Accidents happen. Someone chokes on an ice cube or gets stung by a bee. It is important to know when to call 9-1-1 -- it is for life-threatening emergencies. While waiting for help to arrive, you may be able to save someone's life. Cardiopulmonary resuscitation (CPR) is for people whose hearts or breathing has stopped and the Heimlich maneuver is for people who are choking.

You can also learn to handle common injuries and wounds. Cuts and scrapes, for example, should be rinsed with cool water. To stop bleeding, apply firm but gentle pressure, using gauze. If blood soaks through, add more gauze, keeping the first layer in place. Continue to apply pressure.

It is important to have a first aid kit available. Keep one at home and one in your car. It should include a first-aid guide. Read the guide to learn how to use the items, so you are ready in case an emergency happens.

First-aid kits are nothing new. They go back over 100 years to when, as the story goes, Robert Wood Johnson debuted the first-aid cabinet in 1888.

First-aid kits have changed over the years, but they are as useful as ever. They make it possible for ordinary people to be the help until professional help arrives. You don’t need a special certification to provide first aid, but you do need the right supplies and education.

Kate Elkins is an Emergency Medical Services (EMS) and 911 specialist in the Office of EMS and the National 911 Program. An active paramedic, Elkins also responds to 911 calls and serves as a medical specialist with Maryland Task Force 1, a FEMA urban search and rescue team.

First-hand experience has shown her how important having a well-stocked and maintained first-aid kit can be. “There are certain things you need to have at hand in the moment. In a crisis, you’re not going to have time to go to the store to get what you need,” Elkins points out.

The American Red Cross suggests that a first-aid kit for a family of four include the following items:

• A first-aid guide
• 2 absorbent compress dressings (5 x 9 inches)
• 25 adhesive bandages (assorted sizes)
• 1 adhesive cloth tape (10 yards x 1 inch)
• 5 antibiotic ointment packets
• 5 antiseptic wipe packets
• 2 packets of aspirin (81 mg each)
• 1 emergency blanket
• 1 breathing barrier (with one-way valve)
• 1 instant cold compress
• 2 pair of nonlatex gloves (size: large)
• 2 hydrocortisone ointment packets
• 1 3-inch gauze roll (roller) bandage
• 1 roller bandage (4 inches wide)
• 5 3 x 3-inch sterile gauze pads
• 5 sterile gauze pads (4 x 4 inches)
• A thermometer (non-mercury/non-glass)
• 2 triangular bandages
• Tweezers

Supplement basic items with personal needs and bleeding-control essentials. Things like a commercial tourniquet, bandages, and a felt-tipped pen. Take bleeding-control training to use such and prepare for a bleeding emergency.

Remove, throw away, or use and replace any supplies before they expire. Set a calendar reminder on your smartphone to update the supplies in your kit every six months and/or as the healthcare needs of your family change.

Think about the healthcare needs of your family when putting together a first-aid kit. For example:

• If you have a family member with a severe allergy, include antihistamine medicine and an epinephrine injector.
• If you have elderly family members with fragile skin, including a roll of paper tape can be useful for protecting delicate skin.
• If you or a family member lives with diabetes, include a juice box, glucose tablets and gels, and an emergency glucagon injection kit.
• Chewable, baby aspirin might help someone who has coronary artery disease, provided the person is not allergic to aspirin.

Elkins also suggests attaching a note to your kit with instructions on where to find other items around the house and how to act in specific emergencies. For example, you can use a note to remind you where sugary drinks and foods are kept in case of a diabetic emergency.

A person who is using a first-aid kit in an emergency might need to call 911 for assistance. Having the home or office address written on the outside of the kit itself can give users a handy location reference for 911 operators.

A first-aid kit is a tool, but any tool is only as good as the person using it.

First-aid kits are one place where personal needs and practical skills come together. There are ways to prepare for emergencies that have nothing to do with collecting supplies. This includes learning practical skills that you can use to protect yourself and others.

Many practical skills are easy to learn. Some require special certification or formal training. Others just education. Practical skills include learning how to:

• Perform hands-only cardiopulmonary resuscitation (CPR)
• Operate an automated external defibrillator (AED)
• Apply a tourniquet and control bleeding
• Administer seizure first aid
• Use the contents of a first-aid kit

Family, friends, coworkers, and bystanders—not first responders—are often first on the scene in a medical emergency. Elkins has seen this many times in the field. “One time, we had a patient who had a very bad accident with a circular saw,” she recalls. “There was a lot of blood on the floor. The patient’s coworker, who had no formal training, put all his body weight on the wound and used it to slow the bleeding. He yelled for help until others came and called 911. He saved his coworker’s life because he made the right decision and took action.”

You can take action today. “You Are the Help Until Help Arrives” and “Stop the Bleed” are examples of training that teach you how to provide first care. A good first-aid kit and the practical skill to use it can help you save someone’s life.

No matter how rapid the arrival of professional emergency responders, bystanders will always be first on the scene. A person who is bleeding can die from blood loss within five minutes, therefore it is important to quickly stop the blood loss. Those nearest to someone with life threatening injuries are best positioned to provide first care.

The numbers are staggering. About 350,000 people have a cardiac arrest outside of the hospital each year, and about 9 in 10 of them die.

Bystanders and family members are often first to respond in a medical emergency, but, according to some research, they may hesitate to do cardiopulmonary resuscitation (CPR)—even if they have been trained in CPR and how to use an automated external defibrillator (AED). The most common reasons for responders’ reluctance are mistrust of their abilities and fear of injuring the victim, according to a study in Emergency Medicine Journal.

That was before the coronavirus disease 2019 (COVID-19) outbreak and CDC’s recommendations to keep a physical distance of at least 6 feet from other people and wear a mask in public settings.

Cardiac arrests still happen outside of hospitals during the COVID-19 outbreak, and victims still need help. If you are in the position to save a life, you should.

CPR keeps blood flowing and provides oxygen to the brain and other vital organs, giving the victim a better chance of a full recovery. If performed in the first few minutes of cardiac arrest, it can double or triple a person’s chance of survival.

If you are uncomfortable with putting your mouth on a stranger’s mouth because the other person may have COVID-19, you can do hands-only CPR until help arrives, according to the American Heart Association (AHA).

You don’t need a special certification or formal training to do hands-only CPR. If cardiac arrest happens to someone near you, don’t be afraid to take action:

1. Call 9-1-1 right away. If another bystander is nearby, save time by asking that person to call 9-1-1 and look for an AED while you begin CPR. All 50 states have laws or regulations requiring AEDs in that public gathering places.
2. Give hands-only CPR. Push down hard and fast in the center of the chest at a rate of 100 to 120 compressions or pushes a minute. Let the chest come back up to its normal position after each push. AHA recommends timing your pushes to the beat of the song “Stayin’ Alive.” This method of CPR is called “hands-only” and does not involve breathing into the person’s mouth.
3. Keep giving hands-only CPR until medical professionals arrive or until a person with formal CPR training can take over.

You CAN make a difference, but you must be willing to help.

A poisoning may have occurred. What should I do?

Follow these basic steps at the first sign of a poisoning:

If the person inhaled poison

Get to fresh air right away. Call the toll-free Poison Help line (1-800-222-1222), which connects you to your local poison center.

If the person has poison on the skin

Take off any clothing the poison touched. Rinse skin with running water for 15 to 20 minutes. Call the toll-free Poison Help line (1-800-222-1222), which connects you to your local poison center.

If the person has poison in the eyes

Rinse eyes with running water for 15 to 20 minutes. Call Poison Help (1-800-222-1222), which connects you to your local poison center.

In some cases, you should not try to give first aid

If the person swallowed the wrong medicine or too much medicine: Call Poison Help (1-800-222-1222), which connects you to your local poison center.

What should I do if my child swallows something poisonous?

Right away call the toll-free Poison Help line (1-800-222-1222), which connects you to your local poison center. Every poisoning is different.

Treatment advice will depend on the type and amount of poison involved. The child’s age, weight, and medical history will affect treatment, too.

Should I use activated charcoal when I suspect someone has been poisoned?

No. Activated charcoal addresses certain poisons, but it is difficult to use. Your poison center will decide if activated charcoal should be used. The poison center may call a hospital to advise what type of treatment to use.

Know how to help someone who is choking. Giving abdominal thrusts is a method of applying pressure to remove an obstruction, like a piece of food, from a person’s windpipe. Along with hands-only cardiopulmonary resuscitation (or CPR), knowing how to respond in a choking emergency is a basic life-saving skill that anyone can learn and teach to others.

If you suspect a person is choking and/or see someone giving the universal sign of choking—holding their neck with one or both hands—immediately take the following steps:

1. Ask the person if they are choking. DO NOT perform first aid if the person is coughing forcefully and is able to speak.
2. If they are unable to speak, perform abdominal thrusts:
   • Stand behind the person and wrap your arms around the person’s waist. For a child, you may have to kneel.
   • Make a fist with one hand. Place the thumb side of your fist just above the person’s navel, well below the breastbone.
   • Grasp the fist tightly with your other hand.
   • Make a quick, upward and inward thrust with your fist.
   • Check if the object was dislodged.
   • Continue thrusts until the object is dislodged or the person loses consciousness.
3. Call 911 if the person loses consciousness. Always call 911 in a life-threatening emergency.

About 1 out of 10 people may have a seizure during his or her lifetime. That means seizures are common, and one day you might need to help someone during or after a seizure.

Learn what you can do to keep that person safe until the seizure stops by itself.

Do I call 911?

Seizures do not usually require emergency medical attention. Only call 911 if one or more of these are true:

• The person has never had a seizure before.
• The person has difficulty breathing or waking after the seizure.
• The seizure lasts longer than 5 minutes.
• The person has another seizure soon after the first one.
• The person is hurt during the seizure.
• The seizure happens in water.
• The person has a health condition like diabetes, heart disease, or is pregnant.

First aid for any type of seizure

Stay with the person until the seizure ends and he or she is fully awake.

There are many types of seizures. Most seizures end in a few minutes.

These are general steps to help someone who is having any type seizure:

• Stay with the person until the seizure ends and he or she is fully awake. After it ends, help the person sit in a safe place. Once they are alert and able to communicate, tell them what happened in very simple terms.
• Comfort the person and speak calmly.
• Check to see if the person is wearing a medical bracelet or other emergency information.
• Keep yourself and other people calm.
• Offer to call a taxi or another person to make sure the person gets home safely.

First aid for generalized tonic-clonic (grand mal) seizures

When most people think of a seizure, they think of a generalized tonic-clonic seizure, also called a grand mal seizure. In this type of seizure, the person may cry out, fall, shake or jerk, and become unaware of what’s going on around them.

Here are things you can do to help someone who is having this type of seizure:

• Ease the person to the floor.
• Turn the person gently onto one side. This will help the person breathe.
• Clear the area around the person of anything hard or sharp. This can prevent injury.
• Put something soft and flat, like a folded jacket, under his or her head.
• Remove eyeglasses.
• Loosen ties or anything around the neck that may make it hard to breathe.
• Time the seizure. Call 911 if the seizure lasts longer than 5 minutes.

Stop! Do NOT

Knowing what NOT to do is important for keeping a person safe during or after a seizure.

Never do any of the following things

• Do not hold the person down or try to stop his or her movements.
• Do not put anything in the person’s mouth. This can injure teeth or the jaw. A person having a seizure cannot swallow his or her tongue.
• Do not try to give mouth-to-mouth breaths (like CPR). People usually start breathing again on their own after a seizure.
• Do not offer the person water or food until he or she is fully alert.

Workers should take these steps if a snake bites them:

• Seek medical attention as soon as possible (dial 911 or call local Emergency Medical Services [EMS]).
  • Antivenom is the treatment for serious snake envenomation. The sooner antivenom can be started, the sooner irreversible damage from venom can be stopped.
  • Driving oneself to the hospital is not advised because people with snakebites can become dizzy or pass out.
• Take a photograph of the snake from a safe distance if possible. Identifying the snake can help with treatment of the snakebite.
• Keep calm.
• Inform your supervisor.
• Apply first aid while waiting for EMS staff to get you to the hospital.
  • Lay or sit down with the bite in a neutral position of comfort.
  • Remove rings and watches before swelling starts.
  • Wash the bite with soap and water.
  • Cover the bite with a clean, dry dressing.
  • Mark the leading edge of tenderness/swelling on the skin and write the time alongside it.

Do NOT do any of the following:

• Do not pick up the snake or try to trap it. NEVER handle a venomous snake, not even a dead one or its decapitated head.
• Do not wait for symptoms to appear if bitten, get medical help right away.
• Do not apply a tourniquet.
• Do not slash the wound with a knife or cut it in any way.
• Do not try to suck out the venom.
• Do not apply ice or immerse the wound in water.
• Do not drink alcohol as a painkiller.
• Do not take pain relievers (such as aspirin, ibuprofen, naproxen).
• Do not apply electric shock or folk therapies.

Injuries to the eye can cause permanent vision loss. Act quickly if a child is injured in or near their eye. Learn what caused the injury, apply appropriate first aid, and get immediate medical help.

Administer the proper type of first aid, depending on the cause of injury:

• Chemical: Rinse the eye immediately for at least 15 minutes with water OR hold the child's face under a faucet to rinse the eye.
• Foreign body in the eye: Allow the eye to tear or rinse out the eye with a commercial eyewash to dislodge the particle. Do not try to remove the particle with tweezers.
• Blow to the eye: Seek medical care if the child complains of pain, has blurred vision, has blood in the eye, or has any change in the appearance of the eye, including discolored skin around the eye.
• Cut or puncture to the eye
  • Do not rinse the eye or try to remove any particles or objects lodged in the eye.
  • Cover the eye with an eye shield or with a paper or plastic foam cup from the brow to the cheekbone. Secure it in place with adhesive tape.
  • Do not allow the child to rub their eye.
  • Do not bandage or place pressure.
  • Seek immediate medical care.

Keep the following items in your first aid kit:

• Eye wash for chemical contact with the eyes. This can be a commercial eye wash or saline solution. Water will also work in an emergency, but not for cuts or punctures.
• Small paper or plastic foam cups, and first aid tape
• Eye shield
• Phone numbers for emergency services, the closest hospital emergency department, Poison Control, and an ophthalmologist

Although being traditionally administered by emergency personnel, naloxone can also be administered by minimally trained individuals in the community.

Five Essential Steps in Responding to an Opioid Overdose

1. Identify Overdose
   If someone is not breathing, is struggling to breathe or unresponsive, call their name and rub your knuckles on their chest (sternum-rub). If they are still unresponsive, they may be experiencing an overdose. Other signs that may help you identify an overdose are; blue or pale skin color, small pupils, low blood pressure, slow heart rate, and slow or shallow breathing.

2. Call 911
   After identifying an overdose, get help as quickly as possible. Call 911 and tell the operator whether the person is unresponsive and/or not breathing.

3. Administer Naloxone
   Naloxone is available as an injection and as a nasal spray. Follow the package instructions. While prepping the naloxone dose, do not go too long without giving rescue breaths. Store naloxone in an accessible place that you can easily reach in the event of an emergency, and tell your friends and family where it is stored.

4. Give Rescue Breaths
   When attempting to administer rescue breathing;

   • Check that no objects are in the person’s mouth that could block breathing;

   • Place one hand on the chin and tilt the head back. With the other hand pinch the nose closed;

   • Administer two slow breaths and look for the chest to rise.

   • Continue rescue breathing (1 breath every 5 seconds) until the person starts breathing on their own. Continue this for at least 30 seconds. If the person is still unresponsive, administer the second dose of naloxone.

5. Stay Until Help Arrives
   Naloxone can reverse an overdose, but can also cause withdrawal. After administering naloxone, stay with them, and make sure the patient does not take any more opioids, which could cause another overdose. In these situations, repeat doses of naloxone may be needed.

Rescue Position

Even though it is not advised, if you must leave someone alone at any time, put them in the rescue position: on their side with their top leg and arm crossed over their body. This makes it difficult for them to roll over, and reduces the chances that they will stop breathing or choke.

Personal health preparedness isn’t only about collecting supplies. Level up your emergency preparedness. Learn practical skills you can use to help yourself and others. Here are 10 skills you can learn to prepare for an emergency, in no particular order.

1. How to wash your hands the right way. Washing your hands is one of the most effective ways to prevent the spread of germs. Clean hands can help stop the spread of respiratory and diarrheal infections from one person to another. Follow these five steps to wash your hands the right way every day, including during an emergency.
2. How to administer CPR. Cardiopulmonary resuscitation (CPR) can help save a person’s life if their breathing or heart stops. You don’t need a special certification or formal training to perform CPR, but you do need education. Hands-only CPR is simple to learn and easy to remember.
3. How to work an automated external defibrillator (AED). AEDs give step-by-step voice instructions, but training is still recommended. Classes can teach you how to recognize the signs of a sudden cardiac arrest, when to call emergency medical services, how to administer CPR, and how to use an AED.
4. How to use a portable generator. Portable generators produce a poison gas called carbon monoxide (CO). The risk of CO poisoning increases after an emergency. Sixteen of the 129 Hurricane Irma-related deaths in Florida, Georgia, and North Carolina were because of CO poisoning. If using a generator during a power outage, remember to always
   • place it outdoors at least 20 feet away from any window, door, or vent.
   • operate it in a dry area.
   • use a battery-powered or battery back-up CO detector.
5. How to perform first aid. The risk for injury during and after an emergency like a natural disaster is high. Prompt first aid can help heal small wounds and prevent infection. It is important to know how to care for cuts, burns, and other kinds of injuries. Keep a well-stocked and maintained first-aid kit that includes an emergency first-aid reference guide.
6. How to stop severe bleeding. Serious injuries can cause heavy bleeding. A person who is bleeding can die from blood loss within five minutes. If you are a bystander to a medical emergency, you are the help until professional help arrives. Learning what to do in a bleeding emergency, including how to apply a tourniquet, can save a person’s life. A tourniquet is a last resort if applying pressure does not stop the bleeding.
7. How to help someone who is choking. Fast action can save the life of someone who is choking. Young children are at especially high risk of choking. They can choke on foods like hot dogs and grapes, and small objects like toy pieces and coins. Learn when and how to do back blows and perform abdominal thrusts.
8. How to turn off utilities. Household utilities can pose potential health and safety threats after an emergency. Know where and how to turn them off in the aftermath of a natural disaster like an earthquake. Contact your utility providers with questions.
9. How to use a fire extinguisher. Use fire extinguishers on small fires only. When operating a fire extinguisher, remember the acronym PASS:
   • Pull the pin.
   • Aim low at the base of the fire.
   • Squeeze the lever slowly and evenly.
   • Sweep the nozzle from side to side.
10. How to call 9-1-1. While making the call is easy, you may not know what to expect when you call. Prepare to answer questions about yourself and the emergency. Your answers help the call-taker get the right kind of help to you. Also, don’t hang up until the call-taker instructs you to do so. Many 911 centers can tell you how to help until professional help arrives.

Honorable mentions include learning how to keep food safe after an emergency, how to make water safe, how to administer naloxone, and how to perform seizure first aid.