FOR A SAFE FUTURE..

FIRST Al

GUIDE FOR

USDA

EMPLOYEES

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Agriculture Handbook No. 227

United States Department of Agriculture
FOREWORD

This First Aid Guide is for use in emergencies by

all employees of the Department of Agriculture.

It should be particularly helpful for employees who

work in areas where medical facilities are not

readily available. The guide reflects the current

concepts of physicians, the American Red Cross

and others in the field. As first-aid concepts

change and are found valid, new editions or corrections will be made.

It has been said, in truth, that the only good

that can come from any accident is knowledge

of how to prevent similar accidents and injuries.

Every employee in this Department is involved in

our accident prevention program. Working together we can make the Department a safe and

healthy place for all to work.

This guide replaces several that have been published by various agencies of the Department.

Information and sketches have been freely used

from the agency guides, especially the Forest

Service guide, and from the American Red Cross

First Aid Text Book.

Special acknowledgment is made to Melvin T.

Johnson, M.D., former Chief of the Health Division, now Assistant Director of the Medical Division of the U.S. Civil Service Commission, who

planned the publication before transferring to the

Commission.

Henry Shepherd Lee K. Buchanan/ M.D.

Safety and Welfare Officer Chief, Health, Safety,

and Welfare Division

Office of Personnel

Issued October 1962
INDEX

Page

Abdominal wounds 43

Acid poisoning 13

Alkali poisoning 13

Animal bites 44

Apoplexy-StroUc 49

Appendicitis 52

Arm fracture 29

Arterial bleeding 4

Artificial respiration 8

Back fracture 32

Bandaging 42

Bites, animal 44

Bites, insect 16

Bites, snake 14

Bleeding, serious 4

Blisters 46

Bodies in ear 55

Bodies in nose 55

Boils 54

Bone fractures 29

Bruises 40

Burns 21

Carrying victims 60

Chemical burns 23

Chigger bites 18

Choking 11

Cold injuries 27

Colds 54

Collarbone fracture 36

Compound fracture 29

Concussion, skull 31

Crushed foot 37

Crushed hand 37

Cut artery 4

Cut vein 4

Diarrhea 53

Dislocations 38

Drowning 11

Earache 55

Ear injury 55

Elbow fracture 36

Electrical burns 24

Electric shock 11

Emotional stress 56

Epilepsy 51

Page

Excessive heat 24

Exposure to cold 27

Eye wounds 44

Fainting 50

Finger fracture 37

First aid kits 62

Food poisoning 13

Foot fracture 37

Fractures 29

Frostbite 27

Gases 7

Gunshot wounds 43

Hand fracture 37

Heart failure 48

Heart stoppage 9

Heat exhaustion 25

Heat injuries 21

Hernia 52

Hives 55

Infected wounds 46

Injuries due to cold 27

Insect stings 16

Internal injury 53

Ivy poison 19

Jaw fracture 35

Kneecap fracture 37

Leg fracture 29

Lightning 11

Loading victims 60

Medical emergencies. ... 47

Neck fracture 32

Nosebleed 5

Nose fracture 35

Nose injury 55

Oak poison 19

Objects under nails 45

Objects under skin 45

Pelvis fracture 33

Pimples 54

Poisoning 12

Poison ivy 19

Poison oak 19

Poison snakes 14

Poison sumac 19

Preparing to carry 59
Pressure points

Principles of first aid.

Puncture wounds. . . .

Red bug bites

Red eyes

Rib fracture

Scalds

Scorpion bites

Serious bleeding. . . .

Shock

Simple fracture

Skull fracture

Smoke

Snake bite

Snowblindness

Spider bites

Spine fracture

Spotted fever tick

Page

4

3

42

18

55

34

21

17

4

6

29

31

10

14

28

17

32

18

Sprains

Stings

Stoppage of breath.

Stoppage of heart. .

Strains

Styes

Sunburn

Sunstroke

Tick bites

Toe fracture

Toothache

Transportation

Tronsporting victims.

Uses of kit material.

Venous bleeding.. .

Wounds

Wound treatment...

Wrist fracture

For forms to be filled out, see inside back cover.

Page

39

16

7

9

40

55

24

24

18

37

55

58

58

63

4

41

41

37

This First Aid Guide presents instructions for use in o wide

variety of emergency situations. Tfie guide is not, tiowever,

intended to cover some of the specialized needs for emergency

medical care that might arise in the event of a nuclear attack.

We recommend that employees of the Department and their

families also have and become familiar with publications especially geared to nuclear emergencies. One such recommended

publication is "Family Guide—Emergency Health Care" (published by the Office of Civil Defense, Department of Defense,

and the Public Health Service, Department of Health, Education, and Welfare).
PRINCIPLES OF FIRST AID

DO THESE THINGS FIRST:

1. Restore breathing.

2. Stop severe bleeding.

3. Treat shock.

4. Call a doctor immediately.

FIRST AID
SERIOUS BLEEDING CUT ARTERY, VEIN

SERIOUS BLEEDING

Cut Artery or Vein

Symptoms

1. Cut artery, bright red blood

spurts or wells up

2. Cut vein, dork red blood flows

steadily or oozes

First Aid

1. Remove or cut clothing from

wound

2. Always apply pressure at once.

Seconds count. Loss of 2 pints

of blood can be fatol.

a. Apply direct firm strong

pressure preferably on sterile

dressing over wound first.

Direct pressure on the wound

will seldom fail to control

bleeding if enough pressure

is used.

b. If this fails to stop flow,

apply firm strong pressure to

nearest pressure point. See

sketches.

c. A tourniquet should only be

used for cut arteries that cannot be controlled by a. or b.
Internal Bleedins

Symptoms

1. Restlessness

2. Anxiety

3. Thirst

4. Pale face

•5. Weak, rapid pulse

6. Weakness

First Aid

1. Keep victim flat on back. Exception: If he cannot breathe

because of lung puncture.

2. Turn his head to side for vomitins.

3. Keep him quiet, reassured.

4. Move him only in lying position to a hospital.

Nose Bleed

1. Have victim sit with head thrown

back, breathing through mouth, \C

clothing at neck loosened.

2. Press nostril continuously to middle portion for 5 to 10 minutes.

This will stop nearly all bleeding

in front of the nasal bones.

3. If bleeding continues pack

gauze into nostril and take victim to doctor.

mé\

SERIOUS BLEEDING INTERNAL, NOSE
SHOCK CAUSE, SYMPTOMS

SHOCK

SHOCK is a depressed state of

body functions caused by injury.

Unless treated, the condition often

results in death, although the injury

itself would not be fatal.

TREAT FOR SHOCK IN ANY INJURY CASE.

Factors Contributing to Shock

1. Exposure

2. Pain

3. Rough handling

4. Improper transportation

5. Loss of blood

6. Fatigue

7. Broken bones and internal injuries

Symptoims

1. Symptoms usually develop

gradually and may not be

noticeable at first

2. Skin pale, cold, moist, clammy

3. Eyes vacant, lackluster, pupils

dilated

4. Breathing shallow, irregular,- air

hunger

5. Nausea, faintness, or even unconsciousness

6. Pulse weak, irregular, rapid, or

absent in extreme cases
First Aid

1. Position: Keep victim lying flot.

Raise legs 12 to 18 inches,

unless head is injured or chest

is punctured.

2. Heat: Keep victim only worm

enough to prevent shivering.

Conserve body heat by blanket

underneath.

3. Fluids: If conscious, give water

or dilute salt solution (Va teaspoon of table salt to quart of

water) as tolerated.

STOPPAGE OF BREATH

Smoke, Gases, Drowning,

Low Concentration of Oxygen, and Respiratory Paralysis.

Rescue Operations

1. Consider hazards in rescue operations.

2. Provide for minimizing hazards.

3. Use anything which will float to

assist in rescue from drowning. .

4. Use rope on rescuer when entering gas or smoke filled area.

STOPPAGE, BREATH 7 FIRST AID
STOPPAGE, BREATH 8 ARTIFICIAL RESPIRATION

Basic Principles oí Artificial Respiration

1. To obtain and maintain airway

ireedom.

2. Increase and decrease the size

of the chest—alternately.

3. Move air in and out by external

or internal methods.

ALL OTHER CONSIDERATIONS ARE SECONDARY

First Aid Artificial Respiration by

Mouth-to-Mouth Method

1. Place victim on his back, if possible.

2. Turn his head to one side and

clear his mouth of any foreign

matter.

3. Place your hands at the base of

the victim's jaw. Lift jaw up so

that the lower teeth are in front

of the upper teeth. A free air

passage must be provided.

4. Place your mouth over the victim's mouth. Pinch his nostrils

to close off his nasal passages.

5. Blow into the victim until you

see his chest rise. Take your

lips away and let his lungs

empty themselves. Repeat this

procedure as rapidly as lungs

empty themselves for the first few

minutes. Then, 12-16 times per

minute.
Keep his neck arched backward

at all times to maintain free air

passage.

If you use an artificial respirator

and mask follow the foregoing

instructions with the exception of

mouth-to-mouth method. Remember you must see the chest

rise to be successful.

Stopped Hearts

Closed Heart Massage

CLOSED HEART MESSAGE REQUIRES SPECIAL MEDICAL TRAINING. THE METHOD HAS NOT BEEN ADOPTED BY THE AMERICAN RED CROSS. ARRANGE TO TAKE COURSES OFFERED TO

SPECIAL RESCUE GROUPS.

If, in spite of mouth-to-mouth

breathing, the injured persons fails

to respond, it may be because his

heart has stopped. If no pulse is

felt at the wrist, no sound heard

with the ear to the chest, if the

color is poor, or if the pupils are

dilated, you can be fairly certain

the heart has stopped. These steps

taken promptly may save a life:

1. Place the victim on his back on

a firm surface and raise his legs

to drain leg blood toward heart.

2. Raise his chin by extending his

neck (same as with mouth-tomouth breathing).

3. Place the heel of one hand on

the lower part of the breastbone

and the other hand directly on

top of the first hand.

STOPPAGE, HEART

629009 O—62 2

9 CLOSED HEART MASSAGE
STOPPAGE, BREATH 10 SMOKE

4. Press down firmly with both

hands, then raise both hands

from the chest to allow it to

expand.

5. Repeat 60-80 times per minute.

6. If alone, stop every 30 seconds

to do mouth-to-mouth breathing

3 or 4 times.

7. With two persons, one does the

heart massage for 5 times, then

the other does mouth-to-mouth

once, and repeat.

8. Check the pulse periodically.

Some will start to beat on their

own in a few seconds/ others

won*t until treated by a doctor

with electricity.

9. When calling for the ambulance

and hospital, alert them that the

heart is stopped so preparations

can be made.

Smoke Exposure

Symptoms

1. Unconscious

2. Breathing stopped

3. Face and lips blue, flushed oi

pale

4. Pulse weak or absent.
First Aid

1. Rescue breathing.

2. Treat for shock.

3. Keep victim lying down, quiet

and warm 24 h ours.

Electric Shock and Lishtning

Symptoms

Same as for smoke above, except

there may be burns, and body may

be rigid at first

First Aid

1. Always protect yourself against

shock.

2. If victim is on pole and rescue

may take several minutes, start

rescue breathing while rescue

tackle is being adjusted.

3. If victim is on wire on ground,

remove wire with dry pole or

rope before touching him.

4. Use mouth-to-mouth artificial

respiration as above, then treat

burns.

Choking

Drownins

1. If victim is not breathing start

artificial respiration at once.

2. Do not waste time attempting

to remove water from lungs.

Little, if any, can be drained

out.

STOPPAGE, BREATH 11 SHOCK, DROWNING
POISONING 12 POISONS, ACIDS

POISONING BY MOUTH

Objectives

To dilute the poison as fast as

possible. Then except as advised

induce vomiting.

Symptoms

1. Pain in stomach and vomiting,-

diarrhea with food poisoning

2. Flushed or bloated face

3. Mouth may be burned

4. Convulsions

5. Unconsciousness

Poisons not Acid or Alkali

1. DILUTE: Give large amounts of

fluid, 4 to 7 glasses of solution

of 1 teaspoon of either baking

soda or salt in 1 glass of warm

water, or milk.

2. WASH OUT: Induce vomiting

by tickling throat.

3. Give antidote, if one is known.

4. When poison is unknown give

antidote of 1 part strong tea,

1 part milk of magnesia, 2 parts

burnt toast.

5. Give heaping tablespoon of

Epsom salts in water.

6. If petroleum products, don't induce vomiting—dilute only.

SODA I
Acids

1. Avoid vomiting if possible.

2. Neutralize with alkali such as

baking soda, magnesia, chalk

in water.

3. Give milk, olive oil, or egg

white.

Alkalies

1. Avoid vomiting if possible.

2. Neutralize with weak acid such

as lemon juice or vinegar.

3. Give milk.

Skin Contamination

1. Drench with water.

2. Apply stream of water on skin

while removing clothing.

3. Cleanse skin thoroughly with

soap and water. Rapidity in

washing is most important in reducing extent of injury.

Food Poisoning

Symptoms

1. Uncomfortable feeling in upper

abdomen

2. Pain and cramps

3. Nausea and vomitiny

4. Diarrhea

POISONING 13

^O-üAV

ALKALI, SKIN, FOOD
POISON

5. Prostration

14 FOOD, SNAKES

6. Unconsciousness in severe coses

First Aid

1. Coll doctor.

2. Never give a physic unless ordered by doctor.

3. Save samples of food, vomitus,

or excreta for analysis.

4. Keep victim worm, in bed.

5. If vomiting persists, give small

drinks from glass of water containing teaspoon of soda.

6. May give him sweetened strong

tea.

POISON SNAKES, INSECTS, PLANTS

Snake Bites

Prevention

1. Wear high shoes.

2. Watch for snakes.

3. Carry snakebite kit.

4. Differentiate poisonous snakes

with typical fang punctures and

nonpoisonous variety with multiple teeth marks.

Symptoms

1. Immediate pain

2. Swelling, purple color
3. 1 or 2 fang puncture points

4. Weakness, short breath

5. Rapid, weak pulse

6. Vomiting, faintness

First Aid

1. With competent medical centers available in the area within

2 hours, the preferred first aid is

to put the person, or at least the

part, to rest, apply a tourniquet

above the injury, and transport

immediately to the nearest

hospital or doctor.

2. If professional help is not available within a few hours—

a. Apply tourniquet above

bitten part or area of swelling.

b. Immobilize part. Keep victim quiet and warm.

c. If antivenom is available,

use as directed. If antivenom is not available, make

two incisions as deep as twothirds the distance between

fang marks and about Vs to

% inch long through the fang

marks in the same direction

as the limb (not crosswise).

Wash out blood, lymph, and

venom and use suction every

15 minutes for 2-3 hours.

POISON 15 SNAKES
POISON 16 SNAKES, INSECTS

This procedure is only valuable if done within an

hour—and preferably within

a very few minutes after the

bite. Then keep injured

part in ice bath. After an

hour remove from ice bath

but keep cool for 24 to 96

hours.

d. Treat for shock/ give plenty

of drinking water.

e. In places more than 8 to

12 hours from nearest hospital or doctor, persons might

be equipped and trained to

use antivenom.

Insect Sting

PERSONS SENSITIVE TO INSECT STINGS SHOULD GET VACCINE BEFORE INSECT SEASON.

1. Remove stinger if possible.

2. Apply paste of baking soda

and cold cream.

3. Cold applications will relieve

pain.

4. Calamine lotion will relieve

itching.

5. If multiple, an unusual reaction,

or history of a severe reaction,

take victim to a doctor.

I :

So o ^
Black Widow Spider Bites

Symptoms

1. Slight swelling, redness, tiny red

spots

2. Immediate burning, spreading

pain

3. Abdominal pain and rigidity,

nausea and vomiting

4. Fever, sweating, severe headache

5. Rarely fatal in adults but often

so in infants and children

First Aid

1. Keep victim lying down, quiet

and warm. If he must be moved,

use a stretcher.

2. Get doctor immediately.

Scorpion Sting

Less dangerous than black widow

spider except in infants

Symptoms

1. Severe pain and swelling

First Aid

1. Cold packs

2. Get to doctor

POISON

629009 O—62 3

17 INSECTS
POISON 18 INSECTS

Chigger,

Red Bug Bites

Symptoms

1. Localized itching, redness,

usually under belt or other

tight clothing

First Aid

1. Apply calamine lotion.

2. As a preventive rub dimenthyl

phthalate or flowers of sulphur

on ankles and socks.

Rocky Mountain

Spotted Fever Tick Bites

Prevention and First Aid

1. Examine body and clothes after

any exposure and always remove ticks after each shift.

2. Have partner inspect back.

3. Remove ticks by gentle traction /">]

with forceps. If mouth parts \^

break off, remove them from

flesh.

4. If forceps method unsuccessful

try covering with thick oil for

awhile first.

5. Then gently scrub area with

soap and water.
Symptoms of Disease

1. Chills and fever

2. Sweating

3. Pains in bones, muscles, joints

4. Back and head aches

5. Coughing, vomiting, weakness

6. Rash appears in 2 to 4 days

First Aid

1. Early medical treatment

2. Complete rest

Poison Oak, Ivy, Sumac

Prevention

1. Wash thoroughly with thick

soap suds.

2. Wash clothing and shoes in

thick hot suds.

3. Destroy plants wherever practicable.

4. Avoid smoke from burning

plants.

5. Wear protective clothing.

6. If very sensitive obtain vaccine

before the season. '^'^JW^

POISON 19 OAK-IVY-SUMAC
POISON 20

Symptoms

1. Skin red, swollen

2. Small blisters, which may form

large blisters later

3. Violent itching

First Aid

1. Wash as above under PREVENTION.

2. Make paste by heating soap

and water to consistency of

lard, apply thickly to rash,

allow it to dry, and leave on

overnight.

3. Orr use calamine solution. lutic

4. Or if in the field the extract of

the plant "Jewel Weed" also

called "Touch-me-not" may be

used both as a preventive and

as a treatment.

5. Consult doctor about extracts

of poison ivy or oak to reduce

sensitivity to these poisons.

6. Commercial preparations are

available.

OAK-IVY-SUMAC

y^ ^
HEAT INJURIES

Burns and Scalds

Symptoms and Classification

1. First degree—skin reddened

2. Second degree—skin blistered

3. Third degree—skin cooked or

charred, may extend to underlying tissue

First Aid

For small first and second degree

burns covering up to 1 percent

of body surface (size of hand):

1 .If ice water is available, soak the

part 20 to 30 minutes.

2. Wash and/or use antiseptic

(povidone-iodine complex

suggested).

3. Place sterile gauze over burned

area.

4. Bandage entire area snugly.

HEAT INJURIES 21 BURNS, SCALDS
HEAT INJURIES 22

For large burns of any degree:

1. If doctor or hospital is available

within 30 minutes or less:

a. Treat for shock.

b. Rush io hospital, untreated.

2. If in isolated area:

a. Remove clothing from burn, \^

cut around cloth that sticks

to burned area.

b. May apply antiseptic (povidone-iodine complex suggested).

c. Cover burn with sterile dressing.

d. Cover this with 8 to 10 layers

of loose sterile or clean

dressing.

e. Dress burn so it cannot touch

other burned or unburned

skin.

f. Bandage snugly so there is

moderate pressure on burn.

g. Treat for shock.

h. If victim is conscious, he

should drink all he wishes of

solution containing 1/2 teaspoon baking soda and 1 /2

teaspoon of salt to 1 quart

of water.

BURNS, SCALDS
i. DO NOT

(1) Touch burn with fingers.

(2) Breathe on burn.

(3) Apply antiseptic other

than as indicated above.

(4) Break or drain blisters.

(5) Change dressing. Doctor should do this.

CkemicalIB(Durns

1. Flush thoroughly with water to

remove all of chemical.

2. Treat like other burns.

3. If eye is burned by creosote or

other chemicals, after flushing

with water, cover with sterile

compress and see doctor.

Inhalation Burns

1. Carry patient to fresh air immediately.

2. Apply artificial respiration if

breathing has stopped or is inadequate.

3. Prevent chilling.

4. Do not give alcohol in any form.

HEAT INJURIES 23 BURNS
HEAT INJURIES

Electric Burns

24

Treat like other burns, but cover

wider area with dressing because

these burns are usually more extensive than they appear to be.

BURNS, SUNSTROKE

Sunburn

Use petrolatum or cold cream for

mild cases. For severe sunburn

treat as other burns.

Lxcessive Heat

Some of the adverse effects of excessive heat and copious sweating

may be lessened by the regular use

of ample drinking water and liberally salted foods, rarely salt tablets.

Sunstroke

Cause

Exposure to heat, particularly the

sun*s rays

Symptoms

1. Headache

2. Dizziness

3. Red face

4. Hot, dry skin
5. Strong, rapid pulse

6. Very high temperature

7. Usually unconscious

First Aid

1. Put victim in shade, lying on

back, with head and shoulders

raised, clothing removed.

2. Cool the body with ice, water

or "rubbing alcohol'* or fanning.

3. Give cool drinks, no stimulants.

4. Call doctor.

Heat Exhaustion

Cause

Exposure to heat either outdoors

or indoors

Symptoms

1. Pale face

2. Dizziness

3. Vomiting

4. Profuse sweating

5. Moist cool skin

6. Weak pulse

7. Low temperature

HEAT INJURIES

629009 0—62—

25 HEAT EXHAUSTION
HEAT INJURIES 26 HEAT EXHAUSTION

8. Faint but seldom unconscious

for long

9. May have cramps in abdomen

or limbs

First Aid

1. Lay victim down with body

level or head slightly lowered.

2. Give several glasses of solution

of y^ teaspoon salt in glass of

water.

3. Remove victim to circulating

air and out of direct sun rays.
INJURIES DUE TO COLD

Frost Bite

Symptoms

1. Considerable pain and redness ^^yniL

in fingers, toes, cheeks, ears, or ^^^^^¡r^

nose —^^

2. Later grayish-white color due

to frozen tissues

First Aid

1. Until victim can be brought

indoors, cover part with woolen

cloth or warm skin of victim or

first aider.

2. Thaw out frozen part rapidly in

warm room, or in warm water

100^-105° F. or electric blankets at 100"^ F.

3. May give warm drinks.

4. Get early medical attention.

Prolonged Exposure to Cold

Symptoms

1. Victim becomes numb, drowsy

2. He staggers, eyesight fails, and

he becomes unconscious

COLD INJURIES 27 FROSTBITE
COLD INJURIES

First Aid

28 EXPOSURE, SNOWBLINDNESS

1. Place him in warm room and

apply artificial respiration if

breathing ha^ stopped.

2. If only chilled and not unconscious, put him in warm bed and

give hot drinks.

Snow Blindness

Prevention

Wear good quality, dark glasses

in snow country, particularly in

early spring and at high elevations.

Symptoms

1. Burning, smarting, sandy feeling

in eyes

2. Pain in eyes or forehead

3. Sensitivity to light, eyes watering

First Aid

1. Cold compresses on eyes.

2. Use mild eye drops or mineral

oil.

Wear dark glasses.
FRACTURES

Fracture oí Arm or Leg

Symptoms oí Simple Fracture

1. Victim may hear or feel bone

snap, and grating

2. Pain and tenderness at break

3. Inability to use injured part or

to move adjacent joints

4. Broken part may be swollen and

deformed, discolored

Symptoms of Compound Fracture

1. Same as above, plus presence of

wound extending from fracture

through the skin

2. Fractured bone may protrude

3. Frequently there is severe bleeding

First Aid

1. If doctor is nearby, do not move

broken limb or patient. Keep

broken ends and adjacent parts

quiet.

2. If bleeding, cut away clothing

and control flow by sterile compress and pressure, then bandage. Use tourniquet only as

last resort to save life when severe bleeding cannot be con-

^c§

FRACTURES 29 ARM, LEG
FRACTURES 30 ARM, LEG

trolled otherwise. Tourniquet

should be loosened only by

physician (unless over 2 to 3

hours).

3. If necessary to move, hove

splints, pods, and ties ready,

then:

a. Give complete immobilization to fractured bone and

next joint in either direction from fracture, by well

padded splints.

b. If the long leg bones are

broken and victim must be

moved some distance to doctor, apply traction splint, unless bone is protruding, in

which case immobilize leg

by placing sterile dressing

over wound and splinting in

place.

4. After splint is in place, examine

every 20 minutes to be sure

limb swelling has not cut off

circulation.

>'^

^^

^^^Ê'^
Skull Fracture and Concussion

Symptoms

1. Bump or cut on head

2. Victim dozed or unconscious

3. Bleeding or fluid from ears,

mouth, nose

4. Pupils of eyes may be unequal

in size

First Aid

1. Keep victim lying down, warm.

a. If face normal color or i%

flushed, raise head and j^

shoulders.

b. If face is pale, lower head

slightly.

2. Move only if necessary, and

then horizontally.

3. Give no stimulants.

4. Apply sterile gauze and bandage to open scalp wound.

5. If strangling from blood and

mucous, lower head and turn to

drain.

6. Get doctor as soon as possible.

7. Do not leave victim alone.

FRACTURES 31 SKULL, CONCUSSION
FRACTURES 32 SPINE

Spine Fracture

Symptoms

1. Pain in neck or back

2. There is no interference of

hands or feet unless spinal cord

is injured. If victim cannot

open and close fingers readily,

or grasp your hand firmly, his

neck may be broken. If he can

move fingers, but not feet or

toes, his back may be broken.

3. Severe shock

4. If victim is unconscious and

and spinal injury is suspected,

treat as neck fraà+ure.

First Aid

1. Get doctor. Victim should not

be moved without medical

supervision unless no doctor is

obtainable.

2. Don't let victim move or lift

head.

3. Cover with blankets according

to temperature.

4. If no doctor is available and

victim must be moved, the

method will depend on materials available. Face up on

rigid surfaces, face down on

non-rigid surfaces. Transport all

neck injuries face up.
a. Do not tilt head forward,

backward, or sideways under

any circumstances.

b. Slide him onto support in the

direction of support.

c. Head should be well padded

at sides to prevent motion.

d. Tie hands across chest, and

tie head and body rigidly to

board. Pad under neck to

keep head neutral.

5. When moving victim with fractured back, tie to rigid support

with pad under lower spine.

6. Blanket lift can be used if victim

stays face down. The blanket

lift should be used only when a

rigid support cannot be obtained

or improvised.

Pelvis Fracture

Symptoms

1. Much pain around pelvis if

standing or walking

May have little or no pain if

lying down

2. May have severe shock

FRACTURES 33 SPINE, PELVIS
FRACTURES 34 PELVIS, RIB

First Aid

1. Move victim on back on rigid

stretcher, door, or board.

2. Bandage knees and ankles together.

3. Bend or straighten knees, whichever is most comfortable.

Rib Fracture

Symptoms

1. Severe pain on deep breathing

or coughing

2. Break may be felt by fingers

on rib

3. Shallow breathing

4. If lung punctured, frothy bright

red blood may be coughed up.

First Aid

Objective is to control pain, and

restrict rib motion.

1. If chest is punctured, apply airtight dressing only. Have victim lie quietly/ move him lying

down to doctor.
2. If chest is not punctured, apply

2 or 3 triangular cravat bandages around body.

a. Tie first one loosely over

break with knot over a pad,

on side opposite break. As

victim exhales, tighten knot.

b. Repeat a. above with 2 more

cravats, one above, one below, first one.

3. Six-inch elastic rubberized roller

bandage makes excellent splint.

Nose Fracture

1. Do not splint.

2. Apply sterile compress if open

wound, held lightly in place

with 4 tail bandage.

3. Get to doctor for X-ray and

possible reduction of fracture.

Lower Jaw Fracture

1. Place palm of hand below jaw

and raise it gently to bring

teeth together.

2. Support jaw with bandage under

chin, tied on top of head.

3. If victim vomits, release bandage

immediately, support jaw with

hand, and rebandage when

vomiting stops.

FRACTURES 35 RIB, NOSE, JAW
FRACTURES 36 COLLAR, ELBOW, HAND

Collar Bone Fracture

Symptoms

1. Fracture can sometimes be felt

by finger

2. Injured shoulder may be lower

3. Victim usually cannot raise arm

above shoulder

First Aid

1. Put arm in triangular bandage

sling, with hand raised above

elbow level and ends of fingers

uncovered.

2. Tie arm snugly to side of body.

Elbow Fracture

1. If arm straight, apply fixation

splint entire length of arm.

2. If arm bent, apply arm sling and

bind upper arm snugly to side

of body.
Hand or Wrist Fracture or

Crushing Injury oF Hand

1. Apply padded splint to front

of hand, from elbow to beyond

finger tips.

2. Place arm in triangular bandage

sling with hand in most comfortable position.

Finger Fracture

1. Immobilize by splints and ties.

2. Support hand, slightly raised,

in sling.

Kneecap Fracture

1. Straighten limb.

2. Tie limb to well-padded 4-inch

board reaching from buttock to

heel, leaving kneecap exposed.

In emergency a pillow or blanket can be used instead of board

Foot and Toe Fracture or

Crushing

1. Apply several dressings padded

with cotton, or a small pillow,

bandaged snugly in place.

FRACTURES 37 FINGER, KNEE, FOOT, TOE
DISLOCATIONS 38 AND SPRAINS

DISLOCATIONS, SPRAINS, STRAINS,

BRUISES

Dislocations

Symptoms

1. Intense pain

2. Deformity

3. Swelling

4. Loss of movement

First Aid

1. Apply cold compresses and

elevate injured part.

2. If necessary to move victim,

support dislocated elbow or

shoulder in loose sling; if hip

dislocated, place pillow under

knees.

3. Gentle traction may be tried to

reduce the dislocation of finger

joints. If it fails, do not persist.

This should not be tried for a

dislocated thumb.

4. Keep other dislocations immobilized in the dislocated position until medical help can be

had.
Sprain

SPRAINS ARE TEARS OF LIGAMENTS SUPPORTING A JOINT

Symptoms

1. Pain at joint

2. Swelling

3. Discoloring

First Aid

1. Elevate the part, if practical,

by putting wrist in sling, ankle

on pillows.

2. Apply cold applications, ice,

or running water, in early stage

up to 6 or 8 hours/ hot applications after 24 hours.

3. If 1 and 2 cannot be done,

immobilize part as much as possible by bandaging. Keep injured part quiet.

4. If person must walk with sprained

ankle, support it as shown in the

sketch.

DISLOCATIONS 39 SPRAINS
DISLOCATIONS 40

Strains

STRAINS ARE INJURIES TO MUSCLES OR TENDONS.

Symptoms

Pain in muscles, increasing stiffness

First Aid

1. Rest injured muscle.

2. In first 24 hours, cold packs to

anesthetize and avoid swelling.

3. After 24 hours, heat to reduce

muscle spasm and increase circulation.

4. Massage to loosen up muscles.

STRAINS, BRUISES

Bruises

Symptoms

Pain, swelling, discoloration.

First Aid

1. Apply ice or cold cloths immediately to reduce swelling

and relieve pain.

2. Elevate injured part.

3. If skin is broken, treat as any

open wound.
WOUNDS AND BANDAGING

ALL WOUNDS, NO MATTER

HOW SMALL, SHOULD BE

TREATED TO PREVENT INFEC

TION. WHEN BLEEDING IS

NOT SEVERE, INFECTION IS

THE CHIEF DANGER. UNCLEAN FIRST AID IS MORE

DANGEROUS THAN NO

TREATMENT AT ALL.

First Aid

1. If wound is severe and doctor

is nearby, cover wound with

sterile pad, then bandage and

take victim to doctor.

2. In isolated areas, if possible

thoroughly wash wound with

soap and water,- then cover with

sterile pad and bandage.

Otherwise cover and bandage

until washing can be done

later.

3. If wound is so large that it will

have to be sewed up:

a. After washing, cover with

sterile gauze, then bandage

and take victim to doctor.

b. If doctor cannot be reached

for several hours, after washing, close wound by finger

WOUNDS & BANDAGING 41 FIRST AID
WOUNDS & BANDAGING 42 PUNCTURE

pressure and apply butterfly

taping, then bandage.

4. If wound is well washed, no

antiseptic is needed. If one is

used, povidone-iodine complex

is suggested.

Bandaging

1. Always apply sterile gauzç

pad directly on wound, then

bandage over this.

2. Never use absorbent cotton or

adhesive tape directly on a

wound, except a narrow bridge

of adhesive,sterilized over flame,

to hold wound edges together.

3. Bandage snugly but not tightly/

ends of fingers and toes uncovered, if possible, to check

on circulation.

Puncture Wound

1. Encourage bleeding by mild

pressure at edge of wound.

2. Apply sterile pad and bandage.

3. Always get doctor to clean

wound to prevent tetanus.

4. Doctor should determine need

for tetanus vaccine.
Gunshot Wounds

1. Stop blood flow.

2. Apply sterile dressing and

bandage.

3. Immobilize fractures.

4. Treat for shock.

5. Get victim to doctor for thorough

examination and lockjaw prevention.

6. Depending on local laws, report to authorities.

Abdominal Wounds

1. Keep victim warm, on back.

2. Give him nothing to drink.

3. Do not clean wound. Cover

with sterile dressing and bandage.

4. If intestine is protruding, don*t

push it back in:

a. Cover with sterile dressing

kept moist with warm salt

water, 1 teaspoon to a pint.

b. Raise knees.

5. Get to hospital quickly, treating for shock enroute.

WOUNDS & BANDAGING 43 ABDOMINAL
WOUNDS & BANDAGING 44

Animal Bite

Dog, Cat, Wildlife, Any Mammal

1. Wash wound thoroughly with

soap and water.

2. Apply sterile pad and bandage.

3. Consult doctor about rabies

or tetanus shots.

4. Confine animal for observation.

If necessary to kill, do not

damage its brain, so that it may

be examined.

ANIMAL BITE, EYE

Eye Wound

Object imbedded in eye or surrounding tissues:

1. Do not rub the eye.

2. Tell patient to look down.

a. Grasp edge of upper lid,

make slight pressure on the

skin surface of the lid with

the side of a blunt pencil or

the edge of a match stick,

and turn the inner surface

of the lid upward.

b. Remove foreign body with

the corner of a piece of

gauze or a clean handkerchief.
If the foreign body is seen on

the clear front part of the eye

have patient wink several times

and see if it can be dislodged.

If the foreign body is imbedded

and cannot be dislodged do

not attempt to remove it. Have

the patient close the eye, place

a pad or piece of moist cotton

over the closed lid, bandage

and obtain medical attention.

Objects under Skin and Nails

1. Apply antiseptic—povidoneiodine complex recommended.

2. Sterilize needle, knife, or

tweezers in flame, then remove

object.

2. Encourage bleeding by gentle

pressure.

4. Apply sterile pad and bandage.

5. If splinter breaks off under nail,

scrape nail thin, then cut Vpiece over splinter, remove as

above, if patient cannot be

taken to doctor within 12 hours.

WOUNDS & BANDAGING 45 SKIN, NAILS
WOUNDS & BANDAGING

Blisters

46 BLISTERS, INFECTED

1. Wash with soap and warm

water.

2. Sterilize needle over open flame.

3. Puncture blister at edge.

4. Gently press out water or blood

with sterile pad.

5. Apply small adhesive dressing.

6. If blister has broken^ wash and

dry with sterile gauze/ apply

sterile dressing.

7. If blister develops infection see

doctor at first indication.

8. Small blisters—merely wash and

cover with sterile bandage/ only

puncture when large and must

to get shoe on, etc.

Infected Wounds

Symptoms

1. Throbbing pain and heat

2. Extreme swelling, redness

3. Pus and red streaks

4. Tenderness, fever

5. Swollen glands

First Aid

1. Rest in bed.
2. Hot applications of 2 level teaspoons of salt in 1 quart of

water, preferably by putting

infected part directly in the

solution.

3. Change application often

enough to keep hot, and continue for an hour.

4. Elevate part, then repeat hot

application in 3 or 4 hours.

5. Repeat process until doctor can

be seen.

MEDICAL EMERGENCIES

Insulin Reaction—Diabetics

Symptoms (usually sudden onset)

1. Skin—moist and pale

2. Rapid pulse

3. Tremor or even convulsions

4. Victim becomes weak; may become unconscious

First Aid

1. If conscious, give sugar, candy,

or orange juice

2. If unconscious, get to doctor for

injection

MEDICAL EMERGENCIES 47 INSULIN REACTION
MEDICAL EMERGENCIES 48

Heart Attack

Symptoms

1. Pain—heavy and excruciating

under the breastbone,- may radiate to neck, jaws or arms,- may

be in upper abdomen

2. Shortness of breath, may feel he

has to sit, stand, or walk to

breathe

3. May perspire freely

4. May be in shock

5. Often severe anxiousness

6. Often history of previous bouts

of pain behind the breastbone,

especially with exertion

HEART ATTACK

First Aid

1. Call doctor.

2. If victim has medication for

pain have him take it.

3. Put at rest and make comfortable.
4. Give oxygen if available.

5. Stay with him and reduce his

anxiety.

6. Treat shock.

7. Transport only if necessary—

preferably lying down with head

level (head down in cases of

shock).

Apoplexy-Stroke

APOPLEXY OR STROKE RESULTS FROM RUPTURE OF

A BLOOD VESSEL IN THE BRAIN OR A BLOOD CLOT

Symptoms

1. May follow over-exertion

2. Face may be red, but sometimes ashen gray

3. Slow pulse and heavy breathing

4. One eye pupil may be larger

than other

5. One side of body may be

paralyzed or victim may have

difficulty speaking

6. May be unconscious

7. May be very minor, especially

in older persons, with only headache and dizziness; sudden

memory loss, change of mood,

numbness ordifficultyusingbody

part.

MEDICAL EMERGENCIES 49 APOPLEXY
MEDICAL EMERGENCIES

First Aid

50 FAINTING

1. Lay victim on back with head

and shoulders raised.

2. Nothing by mouth.

3. Keep warm and comfortable.

4. Call doctor.

5. If doctor is not available, transport lying down with head

raised.

Fainting

Prevention

Victim should sit down and put

head between knees, or lie down

immediately.

Symptoms

1. Pale face, drooping eyelids

2. Perspiration

3. Dizzy

4. Shallow breathing

5. Weak pulse

6. Unconsciousness finally

First Aid

1. Keep victim lying down, with

head lower than body.

2. Loosen tight clothing.

3. Can use ammonia inhalant.

4. Keep him resting until fully recovered.
Epilepsy

Symptoms

1. Convulsion may or may not

come with warning

2. Pale face, eyes roll up

3. Victim utters hoarse cry, falls

to ground

4. Turns blue, bites tongue, loses

consciousness

5. Jerks head, arms, legs wildly

6. Froths at mouth

7. May become conscious, or else

pass into deep sleep in 2 to 30

minutes

First Aid

1. Prevent victim injuring himself

by pushing objects out of the

way.

2. If anticipated, place soft object

between teeth.

3. Let victim rest undisturbed after

attack. Do all you can to keep

embarrassment at a minimum.

MEDICAL EMERGENCIES 51 EPILEPSY
MEDICAL EMERGENCIES 52

Appendicitis

Symptoms

1. Cramping pain over all or part

of abdomen continuing and

changing to localized pain, tenderness and rigidity usually in

lower right part oí abdomen

2. May be fever, nausea, or vomiting

First Aid

1. Put victim in bed.

2. Don't give food or medicine,

and only sips of water.

3. Call doctor.

Hernia

Prevention

1. Get firm footing and handholds

when lifting.

2. Lift with your leg and arm

muscles, not your back/ keep

back straight.

3. Don't twist when you lift.

4. Get help with heavy loads.

5. Avoid heavy lifting and straining.

Symptoms

1. Swelling in groin appears suddenly, or after a delay

APPENDICITIS
2. Swelling may disappear when

victim lies on back

3. May develop pain, soreness

or swelling may not disappear

when lying down; if so

First Aid

1. Lay victim on back.

2. If hernia does not go back into

place, lay him on stomach and

bring his knees up under his

chest.

3. Lay on back again and apply

cold compresses to hernia,

whether or not it went back into

place.

4. Move him lying on back to

doctor.

Diarrhea

1. Put victim on tea or hot water

and dry toast diet until he has

no bowel movement for 24 hours.

2. If continues, refer to a physician.

Internal Injuries

Symptoms

1. Nature and extent of injury usually is not clear

2. Severe shock is often present

MEDICAL EMERGENCIES 53 HERNIA, DIARRHEA
MEDICAL EMERGENCIES 54

First Aid

1. Get a doctor.

2. Keep victim lying down, treat

for shock.

3. Do not give him liquids or food.

4. Transport him carefully in a

lying position.

Colds

1. Rest in bed is best cold treatment.

2. If gargle is needed, use Va teaspoon of salt and Vs teaspoon

of soda in glass of hot water.

3. Drink extra fluids.

4. Take aspirin or cold tablets.

5. Eat light, easily digested foods.

6. Call doctor if you have fever,

chills, aches, or hard cough for

over 24 hours.

INTERNAL INJURIES

Boils and Pimples

1. Do not squeeze.

2. Treat as an infected wound, with

hot salt applications to draw.

3. Wipe off discharge with sterile

gauze/ apply sterile pad and

bondage.
Earache

1. Do not allow victim to blow

nose hard.

2. Apply hot water bottle to ear.

3. Drop in warm mineral oil to

relieve pain.

4. Persistent earache should always

be treated by a physician.

Foreign Bodies in Ear or Nose

Insert warm mineral oil and let only

doctor remove.

\^úf

Hives

Sponge area with strong baking

soda solution or apply calamine

lotion. If hives persist, see doctor.

Toothache

1. If no cavities are visible, apply

heat or cold to outside of jaw.

2. If there is cavity in tooth, clean

out with cotton on end of toothpick.

3. Dip another piece of cotton in

oil of cloves and insert in cavity.

Styes and Red Eyes

1. Apply warm compresses several

times a day.

2. See doctor if no improvement

in 2 or 3 days.

MEDICAL EMERGENCIES 55 EARS, HIVES, TEETH, STYES
EMOTIONAL STRESS 56 FIRST AID

EMOTIONAL STRESS

Signs of Emotional Distress

ALL INVOLVE CHANGE IN

BEHAVIOR.

I. Early

Person's usual manner may be

overemphasized. Ouiet person

may become more withdrawn. A

conscientious person becomes even

more concerned with details. The

outgoing person goes into "high

gear" and becomes overly active.

These are examples of too much

stress. All persons have had them

for short periods. If they persist

they need attention.

First Aid

Act as a friend. Let victim realize

you know he is under stress. Hear

him out. Don't give advice. If

his problem has a solution that you

can do something about, fine. If

nor, refer him to your supervisor,

personnel officer, or employee relations officer or suggest he see his

doctor.

II. Intermediate

With increased stress, instead of

the earlier behavior, he may become increasingly restless or agi-
fated. He may be unable to concentrate. He may become tense

and jittery, perspire freely, ieel

panicky. He may be drinking excessively. He may begin to use

up his sick leave.

First Aid

Alert your supervisor, personnel

officer, or employee relations officer. They are better trained to

help and direct him. In the meantime show him you are his friend

and hear him out.

III. Serious Emotional Stress

A radical change in behavior. The

quiet person becomes noisy and

aggressive. He may show unusual

blueness with thoughts of suicide.

He may show excessive activity

and talkativeness with loose association of thoughts. He may have

irrational thoughts.

First Aid

Get him to a doctor. Be quiet and

deliberate and friendly. Don't

leave him. Don't become angry

or frightened, this will only frighten

him. He is not dangerous, just

very frightened and alone.

EMOTIONAL STRESS 57 FIRST AID
TRANSPORTING VICTIMS 58 PREPARATION

TRANSPORTING VICTIMS

DO NOT BE HURRIED INTO MOVING AN INJURED OR ILL

PERSON. POOR TRANSPORTATION METHODS CAN RESULT

IN INCREASED INJURIES. VICTIMS OFTEN MUST BE MOVED

LONG DISTANCES UNDER PIONEERING CONDITIONS, SO PLAN

AND EXECUTE THE JOB CAREFULLY TO AVOID AGGRAVATING INJURY OR SHOCK. CONSIDER POSSIBILITY OF HELICOPTER EVACUATION WHERE DIFFICULT TRAIL TRANSPORTATION

IS THE OTHER ALTERNATIVE. IF VICTIM MUST BE PULLED TO

SAFETY, PULL IN DIRECTION OF LONG AXIS OF BODY, NOT

SIDEWAYS.

Preparation

1. Always give essential first aid

before transporting, then there is

not so great a hurry to move.

2. Make victim as comfortable as

possible/ loosen tight clothing,

and always treat for shock.

3. To put a blanket under victim

pleat in folds and lay along

side of body, working it under

as shown in the illustrations.

For head and spine injuries,

insert lower end under victim's

head, hold head and shoulders

against pull of blanket as it is

pulled under the body of the

victim from head to foot.

4. Be sure fracture cases are well

padded.

5. If a compound fracture case has

to be carried a long distance,

traction splints on legs will help
to decrease serious shock and

make victim more comfortable.

Watch for dangers of dislocation with too much traction.

Improvised stretchers are satisfactory for short distances, but

for longer travel, especially

through rough country, use the

best equipment and manpower

available, allowing for extra

men to spell off the others.

a. Folding type canvas or metal

cots, or even chairs in some

cases, are good emergency

stretchers.

b. An air mattress provides for

greater comfort on a stretcher

and therefore less danger of

shock.

c. Wheel or wire stretchers

should be flown in and

dropped if possible for back

country stretcher cases.

TRANSPORTING VICTIMS 59 FIRST AID
TRANSPORTING VICTIMS 60

Loading

1. To load or unload a stretcher, 3

bearers dre needed, and a

fourth is desirable.

2. Place stretcher close to victim,

who is on back with feet tied.

3. Three bearers face victim's uninjured side, one at shoulder, one

at hips, one at feet.

4. Bearers kneel on knee nearest

victim's feet, place arms under

victim, at neck, shoulder, back,

thighs, legs, feet.

5. Bearer in command says "lift,"

all lifting victim together up on

their knees. Bearer in command pushes stretcher under the

victim.

6. At his command, "lower", the

bearers gently lower victim to

stretcher.

7. Assure that victim is properly

covered, padded, and firmly

bound to stretcher in a comfortable way that will not aggravate injury but will prevent

further injury, slippage, or roll.

8. Unloading procedure is reversed.

Carrying

1. To lift and carry stretcher, bearers are on ends, and usually

two on each side if terrain

permits.

a. Stretcher is raised and started

off on given signals.

LOADING
b. The front and side bearers

start on left foot, rear bearer

starts on right foot.

c. Victim is carried feet firist

except when carrying up

hills, stjaep grades or stairs.

4. Leg fracture victims are carried uphill feet first and

downhill head first.

2. Rescue crew with a severalmile carry should have 10-12

men, paired off according to

size, with each pair carrying

stretcher for 10-15 minutes.

3. Watch victim for increased signs

of shock, and check his dressings.

4. Victim is usually transported

with head lower than body,

unless head is injured or if

breathing is difficult.

5. Victim should be able to see

where he is going.

6. Serious cases should be transported lying down.

7. Be particularly careful with head

injury coses. Victim with injury to back of head should be

laid on his side.

8. Never jackknife on injured person when it is absolutely necessary to transport the victim in

the back seat of a car.

TRANSPORTING VICTIMS 61 CARRYING
FIRST AID KITS 62 STANDARDS

FIRST AID KITS:

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Uses for First Aid Materials

TRIAN GULAR BANDAGES

40"

Bandages over sterile dressings

IÍ sterile, For direct application

over wound

Arm and hand sling

Pressure bandage for sprains and

strains

Head, trunk, and large area bandaging

Padding for serious burns, freezing

and splints

Ties for splinting broken bones

Traction ties for broken legs

Tourniquets for stopping bleeding

BANDAGE COMPRESS,

STERILE

Direct application on wounds

For applying direct pressure to

stop bleeding ^% ^^^^

ANTISEPTIC—POVIDONEIODINE COMPLEX

SUGGESTED

FIRST AID KITS 63 USES FOR MATERIALS
FIRST AID KITS 64 USES FOR MATERIALS

ADHESIVE COMPRESS, 1"

STERILE

Direct application on minor wounds

Taping foot or hand abrasions to

prevent blistering and infection

SOAP, BAR OR TUBE

To cleanse first aider*s hands before

applying first aid to wounds

To cleanse wounds

EYE DRESSING KIT

For loose bandaging of eyeball

injuries

ASPIRIN

To counteract pain and relieve

shocl<

OTHER FIRST AID SUPPLIES

Outlying stations not accessible to

a doctor or drug store may want

these materials, depending on their

work hazards:

MINERAL OIL, for eye, ear,

nose injuries

EPSOM SALTS for poison treatment

SODA, SALT for burns and poison

OIL OF CLOVES for toothaches

RUBBING ALCOHOL for aches,

sprains, strains

SCISSORS, FORCEPS, NEEDLES,

SPLINTS

U.S. GOVERNMENT PRINTING OFFICE : 1962 O—629009
Report all accidents with or without injury on USDA

Form AD-278 (Supervisores Report of Accident).

Consult your administrative officer for Bureau of Compensation Forms.
Growth Throufh Agriculturil Progrcss