Curious about how to move someone during an emergency? It’s easy – you just toss them over your shoulder, as seen in all the movies, and run like crazy, right? Wrong! In this article, we’ll talk about an often-overlooked side of emergency care. Patient movement. 

During an emergency, there are several things to consider before you move a patient. First, is there an immediate environmental threat to their lives? Such as fire, flooding, or an incoming train. Second, does the patient’s condition warrant movement. Finally, should you perform lifesaving treatments, like airway or bleeding control before moving them?

In the next paragraphs, we’ll talk about what you should know about moving an injured person. Then, we’ll list five techniques you can use to move someone during an emergency.

Legal Concerns about Moving Patients in an Emergency

Before we talk about when you should or should not carry a person during an emergency, know this: this article should not be taken as professional medical advice. Always seek professional training and refer to your local laws. 

With that said, we will talk about patient movement from a first responders’ perspective, and when and why the decision is made to move or leave the patient in place. 

One last thing – some people are afraid to move a patient (even when they know they should) because they are afraid of being sued. Now, this should not be taken as concrete medical advice, but there are things called Good Samaritan laws in many states. These laws essentially protect civilians who acted with good faith when trying to help someone.

If you can, familiarize yourself with local laws, and remember the golden rule: do onto others as you’d want them to do to you.

Ways First Responders move Someone in an Emergency 

We’ll assume that you’ve decided to move someone, but now you’re wondering how to do it. 

First, let’s talk about how first responders move patients – this will give you some idea of the approach. Then, we’ll talk about some techniques for patient movement that anyone can use. 

Here are some tools the pros use: 

• Backboards 

• KED boards

Let’s go into more detail below. 

The Backboard 

Backboards are long, wide, and flat board that is placed under a patient. The patient is then strapped to the backboard, allowing multiple responders to use the handles on the edges of the backboard to lift the patient. 

The backboard has, historically, been used for two main purposes. 

First, as an extrication tool. For example, a patient might be far out in a field and the responders need to carry them a distance to the ambulance. In this case, it would be easier to strap the patient to the backboard and use multiple people to carry them, then to try to carry the person with nothing.

Second, the backboard has been used for suspected injuries to the spinal cord. The thinking goes that the backboard would help stabilize the spine, similar to how a spine stabilized a broken leg. However, using the backboard explicitly for this purpose has fallen out of favor in many health systems.

KED Board

If the patient is trapped in a vehicle, the responders might use something called a KED board. These are almost like a mini backboard, but they are flexible, and only secure the patient from the head to the torso. These can be strapped around the patient and then used to pull them out of a vehicle.

Finally, first responders will often use some type of sheet to move patients. This technique is often used for carrying a patient a short distance when the patient has no risk of spinal cord injury. These sheets, often known as Smith Cots, transport litters, or mega movers, are essentially a durable tarp with handles attached. 

On top of these methods, there are some other techniques first responders use to carry patients without tools. Many of the techniques can also be used by civilians to move someone during an emergency. 

Ways You Can Move Someone During an Emergency 

Now that we’ve talked about how responders use tools to move patients, and some of the reasoning behind the patient movement, let’s look at some techniques for moving patients without any equipment. 

Here are five ways you can move someone in an emergency: 

• Shoulder drag 

• Clothing drag 

• Leg drag  

• Sheet drag 

• Harness and litter 

Let’s look at these in more depth. If you'd like more pictures of these techniques and a deeper analysis, see this PDF on moving patients. 

Shoulder Drag 

The shoulder drag might be the most intuitive. If the person isn’t too large, you can stand behind them and hook your arms underneath their shoulders. For some people, to ensure the person doesn’t slip away, you can grab their wrists after placing your arms under theirs. From this position, you can pull them across the floor, away from dangers. 

The risks: If the person is large, this can be difficult for one person. Also, since you are walking backward there is the risk of tripping. This should only be used in an emergency. 

Clothing Drag 

Some people might be able to get more leverage by just grabbing the clothing of the person, around their shoulders. This allows you to pull on their shirt and drag them to safety. When done properly, there should be no pressure on the person's neck, all pressure should be directed at the underarms. 

In some cases, it may be necessary to drag from the pantlegs. This all depends on the situation. 

Leg Drag 

As we touched on in the last section, there may be times when you need to briefly move someone by pulling on their pant legs. It could be that you’re alone and you’re unable to access their upper body. Or it could be that the person is slumped into a corner.

In any case, to perform this maneuver, you either grab the person by the ankles and pull them, or you can try grabbing the leg of their pants. This is not an ideal method by any means, and once the person is safe, it’s important to switch to another method. 

Sheet Drag to Move a Patient to Safety 

A sheet is a powerful thing. In an emergency, it can help you move someone to safety. There are two ways this works. 

First, you can carefully roll the patient on their side while stabilizing any broken bones and slide the sheet underneath them. Then, roll them back and pull the ends of the sheet to move them. Just be careful they don’t slip off. 

Second, you could roll the sheet up to make a rough rope and then wrap the rope underneath their shoulders. Now you can pull them to safety, similar to the clothing drag method. This technique is sometimes used to pull a patient out of a ditch or a burning vehicle, as it’s quick and effective. 

Of course, ensure you get training before attempting any of these maneuvers. 

Use a Litter or Harness 

Sometimes, first responders will carry a small litter (sometimes called a stokes basket) that makes it easier to extricate patients from austere environments. They may also carry products like a simple transport litter or a product like the hasty harness. 

The hasty harness is a simple and durable strap that allows first responders and firefighters to rapidly move patients in an emergency. If you’re curious about how this product works, you can look at this video on moving a patient with a hasty harness. 

As you might imagine, the ways to move a patient during an emergency are almost endless. Patients can end up in some odd situations, requiring responders to get creative. As a final note, it’s often helpful (if you have the time) to ask a patient if they have any ideas on how they should be moved – sometimes they have the best ideas. 

What if You Can't Move the Patient? 

If you can't move the patient in an emergency, always do your best to keep their airway clear and control bleeding. Both bleeding control and airway management should be performed before, during, and after you move a patient. 

Also, call for help early and often.

Should You Move a Person in an Emergency Situation?

The real question is when should you move someone in an emergency? Well, as you might expect, the number of potential situations and the nuances of each of those situations are endless. Answers aren’t cut and dry. 

At the end of the day, try to do the right thing. If you see someone who needs help, help them. The best way to help make this decision is to get professional training.

After you place yourself in various scenarios and talked with professionals who have moved thousands of patients during emergencies, you’ll be in the best position to decide how to move or care for someone during an emergency. If you’d like, you can watch this video about moving patients. 

Final note: Keep in mind that protocols and procedures change rapidly in the medical field. Take nothing in this article as medical advice and understand that the techniques listed in this article may become outdated in time. Do your best to stay up to date on your local laws and emergency protocols. 

Do CAT Tourniquets Expire? (And other Tourniquet Questions)

CAT tourniquets must withstand bullets in battle and blood in the ambulance, but can they withstand the test of time? Many people wonder if CAT tourniquets expire. In this article, we’ll answer these questions and many more. 

CAT tourniquets do not have an expiration date; however, they should be checked from time to time to ensure they are still in working order. In general, you want to have a separate “practice” tourniquet, as repeated use of a tourniquet can cause it to wear. 

Below, we’ll dive a little deeper into the reason CAT tourniquets don’t really expire, and what you can do to ensure your tourniquets, whether it’s a SOF-T or a SAM, are ready to go! 

How Long Do CAT Tourniquets Last? 

CAT tourniquets can last many years when stored properly. If you have a genuine CAT tourniquet, then there’s no reason the CAT tourniquet couldn’t last indefinitely with proper storage and care. 

How should you store a CAT tourniquet? You should store your CAT tourniquet out of the sun in a dry location. With that said, CAT tourniquets are made to withstand the worst environments in the world, so they won’t be harmed by exposure to the sun or the water. Of course, you wouldn’t want to repeatedly expose the tourniquet to water, as this could inhibit its ability to secure itself. 

Check to see that your tourniquets are in good working order before a shift or at the end of the day. Ensure there is no built-up dirt or mud, and that the buckle and straps were not harmed in some way. 

It’s not recommended to practice with the tourniquets you’ll be using in real scenarios – let me clarify – you should definitely practice with the same model of tourniquet; however, repeatedly using your tourniquets could expose them to wear and tear, making them less effective during a live event. 

We talk more about this in the next section. 

Can You Reuse CAT Tourniquets? 

In general, you should not reuse a CAT tourniquet. A CAT tourniquet for strictly training purposes can certainly be reused. If you’ve used the CAT on someone in the field, then there is the potential for blood and grime to build up on the CAT, making it unwise to reuse them. 

Further, as we just discussed in the last section, the stress placed on a tourniquet during use could cause the tourniquet to fail during future uses. Tourniquets are not made to be reused.  

Do SOF-T Tourniquets Expire? 

Like CAT tourniquets, SOF tourniquets do not expire either. If you store them correctly and try to protect them from the dirt and the mud, then you will end up with a tool that will last for many years. 

You should still perform routine checks on your tourniquets – no matter how silly they seem. Too many times an ambulance crew will say “I checked that yesterday, I don’t need to check it today.” And then they go on a call, only to find that another crew took their gear over the night shift, or that their gear was replaced with something worn or broken. It happens. 

This is sort of like the “treat every gun as if it’s loaded” rule – it’s there to keep you safe. Just as you should treat every gun as if it’s loaded, you should also treat every medical kit as if it’s missing something – and check it daily! 

Now let’s talk about some more common questions about tourniquets in general. 

Common Questions about CAT Tourniquets 

Let’s go over several common questions people have about CAT tourniquets and tourniquets in general. Out of all the medical skills and equipment, it seems that tourniquets are some of the most misunderstood. And this is bad because tourniquets are some of the most important pieces of gear. 

Here are some frequently asked tourniquet questions: 

• Do tourniquets always lead to amputation? 

• How many tourniquets can you apply? 

• What’s the best tourniquet for first aid? 

• How long can tourniquets stay in place? 

• How should you fold and stage a tourniquet? 

• What’s the best way to carry a tourniquet?

Let’s look at these in more depth. 

Do Tourniquets Always Lead to Amputation? 

No, tourniquets do not always cause an amputation. This was a common belief for many years, and unfortunately, it lives on to this day. Tourniquets can stay in place from two to six hours without causing long-term damage – of course, this will depend on the severity of the injury, how the tourniquet was placed, and how long it takes for the patient to receive definitive care. 

You should train yourself in how to stop a bleed and use a tourniquet. These are some of the most misunderstood yet important skills to know. Many people think stopping a bleed is a simple task. It’s not. Yes, it’s simple in principle, but in practice, there are many moving parts and things to consider. 

Here’s a video that shows you how to use a tourniquet. Also, seek out expert first aid training and never stop practicing. Practice is the only way you’ll be able to perform these skills properly in a high-stress situation. 

How Many Tourniquets Can You Apply? 

If the person has arterial bleeds from all four limbs, then you could theoretically apply four tourniquets – one per each limb. 

However, the more plausible scenario is applying a maximum of two tourniquets. The first tourniquet should be placed about two inches from the wound, and if the bleeding doesn’t stop, you should apply a second tourniquet above the first tourniquet (closer to the heart) and leave the first one in place. 

If this doesn’t work, you’re either applying them incorrectly, or you need to consider another way to stop the bleed (wound packing, better direct pressure). 

What’s the Best Tourniquet? 

The best tourniquets are probably the SOF Tourniquet and the CAT tourniquet. There are other tourniquets out there that work well; however, these two have the longest track records and some of the best reputations. Both these tourniquets are used by the military, law enforcement, and EMS. 

The SOF tourniquet packs down a little bit smaller than the CAT, but the CAT has larger controls that may be easier to use for some people. Again, training. That’s the key. Let’s talk about another common tourniquet question. 

How Long Can Tourniquets Stay in Place? 

After you’ve placed the tourniquet, the most common advice is to leave it in place. However, there are times when you should consider removing the tourniquet. 

NOTE: This article is not meant to be definitive medical advice – always refer to local laws and professional medical guidance.        

With that disclaimer out of the way, here are a few things to keep in mind. First, there are times when you’ll place the tourniquet in haste, seeing bad bleeding and going straight to the tourniquet. This is usually okay. However, if, after placing the tourniquet, you soon see that the bleed did not need a tourniquet, you can remove it (while still controlling the bleed). 

However, if the tourniquet has already been left in place for a significant period of time, it’s best to leave it in place and wait for surgical care.

Again, there is a lot of gray area in this decision, so ensure that you double-check everything with your local medical authority – this article should not be taken as medical advice! Even well-established rules can change over time, so keep up with things and always check for updates. 

How Should You Fold and Stage a Tourniquet? 

There’s an art and a science to folding and preparing your tourniquets. The art comes down to personal preference. If you play around with your tourniquets, you may find a folding and staging method that works best for your setup. However, the science comes down to concrete needs. For example, you need to be able to apply the tourniquet rapidly. Also, you should be able to deploy and apply the tourniquet with one hand. 

If you’d like you can watch this video on how to stage a tourniquet. It’s much easier to watch the process than explain it in words.  

What’s the Best Way to Carry a Tourniquet? 

The best way to carry a tourniquet is to have it always within reach. How do you do this? A couple of ways. The most obvious way is by carrying it on your person, in a pocket, or on a belt. However, some people may choose to strategically place the tourniquets throughout their lives. 

For example, they might have one tourniquet attached to the visor of their vehicle, they might have one on their desk at work, and another in their kitchen. Wherever it is, you need to ensure the placement is consistent. 

If you choose to carry the tourniquet on your person (that’s my recommendation) you can go a couple of routes. First, you can buy a more pocketable tourniquet, such as the SOF tourniquet. Or you could buy a specified tourniquet carrier and keep it on your hip or backpack. If you’re curious, you can learn more about this in my article on tourniquet carriers. 

What are the Different Types of Medical Kits?

If you’re wondering about the different types of medical kits, this article will give you a strong introduction. Some people might think a medical kit is pretty standard; however, like a mechanic has different tools for different jobs, a physician or paramedic will have different medical kits and tools for different injuries and illness. 

Some medical kits are categorized by purpose, for example, trauma kits, med kits, surgical kits, airway kits, and splints. Other medical kits are categorized by size: pocket kits, vehicle kits, IFAKs, and expedition bags. Understanding the various types of medical kits will make you more organized, potentially making you a better responder in an emergency. 

This article will talk about the various types of medical kits carried by professionals, and it will give you an idea of the kinds of kits that are useful to have on hand. 

The Two Main Categories of Medical Kits 

There are usually two primary ways to categorize first aid kits – either by size or by their designated use. As medical kits become smaller, they will carry less and less “fluff” and more “meat.” The fluff would be categorized as items of comfort or convenience, the “meat” would be items that are lifesaving. These philosophies guide many decisions in first aid kits. 

Here are the two categories of first aid kits: 

• First aid kits by use. These first aid kits have a specific purpose, and they are marked clearly for their intended use. 

• First aid kits by size. These kits are made for different areas. Some for a pocket, some for a backpack, and some to be carried in a large duffel bag, or even to set up a mobile clinic in austere environments. 

Below, we’ll outline the specifics of each of these categories. Let’s start with first aid kits by use. 

The Different Types of First Aid Kits by Use 

There are many types of medical conditions. When a first responder is working on a patient, they need to have all their tools ready to go – there’s no room for disorganization during an emergency. Your mind will already be going a million miles an hour, so you want to have everything around you as standardized as possible.

Let’s talk about the most common types of first aid kits. 

Note: we will list many types of medical packs – not all of them will be within a civilian responder’s scope of practice, meaning that you don’t just get to perform surgery because you have a knife. However, for the sake of information, we’ll cover them. 

Types of first aid kits based on purpose: 

• Medical kit for Trauma and Bleeding Control 

• First Aid kit for medications (med kit)

• Medical Kit for Surgery 

• Medical Kit for Airway Management 

• Medical Kit for Splints 

These are some of the many subcategories of medical kits that professional responders will carry. You can use this information to guide the creation of your medical kits. 

Trauma Kits and Bleeding Control 

Trauma kits are some of the most popular kits. The reason they are so popular is that they are probably the single most lifesaving type of kit in the civilian world (along with good CPR and airway management, bleeding control is one of the most important first aid skills). 

The typical trauma kit will have various subcategories. The most common components are packing gauze, pressure bandages, and a tourniquet – these make up the bleeding control portion of the trauma kit. However, trauma goes beyond bleeding control. 

There will also be chest seals and occlusive dressings in a trauma kit, allowing the responder to treat wounds to the chest and abdomen. 

Finally, the trauma kit may have burns sheets, burn gel, and perhaps some IV supplies. Treating burns requires careful planning and equipment, so sometimes there is a burn kit that is separate from the trauma kit. However, it’s important to know that burns fall under the umbrella of “trauma.” 

Med Kit - Emergency Drugs and Pain Control

The med kit has useful medications to be used during an emergency. These don’t all need to be emergency meds, but they should all serve a specific purpose. In the ambulance, there will usually be three main categories of medications: cardiac (anything with the heart), breathing, and pain control. There are other supplemental medications, but in general, these are the three areas. 

You can use this to guide your own med kit. Ideally, you should have medications that match up with the needs of the people you’re serving. Some people might require an Epi-pen, some might require Aspirin, and others might just need some ibuprofen. 

The med kit is usually separate from everything else - or can at least be easily removed. Med kits also include all the syringes and vials needed to administer the medications accurately. Often, there is also information included about dosing. Though it’s good to become familiar with meds and doses, relying on memorization during an emergency can prove unreliable. 

Medical Kit for Surgery 

This kit will fall out of the scope of most civilians. However, a trained practitioner may carry some simple surgical equipment for emergency use. These will not often be for major surgery, but rather smaller operations, or emergencies. 

For example, a paramedic carries some surgical supplies for cricothyrotomies (cutting open the throat to establish an airway). They may also carry decompression needles for tension pneumothorax (relieving pressure on the lungs and heart). Some will perform escharotomies (cutting through burned tissue to allow a person to breathe), others may be trained in more invasive procedures, such as chest tubes.

It’s good to be aware that these are possibilities in the field, but only authorized individuals should attempt these procedures. Now let’s talk about airway management. 

Airway Management Medical Kit 

Airway management is another medical kit that is usually separate from other kits. The airway kit is ready to handle any emergency that could impact a person’s ability to breathe. The airway kit will have a multitude of supplies depending on the level of the provider. 

Often, there will be a BVM or a CPR mask – used to provide supplemental breaths. Other times there will be a simple rescue mask barrier device. 

OPAs and NPA are common items in an airway kit. More advanced providers may have endotracheal tubes for intubation, Magill forceps to clear blockages, and a bougie to facilitate intubation (basically a long, flexible, plastic stick). 

Airway management also requires a unique set of skills that need to be practiced. If you’re curious, read this guide to better airway management. 

Medical Kits for Splints and Slings 

This kit deals with the musculoskeletal systems – bones, muscles, tendons, and ligaments. For this kit, you will see various splints as well as tools to treat a sprain, break, or strain. 

For this kit, there will typically be a myriad of items for splinting, including some large splints such as board splints and traction splints for treating arms and legs. 

However, there will also be moldable splints, which are easily portable, as well as a triangular bandage, which can be used to create a sling and swath. 

For a civilian kit, it’s difficult to carry the larger splints, but there are ways to improvise splints with branches, walking sticks, or even pillows. 

This is not an exhaustive list of medical kits, but these are some of the most common kits you’d find on an ambulance. There may be many situations where these kits are modified to fit the needs of the provider. This list will hopefully help you as you build your own kits. 

Types of Medical Kits by Size 

As we said earlier, medical kits are also categorized by size. Some large and some small. Let’s go over how the various sizes work, and what they can do for you. 

Sizes of medical kits: 

• Pocket kits 

• IFAKs 

• Full medical Kits 

Let’s look at these three main sizes 

Pocket Medical Kits 

These kits are meant to be carried on the person, either in the pocket or in a purse. Regardless, the goal is for them to be on hand at any moment. An ankle kit could also fit into this category. The goal is to have the essentials ready to go. 

For these small kits, you usually only include the most important items: tourniquets, epi-pens, packing gauze. It wouldn’t make sense to waste space with ice packs or other secondary supplies. 

Individual First Aid Kits (IFAK)

These kits are a little bigger than pocket kits. IFAKs are usually made for some operational capacity – not necessarily everyday carry. For example, a police officer, soldier, or hunter will often carry an IFAK on their belt. 

The IFAK is built will a few more supplies than the pocket kit. Also, the IFAK is built for the person who carries it, so it will contain supplies needed specifically by them – such as prescription meds. 

To learn more, read this guide to IFAKS. 

Large First Aid Kits – Full Kits 

The full first aid kit is usually a large bag that contains all the smaller kits within. This kit might be the size of a backpack, or it might be the size of a duffel bag. Usually, the large first aid kits act as the “base camp” for the smaller kits. 

To see a large medical kit in action, check out this video on the rapid-access trauma system. 

This article is only meant for informational purposes. Always follow local laws and regulations regarding what you can and cannot carry and what you can and cannot do – many areas are different. Finally, remember that training always trumps gear. Get trained, keep training. 

Is it Cheaper to Build Your Own First Aid Kit?

Are you wondering if it’s cheaper to build your own first aid kit than to buy a pre-made kit? In this article, we’ll talk about the pros and cons of building your own first aid kit vs. buying a first aid kit that’s prepackaged. We’ll also delve into some tips and tricks to getting the most from your first aid kit. Let’s jump in. 

If you’re serious about a first aid kit, there are advantages to building it yourself. In some cases, it's cheaper to build yourself, in other instances, it isn't. It all depends on the type and scope of the first aid kit.

Below, we’ll outline the pros and cons of building your own first aid kit. Remember - there is a difference between price and value, and this differentiator will come into play throughout this discussion. 

The Cheapest First Aid Kit: Consider Your Needs 

What’s the cheapest first aid kit? Well, it depends on your needs. When you’re looking for a first aid kit, the first thing you need to do is establish when, where, and how you’ll use it. 

Here are three general categories of people who carry a first aid kit: 

• The professional first responder. If you’re a professional first responder, then you’ll probably carry a few advanced items. However, on the other hand, as a professional, you might be well equipped to improvise items, reducing the amount of stuff you carry. 

• The non-medical person. This is the mom or dad who wants to be ready when their children come to them with bloody noses and mangled limbs. These people usually want a little bit of everything, and they also need a system that’s easy to carry. 

• The guide/outdoorsman. If you’re a guide or an avid outdoorsman, then you’ll probably need to carry extra supplies, and you’ll need to think about the long term. 

What’s the point of outlining these profiles? Know who you are. Think about your needs. Don’t just grab some gear, even nice gear, and assume you’re all set with everything you need. You should always be thinking about purpose. 

The cheapest solution will be the one that meets your needs with the least amount of extra waste. Let’s talk about what this means. 

Understanding Value and Waste for First Aid Kits

You might think the cheapest first aid kit is the one you buy off the shelf of a big box store. However, to a professional first responder, that’s not even a first aid kit. Why? Because they aren’t looking for a box of Band-Aids. They want tourniquets, packing gauze, chest seals, moldable splints, and more.

Sadly, many times, these essential first aid items are not included in many of the big-box stores, pre-made “first aid kits.” It’s much better to build your own in this case, ensuring you have the gear you need.

Advantages to Building Your Own First Aid Kit 

Building your own first aid kit has many inherent advantages, particularly for those who are new to the first aid world. In some cases, it will be more expensive to buy all the first aid components individually instead of buying them as a package, but for those new to first aid, it might be worth it. 

Here are a few reasons it’s worth it to build your own first aid kit: 

• Customization. If you have a specific health concern, you can add gear to suit your needs. 

• Organization. If you’re new to first aid, building your own first aid kit will force you to understand each part. 

• First aid bag. When you build your own first aid kit, you typically need to find a good bag as well. This improves the system by allowing you to buy a medical pouch that works for you. 

Now let's talk about how to build a first aid kit without going overboard. 

How to Build a Budget First Aid Kit 

The first step is to make a list of the medical items you need. Ask yourself if there are any medical conditions unique to you or your family. In some cases, there will be people who are allergic to bees, so it would be wise to carry an Epi-pen, or some sting relief pads. 

Some people might have a weak ankle that frequently sprains, in this case, it would be wise to carry some Ace wrap and ice packs. 

And of course, everyone should have the fundamentals, which include items for major bleeds and airway management. 

We’ve talked about building first aid kits in other articles, so here are a few links for specific types of first aid kits: 

1. How to Build a Backpacking first aid kit 

2. How to Build a Vehicle first Aid Kit 

3. How to Build a Family first aid kit

If you'd like, you can also watch this video on building a budget trauma kit. Now, let's go over a few tips for staying within the budget:

• Modularity 

• Overlapping items 

• Learn to Improvise 

Let’s look at these in more depth. 

Modularity for a First Aid Kit 

Instead of having fifteen first aid kits, have only several placed in key locations, like one in the car and one in the kitchen. While we believe it’s always good to have extra emergency supplies, there’s no reason to be excessive, and sometimes, if you have too much, it’s easy to become disorganized. 

For modularity, you might have one large first aid kit and a few smaller first aid kits. The smaller first aid pouches will fit into the larger kits, but when you need to be more mobile (say you’re walking with your kids at the park) you can take out the smaller pouch and place it in your pocket. 

This takes some habit building to do correctly, but once you get used to it, you’ll find that you have less clutter while still having the essential gear you need.

Overlapping Items in a Medical Bag

There are a lot of items out there – if you buy a first aid kit from the pharmacy, it will have a ton of variations of items - big gauze pads, little gauze pads, big band-aids, little band-aids, rolled gauze, trauma pads, more band-aid. But all this stuff can be replaced by a single pack of compressed gauze. 

Think about this when building your kit. There are a few items that are difficult to duplicate, like a tourniquet, but many other things have different uses. For example, the Israeli bandage is built for a ton of different uses – from splinting to bandaging to creating a sling and swath. 

If you buy a few “multi-use” items, you will find yourself spending less money overall, while still having the same functionality. 

Training and Learning to Improvise First Aid Items

As they say, the more you carry in your head, the less you’ll carry in your pockets. However, no matter how well trained you are, it’s often more effective to have the gear your need ready to go during an emergency. 

Getting trained will do several things for you. First, it will help you cut down on non-essential gear. Second, it will make you more effective with the gear you have. You’ll know how to use the gauze or splint for more than its intended purpose, and you’ll know how to do it with less stuff. 

Are Some Pre-made First Aid Kits Worth It? 

Yes, some pre-made kits are worth it, particularly once you know how to use the components, and you understand you’re getting a quality product. 

For example, the Civilian Medical trauma kit by Medical Gear Outfitters is built with professional tools, and it doesn’t overlook any of the essential gear. 

Mistakes to Avoid when Building an Inexpensive First Aid Kit

When you’re looking to buy a first aid kit, there are a few mistakes to avoid. 

Ironically, the first mistake people make with first aid kits is going cheap. Yes, the title of this article is about “cheapness”, but when it comes to first aid kits, you should be thinking about quality and value. Certainly, there’s nothing wrong with wanting to get the most with the money you have, but you don’t want to “race to the bottom.” This is a matter of life and death. You need good tools to perform during high-stress situations. 

Lack of training is the next mistake. When it comes to first aid, training is everything. I’ll go even further and say, just taking a weekend first aid class does not mean you’re “trained” for an emergency situation, any more than a person could take a weekend swimming class and be ready for the Olympics. If you want to perform well under pressure, then you need to dedicate yourself to hours and hours of consistent training. 

Disorganization is the final major mistake. You might have the greatest first aid kit that mankind's eyes have ever seen, but if it’s tucked deep in the closet in your room, it will be of no help during an emergency. Just like you brush your teeth every night (hopefully), you should build a habit of having a good first aid kit ready to go at all times. 

First Aid Gear Checklist: Vacations and Camping

Are you getting ready for a vacation? Anytime you’re planning a vacation or camping trip you should take a moment to consider your first aid kit. We’ve talked about a vehicle first aid kit; now, let’s discuss medical items to pack while on vacation.

There are logistical and equipment-based concerns when you go on an extended trip. For this guide, we’ll assume you’re traveling domestically; however, there may be more concerns if you’re in a foreign country. 

We’ll start by discussing gear for a general vacation, but we’ll also explain how to prepare for a more primitive environment, particularly if you’ll be doing tent camping or backpacking. 

Let’s talk about what to pack in your first aid kit. 

Best Items for a Travelers First Aid Kit 

Let's start with the list of items you should consider bringing on most vacations and camping trips. Later on, we'll go into some of the "theory" behind why you should pack certain things. 

Don't forget to pack these first aid items before your vacation: 

1. Gauze and bandaging. Some packed gauze for larger bleeds and Band-Aids for those scratches.  

2. Tourniquet and pressure bandages. For those more serious injuries, a good tourniquet should also be carried on in person when possible. You don't want to be digging for a tourniquet when you need one. 

3. Airway supplies. Including NPA and OPA; however, ensure you know how to use them. Also, a rescue mask is nice to have in your medical bag. 

4. Splints. A small moldable splint works great for treating almost any sprain, strain, or broken bone. 

5. Triangular bandage. The triangular bandage is incredibly useful for a multitude of injuries, including making slings, creating a makeshift tourniquet, and binding a splint. 

6. Medical scissors. If you're curious about all the uses for these, you should check out our article on trauma shears. These are great for cutting clothes away from an injury or cutting medical tape. 

7. Cold packs. A good cold pack can become especially useful during the summer, not to mention after someone gets a bruise that needs some ice. 

8. Disinfectant. Get some antibiotic ointment, both a tube and some small packs for quick use. 

9. Medical tape. Keep some of this handy for securing bandages or for keeping Band-Aids in place. 

10. Tweezers. Don't let those splinters win - keep some tweezers ready! Also, if you'll be outside at all, grab some tick removers. 

11. Insect repellant. Wear insect repellant around mosquitos - you don't want to be lunch. You can also wear repellant to deter ticks, but ensure you get the right kind of repellant. Think about treating your clothing with permethrin to prevent ticks. 

12. A good medical bag. Get a medical bag that everyone knows is the first aid kit. Look for one with separate but easily accessible compartments. Buy nice or buy twice!

Note: This list is not all-encompassing. The best thing you can do is consider the type of vacation you're taking, the people on the trip (do some of them have specific health conditions/allergies?), and the environment you're traveling to and through. We'll chat about all this more below! 

Understanding First Aid for Vacations and Camping Trips 

Let’s talk about some of the why behind what you should pack. We’ll break this down based on sections. Some will be more worried about emergency first aid; others will have comfort-based concerns. Know this: It only takes a few mosquito bites to make your vacation uncomfortable, so let’s not brush over the small stuff – at the same time, it’s important to prioritize the lifesaving gear. 

Understanding essential first aid supplies for vacations: 

• Emergency first aid, bleeding control, airway 

• Prescription medications and over-the-counter (OTC) drugs 

• Protection from the environment 

• Think about logistics

Let's talk about these. 

Emergency First Aid: Bleeding Control First Aid 

First, make sure you have the essentials covered. These are the things that can cause the most harm the fastest. In medicine, we have a name for these things: ABCs. Airway, breathing, and circulation. Essentially, you need to be ready to help someone breathe, stop someone from bleeding and keep the blood pumping. 

To stop major bleeding, the essential items are packed gauze and a tourniquet. Get some compressed gauze and buy a reputable tourniquet, like a SOF or a CAT. For breathing control, learn basic airway maneuvers and how to use a BVM. Finally, make sure you know CPR!

Medications for a Vacation First Aid Kit 

If you’ll be away for a while, ensure you have adequate stores of prescription medications or any OTC meds that you’re relying on. Take into account the possibility that you could be delayed on your trip, or flights could be canceled. Do you still have enough medications to last? 

Also, even if you’re normally healthy, it may be wise to pack some OTC meds like benadryl, aspirin, ibuprofen, Tylenol, laxatives, Pepto-Bismol, Tums; all the usual things. Why? Sometimes, traveling to new areas and new climates can mess up our bodies a bit. It’s better to be prepared. Plus, you’ll probably end up using it on someone else. 

Protection from the Environment 

One thing to consider for vacation travel is the environment. Why do you need to worry about the environment? Will you be driving in your nice car? Well, regardless of your mode of travel, you could end up trapped. If there’s a major accident on a rural highway, traffic can be stopped for a long, long time (we’ve all seen the news about multi-car pileups involving dozens of vehicles) 

Bring some extra water and blankets. If you need to sleep in your vehicle overnight, you don’t want to freeze (in the winter), and you don’t want to overheat in the summer. 

On a less doomsday-ish level, think about extra sunscreen and aloe vera (a bad sunburn can make a vacation unpleasant). 

Will you be hiking? You don’t want to get trapped in the rain. Bring some sort of water-resistant clothing, regardless of the time of the year. Further, remember to bring a water filter or some other way to obtain pure water. 

Vacations: First Aid, Emergency Care, and Logistics 

This is an element of vacation that is often overlooked. How close is the nearest hospital to where you’ll be camping or staying? Also, realize that the ambulance response in very rural areas can be quite a while.

If you’re pregnant or have a health condition that requires proximity to the hospital, plan your trip accordingly. All it takes is a quick look at the maps apps on your phone to locate various medical buildings. 

It might not be practical for everyone to carry a huge medical bag, but someone should have a fully stocked kit (acting as the hub), while individuals should still carry some bare essentials (like gauze and a tourniquet). 

Mistakes to Avoid When Packing First Aid for Vacation 

There are a few pitfalls you can avoid when packing your first aid kit. As they say, we can often learn more from our mistakes, so here are a few mistakes to avoid when making a medical kit before a vacation. 

Mistakes to avoid:  

• Not packing enough 

• Buying a generic kit 

• Having an unbalanced kit

Let's look at these in more depth. 

Not Packing a Complete Kit 

Usually, we're all about traveling light. However, when it comes to packing first aid and medical gear, you don't want there to be any holes in your kit. Now, if you're an experienced traveler, then you might have a better read on the quantity of supplies.

However, if you're starting out, don't skimp too much; pack a bit of everything and then see what you used and how it worked. You can always adjust next time. 

Buying a Generic First Aid Kit 

We've all purchased a generic "first aid" kit from some big-name store, and this isn't so much a mistake as it is an oversight. Sure, these kits come with a bunch of Band-Aids, and band-aids are nice, but these kits almost never come with a good tourniquet, a splint, or a proper supply of medications. They're often bloated and not in a good way. 

Even if you have one of these fast kits, you can fortify it by adding the first aid tools you need. 

Avoid an Unbalanced First Aid Kit 

We all worry about something. Some worry about sunburns, and some worry about bee stings. Both are valid concerns; just be sure you don't forget something because tunnel vision kicked in. 

This goes for everything, bleeding control, splints, ice packs - make sure you have a nice balance of gear. 

Final Thoughts on How to Build a Vacation First Aid Kit 

The only way you can really relax is to be truly prepared. Sipping a cool lemonade and looking at your favorite wildlife will be even better when you know you’ve planned for possible emergencies. 

Consider bringing extra over-the-counter medications, as travel can often bring on ailments. Further, if you're headed out into the wilderness, whether backpacking or doing some rural camping, consider adding some survival elements to your first aid kits, such as water filters, e-blankets, and fire-starting material. 

If you'd like more information on these topics, you can read our article on how to build a survival first aid kit. Also, you can check out our article on first aid kits for backpacking trips. 

At the end of the day, what you store behind your eyes is more important than what's in your backpack! Get some training! 

The Best Way to
Treat Bee and Wasp Stings

Are you wondering how to treat a bee sting? Wasps and bees can become aggressive. It’s important to be ready with a plan when you or your child is stung. It’s rare, but there are cases where bee and wasp stings are life-threatening. 

To treat a bee sting, first ensure the stinger is removed. If the patient is known to be allergic, use an epi-pen or call 911. If the bee or wasp sting isn’t serious, you can use ice, NSAIDs (ibuprofen), and elevation (raise the limb) to reduce pain and swelling. 

Don’t worry. We’ll talk about all this in more depth. Also, we’ll discuss how to know if someone is having a serious anaphylactic reaction and some things you can do to prevent stings in the future. 

How to Treat a Hornet, Bee, or Wasp Sting 

Stings from these insects, known as Hymenoptera, can be super painful. But they can also lead to life-threatening situations. This article will follow a logical step-by-step pattern.

First, we’ll talk about recognizing a sting and how to know if it’s serious. Then, we’ll talk about the steps for treatment, as well as some things that may happen in the days following the sting – so you know what to expect. 

Steps to treat a bee sting: 

1. Recognize the sting/Find cover (from a swarm)

2. Remove the stinger 

3. Treat the sting: Minor reaction

4. Treat the sting: Serious reaction

Let’s go over these steps.

Recognize the Sting 

If you feel a sting, look at and expose the area. Bees can sting through clothing, though it may be more difficult for them to get to the skin (if the clothing is relatively thick/baggy). 

Should you be swarmed by bees, it’s important to run away from the swarm fast. Where should you go? Well, most people suggest getting indoors or into a vehicle.

The swarm of bees will be less likely to follow you indoors, and you will be able to focus on removing the bees that are already on you. Shield your face and your neck – these are the most dangerous areas to be stung, as the swelling could cause a blockage to the airway. 

Note: in general, only killer bees will swarm in this aggressive attack. Regular honeybees are usually less aggressive. 

Once you’ve realized you’ve been stung and you’ve escaped the swarms, it’s time to remove the stingers. 

Remove the Stingers 

There’s a common thought out there that you should use something like a credit card to scrape the stinger from the skin. The thinking is that you don’t want to squeeze out any more venom. This is no longer recommended by the American College of Emergency Physicians, as it wastes time – just get the stinger out.

The stinger already has a muscle in it that’s involuntarily contracting, so it doesn’t matter if you use a credit card or not: the longer that stinger stays in, the more venom potentially that will enter the victim - if you have a credit card in your hand, great. Otherwise, just grab the stinger and get it out. 

Once you have the stinger out, it’s time to think about treatment. 

Treating the Bee Sting: Minor Reaction

If the sting is only minor, one or two stings, and you know that the person is not allergic, then you don’t need to panic (even if they are allergic, panic is a bad thing). Make sure the person moves to a safe area where they can rest. Then, clean the sting site with soap and water, or you can use a sting pad or sting ampule to clean the wound and provide pain relief.

After that, if their person tolerates the pain well, there isn’t a whole lot that needs to be done. However, even if the sting seems minor, it’s best to rest for a while and ensure that it doesn’t turn into something more serious. 

Sometimes, the person won’t show serious symptoms for several hours. So, don’t leave the person alone for the rest of the day. Further, there are times when people will develop sickness several days later, usually feeling aching or developing a minor fever. Often people don’t realize this sickness was from the bee sting.

Now, let’s talk about what you should do if it develops into something more serious. 

Treating the Bee, Wasp, or Hornet Sting: Serious Reaction 

If you know that the patient is allergic to bees and they have an epi-pen, it’s best to use the epi-pen right away. Make sure you’re familiar with the epi-pen – it’s not unheard of for people to accidentally press the wrong end of the pen and stab their finger. When people get scared, fine motor skills decrease. 

After you’ve used the epi-pen, call 911 or get the patient to the hospital. There may be a more serious reaction after the EPI wears off.

Clean the wound and you can use ice packs to decrease swelling. If the patient is having trouble breathing, it’s best not to give them anything by mouth. However, if they can tolerate it, you can give them Benadryl to help reduce the histamine response. 

Let’s talk about how to recognize an anaphylactic reaction – there’s a first time for everything. 

How to Recognize an Anaphylactic Reaction from a Bee Sting 

An allergic reaction is different from an anaphylactic reaction. Anaphylaxis is a full-body response, and it is often known as anaphylactic shock. Anaphylaxis is often known as an overreaction. 

In the medical world, shock means something different than psychological “shock.” Medical shock means the body is no longer able to compensate for the injury or illness it has sustained – if something doesn’t change, the patient may not survive.

So, how do you recognize that someone is in anaphylactic shock? 

Signs of anaphylaxis: 

• Trouble breathing. Trouble breathing is the tell-tale sign that something is wrong. If someone says that they are having trouble breathing or you can hear wheezes, pay attention, call 911, and act fast. 

• Profuse hives. These look like raised rashes on the skin. They may start as small red dots and then grow larger – they often show up on the chest, back, or abdomen; however, they could be anywhere on the body. 

• Swelling. You may notice the patient's lips and tongue begin to swell. If someone says their tongue is swelling, this is a serious emergency. However, there may also be swelling on the hands and feet. 

• Low blood pressure. This is one of the signs of shock. Also, the patient may have sweaty skin, a weak and rapid pulse (in the wrist) and altered mental status (they may feel drowsy). 

• Nausea. Some people feel the need to vomit. 

If you notice any of these signs and symptoms of anaphylaxis, the patient may either be in the beginning or end stages of anaphylaxis. What’s the treatment? This patient needs epinephrine, but they also need to get to the hospital as quickly and as safely as possible. 

How to Protect Yourself from Bees, Wasps, and Hornets 

As we said, regular honeybees pose little threat to people. However, there are more and more killer bees (also known as Africanized honeybees, they escaped captivity about 50 years ago. Their venom is no more potent, but their affinity to attack in swarms is what makes them so dangerous). 

Wasps, hornets, and yellow jackets are more aggressive than honeybees. Let’s talk about several steps to keep yourself and your family safe. As we like to say around here, an ounce of prevention is worth a pound of cure. 

Steps to stay safe from bees, wasps, and hornets:

• Watch the environment. Just beware of the places bees and wasps hide. Yellow jackets like to hide in the ground, wasps like to find cracks in the wall, and hornets may make a large nest in trees or under the deck. Keep your eyes peeled around these locations. Be careful when walking in a new area or sitting on a park bench. 

• Remove the problem. You can hire someone to come and relocate honeybees. These bees are helpful to the environment, and they make honey! If you have someone move them, then you can avoid killing them. 

• Spray the hive. This may be your only option for yellow jackets, wasps, and hornets. You can spray the hive, hopefully eliminating the threat. In general, only use this option if the hornets are a direct threat to your home – like if they have a nest around a door or deck.

Also, if you spray the hive, wait until the just after sundown, when the wasps are back in the nests – this ensures they don’t just start a new hive in the same area. 

Let’s go over some final thoughts.

Final thoughts: Treating Bee and Hornet Stings 

The first step is to get away from the hive or swarm. Then, you need to remove the stingers. Don’t worry about how you remove the stingers; just get them out as quickly and efficiently as you can. Wash the wound with soap and water; this will protect from infection.

You can use ice for pain and elevate for swelling. If you're curious, here's a video explaining some quick tips on bites and stings. If it’s a serious reaction, you need epinephrine, and you need to get the patient to the hospital.  

Are you wondering what to do if you drive up on a car wreck? People drive fast in the summer. Cars slide in the winter. Some drivers are inebriated. Others are distracted by their phones. Sadly, car collisions happen. How should we approach and respond to a car accident? 

In this article, we'll discuss car crashes from several angles. What should you do if you witness a crash? How should you prevent them? If you're curious to hear more on the first aid side, read our article on building a vehicle first aid kit.

Three Phases of a Car Crash 

For this article’s purpose, we’ll discuss three phases of a car crash. There's the pre-crash phase - when you're just driving around without a care. There's the crash phase - when that truck comes out of nowhere and strikes your vehicle. And finally, you have the post-crash phase, when you assess victims, injury, damage, and perform the treatment. 

Here are the three phases of a car crash:  

1. Pre-crash 

2. Crash 

3. Post-crash 

This article will focus on 1 and 3, the two areas where you have the most control. Unfortunately, there's little you can do during phase two, the crash itself. As your vehicle flips through the air or rolls in a ditch, your mind will struggle to do anything meaningful. However, we'll still talk about it so you understand what to expect and how to prepare. 

Pre-Crash: How Can We Prevent Car Accidents? 

The best thing, I think we can all agree, is preventing a crash in the first place. I'd argue that this is the most important, even more so than the rescue phase. 

It's unfortunate, but preparation doesn't always get the spotlight. For some reason, we're more interested in high-speed heroics. For example, few people care when a firefighter discovers a faulty fire alarm during a routine inspection - even though, potentially, he could be saving the lives of an entire apartment by correcting that small issue. However, we get excited about people running into burning buildings to save their families or pets. 

The second situation is more exciting and the stuff that makes for good TV shows, but it's not the only form of bravery or heroism. Perhaps someone could have prevented the fire in the first place. 

We should probably place more focus on preparation. Sure, it's not as "cool," but it's just as important. 

Here are several ways to prepare for and prevent a car accident:  

1. Start fostering better habits. If someone tends to text, drive too fast, or run red lights, they should consider making some changes. Eventually, it will catch up to them. Thinking "it won't happen to me" is common. But, as a paramedic, I can say without hesitation: "it won't happen to me" happens to people every single day. 

2. Keep your car maintained. Ensure that your car's brakes and tires work properly. It's always smart to double-check the vehicle as often as you can. 

3. Store a vehicle first aid kit. Just building a first aid kit will serve as a reminder that accidents can happen and will help you remember to drive safer. 

4. Don't take risks. Careful in the rain, the ice, the snow, and the fog. These really are risky conditions. However, also keep your eyes open in good weather when others let their guard down.

Let's talk about the crash phase and what to expect.

Crash-Phase: What a Car Accident Does to Your Body

During the crash, there's some value in understanding how energy transfers to the body and how different crashes can cause different injuries. Of course, there is no way to predict injuries with 100 percent accuracy. However, some patterns can help guide us. 

In general, car accidents are categorized based on how a vehicle impacts another vehicle, a nearby object, or even the ground. Also, you should know that the faster the vehicles are traveling, the more deadly and dangerous a car accident will be. All that speed is energy, and it will be released upon impact. 

Here are several crash patterns and associated injuries: 

• Head on. Where two or one vehicle makes a frontal impact after a forward motion. The head tends to snap forward, and this is where airbags come into play. Look for head injuries, neck, and hips—also as seat belt injuries from the body against the belt. 

• Broadside. The main impact areas are the driver or passenger side or driver side. Again, the head is always vulnerable but also look for hip injuries and chest injuries. 

• Rear-end impact. Depending on the situation, this can be one of the less dangerous impacts. However, there can still be head injuries, neck injuries, and spinal issues. If the impact was hard enough, any injury is possible. 

• Rollover. Often categorized as the most dangerous, as the impacts are coming from all sides. Be ready for anything. Also, if the vehicle is still on its side or top, the rescuer should be very careful. Only approach the vehicle if it's stable. Usually, this is one of the fire department's jobs when they arrive - stabilization and extrication. 

Now let's talk about the post-crash phase, treating injuries, and the best approach.  

Post-Crash Phase: What to Do After a Car Accident

What should you do if you drive by a crash? Let's talk about several scenarios here. One thing to keep in mind: there are a lot of nuances to this discussion. What we discuss in this section is only some standard guidelines and may not apply to all situations, people, or laws. 

Let's get this one out of the way: if you drive by a crash, should you stop to help? This one might seem like a no-brainer for some people who think you should always stop and help. However, others might think you should never stop because you'll "get in the way" or "cause more problems." 

What's the answer? There is truth in both choices. However, as always, the best decision lies somewhere in the middle. 

Should You Stop to Help if You See a Car Crash?

If you witness a crash in front of you, there's nothing wrong with stopping and checking on the victims if it's safe to do so. What is safe? If it's a six-lane highway in the middle of a thunderstorm, you'll have to decide if stopping is worth the risk. Will you become another victim? We want to avoid this at all costs. Also, if it looks like someone is bleeding or unconscious, there might be more urgency than if someone is walking around.

If you see a wreck, but police or fire is already on scene. In this case, it's often best to let the police and fire department do their job. However, there may even be a nuance to this. In some cases, first responders might want help from trained hands. I've enlisted numerous bystanders at various times (those who volunteered to help) to perform CPR or hold equipment or go ask someone something. 

As a paramedic, I've never been irritated by someone asking, "is there any way I can help?" As long as they are respectful and have themselves under control, there have been many times I'm thankful for bystanders who stopped to help out. 

At the end of the day, you'll have to decide whether to stop and help or not. If you're a trained responder, you might be more likely to help. In any case, use common sense. Also, asking the question, "what would I want someone to do for me if I was in a car crash?" Would you want people to just drive by? At the very least, calling 911 to ensure an ambulance is on the way is important. 

Watch this video explaining what to do if you witness a car crash. It will provide more context. 

Car Crash First Aid 

This has only been a discussion about how to approach and handle a car accident on a strategic level; however, you should spend time training in the actual skills needed to help someone. I'll leave several links below to articles that teach you first aid techniques. But there is no substitute for hands-on training. 

Useful first aid guides for car crashes: 

• How to stop major bleeds 

• How to perform rescue breaths 

• How to perform good CPR 

These three skills can save a life. Make sure you know them. They will make you a more effective responder when you need to help someone in a car crash. 

Final Note: The Myth of 'Accidents'

What's an accident? If someone was texting and driving, and they proceeded to cause a crash, is that really an accident?  

Often, an accident is understood as "no one is at fault" - as in, there is nobody to blame. If someone was responsible, then that's not a true accident. They may not have intended the outcome, but if someone engages in risky behavior and then cries "accident" when something bad happens, this shows recklessness. 

The point of this thought exercise is to realize that true accidents, where no party was truly responsible, are usually quite rare. Instead of passing off all car crashes as "accidents," we should consider how we could have prevented the outcome. 

For example, the person texting and driving can put their phone away next time. Or the person speeding can slow down. This will prevent future "accidents" from occurring. Paramedic instructors often say, "there are no accidents." There's certainly an element of truth to this. 

A heat-related emergency can creep up when we don't expect it. This article will analyze the different types of heat-related emergencies and how you treat them. 

Heat emergencies come in several forms. Some people might be thinking of burns here, but this article will specifically discuss environmental emergencies. Under heat emergencies, you have heat cramps, heat exhaustion, and heat stroke.

Let's figure out more about these ailments and chat about how you can stay prepared. 

The Categories of Heat Emergencies 

Heat emergencies have specific categories, though each one can overlap with the other, and some people will move through these categories faster than others. 

Here are the two categories: 

• Heat cramps (an early warning) 

• Heat exhaustion 

• Heat stroke

Below, we'll detail each in more depth. After we talk about the signs and the treatment, we'll talk about who is most at risk for heat emergencies and how you can prepare yourself. 

Heat Cramps: Signs and Treatment 

Heat cramps are a common symptom of the beginning stages of heat exhaustion. As your body sweats and your muscles work, certain electrolytes can become imbalanced, leading to incredibly painful cramps. 

These cramps are most likely to start in the legs, and they may happen during or after an extended period of exertion. 

How do you treat heat cramps? Ensure the person moves to a cool area. Then, give them cool drinks to replace lost water. Also, sports drinks or electrolyte drinks can help. Just be sure you don't allow the person back into the heat until they're fully recovered - it's probably best to forgo further activity that day. 

Heat Exhaustion: Symptoms and Treatment 

What is heat exhaustion? Heat exhaustion is the beginning phase of the body's inability to cope with the heat. Think about someone trying to run a marathon. They're running but haven't trained, and eventually, they collapse. Exhausted. Their muscles no longer have the strength the carry them on, even if they wanted to. 

This is the same idea with heat exhaustion - you're not just overheated; you're now past the point of return unless quick action is taken. 

What are the signs? If you see some breathing heavily and sweating - you'll also often see nausea and vomiting; some people may have blurry vision and intermittently pass out. 

If you notice these signs, get the person out of the heat as fast as possible and give them fluids to drink if they can (be careful about trying to give fluids to someone who is in and out of consciousness, you could obstruct their airway). 

Remove excess clothing and fan the person while providing moisture to the skin. Cold packs in the armpits, behind the neck, and groin can aid cooling. Ensure the person can sit or lay down. You want to avoid having them walk at all until they're stable. 

Further, if you notice their condition begins to worsen - they lose consciousness completely, or they're completely delirious - then it's time to call 911. In some cases, if you know the heat exhaustion is bad, you might choose to call 911 even sooner.

Heat Stroke: Signs and Treatment 

Heat stroke is a medical emergency. If you notice any of the signs or symptoms, you need to act fast. 

Heat stroke is the final stage of a heat emergency. After heat exhaustion, if the person doesn't begin to cool down, their body can go into complete overload, leading to shock. How do you know if someone is experiencing heat stroke? 

The tell-tale sign of heat stroke is an altered level of consciousness. If you witness someone go from normal mentation to passing out or delirious, there's a good chance they have heat stroke.  

Another sign of heat stroke is elevated core body temperature, usually above 104 F. However, if someone is unconscious, it doesn't matter what their body temperature is: they need help.  

Finally, one of the oddest symptoms of heat stroke is that the patient may no longer be sweating (this isn't always the case). You might see that the patient has red skin but that their skin is dry. Again, this shows how completely spent the body's cooling mechanisms are. 

How do you treat heat stroke? There are a couple of things to do. 

First, get the patient out of the heat. As you're moving them to a cool spot, have someone call 911. The patient will likely need IV fluids and may require advanced airway control if they remain unconscious. 

Remove extra clothing and drench the patient with cool water - you should also consider placing ice packs in the armpits and the groin. Keep your eye on their breathing.

With heat stroke patients, it may be difficult (or dangerous) to have them drink. However, if they're alert, give them sips of cool water or sports drinks. Keep them still and cool. Actively fanning them can help - make sure they get out of the heat! 

You can read this article for more on treating heat-related illnesses. 

Who Is at Risk for Heat-related Emergencies? 

Knowing how to treat a heat emergency is important but knowing how to prevent them in the first place is even better. Often, the reasons for a heat-related emergency come down to something going wrong before the person is in the heat.

Most people who are playing a sport will know how to take a break when they're tired, drink some water when they're thirsty, and alert someone if they begin to experience cramps. These are all internal ways our bodies keep us safe from the heat. However, there are times when this self-protection cycle is messed up - usually in someone vulnerable or impaired. 

Here are some people at risk of heat stroke: 

• Older adults 

• Young children 

• Impaired individuals 

Let's talk about this a little further. 

Older Adults: Heat Illness 

Some older adults will have trouble staying cool. There are a couple of reasons why. First, they may have a condition that inhibits their ability to feel thirst or sense that they're overheated. Sometimes, they may be taking medications that dull the senses. 

Second, some older adults live alone and may not have air conditioning. In the summer months, it's common for their homes to overheat, and the person inside to become affected by too much heat. 

Finally, older adults may have other ailments compounded by the issue. Where a younger person could easily regulate the high temperature, someone with heart failure may have a low tolerance for deviations in body temp. 

If you know someone who lives alone or has concurrent medical problems, keep them in mind during the very hot months of the summer - make sure they have what they need to stay cool. 

Children: Heat Emergencies 

Young children are some of the most common victims of heat emergencies. There are physiologic reasons that children have a harder time regulating body temperature; however, one of the more common reasons may be their lack of control in certain circumstances. 

For example, we've all heard horror stories about children left in hot vehicles. They don't know how to open the doors, so they end up falling victim to extreme temperatures. 

Another common situation is the young baby who is overdressed and trapped in a car seat or a stroller. Believe it or not, these emergencies don't just happen in the summer months. Parents often overdress their babies in the cooler months, and this can lead to overheating. 

Always watch young kids. If they are sweating, acting irritated, or turning red, they may be overheating. Ensure they have liquids and a cool environment. 

Finally, let's talk about one last category. 

Impaired People: Heat-Related Emergencies 

This may be obvious, but it's good to keep in mind. Anyone who's under the influence (large or small) of drugs (including alcohol), prescription or otherwise, may be at risk of heat-related illness. 

This common scenario is someone drinking while playing an outdoor activity or trying to go for a hike after taking a new prescription medication. These substances can reduce the ability to feel thirst, reduce the body's ability to respond to increasing temperature, and increase the likelihood of a heat emergency. 

How to Prepare for the Heat 

If you're performing an outdoor activity in a heated environment, take the time to stop and rest and sip cool liquids continuously. Water should always be available. Old-fashioned ideas of "no water" during conditioning are dangerous and foolish. If your kid tells you their coach denied them water, it might be time for a new coach.  

Here are a few things to keep close during the hot months: 

• Plenty of pure water. 

• Sports drinks for electrolytes 

• Handheld fans/with mist 

• Light clothing

• Cold packs 

• Thermometer 

Also, make sure you avoid alcohol while out in the heat. Many recommend avoiding caffeine as well, as this may facilitate dehydration. 

Final Thoughts: Heat Emergencies 

Don't overlook the heat! Be sure to stock your family medical kit with water and cooling packs. Also, sports drinks are useful. 

If you know what to look for and you know what to avoid, you'll be that much closer to protecting your family from the very real threat of heat-related illness. 

Be sure to get some live training. Also, know that the advice in this article is for informational purposes only. It may change in the future. Always follow local laws and consult with a trusted physician. 

Do you know CPR?
Do you know the differences between CPR for adults and children?
What about infants?

CPR is a lifesaving skill. Though it's simple, it takes practice to master. Unfortunately, due to the misconception that CPR is "easy," it's often under-taught and under-practiced.

An NBA basketball player could demonstrate how to shoot a 3-pointer in 30 seconds, but it would still take hours and hours (if not years and years) of practice to shoot a 3-pointer effectively. The same is true with CPR; there's rhythm, coordination, timing; and all of this is made more difficult by the immense stress. To perform CPR well, you must fervently study and practice.

In this article, we'll go over some of the common variations of CPR and attempt to shed light on the nuances involved in this lifesaving skill. We will also take a close look at hands-only CPR.

The Different Ways CPR is Performed 

CPR is not performed the same way for all people. Learning the different needs of different patients can make you a more effective responder. Many people, when they learn CPR, only briefly see how to perform CPR on children. Nonetheless, knowing the variations based on age groups is important. 

Here are the types of CPR we will cover in this article: 

• Hands-only CPR (Adult)
• Traditional CPR (Adult)
• Child CPR
• Infant CPR
• Newborn CPR

Note: this guide is merely meant to be an overview to help broaden the rescuer's understanding. This is not a step-by-step guide on how to perform CPR. You should take the time to perform more research on CPR and sign up for a local class. CPR is a mental and physical skill, so hands-on practice is important. 

Hands-Only CPR for Adults 

Hands-only CPR requires the rescuer to only push on the chest, foregoing any rescue breaths or airway control. Why is hands-only CPR a thing?  

The AHA wanted people not to hesitate to provide CPR if they witnessed someone suddenly collapse. However, many people do hesitate, as they're worried they won't perform the skill correctly, potentially hurting the patient. They also hesitate to perform mouth-to-mouth on strangers and worry about catching a disease.   

So, the AHA decided to emphasize hands-only CPRs for untrained bystanders, feeling this would be more valuable than no CPR at all. Indeed, in the phases just after someone collapses, there isn't a huge difference in effectiveness between hands-only CPR and traditional CPR - however, there are many nuances to this statement. 

How Does Hands-Only CPR Work? 

Bystander hands-only CPR is recommended for adult patients who are victims of a witnessed collapse - that means the rescuer saw them go down. 

The rescuer should call 911, ask for an AED, and begin performing compressions. The hands are placed on the sternum, right in between the nipples. The compression rate is 100-120 beats per minute, and the rescuer should only stop if someone else is ready to take over. 

Here's a video explaining hands-only CPR. This is not recommended for children or infants. See more below on the misconceptions around hands-only CPR. 

Hands-Only CPR: Misconceptions

Not only are there nuances, but there are also some misconceptions about hands-only CPR. A prominent hands-only CPR misconception is that we're "moving away" from rescue breathing. 

I'm unsure how this falsehood started, but it could be that people view implementing hands-only CPR as an inference that traditional CPR is less effective. On the contrary, this has never been stated by the AHA. Indeed, traditional CPR is still recommended in many cases.  

As it happens, traditional CPR with rescue breaths is recommended for children, infants, drowning victims, overdose victims, and unwitnessed collapses. If you're curious, you can read the AHA FAQ on hands-only CPR for more information. 

Traditional CPR: Adults 

For adult patients of unwitnessed collapse, overdose, drowning, or respiratory ailments, traditional CPR is still the recommended practice. Also, if you're a trained rescuer, traditional CPR is still recommended.  

If you're untrained, providing hands-only CPR still may help; however, the preference is to include airway management and rescue breathing. Get trained! 

Traditional CPR involves checking a pulse, opening the airway, and providing 30 chest compressions (100-120 beats per minute) and 2 rescue breaths. This is continued until help arrives. Traditional CPR also involves understanding an AED and applying it correctly. 

There are variations of adult CPR that include asynchronous breathing and compressions, but these usually require advanced airway techniques. 

Mouth-to-mouth and diseases: If you're curious, read this article on the transmission of infectious diseases by mouth-to-mouth. As you'll see, the risk is much lower than you probably think. Still, it's something you'll have to consider. If you can, grab a pocket CPR mask and carry it with you.

Also, take some time to read this article on rescue breathing.

Let's talk about the kids. 

How to Perform CPR on Children 

There are a few ways children vary from adults. When it comes to CPR, these can mean fairly big differences. First, what is the definition of a child? 

In the medical field, a child is usually anyone pre-pubescent. That means most 14-year-olds are treated as adults. However, this is not the case in all circumstances. If someone is irregularly small, they may be treated as a child. For our purposes, a child is anyone who hasn't been through puberty. 

When treating a child, the main difference is the ratio of chest compressions and the airway. Children have reduced oxygen stores, which means that rescue breathing is important. 

Children and infants have relatively larger heads in proportion to their bodies than adults; this makes it more likely that their airways will close during CPR, as their larger head will force their chin down into their chest. This, on top of oxygen stores, is why it's important to manage a child's airway and breathing during CPR. 

CPR Variations for children:  

• CPR rate is 15 chest compressions to 2 rescue breaths (with two rescuers). 
• Push 1/3 the depth of the chest (instead of the standard 2 inches for adults). 
• Traditional CPR is recommended (with rescue breaths)
• You can use just one hand and palm on the center of the chest 
• You can injure the child further with too much force 
• Place padding behind the shoulders 

These are just a few of the variations for children. If you're curious about building a full first aid kit, see my article on first aid supplies for children.  

Let's talk about infants. 

CPR Variations: Infant and Newborn 

Yes, in the medical world, there is a difference between an infant and a newborn. An infant is often categorized as any child 1 year or less, and a newborn is either (you guessed it) a child who was just born or a child under 28 days. 

Both these children have slightly different CPR needs. Since we started with adults, let's chat about infants, and then we'll talk about newborns. 

CPR for Infants 

Infant CPR is similar to children. However, there are a few key differences between child CPR and infant CPR. The first thing to know is that one of the most common reasons for a child and infant to go into cardiac arrest is breathing problems. These problems could result from several problems, including allergic reactions, viruses, and choking. 

Another thing to know about the infant is that their trachea (or windpipe) is a smaller in ratio to their bodies than an adult trachea. For this reason, children are more likely to choke on small objects and are more likely to experience blockages—just something to keep in mind. 

For infants and newborns, the main difference in CPR is the rate of compressions and when to start compressions. 

For the rate, infants receive 15 chest compressions followed by two rescue breaths. However, the way you provide the compressions is different. You don't want to use the weight of your body with two hands like you would for adults - this could injure the child or infant. 

The best technique is the encircling hands and thumbs technique. For this technique, you hold the infant on a surface with your hands wrapped around either side of the chest. Then, you use both thumbs to push 1/3 the depth of the chest. 

However, you can also use the two fingers technique. You hold out your index and middle finger and use them to push on the center of the chest (between the nipples). 

The second major change is that, for infants, you begin CPR if their heart rate drops below 60 beats per minute. 

Providing CPR for Newborns 

On top of receiving regular newborn care, like drying and warming, responders must be extra vigilant against breathing problems. The first 28 days after birth are the most crucial. 

So, what are the differences in CPR? The first is that resuscitation focuses on breathing - much more than the others. 

For newborns, instead of 30:2 or 15:2, you provide chest compressions and rescue breaths at a ratio of 3:1. This means that you give three compressions followed by one breath: push, push, push, breath. push, push, push, breath. 

We should note that this guideline (3:1) is usually reserved for trained responders. If you use the 15:2 for a newborn, this is often acceptable. However, it will be up to the rescuers to decide. 

Finally, know that guidelines for CPR are always changing. Even the ones in this article could change over the years. Also, professionals all have different opinions. It's important to keep your eyes and ears open to changes surrounding these lifesaving skills.