't attempt to convert from a rectal reading to an oral reading. It's simpler to just report what the reading was and how you took it.

Shortness of Breath

There are few worse feelings than shortness of breath. Severe shortness of breath is a life-threatening emergency.

Causes

here are two parts to breathing:

1. Moving air in and out of the lungs

2. Moving oxygen and carbon dioxide back and forth between the bloodstream and the lungs


Blocking either of these functions can result in feeling short of breath. Shortness of breath also comes from a sudden demand for oxygen in the body due to exercise or stress. High school coaches are rather fond of running "wind sprints" until players are gasping for air, unable to talk. In fact, feeling "winded" is another way to say short of breath.

Anything that interferes with breathing leads to too little oxygen and too much carbon dioxide in the blood. The body needs some of each of these gases in our blood to function properly, but levels need to be kept in balance. There's quite a bit of extra oxygen in the blood, so a short-term lack of oxygen isn't that big of a deal. (We need that emergency reserve in case a bear decides to chase us through the cul de sac, or we have to teach a teenager how to drive.)


Carbon dioxide, on the other hand, builds up pretty fast, and we need to get rid of it in a timely manner. In fact, it's the accumulation of carbon dioxide that makes you feel like you desperately need to inhale when you hold your breath.

The best way to fix shortness of breath is to figure out what's causing it. Things that interfere with moving air in and out of the lungs are:

Types of shortenig breath

Choking

The blocking of an airway due to a foreign object lodged in the throat or windpipe. Choking victims who cannot speak or cough need to have the object removed immediately so they can breathe.

Asthma

Asthma is a medical condition that causes narrowing of the small airways in the lungs. Typically, asthma patients develop wheezing and have increased mucous production in their lungs. Asthma patients can have episodes of increased shortness of breath, often triggered by allergic reactions. Asthma sufferers often have the disease for many years, and the episodes of shortness of breath can be life-threatening.

Chronic Obstructive Pulmonary Disease (COPD)

A disease characterised by an inability to normally move air in and out of the lungs. Unlike in patients with asthma, airflow limitation in patients with COPD is not fully reversible. Tobacco smoking is the main risk factor for COPD.

The diagnosis of COPD should be considered in any person with chronic breathing difficulty and one or more of the following:

* long-lasting cough
* phlegm production
* shortness of breath

Collapsed Lung

A condition that causes the lining of the lung to pull away from the wall of the chest. The space between the lung and the chest fills with air, pushing the injured lung against the heart and the other lung.

Collapsed lung can occur as a result of chest injury, or spontaneously in patients with lung disease.

Automobile and Other Vehicle Accidents

Getting into a vehicle accident is a frightening experience. There are steps you can take to stay safe and get the help you need.

Car Crash

Unless you have really bad luck or are a really bad driver, you haven't been in too many car wrecks. Here are answers to some questions that you may have if you are unfortunate enough to be involved in a vehicle accident.

You Get Out of the Car After the Accident

If you feel injured, weak, dizzy, or have pain in your back or neck, you should stay in the vehicle. Getting out when you are injured is likely to increase the damage. Wait for the ambulance or first responders.

If you feel fine, then decide if you are in an unsafe position. Sitting in your car in the middle of the freeway after dark is not the right place to be. If you do have to get out of the car because it is unsafe, immediately go to the shoulder. If you are in a high-speed area, it is a good idea to wait on the shoulder a few

yards "upstream" (behind your car). If someone runs into your vehicle, it will be pushed further along and can be pushed into you if you are standing "downstream" in traffic.

Consider your safety as well. It is very rare for vehicles to catch fire or explode after a vehicle accident. Vehicles with airbags will often have "smoke" in the cab. Read this FAQ to understand what the smoke is. If you do see black smoke or flames, then immediately exit the vehicle no matter how you feel.

There are two types of first aid -- emergencies that require quick action to save lives and minor injuries or illnesses that can often be handled at home without professional medical care.

Everyday First Aid

What should you do if you"re hurt or sick? In an emergency, call emergency center. Otherwise, look here for first aid tips and procedures for all manner of emergency and non-emergency injuries or conditions. There are plenty of common bumps and bruises that can be handled at home without medical attention. Other times it can be difficult to decide when to see a doctor. This list provides information for everyday illnesses and injuries.

Abdominal Pain

Abdominal pain is one of the most difficult symptoms to identify a cause. The causes of abdominal pain listed below range from relatively minor conditions to life-threatening emergencies. When to Call 911 for Abdominal Pain

It's important to call local emergency no when certain signs and symptoms accompany abdominal pain, regardless of the cause. If a victim of abdominal pain is also

experiencing any of the following, call local emergency no:

* sudden, severe onset of abdominal pain
* vomiting blood

* bloody diarrhea

* neck, chest, or shoulder pain

* rigid (hard) and tender abdomen

* not able to have a bowel movement, especially with vomiting

* pain between shoulder blades

* dizziness

* weakness

* sweating

* confusion

Many conditions mimic the signs and symptoms of poisoning, including seizures, alcohol intoxication, stroke and insulin reaction. So look for the signs and symptoms listed below if you suspect poisoning, but check with the poison control center or local emergency no before giving anything to the affected person.

Signs and symptoms of poisoning:

* Burns or redness around the mouth and lips, which can result from drinking certain poisons

* Breath that smells like chemicals, such as gasoline or paint thinner

* Burns, stains and odors on the person, on his or her clothing, or on the furniture, floor, rugs or other objects in the surrounding area

* Empty medication bottles or scattered pills

* Vomiting, difficulty breathing, sleepiness, confusion or other unexpected signs

When to call for help:

Call 911 or your local emergency number immediately if the person is:

* Drowsy or unconscious
* Having difficulty breathing or has stopped breathing
* Uncontrollably restless or agitated
* Having seizures

If the person seems stable and has no symptoms, but you suspect poisoning, call the poison control center at 800-222-1222. Provide information about the person's symptoms and, if possible, information about what he or she ingested, how much and when.

What to do while waiting for help:

* If the person has been exposed to poisonous fumes, such as carbon monoxide, get him or her into fresh air immediately.

* If the person swallowed the poison, remove anything remaining in the mouth.

* If the suspected poison is a household cleaner or other chemical, read the label and follow instructions for accidental poisoning. If the product is toxic, the label will likely advise you to call the local emergency no if you can't identify the poison, if it's medication or if there are no instructions.

* Follow treatment directions that are given by the poison control center.

* If the poison spilled on the person's clothing, skin or eyes, remove the clothing. Flush the skin or eyes with cool or lukewarm water, such as by using a shower for 20 minutes or until help arrives.

* Take the poison container (or any pill bottles) with you to the hospital.

What NOT to do

Don't administer ipecac syrup or do anything to induce vomiting. In 2003, the American Academy of Pediatrics advised discarding ipecac in the home, saying there's no good evidence of effectiveness and that it can do more harm than good.

Heatstroke is the most severe of the heat-related problems, often resulting from exercise or heavy work in hot environments combined with inadequate fluid intake.

Young children, older adults, people who are obese and people born with an impaired ability to sweat are at high risk of heatstroke. Other risk factors include dehydration, alcohol use, cardiovascular disease and certain medications.

What makes heatstroke severe and potentially life-threatening is that the body's normal mechanisms for dealing with heat stress, such as sweating and temperature control, are lost. The main sign of heatstroke is a markedly elevated body temperature — generally greater than 104 F (40 C) — with changes in mental status ranging from personality changes to confusion and coma. Skin may be hot and dry — although if heatstroke is caused by exertion, the skin may be moist.

Other signs and symptoms may include:

* Rapid heartbeat
* Rapid and shallow breathing
* Elevated or lowered blood pressure
* Cessation of sweating
* Irritability, confusion or unconsciousness
* Feeling dizzy or lightheaded
* Headache
* Nausea
* Fainting, which may be the first sign in older adults

If you suspect heatstroke:

* Move the person out of the sun and into a shady or air-conditioned space.
* Dial 911 or call for emergency medical assistance.
* Cool the person by covering him or her with damp sheets or by spraying with cool water. Direct air onto the person with a fan or newspaper.
* Have the person drink cool water, if he or she is able

Most North American snakes aren't poisonous. Some exceptions include the rattlesnake, coral snake, water moccasin and copperhead.


Excepting the coral snake, these poisonous snakes have slit-like eyes. Their heads are triangular, with a depression, or pit, midway between the eyes and nostrils.

Other characteristics are unique to certain poisonous snakes:

* Rattlesnakes make a rattling sound by shaking the rings at the end of their tail.

*Water moccasins have a white, cottony lining in their mouth.

* Coral snakes have red, yellow and black rings along the length of their body.

To reduce your risk of a snakebite, avoid picking up or playing with any snake. Most snakes usually avoid people if possible and bite only when threatened or surprised.

If you've experienced a snakebite:

* Remain calm

* Don't try to capture the snake

* Immobilize the bitten arm or leg and try to stay as quiet as possible

* Remove jewelry, because swelling tends to progress rapidly

* Apply a loose splint to reduce movement of the affected area, but make sure it is loose enough that it won't restrict blood flow

* Don't use a tourniquet or apply ice

* Don't cut the wound or attempt to remove the venom

Seek medical attention as soon as possible, especially if the bitten area changes color, begins to swell or is painful.

If an animal bites you or your child, follow these guidelines:

* For minor wounds. If the bite barely breaks the skin and there is no danger of rabies, treat it as a minor wound. Wash the wound thoroughly with soap and water. Apply an antibiotic cream to prevent infection and cover the bite with a clean bandage.

* For deep wounds. If the animal bite creates a deep puncture of the skin or the skin is badly torn and bleeding, apply pressure with a clean, dry cloth to stop the bleeding and see your doctor.

* For infection. If you notice signs of infection, such as swelling, redness, increased pain or oozing, see your doctor immediately.

* For suspected rabies. If you suspect the bite was caused by an animal that might carry rabies — including any wild or domestic animal of unknown immunization status — see your doctor immediately.

Doctors recommend getting a tetanus shot every 10 years. If your last one was more than five years ago and your wound is deep or dirty, your doctor may recommend a booster. You should have the booster within 48 hours of the injury.

Domestic pets cause most animal bites. Dogs are more likely to bite than cats are. Cat bites, however, are more likely to cause infection. Bites from nonimmunized domestic animals and wild animals carry the risk of rabies. Rabies is more common in raccoons, skunks, bats and foxes than in cats and dogs. Rabbits, squirrels and other rodents rarely carry rabies.

A well-stocked first-aid kit can help you respond effectively to common injuries and emergencies. Keep at least one first-aid kit in your home and one in your car. Store your kits in easy-to-retrieve locations that are out of the reach of young children. Children old enough to understand the purpose of the kits should know where they are stored.

You can purchase first-aid kits at many drugstores or assemble your own. Contents of a first-aid kit should include:

Basic supplies

* Adhesive tape

* Aluminum finger splints

* Antibiotic ointment

* Antiseptic solution or towelettes

* Bandages, including a roll of elastic wrap (Ace, Coban, others) and bandage strips (Band-Aid, Curad, others) in assorted sizes

* Instant cold packs

* Cotton balls and cotton-tipped swabs

* Disposable latex or synthetic gloves, at least two pair

* Gauze pads and roller gauze in assorted sizes

* Eye goggles

* First-aid manual

* Petroleum jelly or other lubricant

* Plastic bags for the disposal of contaminated materials

* Safety pins in assorted sizes

* Save-A-Tooth storage device containing salt solution and a travel case

* Scissors, tweezers and a needle

* Soap or instant hand sanitizer

* Sterile eyewash, such as a saline solution

* Thermometer

* Triangular bandage

* Turkey baster or other bulb suction device for flushing out wounds

Medications


* Activated charcoal (use only if instructed by your poison control center)

* Anti-diarrhea medication

* Over-the-counter oral antihistamine (Benadryl, others)

* Aspirin and nonaspirin pain relievers (never give aspirin to children)

* Calamine lotion

* Over-the-counter hydrocortisone cream

* Personal medications

* If prescribed by your doctor, drugs to treat an allergic attack, such as an auto-injector of epinephrine (EpiPen)

* Syringe, medicine cup or spoon

Emergency items

* Cell phone and recharger that utilizes the accessory plug in your car dash

* Emergency phone numbers, including contact information for your family doctor

and pediatrician, local emergency services, emergency road service providers and the regional poison control center

* Small, waterproof flashlight and extra batteries

* Candles and matches for cold climates

* Sunscreen

* Mylar emergency blanket

* First-aid instruction manual


Give your kit a checkup

Check your first-aid kits regularly, at least every three months, to be sure the flashlight batteries work and to replace supplies that have expired.

In addition, take a first-aid course to prepare for a possible medical emergency. Be sure the course covers cardiopulmonary resuscitation (CPR) and how to use an automatic external defibrillator (AED). Renew your CPR certification at least every two years.

Prepare children for medical emergencies in age-appropriate ways. The American Red Cross offers a number of helpful resources, including classes designed to help children understand and use first-aid techniques.

A heart attack occurs when an artery supplying your heart with blood and oxygen becomes blocked. This loss of blood flow injures your heart muscle. A heart attack generally causes chest pain for more than 15 minutes, but it can also be "silent" and have no symptoms at all.

Many people who suffer a heart attack have warning symptoms hours, days or weeks in advance. The earliest predictor of an attack may be recurrent chest pain that's triggered by exertion and relieved by rest (angina).

Someone having an attack may experience any or all of the following:

* Uncomfortable pressure, fullness or squeezing pain in the center of the chest. The pain might last several minutes or come and go. It may be triggered by exertion and relieved by rest.

* Prolonged pain in the upper abdomen.

* Discomfort or pain spreading beyond the chest to the shoulders, neck, jaw, teeth, or one or both arms.

* Shortness of breath.

* Lightheadedness, dizziness, fainting.

* Sweating.

* Nausea.

If you or someone else may be having a heart attack:

* Dial your local emergency medical assistance number. Don't tough out the symptoms of a heart attack for more than five minutes. If you don't have access to emergency medical services, have a neighbor or a friend drive you to the nearest hospital. Police or fire-rescue units also may be a source of transportation. Drive yourself only as a last resort, if there are absolutely no other options, and realize that it places you and others at risk when you drive under these circumstances.

# Chew and swallow an aspirin, unless you're allergic to aspirin or have been told by your doctor never to take aspirin. But seek emergency help first, such as calling your local emergency

# Take nitroglycerin, if prescribed. If you think you're having a heart attack and your doctor has previously prescribed nitroglycerin for you, take it as directed. Do not take anyone else's nitroglycerin, because that could put you in more danger.

Begin CPR.
If you're with a person who might be having a heart attack and he or she is unconscious, tell the dispatcher or another emergency medical specialist. You may be advised to begin cardiopulmonary resuscitation (CPR). If you haven't received CPR training, doctors recommend skipping mouth-to-mouth rescue breathing and proceeding directly to chest compression. The dispatcher can instruct you in the proper procedures until help arrives.


Chest wall pain

One of the most common varieties of harmless chest pain is chest wall pain. One kind of chest wall pain is costochondritis. It consists of pain and tenderness in and around the cartilage that connects your ribs to your breastbone (sternum).

Often, placing pressure over a few points along the margin of the sternum results in considerable tenderness limited to those small areas. If the pressure of a finger duplicates your chest pain, you probably can conclude that a serious cause of chest pain, such as a heart attack, isn't responsible.

Other causes of chest pain include:

* Strained chest muscles from overuse or excessive coughing
* Chest muscle bruising from minor trauma
* Acute anxiety with rapid breathing
* Pain from the gastrointestinal tract, such as esophageal reflux, peptic ulcer pain, or gallbladder pain.

The danger from an electrical shock depends on how high the voltage is, how the current traveled through the body, the person's overall health and how quickly the person is treated.

Call your local emergency number immediately if any of these signs or symptoms occur:

* Cardiac arrest
* Heart rhythm problems (arrhythmias)
* Respiratory failure
* Muscle pain and contractions
* Seizures
* Numbness and tingling
* Unconsciousness

While waiting for medical help, follow these steps:

1. Look first. Don't touch. The person may still be in contact with the electrical source. Touching the person may pass the current through you.

2. Turn off the source of electricity if possible. If not, move the source away from you and the affected person, using a nonconducting object made of cardboard, plastic or wood.

3. Check for signs of circulation (breathing, coughing or movement). If absent, begin cardiopulmonary resuscitation (CPR) immediately.

4. Prevent shock. Lay the person down and, if possible, position the head slightly lower than the trunk, with the legs elevated.

Caution

* Don't touch the person with your bare hands if he or she is still in contact with the electrical current.

* Don't get near high-voltage wires until the power is turned off. Stay at least 20 feet away — farther if wires are jumping and sparking.

* Don't move a person with an electrical injury unless the person is in immediate danger.


Shock: First aid


Shock may result from trauma, heatstroke, allergic reactions, severe infection, poisoning or other causes. Various signs and symptoms appear in a person experiencing shock:


* The skin is cool and clammy. It may appear pale or gray.

* The pulse is weak and rapid. Breathing may be slow and shallow, or hyperventilation (rapid or deep breathing) may occur. Blood pressure is below normal.

* The eyes lack luster and may seem to stare. Sometimes the pupils are dilated.

* The person may be conscious or unconscious. If conscious, the person may feel faint or be very weak or confused. Shock sometimes causes a person to become overly excited and anxious.

If you suspect shock, even if the person seems normal after an injury:

* Dial call your local emergency number.
* Have the person lie down on his or her back with feet higher than the head. If raising the legs will cause pain or further injury, keep him or her flat. Keep the person still.

* Check for signs of circulation (breathing, coughing o Keep tr movement). If absent, begin CPR.

*keep the person warm and comfortable. Loosen belt(s) and tight clothing and cover the person with a blanket. Even if the person complains of thirst, give nothing by mouth.

* Turn the person on his or her side to prevent choking if the person vomits or bleeds from the mouth.
* Seek treatment for injuries, such as bleeding or broken bones.

To distinguish a minor burn from a serious burn, the first step is to determine the degree and the extent of damage to body tissues. The three classifications of first-degree burn, second-degree burn and third-degree burn will help you determine emergency care:

First-degree burn
The least serious burns are those in which only the outer layer of skin is burned. The skin is usually red, with swelling and pain sometimes present. The outer layer of skin hasn't been burned through. Treat a first-degree burn as a minor burn unless it involves substantial portions of the hands, feet, face, groin or buttocks, or a major joint.

Second-degree burn
When the first layer of skin has been burned through and the second layer of skin (dermis) also is burned, the injury is called a second-degree burn. Blisters develop and the skin takes on an intensely reddened, splotchy appearance. Second-degree burns produce severe pain and swelling.

If the second-degree burn is no larger than 3 inches (7.5 centimeters) in diameter, treat it as a minor burn. If the burned area is larger or if the burn is on the hands, feet, face, groin or buttocks, or over a major joint, treat it as a major burn and get medical help immediately.

For minor burns, including first-degree burns and second-degree burns limited to an area no larger than 3 inches (7.5 centimeters) in diameter, take the following action:

* Cool the burn. Hold the burned area under cold running water for at least five minutes, or until the pain subsides. If this is impractical, immerse the burn in cold water or cool it with cold compresses. Cooling the burn reduces swelling by conducting heat away from the skin. Don't put ice on the burn.

* Cover the burn with a sterile gauze bandage. Don't use fluffy cotton, which may irritate the skin. Wrap the gauze loosely to avoid putting pressure on burned skin. Bandaging keeps air off the burned skin, reduces pain and protects blistered skin.

* Take an over-the-counter pain reliever. These include aspirin, ibuprofen (Advil, Motrin, others), naproxen (Aleve) or acetaminophen (Tylenol, others). Never give aspirin to children or teenagers.

Minor burns usually heal without further treatment. They may heal with pigment changes, meaning the healed area may be a different color from the surrounding skin. Watch for signs of infection, such as increased pain, redness, fever, swelling or oozing. If infection develops, seek medical help. Avoid re-injuring or tanning if the burns are less than a year old — doing so may cause more extensive pigmentation changes. Use sunscreen on the area for at least a year.

Caution

* Don't use ice. Putting ice directly on a burn can cause frostbite, further damaging your skin.
* Don't apply butter or ointments to the burn. This could prevent proper healing.
* Don't break blisters. Broken blisters are vulnerable to infection.

Third-degree burn
The most serious burns are painless, involve all layers of the skin and cause permanent tissue damage. Fat, muscle and even bone may be affected. Areas may be charred black or appear dry and white. Difficulty inhaling and exhaling, carbon monoxide poisoning, or other toxic effects may occur if smoke inhalation accompanies the burn.

For major burns, dial 911 or call for emergency medical assistance. Until an emergency unit arrives, follow these steps:

1. Don't remove burnt clothing. However, do make sure the victim is no longer in contact with smoldering materials or exposed to smoke or heat.

2. Don't immerse large severe burns in cold water. Doing so could cause shock.

3. Check for signs of circulation (breathing, coughing or movement). If there is no breathing or other sign of circulation, begin cardiopulmonary resuscitation (CPR).

4. Elevate the burned body part or parts. Raise above heart level, when possible.

5. Cover the area of the burn. Use a cool, moist, sterile bandage; clean, moist cloth; or moist towels.

Tooth decay is the primary cause of toothaches for most children and adults. Bacteria that live in your mouth thrive on the sugars and starches in the food you eat. These bacteria form a sticky plaque that clings to the surface of your teeth.

Acids produced by the bacteria in plaque can eat through the hard, white coating on the outside of your teeth (enamel), creating a cavity. The first sign of decay may be a sensation of pain when you eat something sweet, very cold or very hot. A toothache often indicates that your dentist will need to work on your teeth.

Self-care tips

Until you can see your dentist, try these self-care tips for a toothache:

* Rinse your mouth with warm water.
* Use dental floss to remove any food particles wedged between your teeth.
* Take an over-the-counter (OTC) pain reliever to dull the ache.
* Apply an OTC antiseptic containing benzocaine directly to the irritated tooth and gum to temporarily relieve pain. Direct application of oil of cloves (eugenol) also may help. Don't place aspirin or another painkiller directly against your gums, as it may burn your gum tissue.

Swelling, pain when you bite, a foul-tasting discharge and gum redness indicate infection. See your dentist as soon as possible.

Call your dentist if:

* The pain persists for more than a day or two
* You have fever with the toothache
* You have trouble breathing or swallowing