When a person is in a state of unawareness and unable to respond to people and other stimuli around him or her, it is termed as unconsciousness. However, there may be other changes later on that medically may be collectively termed as Altered Mental Status or Changed Mental Status and these include sudden confusion, disorientation or stupor.

Understanding the state of unconsciousness
Unconsciousness and any other sudden alteration in mental status needs immediate first aid and must be treated as a medical emergency as it can lead to further damage to the affected person. The best thing for a first aid giver to do if a person is looking less alert than usual, is ask simple questions to judge his/her mental status at the moment. An easy manner and gentle tone is required to make these inquiries, including name, age or the date today- and the answers will indicate whether the person’s mental status is diminished if the responses were incorrect/ or person unresponsive.

Considerations for unconsciousness: a common condition that can be dangerous
Many persons may think that being asleep is the same as being unconscious, however, there is nothing further from the medical truth. An unconscious person will not respond to loud noises, gentle shaking and is unable to cough or clear his/her throat. This is potentially fatal if the person’s airway becomes obstructed as it can lead to death.

Causes and symptoms: understanding the condition of unconsciousness
Unconsciousness can be caused by major illness or injury, as well as substance abuse and alcohol use. Short spells of unconsciousness, commonly referred to as fainting, are often the result of dehydration, low blood sugar or temporary low blood pressure. It can also be caused by serious cardiovascular or neurological illness and a doctor’s opinion needs to be sought to determine the exact cause of the change in mental status. Straining during a bowel movement, strenuous coughing or hyperventilating, such as the condition occurring during a panic attack, are other possibilities.

First Aid steps for dealing with unconsciousness in a person

• Call an emergency medical help line and then proceed to check the person’s airway, breathing, and circulation frequently.
• If the person is breathing, a spinal injury is not evident and patient lying on his back; the first aid giver needs to carefully roll him toward himself and onto the victim’s side. Then, the victim’s top leg should be adjusted in a way to allow the hip and knee to bend at right angles.
• Gently tilt the victim’s head back to keep the airway open.
• However, if the unconscious person’s breathing or circulation stops at any time, roll the person back on to his/her back and begin CPR.
• In case a spinal injury is suspected, leave the person in the same position if he/she is breathing freely, but if the victim vomits, log roll by supporting the neck and spine to keep head position neutral with body position and roll onto his/her side.
• Keep the unconscious person warm till medical help arrives.

The sting of the scorpion is the stuff many classic tales are made of, but for those experiencing it first hand, it may be more than just a yarn for dark, stormy nights ? and quite painful in the bargain too. Since scorpions love the night, they may be difficult to avoid or even sight and as they sting with the tip of their tail- as the last few segments of their abdomen are commonly referred to- they can cause a lot of discomfort and fear in the victim.

However, medical health experts are quick to assure us that most cases of scorpion poisoning causes pain like that of a honey bee sting and is not always fatal.

Knowing the species: facts about scorpions and their ?sting of death?
Scorpions have crab-like pincers that are used to hold and tear apart their prey, usually small insects being their beloved target and not humans, as we like to fear. The small species of scorpions reach maturity at three-fourths inch while their bigger counterparts are known to measure nine-inches. The commonly held belief that scorpion bites are fatal is only true for Centruroides and is restricted to very small children and the elderly or those severely allergic to them. This species, Centruroides, is found in North America and is the only known killer of humans. They are usually old-straw-yellow or yellow with dark longitudinal stripes and reach from 2 to 7.5 centimeters in length, with long, slender pincers instead of bulky and lobster-like ones.

The sting is potent and painful and is increased by a light tap on the area. The other parts of the world can breathe easy as this species is found exclusively in Mexico and the extreme southwestern United States.

Hurry with the first aid: scorpion stings and bites

• First aid for any scorpion sting calls for cooling the wound as this allows the body to break down the molecular structure of the venom more easily.
• The use of cool running water or ice water is advisable since cooling also reduces pain.
• The victim needs to be reassured and spoken to sympathetically and the first aid giver can help ease the trauma of the scorpion bite victim by giving him/her a wet compress to soothe the affected area.
• Keep the victim calm and still as any undue panic and activity can speed up the venom?s spread.
• If the patient has not been administered the Tetanus immunization booster in the last 5 years, a local doctor needs to be contacted for giving this immediately.
• Remove any rings or constricting garments/accessories around the affected area as this site may swell.
• If the scorpion was of the Centruroides species, post-sting symptoms may include heavy sweating, difficulty swallowing, blurred vision, loss of bowel control, jerky muscular reflexes and respiratory distress. In this case, the first aid giver needs to make arrangements for speedy evacuation to a medical facility where necessary Antitoxins are available.

Those persons that are not accustomed to using their muscles frequently or have used them wrongly may suffer from muscular aches and pains. This condition is also known to occur in persons who have overused their muscles. The more severe kind of muscles pain is often accompanied by complaints by the patient of swelling and restricted movement. If referred to a medical health expert, these are the combined result of damage to the muscles, tendons or ligaments and can manifest itself physically in terms of a sprain or strain.

Recognizing the common signs of muscles pains
Medical advice may be needed in case there is serious loss of movement, if the patient complaining of muscles pain finds it is very severe, the area is swollen or warm to the caregiver’s touch; also in situations where the muscles pain has not improved after self-care treatment or is the result of a back injury.

R.I.C.E. the best treatment for muscles pain
Sprains, strains or other soft tissue damage are best treated by the RICE course of therapy for the first 48 to 72 hours and every caregiver needs to be aware of these four crucial steps. RICE treatment refers to:

• Rest-which means no further exercise for the patient for a period of at least 3 days.
• Ice- that needs to be applied in a pack every few hours on the affected area. One precaution however, is to never apply the ice directly on the skin but use the commercially available ice packs and follow the manufacturer’s instructions to a T. If that is not possible, the first aid giver should wrap some cubes of ice in a towel and use it on the affected area.
• Compression- requires the first aid giver to use a firm crepe or elastic pressure bandage to help limit the swelling around the area where the muscles pain has occurred.
• Elevation-is most necessary in treating muscles pain as it helps to keep the injured body part raised and thus, reduce the swelling.

Muscle aches, stiffness or soreness caused by overuse or unaccustomed use can be effectively relieved by anti-inflammatory or products that are used for heat rub therapy too. However, the first aid giver needs to be aware that these products must not be applied to broken skin, or near the eyes or mucous membranes; furthermore, use of these heat rub inducing products is potentially unsafe when used with sealed dressings and therefore best avoided in such a situation. Gentle exercise, massage and medicine may also help restore mobility in the case of muscle soreness and stiffness.

Further first aid steps for muscles pain
After 48-72 hours, the first aid giver can use hot packs heated in boiling water or the microwave, or a hot water bottle to give relief to the patient suffering from muscles pain. Introducing gentle exercise in heated spas or hot baths, doing about 10 very slow stretches, twice a day, without straining or bouncing, is also known to help.

When it comes to spider bites, those most at risk are the very young, the elderly and those with pre-existing cardiovascular disease. This is the case with any kind of poisoning situation a first aid giver may face. The first thing to remember in helping a victim of spider bite is to identify the bite, which means to recognize the symptoms of the bite and classify whether it is venomous or not.

Symptoms of a venomous spider bite

• If the victim has been the recipient of the sharp fangs of a Red-Back Spider, it is possible the bite and the giver – may often go unnoticed, as the spider is really tiny. However, most victims recall feeling the sharp pinprick they felt when on the receiving end, followed in most cases by severe pain at the site of the bite, leading to more general pain.
• Other signs of a venomous spider bite include headache, nausea, vomiting, dizziness, abdominal pain and partial loss of muscle control.
• Often, victims of spider bites have reported extreme perspiration occurring in varying degrees, especially around the area of the spider bite.
• A common enough after effect of a spider bite is swelling of the affected area and so is the quickening of the heartbeat.
• If the first aid gives suspects that a funnel-web or mouse spider is the cause of the bite, the bite needs to be treated as quickly as possible by applying a pressure bandage and immobilizing the victim

First aid steps for treating spider bites
It is important to remember that for treating spider bites, one does not cut the wound or apply a tight tourniquet. For Redback spider bites, even bandaging is not necessary and since this kind of spider bite is painful, it is inadvisable to apply pressure to the area. Instead, applying a cold pack may be more helpful to ease the pain. For most kinds of spider bites, this is helpful and no other first aid is necessary. However, it is prudent to err on the safer side and seek medical opinion to confirm the nature of spider bite and if further medical attention is required.

Understanding the nature of spider bites
Spider venoms are a blend of many chemicals; some toxic, evolved to kill or immobilize insects by attacking their nervous systems; others help break down the victim’s tissues so the spider can ingest a liquefied meal. Unfortunately for us humans, some spider venoms contain chemicals that can be seriously toxic to people, though the common spider venoms cause no more than mild local pain and inflammation. Only when dealing with funnel-web or mouse spider bites, is it necessary to use a pressure bandage as these slow down the movement of both tissue fluid and blood near the surface and prevents the venom from rapidly reaching the bloodstream. Thus, it is a very effective treatment as long as the patient is kept still.

A panic attack can occur in a potentially threatening or scary situation and is a fairly common phenomenon. It is even known to occur when a person recalls previous frightening experience as well as in distressing situations that they are unable to deal with. For the person experiencing a panic attack it is an extremely upsetting situation that compels them to feel anxious or frightened when the attack starts.

Recognizing the symptoms of a panic attack
Among the first aid measures necessary to deal intelligently when trying to help a person suffering a panic attack are the foremost areas of identifying the emergency and any other associated conditions the person may have; this is crucial in giving the right help.

• Physical symptoms of a panic attack include difficulty in breathing, sweating, palpitations or irregular heartbeats and trembling.
• In certain cases, the person may also lose consciousness, complain of dizziness and have convulsions.
• Cut off/avoidance attacks – happen when a person finds it difficult to cope in a very stressful/emotionally demanding situation and the tension builds up into extreme anxiety, resulting in these panic attacks. Over time, they can happen even in situations that are not stressful.

Identifying causes and remedying them likewise: Panic attack facts
Delayed response to extreme stress is another powerful reason for the occurrence of panic attacks as the reaction to a very stressful event or situation-like witnessing violence or tragedy- can cause a kind of panic attack. This form of panic attack is associated with post-traumatic stress disorder – a condition that sometimes happens after a traumatic or stressful event. If such is the case, a person may cry, scream or have flashbacks to the event and lose control over what he/she is doing. Later, such persons may have no recollection of doing such things. According to medical health experts, statistics point to one in three people being at risk for a panic attack at some stage in life; rising with the upheavals of living in stressful and competitive times. However, the occasional panic attack is common for healthy, young adults to have and though frightening, they are not harmful or dangerous.

Dispensing first aid for a panic attack victim
The panic is a reaction to physical sensations in the body, connected to being afraid, to which the person has become sensitized. These natural responses are triggered by adrenalin and can be controlled over a period of time. It is important for the caregiver to remember that the rapid, shallow breathing during a panic attack can make the victim breathe out too much carbon dioxide, which may worsen symptoms. In such a situation, it is necessary to help the person breathe easy, perhaps with the help of a brown paper bag over the nose and mouth -or even using cupped hands- until patient feels better.

It is also crucial to keep the person safe from injury, so guide them away from any potential danger, speak reassuringly and stay with the person until they have recovered.

When dealing with a victim who appears to be in a state of shock, there may be a combination of symptoms. The first aid giver needs to be aware of these different kinds of symptoms of shock to best deal with the necessary emergency aid to be dispensed in such a situation.

Symptoms in a person experiencing shock
A person experiencing shock may exhibit the following symptoms:

• The skin may turn pale or gray, and seem to be cool and clammy to the touch.
• The patient?s heartbeat may become weak and rapid and breathing become slow and shallow with reduced blood pressure that occurs as a result of shock.
• The patient?s eyes may lack brightness and he/she may seem to be staring fixedly for a prolonged time in one direction; some persons in shock reportedly had their pupils dilated for a long period.
• A person may be either conscious or unconscious; if conscious, the person may faint or be very weak or confused and unable to answer simple questions. However, there are instances when being in a state of shock has caused persons to become overly excited and anxious as well. Both reactions are considered normal in a state of shock.
• Even if a person does not exhibit these symptoms and looks normal to the outward eye, it is best to take precautions and treat the person for shock by following the necessary steps.

First aid treatment: steps for helping a person deal with shock
The first aid giver needs to help the person in shock get necessary rest and help him/her to lie down on the back, elevating feet higher than the person’s head.

• This immobilization is necessary to give patient full rest in body and mind and prevent further movement.
• The patient needs to be warm and comfortable and thus the first aid giver can help loosen tight clothing and cover the person with a blanket.
• It is not advisable to give the patient anything to drink as persons in shock are known to weep or have breathing problems suddenly, with instances of violent vomiting or bleeding from the mouth also reported. Any of these can prove to be dangerous if the patient is drinking something at that time as it can cause choking or regurgitation.
• If the person in shock is vomiting or bleeding from the mouth, place the person on his or her side to prevent choking and speak to them soothingly to calm them down.
• Check for additional injuries like bleeding, broken bones and the like while attending to the person in shock.

Severe cuts and burns can cause a state of physiological shock. Fluid loss causes the body to reduce blood flow to the extremities in order to protect vital organ systems and as a result, the body starts shutting down. Thus, to revive the body?s natural functioning, it is necessary to tend to the shock victim in a timely, calm manner as untreated shock can be fatal.

If a nosebleed occurs, it can distressing for parents and children as this is an injury that children are more prone to as compared with adult cases. Even if the injury is actually mild like a nosebleed, it can be a cause of concern for the uninitiated person. Therefore, it is important to know basic first aid in order to deal with such common situations effectively and calmly.

The cause of nosebleeds and how best to deal with it
Nosebleeds are most commonly caused due to insertion of objects in the nose or picking the nose. It helps if the caregiver in the situation remains calm and helps to reassure the patient that the matter will be dealt with properly. The first aid can begin with the first-aid giver seating the person such that his/her head is positioned back to stem the flow of blood.

Permission to have your nose in the air-literally!
The person dispensing first aid in the case of nosebleeds needs to keep the area as clean as possible as backflow all of a sudden can cause blockage or clogging in the nasal passage with difficulty in breathing for the patient. Since it is best to raise the injured area, the nose should be elevated and the head resting on the back of a chair with the patient seated comfortably to reduce the flow. Some children get nosebleeds for no apparent reason or because of a cold or infection. They can sit down and lean forward.

Using the thumb and forefinger to press together both sides of the nose, the first aid-giver can gently advise the child to breathe through his mouth. The child needs to hold this position for about five minutes to help the blood clot and generally experiences relief in a short time. In fact, most nosebleeds do not require professional attention.

Tips to reduce risk for developing nosebleeds

• Use saltwater (saline) nose drops or a spray when you feel an itch coming on, instead of using your finger to pick at your nose.
• Avoid forcefully blowing your nose when you need to sneeze.
• Do not pick your nose or put your finger in your nose to remove crusts. Aside from being an atrocious social habit that can well lose you friends and a date or two, it can definitely cause nosebleeds, which are not very aesthetically appealing either.
• On a more serious note, try and avoid lifting or straining after a nosebleed.
• Elevating the head on a pillow or two while sleeping is known to have helped victims of nosebleeds.
• Application of a thin coat of moisturizing ointment, such as Vaseline, to the inside of the nose, helps prevent nosebleeds.
• Health experts advise patients with a tendency towards nosebleeds to try and limit their use of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen and naproxen sodium.
• Avoid use of non-prescription antihistamines, decongestants and medicated nasal sprays as though they help control cold and allergy symptoms, their overuse may dry the inside of the nose-mucous membranes- and cause nosebleeds.

The first step towards effective first aid is knowing how to identify and treat injuries and illnesses. Many of the situations that need first aid are common enough occurrences, taking place because of lack of knowledge about the area or misjudging the body’s ability to deal with climatic differences. This includes health conditions like heat exhaustion, heat stroke, hypothermia and dehydration.

Hypothermia: some cold facts
To explain Hypothermia in the simplest of terms, it can be said that when the human body is exposed to cold temperatures, it begins to lose heat faster than it can be produced. When the exposure to these cold temperatures is prolonged, it eventually uses up the body’s stored energy, resulting in hypothermia, or abnormally low body temperature. When this body temperature becomes very low, it can affect the brain, make the patient unable to think clearly or move well. This makes hypothermia dangerous as a person may not know it is happening and thus be ill prepared for it.

• Hypothermia is most likely to occur at very cold temperatures, but it can occur even at cool temperatures (above 40′F) if a person becomes chilled from rain, sweat, or submersion in cold water.
• Those prone to Hypothermia are mostly elderly people with inadequate food, clothing, or heating; babies sleeping in cold bedrooms; people who remain outdoors for long periods’the homeless, hikers, hunters and people who drink alcohol or use illicit drugs.

Identifying the warning signs of Hypothermia
In adults, the warning signs of hypothermia include extreme shivering, exhaustion, confusion, fumbling hands, reported memory loss, slurred speech and drowsiness. Among young children, these signs can be interpreted from apparent symptoms indicative of hypothermia like bright red, cold skin, level of very low energy and dullness.

First aid measures for dealing with Hypothermia cases
If any of the above-mentioned signs are noticeable in the patient, the first step in first aid for hypothermia is to take the person’s temperature. If it is below 95, the situation is an emergency and you need to get immediate medical attention for him/her. In case, this is not possible, you will need to restore the body heat in the person by warming him/her up.

• Restoration of body heat is possible by getting the hypothermia victim into a warm room or shelter and removing any wet clothing that is on the person first.
• The center of the victim’s body needs immediate warmth and to target this, warm the chest, neck, head and groin using an electric blanket, if available. Or use skin-to-skin contact under loose, dry layers of blankets, clothing, towels or sheets.
• If the person is conscious, the intake of a warm beverage can help increase the body temperature, but do not give alcoholic beverages.
• After body temperature has increased, keep the person dry and wrapped in a warm blanket, including the head and neck.
• A person with severe hypothermia may be unconscious and even though pulse or breathing may be unnoticeable, CPR should be provided.

Learning the basics of First Aid can help one be better equipped to deal with every day situations and react positively in a state of emergency as well as help save the situation from deteriorating. After dispensing with the necessary first aid, do remember to advise persons around you to be prepared for such instances and have an emergency telephone number or 911 services listed on each phone, or setting any special dialing pre-fixes, which save a lot of precious time in crucial medical emergencies, like those involving an embedded object or burns.

Quick first aid tips: how to deal with an embedded object situation

• Always remember that it is of utmost importance to not display any visible signs of the magnitude of the situation to the patient, as he/she needs to have the caregiver in full control of the situation and calm, not panicking.
• Do not move the patient unless the patient’s location is an immediate threat to their life- if the patient is in water, a fire is burning in the building or vehicle, or there is no way to protect the patient from harm in their current location.
• Keep the patient protected from the environment and covered, if possible.
• Check for injuries other than the area where the embedded object is lodged, for bruises, cuts or bleeding.

Emergency first aid in a situation involving embedded objects
Embedded objects in a wound may cause the person more concern if the first aid giver looks or acts overly worried instead of staying calm and in control of the situation.

• The most important first aid tip is to remember not to try to remove or pull out objects embedded in a wound. Pulling at nails, splinters or a piece of glass in a wound will cause more damage and increase bleeding and therefore, must be avoided at all costs.
• If the patient has an embedded object due to an injury, the caregiver needs to cover the wound lightly, without applying any pressure on the object. The padding must be secured with clean bandages for the required pressure to be exerted around the wound-area but away from the embedded object.
• The pressure applied around the wound area is to stem the flow of blood and reduce any visible signs of injury so that the patient remains calm. Any elevation, if possible, helps to also reduce blood flow and is therefore recommended, without causing any damage to the area where the object is embedded.
• The patient must be advised to rest as this helps to slow circulation.
• If the dressing becomes soaked with blood, instead of removing it, just add another and continue with constant pressure.
• When the bleeding is controlled, maintain pressure keep the elevation constant and the injured limb immobilized for best results.
• Do not seek to try and dislodge the embedded object and call for emergency medical help or 911 services.