Outdoor Life Prepare for Anything Survival Manual (68 page)

An expectant mother may go into labor at an inopportune moment, and you might wind up assisting in the delivery. It’s a trying ordeal, but humans have been having babies as long as humans have been around. Pay attention to these instructions and you can make yourself useful in an urgent situation.

STEP 1
Stay calm and assess your situation. Call for emergency services (they may be able to stay on the line and help you over the phone while you wait), and prepare for the delivery. If the mother is experiencing contractions that are 2 minutes apart or less, delivery is imminent.

STEP 2
Thoroughly wash your hands and arms and be sure the birthing area is clean and covered in sheets or towels. If you have a delivery kit, open it and make use of the gloves, drapes, suction bulb, and other tools.

STEP 3
Help the mother assume a comfortable position during labor (see right for some suggestions). For delivery, reclining is traditional but not the most effective position; instead, some mothers may be on hands and knees, squatting, or even standing.

STEP 4
Give assistance only if needed. When the baby’s head is showing, gently cup and support the head as it emerges. If the umbilical cord is around the neck or head, gently slip it off. Be ready to catch the rest of the baby, too—he or she will be slippery!

STEP 5
Gently wrap the baby in a towel and clean off blood and fluids; this motion also stimulates the baby to begin breathing if he or she hasn’t already (don’t spank the baby—that only happens in the movies). You can also use the suction bulb to help clear the baby’s mouth and nostrils. Give the baby to the mother to hold (skin contact is good), and keep them both warm.

STEP 6
Wait for the umbilical cord to stop pulsating and apply clamps—one about 12 inches (30 cm) from the baby’s abdomen, and another 6 inches (15 cm) past the first clamp.

STEP 7
Await delivery of the placenta about 15–30 minutes after the baby. You can gently encourage this by massaging the mother’s lower abdomen in slow circles. Do not pull on the cord or placenta. Once it is delivered, examine it carefully to see if it is fully intact (if not, the mother may experience more bleeding and may need additional medical care). Your delivery kit may also include a bag to carry the placenta to a doctor.

STEP 8
If the mother is still bleeding, use sanitary pads or dressings to help reduce or stop bleeding. Take her and her newborn to see a skilled medical professional as soon as possible.

Anaphylaxis is a rare type of severe allergic reaction that can be triggered by anything from certain foods to insect stings. Milder reactions can be unpleasant and sometimes a little harmful to the victim, but anaphylactic shock can be lethal if untreated. The allergic reaction can take place within minutes, with the victim experiencing severe swelling and rashes, difficulty breathing, and dangerous changes in blood pressure and heart rate.

If you know a person is experiencing this sort of reaction, it can be countered with epinephrine (the same stuff as adrenaline) administered by a pen-shaped auto-injector. If you stock a few in your medical kit, make sure they’re kept in a stable-temperature environment and are within their expiration date.

STEP 1
Remove the cap from the end of the injector.

STEP 2
Grip the shaft firmly in your hand, with your thumb on its back, and aim for the victim’s thigh muscle. (You can even use the pen through a layer of clothing.)

STEP 3
Jab down firmly against the muscle, keeping the shaft of the pen perpendicular to his or her limb. Hold the injector in place for at least 10 seconds to allow the needle to deploy and the medicine to be administered.

STEP 4
Remove the needle from the victim’s thigh, and carefully dispose of the injector and/or bend the tip to avoid being stuck with it.

STEP 5
Monitor the victim’s condition and get him or her to skilled medical treatment.

There are progressive steps for controlling bleeding. Cover the injury with a dressing, elevate the wound above the heart, apply direct pressure, and use arterial pressure points (see item 337). But if the injury is so severe that those methods aren’t stemming the flow of blood, it’s time to consider using a tourniquet. The victim may lose the use of a body part due to lack of circulation, so this is a last resort to save life at the expense of limb.

Use a strong, broad, flexible object, such as a rolled-up shirt, thick cord, rope, or belt. It should not be so thin as to cut into tissue and cause further injury or bleeding. Ideally, you should be trained in using a tourniquet, and you should get the victim’s permission (in writing if at all possible).

Wrap the tourniquet around the limb as close to the injury as possible, and tie it off as tightly as you can. Alternatively, you can tie the tourniquet around the limb in a loose loop, then tie a handle such as a short, strong stick inside the knot of the loop. Turn the handle several times to twist and tighten.

Whatever method you use, you should secure the tourniquet so that it does not come unwound. If possible, dress and bandage the wound, mark the victim’s forehead with a T and the time the tourniquet was applied to alert the pros, then get the victim to medical care as soon as possible.

You may not be able to handle some medical emergencies on your own, even if you have a decent amount of first-aid or EMS experience. Unless you happen to be a doctor, nurse, or military medic, the sorts of emergencies discussed on the next few pages will definitely require the help of someone with professional training. In a truly critical situation, with no medical help available, you may have to act. Here’s what to do in those circumstances, but we sincerely hope you never have to. Some things really should be left to the professionals.

A lost digit (or worse, appendage) is definitely a major trauma to the body. The victim will obviously lose the use of that body part without immediate intervention.

First, assess and treat the patient’s injury and stop the bleeding; remember, it’s life before limb. A tourniquet may be necessary on larger injuries. For smaller injuries like a toe or finger, wash the site of the injury and the severed digit itself. Apply dressings and bandages to the wound.

The severed part should be thoroughly insulated—wrap it with moistened gauze bandages, seal it in a plastic bag, and place it in a container of ice or cold packs. Get the patient and the body part to a medical facility immediately.

An eye injury is never anything to take lightly, and a serious one needs to be taken care of right away. If small particles or fluids are splashed in the eyes, immediately begin rinsing with cool water. Use as much as there is on hand, and, if possible, flush the victim’s eyes for at least 15 minutes. If the victim has contact lenses and they are not washed out during the rinse, make sure to remove them.

If the victim’s eye has a larger foreign body or has been impaled by something, do not try to remove the object. Stabilize it, and carefully cover both eyes (both eyes move at the same time, so covering both helps keep an injury to one from being worsened by movement of the other). The next step is—you guessed it—seek skilled medical help immediately.

If someone has been so badly injured that her internal organs are exposed, she is definitely in need of serious skilled medical care and long-term treatment. The most important thing you can do in the short term is to limit further damage and reduce the risk of infection.

Any organs that are exposed should be carefully immobilized; do not try to push them back into the body. Cover the area with a trauma dressing soaked in saline, keep the area guarded against any further injury or impact, treat the victim for shock, and get help immediately.

When a victim’s airway is blocked, an absolute last-resort measure is to surgically open the airway, a procedure known as a cricothyrotomy or emergency airway puncture.

STEP 1
Extend the neck and find the soft area between the Adam’s apple and the cricoid cartilage. Keep your finger there as a guide.

STEP 2
Hold the skin taut and carefully make an incision, about 1/2 inch (1 cm) long and 1/2 inch (1 cm) deep.

STEP 3
Puncture the membrane beneath and enlarge the hole with a gloved fingertip.

STEP 4
Insert a rigid tube (like a pen barrel) into the hole, allowing the victim to breathe.