FIRST AID

First aid is the first and immediate assistance given to any person suffering from either a minor
or serious illness or injury, with care provided to preserve life, prevent the condition from
worsening, or to promote recovery. It includes initial intervention in a serious condition prior to
professional medical help being available, such as performing cardiopulmonary
resuscitation (CPR) while waiting for an ambulance, as well as the complete treatment of minor
conditions, such as applying a plaster to a cut.

First aid is an emergency measure, generally consisting of simple, often life-saving techniques
that most people can train to perform with minimal equipment and no previous medical
experience.

The term usually refers to administering care to a human, although it can also be performed on
animals.

It is not classed as medical treatment and does not replace interventions from a trained medical
professional.

First aid is a combination of simple procedures and common sense

FIRST AID KIT

It's important to have a well-stocked first aid kit in your home so you can deal with minor
accidents and injuries.

Your first aid kit should be locked and kept in a cool, dry place out of the reach of children.

Many people also keep a small first aid kit in their car for emergencies.

basic first aid kit

A basic first aid kit may contain:

 plasters in a variety of different sizes and shapes

 small, medium and large sterile gauze dressings
 at least 2 sterile eye dressings

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  triangular bandages
 crêpe rolled bandages
 safety pins
 disposable sterile gloves
 tweezers
 scissors
 alcohol-free cleansing wipes
 sticky tape
 thermometer (preferably digital)
 skin rash cream, such as hydrocortisone or calendula
 cream or spray to relieve insect bites and stings
 antiseptic cream
 painkillers such as paracetamol (or infant paracetamol for children), aspirin (not to be given
to children under 16), or ibuprofen
 cough medicine
 antihistamine cream or tablets
 distilled water for cleaning wounds
 eye wash and eye bath
It may also be useful to keep a basic first aid manual or instruction booklet with your first aid kit.

Medicines should be checked regularly to make sure they're within their use-by dates.

Aims of first aid

The aims of first aid are:

 To preserve life: Saving lives is the main aim of first aid.

 To prevent further harm: The person who has experienced the injury must be kept stable,
and their condition must not deteriorate before medical services arrive. This may include
moving the individual away from harm, applying first aid techniques, keeping them warm
and dry, and applying pressure to wounds to stop any bleeding.

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  Promote recovery: Taking steps to promote recovery may include applying a bandage to
a wound.

The most common term referred to in first aid is ABC. This stands for airway, breathing, and
circulation. A fourth step will appear in the emergency procedures for some facilities.

 Airway: Make sure the airway is clear. Choking, which results from the obstruction of
airways, can be fatal.

 Breathing: Once the airways are confirmed to be clear, determine whether the person can
breathe, and, if necessary, provide rescue breathing.

 Circulation: If the person involved in the emergency situation is not breathing, the first
aider should go straight for chest compressions and rescue breathing. The chest
compressions will promote circulation. This saves valuable time. In emergencies that are
not life-threatening, the first aider needs to check the pulse.

 Deadly bleeding or defibrillation: Some organizations consider dressing severe wounds

or applying defibrillation to the heart a separate fourth stage, while others include this as
part of the circulation step.

Evaluating and maintaining ABC with a patient depends on the training and experience of a first
aider. As soon as ABC has been secured, the first aider can then focus on any additional
treatments.

The ABC process must be carried out in that order.

However, there are times when a first aider might be performing two steps at the same time. This
might be the case when providing rescue breathing and chest compressions to an individual who
is not breathing and has no pulse.

It is important to use a primary survey to make sure the scene is clear of threats before stepping
in to help:

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  Danger: Check for dangers to the injured person and yourself. If there is danger, can it be
cleared, or can the individual be moved away from further harm? If there is nothing you
can do, stand clear, and call for professional help.

 Response: Once it is clear that all danger has ceased, check if the patient is conscious and
alert, ask questions, and see if you get a response. It is also important to find out whether
they respond to your touch and are aware of their pain.

 Airway: Check whether the airway is clear and, if not, try to clear it. Have the injured
person lying on their back, and then place one hand on the forehead and two fingers from
the other hand on the chin. Gently tilt the head back while slightly raising the chin
upwards. Any obstructions need to be removed from the mouth, including dentures. Only
insert fingers into the mouth of the injured indivisual if an obstruction is present.

 Breathing: Is the individual breathing effectively? The first aider should examine the
chest for movement and the mouth for signs of breathing. Afterward, get close to the
person to see if air can be felt on the cheek from breathing.

The first aider then needs to carry out a secondary survey, checking for deformities, open
wounds, medic alert tags, and swellings.

If the injured person is breathing safely, carry out a rapid whole-body check for the following:

 open wounds

 deformities

 medical alert tags advising of underlying conditions

 swellings

This is known as a secondary survey. As soon as this has been completed, place the individual in
a recovery position. At this point, the first aider should call for an ambulance.

Recovery position

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Even if the individual is breathing but is unconscious, there is still a significant risk of airway
obstruction. The recovery position reduces the risk to the patient. A first aider should do the
following:

1. If the individual is wearing glasses, remove them.

2. Kneel next to the person, and place the arm nearest to you at a right angle to the body.

3. Bring the other arm across the chest. Hold the back of your hand against their nearest
cheek.

4. With your other hand, hold the thigh furthest from you and pull up the knee. Make sure
the foot is flat on the ground.

5. Slowly pull down on the raised knee, and roll the body over towards you.

6. Move the upper leg slightly, so that the hip and knee are bent at right angles. This makes
sure that they do not roll onto their face.

7. Gently tilt the head back so that the airway is kept open.

Cardio-pulmonary resuscitation (CPR)

If the person is not breathing, the first aider will need to perform CPR.

In 2008, the European Resuscitation Council and the American Heart Association (AHA)
reversed their policy on the effectiveness of only using chest compressions and advised that they
can be used without artificial respiration on adults who suddenly collapse in cardiac arrest.

It is unlikely that CPR will start a heart. Its purpose is to maintain the flow of oxygenated blood
to the brain and heart, preventing or at least delaying tissue death. CPR can extend the brief
window of time during which successful resuscitation can take place without permanent brain
damage.

In 2005, the International Liaison Committee on Resuscitation (ILCOR) agreed on new

guidelines. The new guidelines make it simpler for first aiders and healthcare professionals to
carry out early resuscitation.

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The new guidelines stated that rescuers should progress straight to CPR if there is no breathing,
rather than checking for a pulse. They also added that rescue breathing must not be performed
without chest compression.

There are two main steps in CPR: Applying chest compressions and then providing breaths.

Apply 30 chest compressions:

The first aider should kneel next to the person who is injured. They should be lying on their
back.

1. For adults, place the heel of one hand in the middle of the chest. Place your other hand on
top of the first hand and interlace the fingers.

2. Push the chest down about 1.5 to 2 inches. If the person is a child aged between 1 and 8
years, compress to a maximum of 1.5 inches with one hand. Let go, and wait for the chest
to come back up completely before repeating. Your elbows must remain straight
throughout.

3. Push the breastbone up and down to a depth of about 5 cm about 30 times, at a pulse rate
of 100 beats per minute.

Provide two breaths:

1. Make sure the airway is open, and pinch the nose so it closes.

2. Gently raise the chin upwards with two fingers of your other hand.

3. Take a deep breath, seal your mouth over that of the person with the injury, and exhale
into the airway.

4. You should see the chest rise and fall.

5. To get another breath, lift your head and breathe in deeply. Perform steps 1, 2, 3, and 4
again.

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Repeat the 30 chest compressions followed by the two breaths about five times, and then check
for normal breathing. If they are not breathing normally, carry on performing CPR. If breathing
restarts as normal, stay with the injured person until help arrives.

Chest compressions alone can be lifesavers – the crucial factor is time. Make sure you respond
quickly.

It is important not to let your hands bounce when performing chest compressions. Make sure the
heel of your hand is touching the chest throughout chest compressions.

You might hear some pops and snaps during chest compressions. These are normal, so do not
stop.

CHOKING

Choking occurs when a foreign object lodges in the throat or windpipe, blocking the flow of air.
In adults, a piece of food often is the culprit. Young children often swallow small objects.
Because choking cuts off oxygen to the brain, give first aid as quickly as possible.
The universal sign for choking is hands clutched to the throat. If the person doesn't give the
signal, look for these indications:

 Inability to talk
 Difficulty breathing or noisy breathing
 Squeaky sounds when trying to breathe
 Cough, which may either be weak or forceful
 Skin, lips and nails turning blue or dusky
 Skin that is flushed, then turns pale or bluish in color
 Loss of consciousness
If the person is able to cough forcefully, the person should keep coughing. If the person is
choking and can't talk, cry or laugh forcefully, the American Red Cross recommends a "five-and-
five" approach to delivering first aid:

 Give 5 back blows. Stand to the side and just behind a choking adult. For a child, kneel down
behind. Place one arm across the person's chest for support. Bend the person over at the waist
so that the upper body is parallel with the ground. Deliver five separate back blows between
the person's shoulder blades with the heel of your hand.
 Give 5 abdominal thrusts. Perform five abdominal thrusts (also known as the Heimlich
maneuver).
 Alternate between 5 blows and 5 thrusts until the blockage is dislodged.

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The American Heart Association doesn't teach the back blow technique, only the abdominal
thrust procedures. It's OK not to use back blows if you haven't learned the technique. Both
approaches are acceptable.
To perform abdominal thrusts (Heimlich maneuver) on someone else:

 Stand behind the person. Place one foot slightly in front of the other for balance. Wrap your
arms around the waist. Tip the person forward slightly. If a child is choking, kneel down
behind the child.
 Make a fist with one hand. Position it slightly above the person's navel.
 Grasp the fist with the other hand. Press hard into the abdomen with a quick, upward thrust
— as if trying to lift the person up.
 Perform between six and 10 abdominal thrusts until the blockage is dislodged.
If you're the only rescuer, perform back blows and abdominal thrusts before calling 911 or your
local emergency number for help. If another person is available, have that person call for help
while you perform first aid.
If the person becomes unconscious, perform standard cardiopulmonary resuscitation (CPR) with
chest compressions and rescue breaths.
To perform abdominal thrusts (Heimlich maneuver) on yourself:
First, if you're alone and choking, call 911 or your local emergency number immediately. Then,
although you'll be unable to effectively deliver back blows to yourself, you can still perform
abdominal thrusts to dislodge the item.

 Place a fist slightly above your navel.

 Grasp your fist with the other hand and bend over a hard surface — a countertop or chair will
do.
 Shove your fist inward and upward.
To clear the airway of a pregnant woman or obese person:

 Position your hands a little bit higher than with a normal Heimlich maneuver, at the base of
the breastbone, just above the joining of the lowest ribs.
 Proceed as with the Heimlich maneuver, pressing hard into the chest, with a quick thrust.
 Repeat until the food or other blockage is dislodged. If the person becomes unconscious,
follow the next steps.
To clear the airway of an unconscious person:

 Lower the person on his or her back onto the floor, arms to the side.
 Clear the airway. If a blockage is visible at the back of the throat or high in the throat, reach a
finger into the mouth and sweep out the cause of the blockage. Don't try a finger sweep if
you can't see the object. Be careful not to push the food or object deeper into the airway,
which can happen easily in young children.
 Begin CPR if the object remains lodged and the person doesn't respond after you take the
above measures. The chest compressions used in CPR may dislodge the object. Remember to
recheck the mouth periodically.
To clear the airway of a choking infant younger than age 1:

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 Assume a seated position and hold the infant face down on your forearm, which is resting on
your thigh. Support the infant's head and neck with your hand, and place the head lower than
the trunk.
 Thump the infant gently but firmly five times on the middle of the back using the heel of
your hand. The combination of gravity and the back blows should release the blocking
object. Keep your fingers pointed up to avoid hitting the infant in the back of the head.
 Turn the infant face up on your forearm, resting on your thigh with the head lower than the
trunk if the infant still isn't breathing. Using two fingers placed at the center of the infant's
breastbone, give five quick chest compressions. Press down about 1 1/2 inches, and let the
chest rise again in between each compression.
 Repeat the back blows and chest thrusts if breathing doesn't resume. Call for emergency
medical help.
 Begin infant CPR if one of these techniques opens the airway but the infant doesn't resume
breathing.
If the child is older than age 1 and conscious, give abdominal thrusts only. Be careful not to use
too much force to avoid damaging ribs or internal organs.To prepare yourself for these situations,
learn the Heimlich maneuver and CPR in a certified first-aid training course
FAINTING
Fainting occurs when your brain temporarily doesn't receive enough blood supply, causing you
to lose consciousness. This loss of consciousness is usually brief.
Fainting might have no medical significance. Or the cause can be a serious disorder, often
involving the heart. Therefore, treat loss of consciousness as a medical emergency until the signs
and symptoms are relieved, and the cause is known. Talk to your doctor if you faint more than
once.

If you feel faint

 Lie down or sit down. To reduce the chance of fainting again, don't get up too quickly.
 Place your head between your knees if you sit down.
If someone else faints
 Position the person on his or her back. If there are no injuries and the person is breathing,
raise the person's legs above heart level — about 12 inches (30 centimeters) — if possible.
Loosen belts, collars or other constrictive clothing.
To reduce the chance of fainting again, don't get the person up too quickly. If the person
doesn't regain consciousness within one minute, call your local emergency number.

 Check for breathing. If the person isn't breathing, begin CPR. Call your local emergency
number. Continue CPR until help arrives or the person begins to breathe.
If the person was injured in a fall associated with a faint, treat bumps, bruises or cuts
appropriately. Control bleeding with direct pressure.

Wounds and bleeding

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The five types of wounds are abrasion, avulsion, incision, laceration, and puncture.
1. An abrasion is a wound caused by friction when a body scrapes across a rough surface.
Road rash is an example of an abrasion. There’s usually not a lot of bleeding, but the
wound needs to be scrubbed and cleaned to avoid infection.

2. An avulsion is characterized by a flap. Avulsions usually occur during violent accidents,

such as body-crushing accidents, explosions, and gunshots. They bleed heavily and
rapidly.

3. An incision is a cut with clean edges.

4. A laceration is a cut with jagged edges. Accidents with knives, tools, and machinery are
frequent causes of lacerations. In the case of deep lacerations, bleeding can be rapid and
extensive.

5. A puncture is a wound where something passes through or becomes impaled in the skin.
Sometimes, a bullet can cause a puncture wound.Punctures may not bleed much, but
these wounds can be deep enough to damage internal organs. If you have even a small
puncture wound, visit your doctor to get a tetanus shot and prevent infection.

Types of bleeding

People with bleeding disorders experience external and internal bleeds.

1. External Bleeds

External bleeds can occur in the mouth, after biting the mouth, lips or tongue. Recurrent, heavy
nosebleeds, without apparent cause are another symptom. Minor cuts that don’t clot or that stop
and then start again also can occur.

2. Internal Bleeds

The most frequent sites of internal bleeds are the knee, ankle, elbow and hip joints. At first the
joint feels bubbly or tingly. As more blood pools in it and swelling occurs, the joint feels tight,
may be hot to the touch and becomes painful to bend. Children may hold or protect the affected
joint, or start limping or crawling.

Bleeds also can occur in large muscles, such as the iliopsoas muscle in the front of the hip,
causing abdominal, hip or back pain. Many women with bleeding disorders experience
menorrhagia, long, heavy menstrual bleeding, and cramps. Soft tissue bleeds under the skin can
leave a telltale sign—large bruises.

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Brain bleeds, or intracranial hemorrhage (ICH), are serious. They can occur spontaneously or
after trauma. Symptoms to be aware of include: painful headache, stiff neck, vomiting,
sleepiness, changed behavior, sudden weakness or balance issues, difficulty walking, double
vision, convulsions and seizures. Other bleeds that need prompt action include those in the eye,
throat or gastrointestinal tract, or that are caused by deep cuts or lacerations. For any of these
bleeds, it’s best to head right to the emergency room

NOSE BLEEDING

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

Nosebleed care

 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 to pinch your nostrils shut. Breathe
through your mouth. Continue to pinch for 10 to 15 minutes. Pinching sends pressure to the
bleeding point on the nasal septum and often stops the flow of blood.
If the bleeding continues after 10 to 15 minutes, repeat holding pressure for another 10 to 15
minutes. Avoid peeking at your nose. If the bleeding still continues, seek emergency care.

 To prevent re-bleeding, don't pick or blow your nose and don't bend down for several hours
after the bleeding episode. During this time remember to keep your head higher than the level
of your heart. You can also gently apply some petroleum jelly to the inside of your nose
using a cotton swab or your finger.
 If re-bleeding occurs, blow out forcefully to clear your nose of blood clots. Then spray both
sides of your nose with a decongestant nasal spray containing oxymetazoline (Afrin). Pinch
your nose again as described above and call your doctor.
When to seek emergency care

 The bleeding lasts for more than 30 minutes

 You feel faint or lightheaded
 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
When to contact the doctor

 You experience frequent nosebleeds. You may need a blood vessel cauterized. Cautery is a
technique in which the blood vessel is burned with an electric current, silver nitrate or a laser.
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.
 You're experiencing nasal bleeding and taking blood thinners, such as aspirin or warfarin
(Coumadin, Jantoven). Your doctor may advise adjusting your medication dosage.

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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.

Animal bites

 Many different types of animals ranging from dogs, cats, hamsters, raccoons, ferrets, and
squirrels can bite adults and children.
 Many times, bites are from the family pet.
 Most states require that animal bites be reported.

Animal bites usually are either provoked or unprovoked. A provoked bite would occur if a
person teases a dog or tries to take away the dog's food while the dog is eating. An
unprovoked bite may occur if the person is sitting in their backyard and a raccoon runs out of
the woods and attacks them for no known reason. A stray dog that approaches a person and
begins to bite them would be considered unprovoked. This type of information is very
important to the healthcare professional taking care of the bite because in certain animal
species "unprovoked" bites can be a sign or indicator that the animal has rabies and needs to
be either captured, quarantined or very closely monitored.

first aid should consist of getting away from the animal to a safe area. Next, apply pressure
on the areas that are bleeding, and going to an emergency department if the injury requires
care

Although most bites need to be checked by a doctor, if the person who was bitten does not seek
immediate attention after the bite has occurred, watch closely for signs and symptoms of
infection. These symptoms may signal there is infection or debris still in the wound (such
as teeth, clothes, or dirt):

 Redness at or around the bite site

 Swelling
 Pus (thick) drainage from the wound
 Increasing pain
 Localized warmth at the bite site

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  Red streaks leading away from the site of the bite
 Fever

Most animal bites should be evaluated in a doctor's office, at a walk-in clinic, or in a hospital's
emergency department for these reasons:

 The risk of infection

 Broken or embedded teeth (cats) or other foreign material in the wound (which will cause
an infection)
 Possible underlying nerve and blood vessel damage
 Risk of tetanus if the person's immunizations are not up to date
 The consideration of risk of rabies, depending on the animal and circumstances of the
bite

These types of bites pose the highest risk of infection and therefore require prompt evaluation:

 Dog bites because of the crushing mechanism of the bite

 Cat bites because of the puncture mechanism of the bite
 Wild animal bites (from raccoons, for example) and dog or cat bites (pets may have
themselves been bitten by stray animals) because of the risk of contracting rabies

Certain bite wounds require immediate attention:

 Bite caused by a wild animal or a stray dog or cat

 Possibility of teeth, dirt, or other matter in the wound
 Excessive bleeding
 Weakness or numbness of the area or another area away from the bite
 Any other symptoms or concern that the person bitten may have regarding a bite wound

Most animal bites should be evaluated in a doctor's office, at a walk-in clinic, or in a hospital's
emergency department for these reasons:

 The risk of infection

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  Broken or embedded teeth (cats) or other foreign material in the wound (which will cause
an infection)
 Possible underlying nerve and blood vessel damage
 Risk of tetanus if the person's immunizations are not up to date
 The consideration of risk of rabies, depending on the animal and circumstances of the
bite

Snake bites
Respond immediately if;

 There is any chance that the snake is venomous

 The person has difficulty breathing
 There is loss of consciousness

1. Note the Snake's Appearance

 Be ready to describe the snake to emergency staff.

2. Protect the Person

While waiting for medical help:

 Move the person beyond striking distance of the snake.

 Have the person lie down with wound below the heart.
 Keep the person calm and at rest, remaining as still as possible to keep venom from
spreading.
 Cover the wound with loose, sterile bandage.
 Remove any jewelry from the area that was bitten.
 Remove shoes if the leg or foot was bitten.

Do not:

 Cut a bite wound

 Attempt to suck out venom
 Apply tourniquet, ice, or water
 Give the person alcohol or caffeinated drinks or any other medications

3. Follow Up

If you treat the bite at home:

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  Contact a healthcare provider. The person may need a tetanus shot. Tetanus boosters
should be given every 10 years.

At the hospital, treatment will depend on the type of snake.

 If the snake was venomous, the person will be given anti-venom treatment.
 A tetanus shot may be given, depending on the date of the last injection.

Burns and scalds

Burns and scalds are damage to the skin caused by heat. Both are treated in the same way.

A burn is caused by dry heat – by an iron or fire, for example. A scald is caused by something
wet, such as hot water or steam.

A burn is tissue damage that results from scalding, overexposure to the sun or other radiation,
contact with flames, chemicals or electricity, or smoke inhalation.
Seek immediate care for major burns, which:

 Are deep
 Cause the skin to be dry and leathery
 May appear charred or have patches of white, brown or black
 Are larger than 3 inches (about 8 centimeters) in diameter or cover the hands, feet, face,
groin, buttocks or a major joint
A minor burn that doesn't require emergency care may involve:

 Superficial redness similar to a sunburn

 Pain
 Blisters
 An area no larger than 3 inches (about 8 centimeters) in diameter
Treating major burns
Until emergency help arrives:

 Protect the burned person from further harm. If you can do so safely, make sure the person
you're helping is not in contact with the source of the burn. For electrical burns, make sure
the power source is off before you approach the burned person.
 Make certain that the person burned is breathing. If needed, begin rescue breathing if you
know how.
 Remove jewelry, belts and other restrictive items, especially from around burned areas and
the neck. Burned areas swell rapidly.
 Cover the area of the burn. Use a cool, moist bandage or a clean cloth.
 Don't immerse large severe burns in water. Doing so could cause a serious loss of body heat
(hypothermia).
 Elevate the burned area. Raise the wound above heart level, if possible.

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 Watch for signs of shock. Signs and symptoms include fainting, pale complexion or
breathing in a notably shallow fashion.
Treating minor burns
For minor burns:

 Cool the burn. Hold the burned area under cool (not cold) running water or apply a cool, wet
compress until the pain eases.
 Remove rings or other tight items from the burned area. Try to do this quickly and gently,
before the area swells.
 Don't break blisters. Fluid-filled blisters protect against infection. If a blister breaks, clean the
area with water (mild soap is optional). Apply an antibiotic ointment. But if a rash appears,
stop using the ointment.
 Apply lotion. Once a burn is completely cooled, apply a lotion, such as one that contains aloe
vera or a moisturizer. This helps prevent drying and provides relief.
 Bandage the burn. Cover the burn with a sterile gauze bandage (not fluffy cotton). Wrap it
loosely to avoid putting pressure on burned skin. Bandaging keeps air off the area, reduces
pain and protects blistered skin.
 If needed, take an over-the-counter pain reliever, such as ibuprofen (Advil, Motrin IB,
others), naproxen sodium (Aleve) or acetaminophen (Tylenol, others).

Fractures
A fracture is a broken bone. It requires medical attention. If the broken bone is the result of
major trauma or injury
Also call for emergency help if:

 The person is unresponsive, isn't breathing or isn't moving. Begin CPR if there's no breathing
or heartbeat.
 There is heavy bleeding.
 Even gentle pressure or movement causes pain.
 The limb or joint appears deformed.
 The bone has pierced the skin.
 The extremity of the injured arm or leg, such as a toe or finger, is numb or bluish at the tip.
 You suspect a bone is broken in the neck, head or back.
Don't move the person except if necessary to avoid further injury. Take these actions
immediately while waiting for medical help:

 Stop any bleeding. Apply pressure to the wound with a sterile bandage, a clean cloth or a
clean piece of clothing.
 Immobilize the injured area. Don't try to realign the bone or push a bone that's sticking out
back in. If you've been trained in how to splint and professional help isn't readily available,
apply a splint to the area above and below the fracture sites. Padding the splints can help
reduce discomfort.

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 Apply ice packs to limit swelling and help relieve pain. Don't apply ice directly to the skin.
Wrap the ice in a towel, piece of cloth or some other material.
 Treat for shock. If the person feels faint or is breathing in short, rapid breaths lay the person
down with the head slightly lower than the trunk and, if possible, elevate the legs.

Types of Fractures
Fractures have a variety of names. Below is a listing of the common types that may occur:
 Greenstick - Incomplete fracture. The broken bone is not completely separated.
 Transverse - The break is in a straight line across the bone.
 Spiral - The break spirals around the bone; common in a twisting injury.
 Oblique - Diagonal break across the bone.
 Compression - The bone is crushed, causing the broken bone to be wider or flatter in
appearance.
 Comminuted - The break is in three or more pieces and fragments are present at the
fracture site.
 Segmental - The same bone is fractured in two places, so there is a "floating" segment of
bone.

Shock
Shock is a critical condition brought on by the sudden drop in blood flow through the body.
Shock may result from trauma, heatstroke, blood loss, an allergic reaction, severe infection,
poisoning, severe burns or other causes. When a person is in shock, his or her organs aren't
getting enough blood or oxygen. If untreated, this can lead to permanent organ damage or even
death.
The main types of shock include:

 Cardiogenic shock (due to heart problems)

 Hypovolemic shock (caused by too little blood volume)
 Anaphylactic shock (caused by allergic reaction)
 Septic shock (due to infections)
 Neurogenic shock (caused by damage to the nervous system)

Signs and symptoms of shock vary depending on circumstances and may include:

 Cool, clammy skin

 Pale or ashen skin
 Bluish tinge to lips or fingernails (or gray in the case of dark complexions)
 Rapid pulse
 Rapid breathing
 Nausea or vomiting
 Enlarged pupils

17
 Weakness or fatigue
 Dizziness or fainting
 Changes in mental status or behavior, such as anxiousness or agitation
Seek emergency medical care
If you suspect a person is in shock, call for emergency. Then immediately take the following
steps:

 Lay the person down and elevate the legs and feet slightly, unless you think this may cause
pain or further injury.
 Keep the person still and don't move him or her unless necessary.
 Begin CPR if the person shows no signs of life, such as not breathing, coughing or moving.
 Loosen tight clothing and, if needed, cover the person with a blanket to prevent chilling.
 Don't let the person eat or drink anything.
 If the person vomits or begins bleeding from the mouth, and no spinal injury is suspected,
turn him or her onto a side to prevent choking.

Drowning

First Aid Management of Drowning

Drowning is defined as respiratory impairment following submersion or immersion

in fluid media – almost all include drowning in water.

Cause of drowning may be either intentional or accidental and it is one of the

commonest causes of injurious deaths in developing countries. Drowning is
common among males in comparison to females, as well as among younger age
groups compared to elderly.

More than half of drowning cases take place in rivers, lakes and swimming pools
than sea. It is to be noted that a deep place is not a necessity when comes to
drowning, this happens specially when other factors like alcohol intoxication is
operational; you can drown in your own bathtub.

Mechanism of death in drowning victim:

Immersion deaths (sometimes can die in water by aspiration of water only up to the
level of the larynx, here the amount of water entering to deep lung tissue is no or
minimal. This is called as dry drowning. The mechanism could be laryngeal spasm,
vagal inhibition or hypothermia.)

Drowning deaths (these are due to aspiration of fluid beyond the larynx up to the

18
distal part of the lung tissue. The mechanism could be mechanically induced
cerebral hypoxia due to respiratory tract obstruction by the fluid. This is called wet
drowning.)

Natural illness before or after entering to water (can fall in to water following
myocardial infarction/heart attack or due to struggle in water to survive can
precipitate pre-existing myocardial infarction.)

Injuries received before or after entering to water. (e.g. thrown into a body of water
following motor vehicle accident)

In a near-drowning case damage to the delicate lung tissue caused by water, sand,
mud etc. can later cause collapse of alveoli leading to adult respiratory distress
syndrome (ARDS) which can be fatal.

Animal predation ( although not true drowning; crocodiles, sharks can cause serious
injuries)

Pathophysiology of drowning:

Wet-drowning: – lungs are not adapted to extract oxygen from water/fluids.

Therefore when water enter into the airways it cause mechanical obstruction of
airways leading to absent O2 transfer to blood, causing hypoxia and death.

Dry-drowning: – when water suddenly hits larynx it can go into spasm totally
obstructing the airway leading to hypoxia without any water entering lung. In some
sensitive individuals sudden gush of water (cold) onto larynx can lead to extreme
vagal nerve discharge causing the heart to stop suddenly.

First aid Management:

Ensure safety of yourself and others.

Remove the patient safely from the water. Do not attempt swimming rescue if you
are not competent in swimming rescues.

Call for life guards and emergency services.

Check the patency of airway, turn patient to lateral side allowing the water to clear
out from the upper airway. Remove any mud, dentures etc.

Check for breathing by feeling respiratory air, looking for the chest movement and
listing for breath sounds. In the same time check for pulse also.

If the victim is conscious coughing and vomiting water keep him on lateral position

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to prevent further aspiration and reassure the victim.

If unconscious and not breathing, start rescue breathing.

If the person regains consciousness and starts breathing, turn him to lateral side and
keep monitoring.

If the pulse is also absent initially start CPR instead.

Remove wet clothing and cover with dry warm cloth to prevent hypothermia.

Attend to other injuries if present (e.g. bleeding following animal bites).

Rescue breathing can begin in the water, but all other care requires that the victim be safely out
of the water. If other people are available, send person to get help and call 911. Send another
person to get an automated external defibrillator (AED).

If the victim is breathing, he or she should be placed on their side in the recovery position to
prevent potential aspiration should vomiting occur (inhaling vomit into the lung).

If the victim is not breathing and has no pulse, begin cardiopulmonary resuscitation (CPR). This
is one of the exceptions to the hands-only CPR guidelines. If possible, rescue breathing needs to
be initiated in a possible drowning victim.

There are some controversies in medical research that potentially might confuse bystanders who
are willing to help. It is important to remember that a drowning victim who is not breathing and
does not have a pulse is effectively dead, and any attempts at helping are appropriate.

Recently, chest compression only resuscitation has been endorsed by the American Heart
Association and the American College of Cardiology, and rescue breathing is not
recommended. This is not the case with drowning, since the initial insult to the body is lack of
oxygen. This requires providing oxygen to the victim as soon as possible. This is a different
situation than a patient who collapses on dry land, usually has a heart rhythm disturbance and
adequate oxygen levels are present in the blood for a few minutes.

It usually is recommended to start rewarming drowning victims by removing wet clothing and
covering them in warm blankets. This is appropriate if the patient who has not lost their pulse, or
has been resuscitated and is awake.

For a potential drowning victim who was administered CPR, and the pulse has returned, but is
still not awake, keeping the patient cool may be appropriate.

Poisoning

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Poisoning is a condition or a process in which an organism becomes chemically harmed
(poisoned) by a toxic substance or venom of an animal.

Acute poisoning is exposure to a poison on one occasion or during a short period of time.
Symptoms develop in close relation to the degree of exposure. Absorption of a poison is
necessary for systemic poisoning (that is, in the blood throughout the body). In contrast,
substances that destroy tissue but do not absorb, such as lye, are classified as corrosives rather
than poisons. Furthermore, many common household medications are not labeled with skull and
crossbones, although they can cause severe illness or even death. In the medical
sense, toxicity and poisoning can be caused by less dangerous substances than those legally
classified as a poison. Toxicology is the study and practice of the symptoms, mechanisms,
diagnosis, and treatment of poisoning.

Chronic poisoning is long-term repeated or continuous exposure to a poison where symptoms do

not occur immediately or after each exposure. The patient gradually becomes ill, or becomes ill
after a long latent period. Chronic poisoning most commonly occurs following exposure to
poisons that bioaccumulate, or are biomagnified, such as mercury, gadolinium, and lead.

Contact or absorption of poisons can cause rapid death or impairment. Agents that act on
the nervous system can paralyze in seconds or less, and include both biologically
derived neurotoxins and so-called nerve gases, which may be synthesized for warfare or
industry.

Inhaled or ingested cyanide, used as a method of execution in gas chambers, almost instantly
starves the body of energy by inhibiting the enzymes in mitochondria that make ATP.
Intravenous injection of an unnaturally high concentration of potassium chloride, such as in the
execution of prisoners in parts of the United States, quickly stops the heart by eliminating
the cell potential necessary for muscle contraction.

Most biocides, including pesticides, are created to act as poisons to target organisms, although
acute or less observable chronic poisoning can also occur in non-target organisms (secondary
poisoning), including the humans who apply the biocides and other beneficial organisms.

Many substances regarded as poisons are toxic only indirectly, by toxication. An example is
"wood alcohol" or methanol, which is not poisonous itself, but is chemically converted to
toxic formaldehyde and formic acid in the liver. Many drug molecules are made toxic in the
liver, and the genetic variability of certain liver enzymes makes the toxicity of many compounds
differ between individuals.

Exposure to radioactive substances can produce radiation poisoning, an unrelated phenomenon.

Signs and symptoms of poisoning

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The symptoms of poisoning will depend on the type of poison and the amount taken in, but
general things to look out for include:

 vomiting
 stomach pains
 confusion
 drowsiness and fainting fits
If a child suddenly develops these symptoms, they may have been poisoned, particularly if
they're drowsy and confused.

What to do

If you suspect that someone has taken an overdose or has been poisoned, don't try to treat them
yourself. Get medical help immediately.

If they're showing signs of being seriously ill, such as vomiting, loss of consciousness,
drowsiness or seizures (fits), request an ambulance or take the person to your local hospital .In
serious cases, it may be necessary for the person to stay in hospital for treatment. Most people
admitted to hospital because of poisoning will survive.

SPRAIN

A sprain is a stretching or tearing of ligaments — the tough bands of fibrous tissue that connect
two bones together in your joints. The most common location for a sprain is in your ankle.

Initial treatment includes rest, ice, compression and elevation. Mild sprains can be successfully
treated at home. Severe sprains sometimes require surgery to repair torn ligaments.

The difference between a sprain and a strain is that a sprain injures the bands of tissue that
connect two bones together, while a strain involves an injury to a muscle or to the band of tissue
that attaches a muscle to a bone.

Signs and symptoms will vary, depending on the severity of the injury, and may include:

 Pain

 Swelling

 Bruising

 Limited ability to move the affected joint

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  Hearing or feeling a "pop" in your joint at the time of injury
Causes

A sprain occurs when you overextend or tear a ligament while severely stressing a joint. Sprains
often occur in the following circumstances:

 Ankle — Walking or exercising on an uneven surface, landing awkwardly from a jump

 Knee — Pivoting during an athletic activity

 Wrist — Landing on an outstretched hand during a fall

 Thumb — Skiing injury or overextension when playing racquet sports, such as tennis

Children have areas of softer tissue, called growth plates, near the ends of their bones. The
ligaments around a joint are often stronger than these growth plates, so children are more likely
to experience a fracture than a sprain.

Risk factors

Factors contributing to sprains include:

 Environmental conditions. Slippery or uneven surfaces can make you more prone to
injury.

 Fatigue. Tired muscles are less likely to provide good support for your joints. When you're
tired, you're also more likely to succumb to forces that could stress a joint.

 Poor equipment. Ill-fitting or poorly maintained footwear or other sporting equipment can
contribute to your risk of a sprain.
Prevention

Regular stretching and strengthening exercises for your sport, fitness or work activity, as part of
an overall physical conditioning program, can help to minimize your risk of sprains. Try to be in
shape to play your sport; don't play your sport to get in shape. If you have a physically
demanding occupation, regular conditioning can help prevent injuries.

You can protect your joints in the long term by working to strengthen and condition the muscles
around the joint that has been injured. The best brace you can give yourself is your own "muscle

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 brace." Ask your doctor about appropriate conditioning and stability exercises. Also, use
footwear that offers support and protection.

Breathing difficulties

Most people take breathing for granted. People with certain illnesses may have breathing
problems that they deal with on a regular basis.

This article discusses first aid for someone who is having unexpected breathing problems.

Breathing difficulties can range from:

 Being short of breath

 Being unable to take a deep breath and gasping for air

 Feeling like you are not getting enough air

Considerations
Breathing difficulty is almost always a medical emergency. An exception is feeling slightly
winded from normal activity, such as exercise.

Causes
There are many different causes for breathing problems. Common causes include some health
conditions and sudden medical emergencies.

Some health conditions that may cause breathing problems are:

 Anemia (low red blood cell count)

 Asthma
 Chronic obstructive pulmonary disease (COPD), sometimes called emphysema or chronic
bronchitis

 Heart disease or heart failure

 Lung cancer, or cancer that has spread to the lungs

 Respiratory infections, including pneumonia, acute bronchitis, whooping cough, croup, and
others
Some medical emergencies that can cause breathing problems are:

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 Being at a high altitude

 Blood clot in the lung

 Collapsed lung (pneumothorax)

 Heart attack
 Injury to the neck, chest wall, or lungs

 Pericardial effusion (fluid surrounding the heart that can stop it from filling properly with blood)

 Pleural effusion (fluid surrounding the lungs that can compress them)

 Life-threatening allergic reaction

 Near drowning, which causes fluid buildup in the lungs

Symptoms
People having breathing difficulty will often look uncomfortable. They may be:

 Breathing rapidly

 Unable to breathe lying down and need to sit up to breathe

 Very anxious and agitated

 Sleepy or confused
They might have other symptoms, including:

 Dizziness or lightheadedness

 Pain

 Fever

 Cough
 Nausea

 Vomiting

 Bluish lips, fingers, and fingernails

 Chest moving in an unusual way

 Gurgling, wheezing, or making whistling sounds

 Muffled voice or difficulty speaking

 Coughing up blood

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 Rapid or irregular heartbeat

 Sweating

If an allergy is causing the breathing problem, they might have a rash or swelling of the face,
tongue, or throat.

If an injury is causing breathing difficulty, they might be bleeding or have a visible wound.

First Aid
If someone is having breathing difficulty, call 911 or your local emergency number right away,
then:

 Check the person's airway, breathing, and pulse. If necessary, begin CPR.
 Loosen any tight clothing.

 Help the person use any prescribed medicine (such as an asthma inhaler or home oxygen).

 Continue to monitor the person's breathing and pulse until medical help arrives. DO NOT
assume that the person's condition is improving if you can no longer hear abnormal breath
sounds, such as wheezing.

 If there are open wounds in the neck or chest, they must be closed immediately, especially if air
bubbles appear in the wound. Bandage such wounds at once.

 A "sucking" chest wound allows air to enter the person's chest cavity with each breath. This can
cause a collapsed lung. Bandage the wound with plastic wrap, a plastic bag, or gauze pads
covered with petroleum jelly, sealing it on three sides, leaving one side unsealed. This creates a
valve to prevent air from entering the chest through the wound, while allowing trapped air to
escape from the chest through the unsealed side.
DO NOT
DO NOT:

 Give the person food or drink.

 Move the person if there has been a head, neck, chest or airway injury, unless it is absolutely
necessary. Protect and stabilize the neck if the person must be moved.

 Place a pillow under the person's head. This can close the airway.

 Wait to see if the person's condition improves before getting medical help. Get help immediately.

When to Contact a Medical Professional

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 Call 911 or your local emergency number if you or someone else has any of the symptoms of
difficult breathing, in the Symptoms section above.
Also call your doctor or health care provider right away if you:

 Have a cold or other respiratory infection and are having difficulty breathing

 Have a cough that does not go away after 2 or 3 weeks

 Are coughing up blood

 Are losing weight without meaning to or having night sweats

 Cannot get to sleep or wake up at night because of breathing difficulty

 Notice it is hard to breathe when doing things that you normally do without breathing difficulty,
for example, climbing stairs

Also call your provider if your child has a cough and is making a barking sound or wheezing.

Prevention
Some things you can do to help prevent breathing problems:

 If you have a history of severe allergic reactions, carry an epinephrine pen and wear a medical
alert tag. Your provider will teach you how to use the epinephrine pen.

 If you have asthma or allergies, eliminate household allergy triggers like dust mites and mold.
 DO NOT smoke, and keep away from secondhand smoke. DO NOT allow smoking in your
home.

 If you have asthma, see the article on asthma to learn ways to manage it.

 Make sure your child gets the whooping cough (pertussis) vaccine.
 Make sure your tetanus booster is up to date.

 When traveling by airplane, get up and walk around every few hours to avoid forming blood
clots in your legs. Once formed, clots can break off and lodge in your lungs. While seated, do
ankle circles and raise and lower your heels, toes, and knees to increase blood flow in your legs.
If traveling by car, stop and get out and walk around regularly.

 If you are overweight, lose weight. You are more likely to feel winded if you are overweight.
You are also at greater risk for heart disease and heart attack.

Wear a medical alert tag if you have a pre-existing breathing condition, such as asthma

Joint injuries

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A sprained joint causes bleeding in the subcutaneous tissue. In addition to pain, the injured area
gathers fluids and swells.

Joint injury occurs when the ligaments surrounding the joint stretch or tear. Even other soft
tissues may be injured. The injury is not always visible. Sometimes, a joint may be dislocated
and remain in a clearly visible malposition.

Causes:
• Falling, slipping.
• Hitting something.
• Twisting of a limb.

Symptoms:
• Pain, swelling.
• Possible malposition.
• Bruise.
• The limb cannot be used as usual.

First aid:
• Apply pressure to the injured area immediately.
• Apply cold to the area for approximately 15–20 minutes. Do not apply cold directly to the skin.
• Bandage the injury carefully to support the joint and the cold.
• If necessary, help the injured person to a doctor.
• If a joint is dislocated, leave it in the malposition and help the injured person to a doctor.
Support the joint and immobilise it as far as possible for the duration of the transport.
Call for help if necessary.

Transportation of patient

Unless the area becomes dangerously unsafe, it is best to avoid

moving an injured or ill person. The reason for this is because any
unnecessary movement can cause additional injury and pain to
the person; resulting in complications for their recovery.

Walking Assist
This method requires the injured or ill person to be conscious.

Technique:

 Place the injured or ill person's arm across your shoulders

and hold it in place with one hand.
 Use your other hand and place it around the person's waist
to support them.

Two-Person Seat Carry

This method requires two people to assist the conscious person in need of transport.

28
Technique:

 Put one arm behind the person's thighs and the other across the person's back.
 Interlock your arms with those of the second person assisting in the transport so that it
goes behind the person's legs and across their back.
 Lift the injured or ill person that is sitting on the “seat” created by the arms of the first-
aiders.

One Person Carry

This method can be used for both conscious and unconscious persons. Similar methods include
piggyback style, fireman carry, or pack-strap carry.

Technique:

 Kneel in front of the person with your back to them.

 Bring your arms around the victim's knees.
 Grasp their hands over your chest.

Note: avoid injury to your own back by keeping straight and lifting with your legs.

Drag Methods
This method includes the blanket drag, ankle drag and the clothes drag.

Technique:

 With the blanket drag method, gather half of the blanket and place it against the person's
side.
 Roll the person towards you and reach over to place the blanket so that it is positioned
under the person.
 Roll the person on the blanket and gather the blanket at the head and drag.

 With the ankle drag method, firmly grasp the person's ankles and move backward in a
straight line.

 With the clothes drag method, grasp the person's clothing behind the neck (gather
enough to secure a firm grip).
 Use the clothing to pull the person head first.

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Stretcher
A stretcher is device that is used to transport an ill or injured person by having the person lie on
the object. This requires at least two people to help assist in the transport. When a stretcher is not
available, objects can be used to create one. There are several ways to make a stretcher. The
technique below is one way.

Technique:

 Use two poles that are somewhat longer than the victim's
height.
 With a few shirts and push the poles through the sleeves.

Note: you can also use a tarp or blanket and wrap the
poles in between.

Disaster management

First Aid during Disaster Management means, the immediate help extended to the affected
victims of any disaster. The disaster can be natural or made. The proportion of the disaster can be
of small scale or may be of catastrophic proportion. The importance of first aid during an
emergency can save many lives as often the rescue operation initiated by the government bodies
and private agencies takes time, especially if the disaster happens in a geographically remote
place. Sometimes the severity of the disaster makes it inaccessible for the relief operations to
take momentum. In such a scenario, the basic knowledge of first aid during any disaster would
not only reduce the amount of suffering, but would also lead to reduction in the number of
fatalities.

Classification of First Aids during Disasters–

Let us understand the first aid required during various disaster management scenario-

Possible First Aid

Type of Disaster Man-made of Natural Services
Fire Man-made, owing to (1)Assist people to
human negligence evacuate the affected
premises through the safest
route.(2)Ensure that
electrical fittings are
untouched.(3)Shut down
all electrical connections,

30
 by putting off the electrical
mains.
(4)Avoiding the sprinkling
of water on fire effected
person or objects.

(5)Appropriate usage of
fire extinguishers.

(6)Protecting children from

the impact of the fire.

(7)Playing second fiddle to

the firemen once the fire
services personnel arrives.

(1) Putting of all

electrical appliances.(2)
Protect children from the
impact of the fire.(3)
Look for fire extinguisher.
(4) Move out through the
emergency exit, even if it
means getting drenched in
the rain.

(5) Protect the human life

fist followed by other non-
Natural, owing to living objects.
Fire thunderstorms
Earthquake Natural (1) Understand and
identify the tremors even if
it is subtle.(2) Ask all the
people residing inside the
building to come out in
open space.(3) Pass on the
message to all possible
known contacts in the area
through telephone if the
time happens to be odd

31
 hours like late nights or
early morning, when
people are fast asleep.
(4) Give priority to save
human lives rather than
protecting non-living
objects.

(5) Protect the children

from building breakdown
etc.

(1) Protect the humans

from high speed winds and
heavy rains.(2) Ensure
smooth flow of water so as
to prevent flooding and
water clogging.(3)
Protect external electrical
and electronic fittings from
lightning have associated
with cyclone, which may
result in fire.
(4) Ensure that high
speed winds don’t cause
physical harm to the
residents by keeping all the
inhabitants in safe places.
Cyclone Natural
Flood Natural (1) Protect people from
water currents.(2) Protect
inhabitants from water
borne diseases.(3) Ensure
everyone consumes non-
contaminated food and
water.
(4) Arranging essentials
and necessities if the water
level is increasing.

(5) Moving to safer

places if the water level
isn’t receding after a point

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 of time.

Mental or Physical Aid?

First Aid during a disaster would comprise of physical and mental aid to be rendered to the
sufferers. Sometimes the physical suffering encountered by the victims may be less vis-à-vis that
of the mental agony. The mental agony may further lead to cases where the population goes into
depression. Apart from the physical assistance in helping the affected to overcome the injury,
first aid during emergency should have quality counseling and support services as well.

The first aid immediately after a disaster may consist of the following-

(1) Attending to the individuals who have broken limbs, bones and apply local massage therapy
only if the aid provider is well-trained on the same.

(2) Disinfecting the body parts/areas where there has been minor bruises with antiseptic and then
plastering those areas with bandage

(3) Attending the parts having burns with utmost caution so as to avoid bringing those areas in
close contact with water

(4) Putting in place a working communication system, even if there has been a complete
breakdown of the same

(5) Attending to the patients on a priority basis depending upon the suffering an individual is
going through

(6) Counseling the sufferers with minor ailments and increasing their motivational level so that
they can join hands with the relief and rescue operators.

(7) Ensure that a chaotic situation is prevented where too many cooks spoils the broth.

(8) Posses the information database regarding the primary health care centers, hospitals,
international and local non-governmental bodies, apart from the civil defense departments of
different areas, which in turn would reduce the response time, immediately after a disaster.

(9) Prevent the spread of contaminated food and drinking water by ensuring the hygienic
distribution procedures.

(10)Focus on personal hygiene of each and every patient impacted by the disaster, which in turn
would reduce the chances of an epidemic, borne out of the tragedy

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(11)Provide post-accident SOS support services to all the affected individuals, which in turn
would reduce the mortality rate of the sufferers.

(12)Personal ability to withstand an environment full of cries and chaos prevailing immediately
after a disaster is an absolute must.

Conclusion
Apart from the aforesaid points, there are many other allied aspects which need to be kept in
mind while handling disaster management episodes. Civil defense colleges are being set up in
many countries, however, the important job of training each and every citizen so as to know the
reaction mechanism immediately after a disaster is still in the infancy stage. In order to reach that
level, where every citizen has the rudimentary knowledge of post disaster management policies,
it is pertinent to have a PPP (Public-Private-Partnership) model, where government bodies join
hands with the private organizations so as to reach out to every nook and corner of the globe.
Although it sounds to be a gigantic task, efforts from all the stakeholders involved in the process,
would make the job quite easier. Therefore, it is imperative for everyone concerned to pool in
their efforts and resources, which would culminate in reducing the human suffering, immediately
after a disaster. As they say, Human Lives are the most important thing, resources and wealth
can be earned back, but a life lost is lost forever!

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