Middlesex Emergency Response Team

Resources and Downloads

• First Aid/CPR/AED Ready Reference Guide (pdf)
  • Printable quick guide that includes info about checking responsive and unresponsive adults, CPR, AED, choking, external bleeding, burns, stroke, and anaphylaxis
• Hands Only CPR website by the American Heart Association

Videos

CPR Refresher

Resources and Downloads

• First Aid/CPR/AED Ready Reference Guide (pdf)
  • Printable quick guide from the American Red Cross that includes info about checking responsive and unresponsive adults, CPR, AED, choking, external bleeding, burns, stroke, and anaphylaxis
• Preventing the Spread of Bloodborne Pathogens Fact Sheet (pdf) from the American Red Cross

Videos

When Seconds Count-Emergency First Aid Training

Bee/Insect Stings:  No Allergic Reaction

Most insect stings for someone who is not allergic need no more than simple first aid.

• Remove any stingers immediately. Some experts recommend scraping out the stinger with a credit card.
• Wash the sting site with soap and water. Placing hydrocortisone cream on the sting can help relieve redness, itching, and swelling.
• Applying ice to the site may provide some mild relief. Apply ice for 20 minutes once every hour as needed. Wrap the ice in a towel or keep a cloth between the ice and skin to keep from freezing the skin.
• Take an antihistamine(diphenhydramine (Benadryl) or a nonsedating one such as loratadine (Claritin)) to help with itching and swelling.
• Take acetaminophen (Tylenol) or ibuprofen (Motrin) for pain relief as needed.
• If it’s been more than 10 years since your last tetanus booster, get a booster within the next few days.
• Most insect stings require no additional medical care.

Bee/Insect Stings:  Allergic Reaction

If you know you may be allergic, especially if you’ve had a severe reaction in the past when stung, seek immediate medical help.  Take an antihistamine (diphenhydramine (Benadryl) or a nonsedating one such as loratadine (Claritin)) as soon as possible. If you have been prescribe epinephrine  (Adrenaclick, Auvi-Q, EpiPen, Symjepi, or a generic version of the auto-injector) for an allergic reaction, use it as directed.

Cold vs. Flu

• Symptoms of a cold usually come on gradually, whereas symptoms of the flu can appear suddenly.
• Symptoms such as sneezing, a stuffy nose and sore throat are more common with colds than with the flu.
• People with the flu usually develop a fever, whereas people with colds rarely do.
• The flu often causes body aches and headaches, which can be severe. If you have a cold, aches are usually mild.
• The flu can cause serious complications, such as pneumonia or bacterial infections, but such complications are rare with colds.

Regardless of whether you have a cold or the flu, the illness will usually go away on its own, but you should visit your doctor if your symptoms change or get worse.

You can also get a seasonal flu vaccine to protect yourself from the flu each year, the CDC said. Unfortunately, there is no vaccine to protect you from the common cold.  Washing your hands frequently can also help prevent either a cold or the flu, since both conditions can spread from person to person via contact with contaminated surfaces. If you get sick with either a cold or the flu, it’s important to stay hydrated and get plenty of rest to help your body recover. (Original article on Live Science)

First Aid for a Cold

Treating your symptoms will not make your cold go away, but will help you feel better. Antibiotics are almost never needed to treat a common cold.

1. Drink plenty of fluids, get enough sleep, and stay away from secondhand smoke.
2. Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) help lower fever and relieve muscle aches.

• DO NOT use aspirin.
• Check the label for the proper dose.
• Call your provider if you need to take these medicines more than 4 times per day or for more than 2 or 3 days.

3. Over-the-counter (OTC) cold and cough medicines may help ease symptoms in adults and older children.

• They are not recommended for children under age 6. Talk to your provider before giving your child OTC cold medicine, which can have serious side effects.
• Coughing is your body’s way of getting mucus out of your lungs. So use cough syrups only when your cough becomes too painful.
• Throat lozenges or sprays for your sore throat.

Many cough and cold medicines you buy have more than one medicine inside. Read the labels carefully to make sure you do not take too much of any one medicine. If you take prescription medicines for another health problem, ask your provider which OTC cold medicines are safe for you.

Wheezing can be a common symptom of a cold if you have asthma.

• Use your rescue inhaler as prescribed if you are wheezing.
• See your provider immediately if it becomes hard to breathe.

First Aid for the Flu

As with a common cold, there is no cure for the flu.  To help lessen symptoms,

• Drink plenty of fluids
• Get plenty of rest
• Treat aches and fevers with over-the-counter medications like acetaminophen, ibuprofen, or naproxen. Ask your doctor which is right for you.  NOTE: Never give aspirin to anyone younger than 19. It’s linked to a condition known as Reye’s syndrome, a serious illness that can damage the brain and liver.
• Over-the-counter (OTC) cold and cough medicines may help ease symptoms in adults and older children. They are not recommended for children under age 6. Talk to your provider before giving your child OTC cold medicine, which can have serious side effects.  Coughing is your body’s way of getting mucus out of your lungs. So use cough syrups only when your cough becomes too painful. NOTE: Many cough and cold medicines you buy have more than one medicine inside. Read the labels carefully to make sure you do not take too much of any one medicine. If you take prescription medicines for another health problem, ask your provider which OTC cold medicines are safe for you.
• Throat lozenges or sprays for your sore throat.
• Ask for an antiviral.  You need to take these drugs as soon as symptoms start to lessen and shorten the flu. Call your doctor if you have signs of the flu  and are at a higher risk for complications. That includes people who are 65 and older or those younger than 2 years of age. It also includes those with certain chronic conditions including problems with lungs, heart, kidney, liver or a weak immune system.

Panic Attack Settling Technique

Call 911 if the panic attach is extreme. However, if someone is having a mild panic attack and they are 18 or over and do not want you to call an ambulance, try the following:

Talk calmly. Ask for their name and tell them yours.

Explain you have a technique which may be helpful and that you are going to guide them through the technique.

Begin with a Deep breath. Explain to them to take in a deep breath through the nose, hold for 4 seconds, and then exhale slowly through their mouth…all the way out. Count out loud for person. Repeat.

Coping Skill Spotlight: 5, 4, 3, 2, 1 Grounding Technique

This technique will take you through your five senses to help remind you of the present. This is a calming technique that can help you get through tough or stressful situations.

5 – LOOK: Look around for 5 things that you can see, and say them out loud. For example, you could say, I see the computer, I see the cup.

4 – FEEL: Pay attention to your body and think of 4 things that you can feel, and say them out loud. For example, you could say, I feel my feet warm in my socks or I feel the hair on the back of my neck.

Ask them to take a deep breath –inhale through the nose; hold for 4 counts; fully exhale through mouth.

3 – LISTEN: Listen for 3 sounds. It could be the sound of traffic outside, the sound of typing or the sound of your tummy rumbling. Say the three things out loud.

2 – SMELL: Say two things you can smell. If you can’t smell anything at the moment, then name your 2 favorite smells.

1 – TASTE: Say one thing you can taste. It may be the toothpaste from brushing your teeth, or a mint from after lunch. If you can’t taste anything, then say your favorite thing to taste.

Take another deep belly breath to end.

Complete the medical incident report. Assess the person. Determine if someone should be called or if they may return to their previous activity.

Videos

CSU Active Shooter Safety Training

Run/Hide/Fight – Surviving an Active Shooter Event

Nonepileptic Seizures or Events

Source: https://www.epilepsy.com/learn/types-seizures/nonepileptic-seizures-or-events

• Nonepileptic events (also called nonepilepsy seizures) are not caused by electrical activity in the brain.
• About 1 in 6 people also has epilepsy seizures or has had them in the past.
• Nonepilepsy seizures may be associated with psychological conditions or other physical problems.

What are they?

Events that look like seizures but are not due to epilepsy are called “nonepileptic seizures.” Some people prefer to use the term “events” rather than seizures. You will see the terms used interchangeably here.

A common type is described as psychogenic (si-ko-JEN-ik), which means beginning in the mind. Psychogenic seizures or events are caused by subconscious thoughts, emotions, or “stress,” not abnormal electrical activity in the brain. Doctors consider most of them psychological in nature, but not purposely produced. Usually the person is not aware that the spells are not “epileptic.” The term “pseudoseizures” has also been used in the past to refer to these events, but we prefer to avoid this term as it is not accurate and has a negative meaning.

It’s important to know that some seizures that are not epilepsy could be caused by other physical problems. These are nonepilepsy seizures too, but not caused by a psychological condition. Further testing is needed to find the exact cause so they can be treated properly.

Are they common?

Psychogenic nonepileptic events are common. About 20% of the people referred to comprehensive epilepsy centers for video EEG (electroencephalogram) monitoring are found to have nonepileptic seizures. About 1 in 6 of these people also has epileptic seizures or has had them in the past.

Psychogenic nonepileptic events have been more widely recognized during the past several decades. They are most often seen in adolescents and young adults, but they also can occur in children and the elderly. They are 3 times more common in females.

What do they look like?

The events most often look like focal impaired awareness (complex partial) or tonic-clonic (grand mal) seizures. Family members report episodes in which the person stiffens and jerks. Doctors rarely witness the actual event, so they are drawn toward the diagnosis of epilepsy. Often years can be spent trying to treat the spells as epileptic seizures without success.

How are they recognized?

Certain kinds of movements and other patterns seem to be more common in psychogenic nonepileptic events than in seizures caused by epilepsy. Some of these patterns do occur occasionally in epileptic seizures. Having one of them does not necessarily mean that the seizure was nonepileptic.

Video EEG monitoring is the best way of diagnosing nonepileptic seizures. The doctor may take steps to provoke a seizure, and then ask a family member or friend to confirm that the event was the same as the usual kind.

Can they be treated?

The good news is that psychogenic nonepileptic events can respond to treatment. A psychiatric evaluation helps sort out possible psychological problems and the types of treatment that may be needed.

Being diagnosed with psychogenic seizures doesn’t necessarily mean the person has a serious psychiatric disorder. Yet treating the nonepilepsy or psychogenic seizures will involve treating whatever psychological problems may be present.

Sometimes the episodes stop when the person learns that they are psychological. Learning what the diagnosis means and what it doesn’t mean is very important.

Some people can learn how to control the events with behavioral techniques, such as relaxation therapy or other forms of cognitive behavioral therapy.

Some people have depression or anxiety disorders that can be helped by medication.

Counseling for a limited time is often helpful. Both individual and family therapy may be recommended.

People who have both epilepsy and psychogenic nonepilepsy seizures or events will require seizure medication as well as treatments for the psychogenic events.

General First Aid for All Seizure Types

• Download: First Aid for Seizures download from the Epilepsy Society

The first line of response: provide general care and comfort and keep the person safe.

Always Stay with the Person Until the Seizure Is Over 

• Seizures can be unpredictable. Some may start with minor symptoms, but lead to a loss of consciousness or fall. Other seizures may be brief and end in seconds.
• Injury can occur during or after a seizure, requiring help from other people.

Pay Attention to the Length of the Seizure

• Look at your watch and time the seizure – from beginning to the end of the active seizure.

START TIME: ______       END TIME: ______

START TIME: ______       END TIME: ______

• Time how long it takes for the person to recover and return to their usual activity.

Ask simple questions: Do you know your name?  YES ____       NO ____

Do you know your date of birth?               DOB: __________      NO ____

Do you know where you are?                                     YES ____      NO ____

Elapsed time to recovery: _______

Stay Calm, Most Seizures Only Last a few Minutes

• Talk calmly and reassuringly to the person during and after the seizure – it will help as they recover from the seizure.

Prevent Injury by Moving Nearby Objects Out of the Way 

• Remove sharp objects.
• If you can’t move surrounding objects or a person is wandering or confused, help steer them clear of dangerous situations.

Make the Person as Comfortable as Possible

• If they are at risk of falling, call for help and lay them down on the floor.
• Support the person’s head to prevent it from hitting the floor.

Keep Onlookers Away

• Once the situation is under control, encourage people to step back and give the person some room. Waking up to a crowd can be embarrassing and confusing for a person after a seizure.
• Ask someone to stay nearby in case further help is needed.

Do Not Forcibly Hold the Person Down

• If a person tries to walk around, let them walk in a safe, enclosed area if possible.

Do Not Put Anything in the Person’s Mouth!

• Don’t worry – a person can’t swallow their tongue during a seizure.

Make Sure Their Breathing is Okay

• If the person is lying down, turn them on their side, with their mouth pointing to the ground. This prevents saliva from blocking their airway and helps the person breathe more easily.
• During a convulsive or tonic-clonic seizure, it may look like the person has stopped breathing. This happens when the chest muscles tighten during the tonic phase of a seizure. As this part of a seizure ends, the muscles will relax and breathing will resume normally. Rescue breathing or CPR is generally not needed during these seizure-induced changes in a person’s breathing.

 Do not Give Water, Pills or Food by Mouth Unless the Person is Fully Alert

• If a person appears to be choking, turn them on their side and call for help. If they are not able to cough and clear their air passages on their own or are having breathing difficulties, call 911 immediately. 

Call for Emergency Medical Help

• A seizure lasts 5 minutes or longer.
• One seizure occurs right after another without the person regaining consciousness or coming to between seizures.
• Seizures occur closer together than usual for that person.
• Breathing becomes difficult or the person appears to be choking.
• The seizure occurs in water.
• Injury may have occurred.
• The person asks for medical help.

Be Sensitive and Supportive, and Ask Others to Do the Same

• Seizures can be frightening for the person having one, as well as for others. People may feel embarrassed or confused about what happened. Keep this in mind as the person wakes up.
• Reassure the person that they are safe.
• Once they are alert and able to communicate, tell them what happened in very simple terms.
• Offer to stay with the person until they are ready to go back to normal activity or call someone to stay with them.

Videos

Seizure First Aid- Epilepsy Foundation