# Scouting/BSA/First Aid Merit Badge

Note: a Wikipedia book on First Aid is under development.

## Requirement 1

Satisfy your counselor that you have current knowledge of all first-aid requirements for Tenderfoot, Second Class, and First Class ranks.

## Requirement 2

    Explain how you would obtain emergency medical assistance from your house, on a wilderness camping trip, and during an activity on open water.
At home: Keep emergency numbers posted at the phone along with your address. 911 service is available in most areas. If phones are not working, go to a neighbor that has emergency training. Know where the fire extinguishers are along with the first aid kit.
Wilderness: Cell phone, radio, messenger, or evacuate. Signal fires and sounds are a last resort if you cannot evacuate. Be sure to leave a map and schedule at home to trigger an automatic rescue response.
Open Water: Powered craft should be equipped with a marine band radio tuned to the emergency channel (#16). Flares and smoke bombs can be carried on any boat but must be used with caution. A distress flag (orange with a black dot and a black square) or signal mirror may be useful over short distances.

## Requirement 3

    Explain the term triage.
Triage: the process of sorting victims, as of a battle or disaster, to determine medical priority in order to increase the number of survivors; the determination of priorities for action in an emergency.
During this requirement you also have to do 3b ( which is, "Explain the steps necessary to assess and handle a medical emergency until help arrives.")

## Requirement 4

    Explain the standard precautions as applied to the transmission of infections.
Treat all blood as if it were contaminated with blood borne pathogens. Thoroughly wash your hands with soap and water before and after treating a sick or injured person. Never use your bare hands to stop bleeding. Use a protective barrier, preferably nonlatex disposable gloves (a new, unused plastic food storage bag will work in a pinch). Safely discard all soiled bandages, dressings, and other used first aid items by putting them in a double bag until they can be disposed of properly in a receptacle for bio-hazards. Always wash your hands and other exposed skin with soap and warm water or an alcohol-based hand sanitizer immediately after treating a victim, even if protective equipment was used.

## Requirement 5

    Prepare a first aid kit for your home. Display and discuss its contents with your counselor.
* Suggested items
* Roller bandage, 2-inch (1); Roller bandage, 1-inch (2); Sterile gaze pads, 3-by-3-inch (12); Alcohol swabs (24); Assorted adhesive bandages (1 box); Elastic bandages, 3-inch-wide (2); Adhesive tape (1 roll); Moleskin, 3-by-6-inch (4); Gel pads for blisters and burns (2 packets); Triangular bandages (4); Soap (1 small bar) or alcohol-based hand sanitizing gel (1 travel sized bottle); Triple antibiotic ointment (1 tube); Scissors (1 pair); Tweezers (1 pair); Safety pins (12); Nonlatex disposable gloves (6 pairs); Protective goggles/safety glasses (1 pair); CPR breathing barrier (1); pencil & paper

## Requirement 6

    Explain what action you should take for someone who shows signs of a heart attack, shock, and stroke.
Lay the victim down and elevate legs. Call 911. Keep warm, calm and comfortable. Monitor breathing as CPR may be required before help arrives. Transport only if no EMS is available. Under no circumstances should the patient attempt to drive to the hospital.
    Identify the conditions that must exist before performing CPR on a person.
Rescue breathing is used if the victim does not begin breathing when the airway is opened. It also helps warm a severely hypothermic person who is breathing very slowly. Chest compressions should only be used when there are no signs of circulation: coughing, moving, pulse, skin color takes more than 2 seconds to return after finger pressure is removed.

## Requirement 7

    Demonstrate proper technique in performing CPR using a training device approved by your counselor.
See First Aid/CPR summary

## Requirement 8

    Show the steps that need to be taken for someone suffering from a severe cut on the leg and on the wrist. Tell the dangers in the use of a tourniquet and the conditions under which its use is justified.
The four steps of severe bleeding are:
* Direct pressure -- place a hand with a cloth firmly over the wound and press hard
* Elevation -- if on an extremity, lift the limb over the person's heart
* Pressure point -- place directed pressure at one of the "pressure points". On the arm, this is between the bicep and tricep on the upper arm (a pulse is normally palpable) and on the leg midway down the thigh and between the two-leg muscles.
* Tourniquet -- (FOR USE IN EMERGENCIES ONLY) tie a cravat, rope or belt above the wound as tight as possible, in order to completely cut off circulation to the injured area. The most typical method of tying it is a simple overhand knot, held tight while a pencil or stick is placed on top of the middle of the knot. Another overhand knot is tied, and the pencil or stick can be twisted to tighten the knot. Cutting off circulation for extended periods can lead to the amputation of the limb, so this must not be used unless all other methods have been tried and there is no hope for help in the near future. The time should be noted when the tourniquet is applied, as this will be helpful for the doctors.

## Requirement 9

    Explain when a bee sting could be life-threatening and what action should be taken for prevention and first aid.
Bee stings can cause a fatal reaction called anaphylaxis in people who have a severe allergy to bee venom. It is possible to have the same reaction to foods and medicines (peanuts and shellfish are also common causes of anaphylactic reactions). The effects are nearly immediate -- swelling of the neck and face, sweating, difficulty breathing and hives are among the most common signs. Many people with severe allergies, especially bee stings, carry a device called an Epi-Pen. An Epi-Pen is a dosage of a powerful hormone, epinephrine, which counteracts an anaphylactic reaction. To use it, remove the safety cap and simply press the needle end firmly against the victim's thigh, about midway between the knee and hip. The spring-loaded needle will automatically extend, delivering the epinephrine into the muscle where it will be rapidly transferred into the bloodstream. The effect of the epi-pen is temporary, however, and the person must still get medical attention quickly.
    Explain the symptoms of heatstroke and what action needs to be taken for first aid and prevention.
Heatstroke occurs when the core body temperature rises too far for the body's natural defense mechanisms to function. Ordinarily, if the body temperature goes up, sweat is released; the sweat evaporates from the surface of the skin, thus removing heat from the body. In an absence of water or salt, sweating can not occur and heatstroke begins. It is a serious, life-threatening problem that can cause death in minutes. A victim should be cooled down, by removing clothing, placing in the shade or other methods, and should be given water to drink in small sips. Do not give large gulps. This will make it worse. If convulsions occur, do not attempt to restrain the victim. Do not move the victim!

## Requirement 10

    Describe the signals of a broken bone. Show first-aid procedures for handling fractures, including open (compound) fractures of the forearm, wrist, upper leg, and lower leg using improvised materials.
Definition: If more pressure is put on a bone than it can stand, it will split or break. A break of any size is called a fracture. If the broken bone punctures the skin, it is called an open fracture (compound fracture). A stress fracture is a hairline crack in the bone that develops because of repeated or prolonged forces against the bone.
    There are several types of bone fracture, including:
       • Oblique - a fracture (also called a simple fracture) which goes at an angle to the axis
       • Comminuted - a fracture of many relatively small fragments
       • Spiral - a fracture which runs around the axis of the bone
       • Compound - a fracture (also called open) which breaks the skin
    Broken Bone Dont's:
       • DO NOT move the person unless the broken bone is firmly secured with a splint or sling.
       • DO NOT move a person with an injured hip, pelvis, or upper leg unless it is necessary. If you must move the person, pull the person to safety by his clothes (such as by the shoulders of a shirt, a belt, or pant-legs).
       • DO NOT move a person who has a possible spine injury.
       • DO NOT attempt to straighten a bone or change its position unless blood circulation appears hampered.
       • DO NOT try to reposition a suspected spine injury.
       • DO NOT test a bone's ability to move.
       • DO NOT give the person anything by mouth.

## Requirement 11

    Describe the symptoms and possible complications and demonstrate proper procedures for treating suspected injuries to the head, neck, and back. Explain what measures can be taken to reduce the possibility of further complicating these injuries.
Anybody that has fallen more than standing height, been in a car crash, or hit their head should be suspected of having a back or neck injury. Symptoms may include the person is complaining of any pain in their head, neck, or back, or they have numbness in any of their extremities. However, the person may not be complaining of any pain at all and still have an injury. The problem with these injuries is that any damage to the back and especially the neck can lead to paralysis or even death. A head injury can lead to brain damage, blood loss, or death. The most important thing to remember about spinal injuries is not to move the person unless absolutely necessary. Moving the person can make a bad injury worse. The only times when you should move such a person is if:
       • You must move them to get to a more seriously injured person.
       • The person is in a dangerous position and you are able to move them to a safer place
       • You need to perform CPR and need to place the person on a hard surface
The best thing that you can do is to tell the person not to move. If needed, hold their head in place. Medical professionals call this "holding C-Spine, " or the inline neutral position. Make sure that the person can breathe and they have a pulse, then wait for help to arrive. If the person is bleeding from the head, try to stop the bleeding. Direct pressure is important here, but do not press too hard as you might further injure the skull. This is the one case where you do not treat for shock! If you notice a clear fluid coming from the ears, nose or mouth, do not stop it.

## Requirement 12

Describe the symptoms, proper first-aid procedures, and possible prevention measures for the following conditions
    Hypothermia
Hypothermia occurs when the core body temperature becomes too cold. Ordinarily, the body begins shivering to regain lost heat. When there is no longer enough energy for this to occur, hypothermia begins and the victim will stop shivering and become confused or unconscious. Warming the victim's body may require extra clothing (or the replacement of wet clothing) or using a fire or body heat. Re-warming should occur over time (rather than suddenly) unless the victim's body temperature also dropped suddenly (i.e. fell into an icy lake). Rapid re-warming of a chronic hypothermia patient can lead to re-warming shock
    Convulsions/Seizures
Convulsions are involuntary muscle spasms that can be caused by a variety of diseases and injuries. There is no emergency treatment, but it is important to not hold the victim down or otherwise restrain him, and to give nothing by mouth (contrary to widely-held opinion, the victim will not "choke on his tongue"). These seizures are not uncommon in people afflicted with epilepsy, and these convulsions are generally not dangerous (though a doctor should still be consulted if the seizure lasts longer than 5 minutes). You should also remove all loose furniture that the victim could injure themselves by flailing a body part into it. If the person does not regularly have seizures, medical help should be called for. Try to reassure the person and be sure that they can breathe. Medical professionals will want to know how long the seizure lasted and if the person injured themselves in any way, especially their head, neck, or back.
    Frostbite
Frostbite occurs when an extremity, often fingers or toes, freezes completely. The skin will first turn blue, then white, and finally black. Get the person to a warm area. Then warm the hand or foot slowly in water, beginning with a room temperature and gradually adding warmer and warmer water. Don't wrap the affected area in anything, this could cause the affected tissue to be killed off.
    Dehydration
Dehydration occurs when there is insufficient amount of water for the normal functioning of the body. It is a serious and potentially life-threatening condition that can result in lowered blood pressure, dizziness, and fainting, among other things. Treatment is usually by replenishing the body with necessary water and electrolytes. It is most important to give the person water. Beverages like soda are not good but are better than nothing. Eating solid food without water content does not help the condition.
    Bruises, strains, sprains
Black and blue marks are common bruises. Apply ice onto the bruise to prevent blood flow around the area. Next day apply a warm wet cloth. A Strain is an injury to a muscle or tendon. Apply ice pack to reduce swelling and pain. Wrap firmly with an elastic bandage to limit the swelling and to protect the injury. Stay off the injury. Good physical conditioning and proper warmup before exercise help to prevent strained muscles and tendons. A sprain is caused by twisting, wrenching, or lifting movements that tear or stretch tissues around a joint. Raise the injured part, apply cold compresses, and treat as a fracture or broken bone.
    Burns
Mild burns cause a painful reddening of the skin. A typical first-degree burn is a sunburn. A second-degree burn is a burn that raises blisters. Severe or third-degree burns char layers of skin and flesh. Do not treat burns with jellies, creams, greases, or sprays. First aid for mild burns, apply ice packs or damp, cold cloths, do not break blisters, let dry and cover it with a loose bandage. For serious burns, protect the burn by draping it with a clean, damp cloth. Do not apply ice, because it could cause shock. Treat for shock. If victim is able to drink, give lots of milk or water or other fluids. Seek medical attention, quickly.
    Abdominal pain
A stomachache is nothing more than a pain caused by overeating, eating too fast, or eating an odd mixture of strange or unusual foods. Have person lie down. Give an antiacid to help relieve the pain. Don’t give the person anything solid to eat.
    Broken, chipped, or loosened tooth
Gently clean. Place cold compress on face, to minimize swelling. Go to the dentist immediately.
    Knocked-out tooth
Pick up tooth carefully by the crown, not by the roots. If dirty gently rinse with water or victims saliva . place in container of milk or sterilized water and go immediately to the dentist. The dentist will prescribe antibiotics for infection.
    Muscle cramps
Muscle cramps are usually caused by lack of water and or electrolytes. Muscle cramps can be minor or painful. The pain might go away in a few minutes. If not, gently massage the cramped muscle you may also try applying ice. Drink plenty of water/fluids/ gatorade to help prevent future cramps.

## Requirement 13

Do the following:
    a. Describe the conditions under which an injured person should be moved.
With helpers under your supervision, improvise a stretcher and move a presumably unconscious person.
'With your counselor's approval, arrange a visit with your patrol or troop to an emergency medical facility or through an American Red Cross Chapter for a demonstration of how an AED is used.
    b. If a sick or injured person must be moved, tell how you would determine the best method.

## Requirement 14

    Teach another Scout a first-aid skill selected by your counselor. Use the EDGE system if needed.

## External links

* First Aid Merit Badge with Workbook PDF, current requirements, and resources.
* Earning Merit Badges in the Boy Scouts of America
* Merit Badges Required to Attain Eagle Scout
* Camping | Citizenship in the Community | Citizenship in the Nation | Citizenship in the World | Communications | Cooking | Cycling OR Hiking OR Swimming | Emergency Preparedness OR Lifesaving | Environmental Science OR Sustainability | Family Life | First Aid | Personal Fitness | Personal Management |
* Earning Merit Badges in the Boy Scouts of America
* Safety
* Emergency Preparedness | Fire Safety | First Aid | Lifesaving | Safety