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HOME
EMERGENCY
GUIDE
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DK Publishing
HOME
EMERGENCY
GUIDE
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CONTRIBUTORS
Dr. Vivien Armstrong • Dr. Sue Davidson • Professor Ian Davis
David Holloway • John McGowan • Tony Wilkins
David R.Goldmannn MD FACP • Allen R.Walker MD • John Cunningham
Produced for Dorling Kindersley by
COOLING BROWN
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Middlesex TW12 2SA
Project Editor • Alison Bolus
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DORLING KINDERSLEY
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DK PUBLISHING
Senior Editor • Jill Hamilton
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Editorial Assistant • Kate Hamill
Every effort has been made to ensure that the information contained in this book is complete and
accurate. However, the publisher is not engaged in rendering professional advice or services to the
individual reader. The ideas, procedures and suggestions contained in this book are general and not
intended as a substitute for consulting a relevant specialist in individual cases. The publisher would in
any event always advise the reader to consult his or her doctor or other health professional for specific
information on personal health matters. The publisher cannot accept any legal responsibility for any
loss or damage allegedly arising from any information or suggestion contained in this book.
First published in the United States in 2003 by
DK Publishing, Inc.
375 Hudson Street, New York, New York 10014
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Copyright © 2002 Dorling Kindersley
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means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written
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A catalog record for this book is available from the Library of Congress.
ISBN 0-7894-9346-2
Color reproduction by GRB Editrice, Verona, Italy
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Page 5 of 260
CONTENTS
Action in an emergency .................10
Resuscitation techniques................12
Choking
(adults and children)...........................22
Choking
(babies under 1) .................................24
Heart attack.....................................25
Asthma attack .................................26
Shock................................................27
Anaphylactic shock .........................28
Head injury......................................29
Stroke...............................................30
Severe bleeding...............................31
Penetrating chest
wounds ............................................32
Cuts and scrapes..............................33
Splinters...........................................34
Eye wound.......................................35
Foreign object in the eye ...............36
Chemicals in the eye.......................37
Bleeding from the mouth ..............38
Nosebleed........................................39
Emergency childbirth......................40
Major seizures.................................42
Febrile seizures................................43
Broken arm......................................44
Broken leg .......................................45
Spinal injuries..................................46
Sprains and strains..........................47
Severe burns....................................48
Minor burns and scalds...................49
Sunburn ...........................................50
Heat exhaustion..............................51
Heatstroke .......................................52
Fainting............................................53
Hypothermia ...................................54
Frostbite...........................................55
Swallowed poisons..........................56
Snake and spider bites....................57
Animal and tick bites.....................58
Insect and
scorpion stings ...................59
First-aid equipment........60
1
FIRST AID
Page 6 of 260
How to use this section .................66
Assessing symptoms (adults) ...........68
Assessing symptoms
(children) ..........................................70
Not feeling well .............................72
Fever (adults) ...................................74
Fever (children) ................................76
Excessive sweating .........................78
Lumps and swellings ......................80
Feeling faint /passing out ..............82
Headache........................................84
Vertigo............................................86
Numbness and /or tingling ............88
Facial pain.......................................90
Difficulty speaking .........................91
Forgetfulness or confusion............92
General skin problems....................94
Rash with fever ..............................96
Eye pain or irritation ......................98
Disturbed/impaired vision ...........100
Earache .........................................102
Sore throat ...................................103
Hoarseness or
loss of voice ..................................104
Coughing (adults)..........................106
Coughing (children).......................108
Shortness of breath
(adults) ...........................................110
Breathing problems
(children) ........................................112
Wheezing......................................114
Difficulty swallowing....................115
Vomiting (adults)...........................116
Vomiting (children)........................118
Abdominal pain
(adults) ...........................................120
Abdominal pain
(women) .........................................122
Abdominal pain
(children) ........................................124
Abdominal swelling.....................126
Anal and rectal problems............127
Diarrhea (adults)............................128
Diarrhea (children).........................130
Constipation .................................132
Chest pain.....................................134
Palpitations...................................136
Poor bladder control....................137
Painful urination..........................138
Back pain ......................................140
Neck pain or stiffness....................142
Arm or hand pain ........................144
Leg pain........................................145
Joint pain......................................146
Swollen ankles..............................148
Erectile dysfunction .....................150
Testes and scrotum
problems.......................................151
Penis problems .............................152
Breast problems ...........................154
Painful menstrual periods ...........156
Heavy menstrual periods.............157
Abnormal vaginal
bleeding........................................158
Vaginal discharge.........................160
Genital irritation
(women) .........................................161
Home medicine chest....................162
Caring for a sick person...............164
2
FAMILY ILLNESS
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Planning for disaster....................220
Severe storm.................................226
Flood .............................................228
Extreme cold.................................230
Wildfire.........................................232
Hurricane ......................................234
Tornado.........................................236
Earthquake ...................................238
Volcanic eruption.........................240
Tsunami.........................................242
Post-disaster survival....................244
Useful addresses
and online listings........................250
Index .............................................253
Acknowledgments .......................256
Home safety..................................172
Yard safety....................................178
Fires in the home .........................180
Gas leaks .......................................184
Plumbing
problems.......................................186
Central-heating
problems.......................................192
Air-conditioning
problems.......................................194
Electrical problems.......................196
Structural problems......................200
Insects and pests...........................208
Furniture and
furnishings....................................210
Home security...............................212
3
HOUSEHOLD EMERGENCIES
4
NATURAL DISASTERS
Page 8 of 260
Page 9 of 260
Knowing what to do in a medical emergency, such as when someone
suffers a heart attack, a deep chest wound, or a snake bite, could save
the victim’s life. This section tells you how to recognize important
symptoms and give appropriate first-aid treatment in a wide range
of situations, with full details on resuscitating an unconscious person.
Action in an
emergency .....................10
Resuscitation
techniques.....................12
Choking
(adults and children).........22
Choking
(babies under 1) ...............24
Heart attack...................25
Asthma attack ...............26
Shock..............................27
Anaphylactic shock .......28
Head injury....................29
Stroke.............................30
Severe bleeding ............31
Penetrating chest
wounds..........................32
Cuts and scrapes............33
Splinters.........................34
Eye wound.....................35
Foreign object
in the eye.......................36
Chemicals
in the eye.......................37
Bleeding from
the mouth .....................38
Nosebleed......................39
Emergency
childbirth .......................40
Major seizures...............42
Febrile seizures..............43
Broken arm....................44
Broken leg .....................45
Spinal injuries................46
Sprains and strains........47
Severe burns..................48
Minor burns
and scalds ......................49
Sunburn .........................50
Heat exhaustion............51
Heatstroke.....................52
Fainting..........................53
Hypothermia .................54
Frostbite.........................55
Swallowed poisons........56
Snake and
spider bites....................57
Animal and
tick bites ........................58
Insect and
scorpion stings...............59
First-aid equipment ......60
1
FIRST
AID
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FIRST AID
Action in an emergency
10
ACTION PLAN
ACTION
ELIMINATE DANGER,
OR REMOVE THE
VICTIM FROM
DANGER, ONLY IF
YOU CAN DO SO
WITHOUT PUTTING
YOURSELF AT RISK.
DIAL 911.
ACTION
PLACE VICTIM IN THE
RECOVERY POSITION
(pp.14–15). CHECK
FOR SIGNS OF INJURY.
DIAL 911 OR CALL
EMS.
ACTION
CHECK THE
VICTIM’S INJURIES
(p.11) AND TREAT
AS APPROPRIATE.
CALL FOR HELP IF
NECESSARY.
Yes
No
Are you and/or
the victim in
any danger?
Yes
No
Is the victim
talking to you?
Yes
No
Is the victim
breathing?
Yes
No
Dial 911 or
call EMS.
Give rescue
breaths
(pp.16–17). Are
there any signs
of circulation?
START
ACTION
GIVE CPR (pp.18–20).
ACTION
CONTINUE RESCUE
BREATHS.
When faced with an emergency, try to remain calm and controlled so that you
can act effectively. Before assessing the victim’s condition and carrying out
the appropriate first aid, make sure that you are not putting yourself in danger.
You will not be able to help anyone else if you become a victim yourself.
If possible, have someone else dial 911 while you deal with the situation.
Yes
No
Is the victim
conscious?
Page 11 of 260
ACTION IN AN EMERGENCY 11
CALLING AN AMBULANCE
1 Dial 911
• Check the victim’s breathing
before calling for help.
• If possible, send someone else to
make the call and ask him or her
to confirm that help is on the way.
• If you are alone with a child who
is unconscious or an adult who
has drowned, choked, or been
injured, give rescue breaths
(pp.16–17) and/or CPR (pp.18–20)
for 1 minute before making the call.
• If you are alone with an adult who
is not breathing and you suspect a
heart attack, dial 911 immediately.
• If you have to leave a victim who
is breathing, place him in the
recovery position (pp.14–15).
ASSESSING A VICTIM’S INJURIES
• Deal first with any life-threatening
conditions the victim may have,
such as unconsciousness (p.21),
breathing difficulties (p.12), or
heavy loss of blood (p.31).
• Check for and treat any
other injuries.
Check the victim to
assess her injuries
2Give information
• Tell the ambulance dispatcher
where you are, your telephone
number, what has happened, the
age, sex, condition, and injuries of
the victim(s), and whether any
hazards are still present, such as
a fire or gasoline on the road.
3Give first aid
• Give the appropriate first-aid to
the victim.
• Stay with the victim until medical
help arrives.
• Monitor the victim’s breathing
(p.68 for an adult, p.71 for a child),
pulse (p.68 for an adult, p.70 for
a child), and consciousness (p.12)
until the ambulance arrives.
Monitor the victim’s
condition while
waiting for the
ambulance
Page 12 of 260
12 FIRST AID
The techniques on the following pages, used in sequence, can help maintain a
victim’s oxygen supply until help arrives. Upon finding an unconscious person,
you need to open and, if necessary, clear the victim’s airway so that air can enter
the lungs. If the victim is not breathing, give rescue breaths to maintain the oxygen
supply, thereby sustaining the victim’s vital organs. If the victim also has no
circulation, give cardiopulmonary resuscitation (CPR) – rescue breaths with chest
compressions – to ensure that air enters the body and is circulated by the blood.
An unconscious victim who is breathing should be placed in the recovery position,
a secure position that keeps the airway open and the head, neck, and back aligned.
CHECKING FOR CONSCIOUSNESS (all ages)
Resuscitation techniques
1Seek reaction
• Ask a simple question, or give
a simple command, such as
“Open your eyes.”
• Shake an adult’s shoulders gently.
!Important
• Never shake a baby or child. Instead,
gently tap the shoulder or flick the
sole of the foot.
2Assess response
• If the victim responds to
speech, assess whether he is
alert and aware of the situation
or confused and sleepy.
• If he responds to touch, assess
whether he reacts readily to your
touch or is sluggish in response.
• If there is no reaction at all, open
the victim’s airway (p.13).
3Monitor victim
• During first-aid treatment, you
will need to repeat steps 1–2
every 10 minutes to check the
victim’s level of consciousness.
• Note any changes in the victim’s
responses to speech or gentle
shaking (adult victims only),
and whether these indicate an
improvement or a deterioration
in his condition, then pass this
information on to the paramedics
when the ambulance arrives.
• If a conscious victim becomes
unconscious, open the airway
(p.13), check breathing (p.14),
and dial 911 or call EMS.
Shake an adult
victim gently by
the shoulders to
see if he responds
Page 13 of 260
RESUSCITATION TECHNIQUES 13
OPENING THE AIRWAY (adults and children)
OPENING THE AIRWAY (babies under 1)
1Tilt head back
• Gently place one hand on the
victim’s forehead.
• Tilt the head back by pressing
down on the forehead.
2Remove any
obstruction
• Look inside the victim’s mouth.
Carefully pick out any obvious
obstruction with your fingers.
3Lift chin
• Place two fingers of the other hand
under the chin and lift it gently.
• Tilt the head to open the airway.
Check breathing (p.14).
3Lift chin
• Place one finger of the other hand
under the chin and lift it gently.
• Tilt the head slightly. If you tilt it
too far, you may block the airway
again. Check breathing (p.14).
Using two
fingers, gently
lift up the chin
1Tilt head back
• Place one hand on the baby’s
forehead, then tilt the head
by pressing on the forehead.
2Remove any
obstruction
• Pick out any obvious obstruction
in the mouth with your fingertips.
Do not over- extend the
baby’s neck
!Important
• If you suspect that there are head
or neck injuries, handle the head
carefully. Tilt the head back slightly.
• Do not sweep your fingers blindly
around the mouth.
BEFORE YOU START
Make sure that you have:
• Checked for consciousness but
had no response (p.12).
BEFORE YOU START
Make sure that you have:
• Checked for consciousness but
had no response (p.12).
Important
• Always be very gentle with a baby’s head
when tilting it back.
!
Page 14 of 260
14 FIRST AID
2Prepare to
turn victim
• Bring the arm farther from you
across the victim’s chest, and
place the back of his hand under
his near cheek.
• Pull his far leg into a bent position;
keep his foot on the floor.
• Pull his knee toward you.
Use leg as
lever to
turn body
2Treat victim
• If breathing has stopped, begin
rescue breaths (pp.16–17).
• If the victim is breathing but
unconscious, place him in the
recovery position (see below and
opposite), then check for injuries.
1Look for
movement
• Kneel beside the victim and put
your cheek close to his mouth.
Listen and feel for any signs of
breathing, while looking along
his chest for signs of movement.
• Do this for up to 10 seconds.
1Position arms
and legs
• Kneel next to the victim.
• If the victim is wearing eyeglasses,
remove them. Also remove any
bulky objects from his pockets.
• Position the arm closer to
you so that it lies at a right
angle to his body, with his
elbow bent at a right angle
and the palm facing upward.
CHECKING FOR BREATHING (all ages)
RECOVERY POSITION (adults and children)
BEFORE YOU START
Make sure that you have carried out
the following steps:
• Checked for consciousness but
had no response (p.12).
• Opened the victim’s airway (p.13).
BEFORE YOU START
Make sure that you have carried out
the following steps:
• Checked for consciousness but had
no response (p.12).
• Opened the victim’s airway (p.13).
• Checked for breathing and found
definite signs (see above).
Look down
across the chest
to see if it rises
Keep palm
facing up
Page 15 of 260
RESUSCITATION TECHNIQUES 15
3Turn victim
• Continue to pull the upper leg
so that the victim rolls onto
his side. If necessary, support his
body with your knees so that he
does not roll too far forward.
• Leave the victim’s hand supporting
his head, and tilt the head so that
the airway stays open.
4Support victim
• Adjust the victim’s hand so that it
supports his head. Bend the hip and
knee of his upper leg at right angles
so that this leg supports his body.
• Check that an ambulance is on
the way.
• Check and record the victim’s
breathing (p.68 for an adult,
p.71 for a child), pulse (p.68
for an adult, p.70 for a child),
and consciousness (p.12)
until help arrives.
Keep
leg bent
1Pick up baby
• Hold the baby securely in
your arms so that his head
is lower than his body.
• Tilt the baby’s head back
to keep the airway open
and to allow any vomit to
drain from his mouth.
• Ensure that you keep the baby’s
head, neck, and back aligned
and supported at all times.
2Monitor baby
• Monitor the baby’s breathing
(p.71), pulse (p.70), and level
of consciousness (p.12)
until help arrives.
Important
• If you suspect a spinal injury, do not move
a baby unless the breathing is impeded or
he is in danger.
! BEFORE YOU START
Make sure that you have carried out
the following steps:
• Checked for consciousness but
had no response (p.12).
• Opened the baby’s airway (p.13).
• Checked for breathing and found
definite signs (see p.14).
Important
• If you suspect a spinal injury, do not move
the victim unless his breathing is impeded
or he is in danger. Maintain his open airway.
!
Keep the baby’s
head tilted
downward to
let fluid drain
RECOVERY POSITION (babies under 1)
Page 16 of 260
16 FIRST AID
GIVING RESCUE BREATHS (adults and children)
1 Breathe into
victim’s mouth
• Check that the victim’s airway
is still open.
• Pinch the victim’s nose closed with
your thumb and index finger.
• Take a deep breath, then place
your open mouth tightly around
his so that you form a good seal.
• Blow air into his mouth for
about 2 seconds.
2Watch chest
• Lift your mouth away from the
victim’s mouth, keeping your
hands in place to maintain his
head position.
• Glance at the victim’s chest; you
should see his chest fall as the air
leaves his lungs. This is called an
effective breath. Repeat the breath.
4Check for signs
of circulation
• Look for any signs that indicate
circulation – breathing, coughing,
and movement of limbs – for up
to 10 seconds.
• If there are signs of circulation,
continue rescue breathing, giving
10 breaths per minute for adults
and 20 for children. Recheck for
signs of circulation every minute.
• If the victim starts breathing
again, place him in the recovery
position (pp.14–15).
• If there are no signs of circulation,
begin CPR (pp.18–20).
Blow steadily
into the
victim’s
mouth
3Repeat breathing
• If there is no chest movement,
readjust his head and try again.
• Repeat rescue breaths up to five
times or until you achieve two
effective breaths. Then check for
signs of circulation (see step 4). OR
• If his chest fails to move even after
rescue breathing, check for signs
of circulation. If you know that
the victim has choked and his
chest still does not move, do
not check for circulation but
go straight to CPR (pp.18–20).
BEFORE YOU START
Make sure that you have carried out
the following steps:
• Checked for consciousness but
had no response (p.12).
• Opened the victim’s airway (p.13).
• Checked for breathing but found
no signs (p.14).
Keep checking
to see if his chest
rises and falls
Page 17 of 260
RESUSCITATION TECHNIQUES 17
GIVING RESCUE BREATHS (babies under 1)
1Breathe into
baby’s mouth
• Make sure that the baby’s airway
is still open.
• Take a breath. Seal your lips
around both the mouth and nose.
• Attempt to give about one breath
per second.
2Watch chest
• Glance at the baby’s chest; it should
rise and fall. Repeat rescue breaths.
• If the chest does not move, readjust
the airway and try again.
• Try up to five times or until you
achieve two effective breaths. Check
for signs of circulation. OR
• If the chest still does not move,
check for signs of circulation.
• If you know the baby has choked
and the chest still does not move,
do not check for circulation but
go straight to CPR (p.20).
3Check circulation
• Look for any signs that indicate
circulation – breathing, coughing,
and movement of limbs – for up
to 10 seconds.
• If there are signs of circulation,
continue rescue breathing (at a
rate of one breath per 3 seconds).
If there are no signs of circulation,
begin CPR (p.20).
pic
Important
• If you have a face shield (p.60), use
this when giving rescue breaths to
prevent cross-infection.
• If the victim has swallowed a corrosive
poison, use a face shield to protect
yourself from the effects of the chemical.
• Before giving the first breath, make
sure that the victim’s head is tilted back
and the airway is open.
!
Place the
shield on the
victim’s face,
with the filter
over her mouth
BEFORE YOU START
Make sure that you have carried out
the following steps:
• Checked for consciousness but
had no response (p.12).
• Opened the baby’s airway (p.13).
• Checked for breathing but found
no signs (p.14).
!Important
• When giving rescue breaths to a baby,
be careful not to blow too hard.
Page 18 of 260
18 FIRST AID
1Find compression
point
• Lay the victim on a firm surface.
• Kneel beside the victim, level with
his chest. Slide your fingers (using
the hand farther from his head)
along the lowest rib to the point
where it meets the breastbone.
• Position your middle and index
fingers at this point.
• Place the heel of your other hand
on the breastbone, just above your
index finger.
This is the
area of the
chest where
you must
apply the
compressions.
2Position hands
• Lift away the fingers of your
first hand and lay this hand on top
of your other hand.
• Interlock your fingers, so that
the fingers of your bottom hand
are not touching the chest.
• Kneel upright with your shoulders
directly above the victim and your
elbows locked straight.
Place fingers
where the victim’s
lower rib and
breastbone meet
3Compress chest
• Press downward, depressing the
breastbone by 11
/2–2 inches (4–5 cm)
on an average adult, then release
the pressure but do not remove
your hands from the chest.
• Compress the chest in this way
15 times at a rate of about 100
compressions per minute (roughly
three every 2 seconds), maintaining
an even rhythm.
GIVING CPR (adults and children over 7)
Raise fingers
away from
the chest
Keep your hands
in position between
compressions
BEFORE YOU START
Make sure that you have carried out
the following steps:
• Checked for consciousness but had
no response (p.12).
• Opened the victim’s airway (p.13).
• Checked for breathing but found no
signs (p.14).
• Given two effective rescue breaths
and checked for signs of circulation
but found none (p.16) OR
• Attempted two rescue breaths and
checked for signs of circulation but
found none (p.16).
Page 19 of 260
RESUSCITATION TECHNIQUES 19
5Repeat CPR cycles
• Continue giving cycles of 15 chest
compressions and two rescue
breaths until help arrives.
• If the circulation returns or the
victim starts breathing at any time,
stop CPR and place him in the
recovery position (pp.14–15).
• Stay with the victim and monitor
his breathing (p.68), pulse (p.68),
and level of consciousness (p.12)
until help arrives.
1Find compression
point
• Lay the child on a firm surface.
• Find the base of
the breastbone
(see opposite),
then position
one hand on the
lower half of the
child’s breastbone.
2Give compressions
• Kneel upright with your shoulders
directly above the child’s chest and
your elbow locked straight.
• Press downward, so that you
are depressing the breastbone
by one-third of the depth of the
chest, then release the pressure
without removing your hands.
• Compress the chest five times at a
rate of about 100 compressions per
minute, keeping an even rhythm.
• Give one rescue breath.
3Repeat CPR cycles
• Continue giving cycles of five chest
compressions to one rescue breath.
• If the child’s circulation and/
or breathing return, place
him or her in the recovery
position (pp.14–15).
• Stay with the child
and monitor his or
her breathing (p.71),
pulse (p.70), and
level of consciousness
(p.12) until help arrives.
GIVING CPR (children 1–7)
4Give rescue breaths
• Give the victim two rescue
breaths (p.16).
Position one
hand ready
for compressions
BEFORE YOU START
Make sure that you have carried out
the following steps:
• Checked for consciousness but had
no response (p.12).
• Opened the victim’s airway (p.13).
• Checked for breathing but found no
signs (p.14).
• Given two effective rescue breaths
and checked for signs of circulation
but found none (p.16) OR
• Attempted two rescue breaths and
checked for signs of circulation but
found none (p.16).
Pinch the nose
and tilt the chin
before placing
your mouth over
the victim’s
Page 20 of 260
20 FIRST AID
Place two fingers
on the breastbone
just below nipple line
Seal your
mouth over
the baby’s
nose and
mouth
GIVING CPR (babies under 1)
1Find compression
point
• Lay the baby on a firm surface.
• Position the tips of two fingers of
one hand on the baby’s breastbone,
a finger’s width below the nipples.
This is the point where you must
apply the compressions.
2Compress chest
• Press downward, so that you
depress the breastbone by one- third of the depth of the chest,
then release the pressure without
moving your hands.
• Compress the chest five times at a
rate of about 100 compressions per
minute, keeping an even rhythm.
• Give one effective rescue breath.
Look for chest
movements
Listen for
breathing
!Important
• When giving rescue breaths to a baby,
be careful not to blow too hard.
3Repeat CPR cycles
• Continue giving cycles of five
chest compressions and one
rescue breath.
• If the baby’s circulation and/or
breathing return, stop CPR
and hold him or her in the
recovery position (p.15).
• Stay with the baby and monitor
his or her breathing (p.71), pulse
(p.70), and level of consciousness
(p.12) until help arrives.
BEFORE YOU START
Make sure that you have carried out
the following steps:
• Checked for consciousness but
had no response (p.12).
• Opened the baby’s airway (p.13).
• Checked for breathing but found no
signs (p.14).
• Given two effective rescue breaths
and checked for signs of circulation
but found none (p.17). OR
• Attempted two rescue breaths and
checked for signs of circulation but
found none (p.17).
Page 21 of 260
RESUSCITATION TECHNIQUES • UNCONSCIOUSNESS 21
An interruption in the normal activity of the brain
results in unconsciousness. This potentially life- threatening condition requires immediate medical
help. The aims of first-aid treatment are to check the
victim’s level of consciousness, open the airway and
check breathing, then, if the victim is breathing, to
put him or her in a stable position until help arrives.
TREATING UNCONSCIOUSNESS (all ages)
Unconsciousness
SIGNS & SYMPTOMS
• No response to loud
noise or gentle shaking
• Closed eyes
• No movement or sound
1Check
consciousness
• Check the victim for signs
of consciousness (p.12).
• Open the victim’s airway (p.13)
and check her breathing (p.14).
• If the victim is not breathing, begin
rescue breaths (p.16 for adults and
children, p.17 for babies).
• If the victim is breathing, place her
in the recovery position (pp.14–15
for adults and children, p.15 for
babies) and treat any injuries
(see step 3).
3Treat injuries
• Examine the victim gently for any
serious injuries.
• Control any bleeding (p.31).
Check for and support suspected
broken arms or legs (pp.44–45).
4Monitor victim
• Stay with the victim until medical
help arrives.
• Monitor her breathing regularly
(p.68 for an adult, p.71 for a
child or baby) and pulse (p.68
for an adult, p.70 for a child
or baby) every 10 minutes.
• Check for any changes in the
victim’s level of consciousness by
asking simple questions or shaking
her gently every 5–10 minutes.
2Summon help
• Dial 911 or call EMS.
• Look for clues to the cause of the
condition, such as needle marks,
medical warning bracelets, or
identification cards.
• Ask bystanders for any information
they may have that you can give
to the emergency services.
Keep
leg bent
!Important
• Do not move the victim unnecessarily in case
there is spinal injury.
• If you need to leave the victim to get help,
place her in the recovery position (pp.14–15
for adults and children, p.15 for babies).
• Do not shake a baby or child.
• Be prepared to begin resuscitation (pp.12–20).
• Do not give an unconscious victim anything
to eat or drink.
Page 22 of 260
22 FIRST AID
An obstruction of the airway, usually caused by food
or a foreign object, can result in choking. The aim of
first-aid treatment for choking is to dislodge the object
as quickly as possible. This involves encouraging the
victim to cough, then, if necessary, using thrusts. If
the obstruction is not removed, the victim will stop
breathing and lose consciousness.
TREATING CHOKING
(adults and children over 7)
Choking (adults and children)
SIGNS & SYMPTOMS
• Coughing, difficulty in
breathing and talking
• Signs of distress, including
holding the throat
• Red face and neck, later
turning gray-blue
1Encourage
coughing
• Ask the victim to cough. This may
dislodge whatever is blocking the
victim’s windpipe.
• Check a child’s mouth to see if
anything has been dislodged.
2Give abdominal
thrusts
• If the victim is becoming weak, or
stops breathing or coughing, carry
out abdominal thrusts. Stand
behind the victim and put both
arms around the upper part of the
abdomen. Make sure he is
bending forward.
• Clench your fist and
place it (thumb inward)
between the navel and
the bottom of the
breastbone. Grasp
your fist with your
other hand. Pull
sharply inward
and upward up to
five times. !Important
• If the victim becomes unconscious,
open the airway, check breathing, and
be prepared to begin resuscitation
(pp.12–20).
• If the victim is pregnant or obese, or
you cannot reach around the victim’s
abdomen, give chest thrusts instead of
abdominal thrusts. Position your fist in
the middle of the victim’s chest, grab
your fist with the other hand, and pull
sharply inward up to five times.
Encourage victim
to cough
3Check mouth
• Check his mouth. If the obstruction
is still not cleared, repeat steps 2
and 3 up to three times, checking
his mouth after each step.
• If the obstruction still has not
cleared, Dial 911 or call EMS.
Continue until help arrives or the
victim becomes unconscious.
Page 23 of 260
CHOKING (ADULTS AND CHILDREN) 23
3Give abdominal
thrusts
• If the child shows signs of
becoming weak, or stops
breathing or coughing, carry
out abdominal thrusts.
• Put your arms around the child’s
upper abdomen. Make sure
that he is bending well forward.
• Place your fist between the navel
and the bottom of the breastbone,
and grasp it with your other hand.
Pull sharply
inward and
upward up
to five times.
Stop if the
obstruction
clears.
1Encourage
coughing
• If the child is still able to breathe,
encourage him to cough. This may
help dislodge the obstruction, and
should always be tried before other
method, such as abdominal
thrusts, are used.
TREATING CHOKING (children 1–7)
2Check mouth
• Check the child’s mouth carefully
to see if anything has been
dislodged. Encourage him to spit
it out, then make sure that the
obstruction has been cleared. 4Check mouth
• Check the victim’s mouth again to
see if anything has been dislodged,
and remove the object carefully.
• If the obstruction is still not
cleared, repeat steps 3 and 4 up to
three times.
• If the obstruction still has not
cleared, dial 911 or call EMS.
• Continue giving abdominal thrusts
until help arrives or the child
becomes unconscious.
Encourage
child to
cough
!Important
• Do not sweep your finger around the
child’s mouth since you might push
an object farther down the throat.
• If the child becomes unconscious,
open the airway, check breathing,
and be prepared to begin
resuscitation (pp.12–20).
Give five
abdominal
thrusts
Page 25 of 260
CHOKING (BABIES UNDER 1) • HEART ATTACK 25
A heart attack is usually caused by a blockage of
the blood supply to the heart. The aims of first-aid
treatment for a heart attack are to make the victim
comfortable and to arrange for prompt transport to
the hospital. The chances of surviving a heart attack
have improved significantly in recent years, but it
is still vital that the victim be treated by medical
professionals as soon as possible.
TREATING A HEART ATTACK
Heart attack
SIGNS & SYMPTOMS
• Sharp chest pain often
extending down left arm
• Nausea and vomiting
• Feeling faint and breathless
• Gray skin and blueish lips
• Pulse that quickens and
then weakens
1Make victim
comfortable
• Raise the victim’s shoulders so that
he is half-sitting and support him
with cushions or pillows.
• Bend his knees and support them
with more pillows.
• Reassure him and keep him as
calm as possible.
2Summon help
• Dial 911 or call EMS. Tell the
dispatcher that you are with
someone who is probably
having a heart attack.
• Call the victim’s doctor, if you are
requested to do so.
3Help with
medication
• If the victim has medication for
angina, help her take it.
4Monitor condition
• Keep the victim calm and rested.
• Check and record the victim’s
breathing (p.68), pulse (p.68), and
level of consciousness (p.12) until
medical help arrives.
Important
• Do not allow the victim to eat or drink.
• If the victim falls unconscious, open his
airway, check breathing, and be prepared
to begin resuscitation (pp.12–20). Prop up legs
with cushions
or pillows
Support victim’s
back with cushions
or pillows
!
Page 26 of 260
26 FIRST AID
Important
• Do not use a preventive inhaler
during an attack.
• If the victim becomes unconscious,
open her airway, check breathing,
and be prepared to begin
resuscitation (pp.12–20).
Call an ambulance if
• This is the first attack and the victim
does not have an inhaler.
• The asthma does not improve after
two doses of reliever inhaler.
• The victim is exhausted and is finding
breathing increasingly difficult.
2Provide
medication
• Give the victim her reliever inhaler,
and ask her to take a dose.
• If the victim is a child, he or
she may need to have a spacer
attached to the inhaler (p.167).
• The effect of the inhaler should
be obvious within minutes if it
is a mild asthma attack.
During an asthma attack, muscle contractions cause
the airways of the lungs to narrow, leading to
swelling and inflammation of the airways’ linings.
This results in difficulty breathing, which can be
life-threatening. The aims of first-aid treatment for an
asthma attack are to help the victim to breathe and
to seek medical help if symptoms do not improve.
TREATING AN ASTHMA ATTACK
Asthma attack
1 Calm victim
• Sit the victim down in a
comfortable position. Leaning
forwards is
usually best.
• Reassure and
calm her.
• Tell her
to breathe
slowly and
deeply.
SIGNS & SYMPTOMS
• Breathing becomes difficult
• Frequent dry, wheezy cough
• Difficulty talking
• Gray-blue tinge to skin
!
3Repeat the dose
• If the inhaler has eased the
symptoms, ask the victim to
repeat the dose.
• Encourage her to continue
breathing slowly and deeply.
• Tell her to inform her
doctor if the attack
was unusually severe.
If inhaler is
effective, ask
victim to repeat
the dose
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Page 28 of 260
28 FIRST AID
2Make victim
comfortable
• If the victim is conscious,
help him into a sitting position
to ease difficulty breathing.
People who have an extreme sensitivity to a specific
substance can suffer a rare and severe type of
allergic reaction known as anaphylactic shock.
The reaction spreads through the body, causing a
sudden drop in blood pressure and narrowing of
the airways, and can be fatal. The aims of first-aid
treatment are to help the victim inject epinephrine
(Epipen) and to summon help.
TREATING ANAPHYLACTIC SHOCK
Anaphylactic shock
1Summon help
• Dial 911 or call EMS, or ask
someone else to do so.
• Tell the dispatcher if you know
what has caused the reaction.
SIGNS & SYMPTOMS
• Itchy red skin rash
• Swollen face, lips, and
tongue
• Anxiety
• Difficulty breathing,
wheezing
!
4Monitor victim
• Monitor victim’s breathing (p.68
for an adult, p.71 for a child or
baby), pulse (p.68 for an adult,
p.70 for a child or baby), and level
of consciousness (p.12) every
10 minutes until help arrives.
3Look for Epipen
• If the victim has an Epipen, get it
for him so that he can administer it.
• Epinephrine is usually
administered
into the outer
thigh, through
any clothing.
Sitting up should
aid victim’s
breathing
Important
• Stay with the victim at all times, except if you
have to leave him to dial 911 or call EMS.
• If the victim becomes unconscious, open
his airway, check his breathing, and be
prepared to begin resuscitation
(pp.12–20).
Place Epipen
against thigh and
depress needle
Page 29 of 260
ANAPHYLACTIC SHOCK • HEAD INJURY 29
Although a head injury sometimes leaves no visible
wound, there may be obvious bruising or bleeding at
the site. The victim may have a headache. The aims
of first-aid treatment are to control bleeding, dress the
wound, and seek medical help. Even apparently minor
head injuries should always be seen by a doctor.
TREATING A HEAD INJURY
Head injury
SIGNS & SYMPTOMS
• Bleeding or bruising at the
site of the wound
• Depression in the skull
• Dizziness or nausea
• Headache and memory loss
1Treat visible
wounds
• If there is a scalp wound, replace
any skin flaps.
• Press a clean pad firmly over the
wound to control the blood flow.
• Maintain the pressure for at least
10 minutes until the blood flow
has been controlled.
• Secure a bandage around the
victim’s head to hold the
pad in position.
2Assess victim
• Check that the victim is fully
conscious by asking simple,
direct questions in a clear voice.
• If she answers your questions,
lay her down in a comfortable
position, then arrange for
transport to the hospital.
• If the victim does not respond, ask
someone to dial 911 or call EMS.
• If you need to leave an unconscious
victim, place her in the recovery
position first (pp.14–15) unless
you suspect a spinal injury.
3Monitor victim
• Monitor the victim’s breathing
(p.68 for an adult, p.71 for a child
or baby), pulse (p.68 for an adult,
p.70 for a child or
baby), and level of
consciousness (p.12)
every 10 minutes
until help arrives.
!Important
• Use disposable gloves and/or wash your
hands well when dealing with body fluids.
• If the victim becomes unconscious, open her
airway, check her breathing, and be prepared
to begin resuscitation (pp.12–20).
Dial 911 or call EMS if
• The victim is unconscious, appears confused,
or her condition is deteriorating.
• There is a depression or soft patch in her
skull, or blood or watery fluid is leaking from
her ears or nose; these indicate a skull fracture.
Lie victim down in
case of shock
Use a pillow
to support
her head and
shoulders
Page 30 of 260
30 FIRST AID
2
An interruption of the blood supply to the brain,
caused by a blood clot or a ruptured artery in the
brain, is known as a stroke. The effect of a stroke
depends on which part, and how much, of the
brain is affected. Although a major stroke can be
fatal, a minor stroke is not life-threatening, and
a full recovery is possible. Whether the victim is
conscious or unconscious, it is important that he or
she is taken to hospital as soon as possible in order
to minimize any brain damage caused by the stroke.
TREATING A STROKE
Stroke
1Lay victim down
• Make the victim comfortable by
laying her down and supporting
her head and shoulders slightly with
cushions or rolled-up blankets.
• Tilt her face to one side to allow
any fluid to drain out of her
mouth, and wipe her face with a
washcloth. Alternatively, place
something absorbent on her
shoulder to soak up the fluid.
• Loosen restrictive clothing around
her neck and chest.
SIGNS & SYMPTOMS
• Acute headache
• Confusion, which could be
mistaken for drunkenness
• Weakness or paralysis,
possibly on just one side
of the body, manifested in
slurred speech, drooping
mouth, and a loss of limb,
bladder, or bowel control
• Possible unconsciousness
Use washcloth
to absorb any
fluid
Summon help
• Ask someone to dial 911 or call
EMS immediately.
Important
• Do not allow the victim to have anything to
eat or drink.
• If the victim is or falls unconscious, open her
airway, check breathing, and be prepared to
begin resuscitation (pp.12–20).
!
3Monitor victim
• Check and record the victim’s
breathing (p.68), pulse (p.68),
and level of consciousness (p.12)
every 10 minutes until help arrives.
Page 32 of 260
32 FIRST AID
A deep wound to the chest can cause direct or
indirect damage to the lungs, which may lead to a
collapsed lung, and damage to the heart. The aims
of first-aid treatment for a penetrating chest wound
are to stop the bleeding, to help prevent the victim
from going into shock, and to get the victim to the
hospital for treatment as quickly as possible.
TREATING PENETRATING CHEST WOUNDS
Penetrating chest wounds
1 Control blood flow
• Expose the wound and press the
palm of your hand against it, or
get the victim to do it himself.
• Support the victim in a semi- upright or half-sitting position.
SIGNS & SYMPTOMS
• Difficult, painful breathing
• Acute distress
• Presence of frothy blood
at mouth
• Possible signs of shock
3Make victim
comfortable
• Encourage the victim to lean
toward the side of the wound.
• Try to make him as comfortable
as possible, using additional
cushions or pillows to support
him as necessary.
• Loosen any restrictive clothing
around his waist.
Cover pad with
plastic wrap and
secure with tape
2Dress wound
• Cover the wound with a sterile
dressing or clean pad.
• Cover the dressing with a piece
of aluminum foil, plastic wrap, or
a plastic bag to prevent air from
entering the chest cavity.
• Secure the dressing with a bandage
or strips of adhesive or micro- porous tape. Apply the tape to
three sides of the dressing only.
Important
• Use disposable gloves and/or wash your
hands well when dealing with body fluids.
• If the victim is or falls unconscious, open his
airway, check his breathing, and be prepared
to begin resuscitation (pp.12–20).
• If you need to put him in the recovery position
(pp.14–15), lay him on his injured side.
!
4Summon help
• Dial 911 or call EMS. Tell the
dispatcher where the injury is and
describe the extent of the bleeding.
• Watch carefully for any signs of
shock developing (p.27).
Page 33 of 260
PENETRATING CHEST WOUNDS • CUTS AND SCRAPES 33
Small wounds, such as cuts and scrapes, rarely bleed
for long and require little in the way of first-aid
treatment. What is important, however, is to clean the
wound and apply a sterile wound dressing as quickly
as possible in order to minimize the risk of infection.
Check, too, that the victim’s tetanus immunization is
up to date, and arrange a booster dose if necessary.
TREATING CUTS AND SCRAPES
Cuts and scrapes
SIGNS & SYMPTOMS
• Oozing blood
• Localized pain
• Scraped area containing
dirt and dust particles
1Clean wound
• Sit the victim down and reassure
her. Even a minor fall can leave a
victim feeling shaky.
• Rinse dirt from the cut or scrape
under cold running water.
• Gently clean the entire wound area
with sterile gauze swabs. Use a
new swab for each stroke and work
from the wound outward.
• Lift any loose material, such as
glass, gravel, or metal with the
corner of a gauze swab.
• Carefully pat the area dry with
a clean gauze swab.
2Dress wound
• For smaller cuts and scrapes,
cover the injured area with an
adhesive bandage.
• For larger injuries, place a sterile
wound dressing over the injury
and bandage it in place (p.61).
• Rest the injured limb, preferably
in a raised position.
Protect scrape
with an adhesive
bandage
Sit victim
down
Wash
scrape
Important
• Use disposable gloves and/or wash your
hands well when dealing with body fluids.
• Do not touch the cut or scrape with your
fingers to avoid infecting the wound.
• Avoid using cotton or any other dry fluffy
material to clean a cut or scrape – such
material is likely to stick to the wound.
!
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Page 34 of 260
34 FIRST AID
SIGNS & SYMPTOMS
• Fine piece of wood sticking
out of skin
• Dark line under skin surface
• Blood oozing from puncture
in skin
Important
• Do not attempt to use a needle to lever
out the splinter.
• Use disposable gloves and/or wash your
hands well when dealing with body fluids.
2Pull out splinter
• Grip the splinter with the
tweezers, then pull it out in a
straight line in the opposite
direction to which it entered.
• Try not to break the splinter.
It is very common to find small splinters of wood
embedded in the skin of hands, knees, and feet,
especially those of children. It is usually possible to
remove splinters by hand or using tweezers, having
made sure that the wound has first been cleaned and
the tweezers sterilized. If splinters remain embedded
or lie over a joint, seek medical help.
TREATING SPLINTERS
Splinters
1Sterilize tweezers
• Using soap and warm water, clean
the affected area thoroughly.
• Sterilize a pair of tweezers by
heating them in a flame.
!
3Clean wound
• Squeeze the area around the
wound to make it bleed. This helps
to flush out any remaining dirt.
• Clean the affected area and cover
it with an adhesive bandage.
• Check that the victim’s tetanus
immunization is up to date.
4Dress embedded
splinter
• If the splinter breaks, or will not
come out, place pads on either side,
and a bandage over it, taking care
not to press down on the splinter.
• Seek medical help.
Sterilize
tweezers
in a flame Squeeze area
to encourage
a little bleeding
Grasp splinter
and pull it
straight out
Page 35 of 260
SPLINTERS • EYE WOUND 35
Any wound to the eye is potentially serious. Blows
to the eye can cause bruising or cuts, and sharp
fragments of materials, such as glass, can become
embedded in the eye’s surface. Even a superficial
scrape can result in scarring and vision deterioration.
The aims of first-aid treatment for an eye wound are
to prevent any further damage, to dress the wound,
and to get the victim to the hospital.
TREATING AN EYE WOUND
Eye wound
SIGNS & SYMPTOMS
• Sharp pain in injured eye
• Visible wound or
bloodshot eye
• Partial or total loss of vision
• Blood or clear fluid leaking
from injured eye
1 2Dress wound
• Hold a sterile wound dressing or
clean pad over the injured eye, or
ask the victim to do it, and ask
him to keep his uninjured eye still.
• Keep his head steady.
Tell victim to keep
both eyes still
3Summon help
• Ask someone to dial 911 or call
EMS. If you call yourself, first
place some cushions under the
victim’s head for support.
• Alternatively, if you can keep the
victim still and laying down, take
him to the hospital yourself.
Support his
head
Keep
injured eye
covered
Keep victim still
• Lay the victim on a firm surface,
placing a blanket underneath him
if it is cold.
• Kneel down and support his head
on your knees,
holding it as still
as possible.
• Tell him to
keep both
his eyes shut
and still.
Important
• Do not touch the affected eye or
allow the victim to touch it.
!
Page 36 of 260
36 FIRST AID
!Important
• If anything is stuck to the eye, penetrating the
eyeball, or resting on the colored part of the
eye, treat as for an eye wound (p.35).
• Do not touch the affected eye or allow the
victim to touch it.
2Flush out object
• If you can see something floating
on the white of the eye or trapped
under the lower lid, try to flush it
out with clean water.
• Tilt the head so that the injured
eye is lower than the other one.
• Pour water carefully into
the corner of the injured eye,
allowing the liquid to drain away.
• Alternatively, tell the victim to
immerse her face in a sinkful of
water and try blinking.
Eyelashes, bits of dust, and dislodged contact lenses
are common eye irritants. They usually float on the
white of the eye, and can be easily removed. Anything
that rests on the coloured part of the eye or is stuck
on or embedded in the eye’s surface, however, will
demand hospital attention. Your aims are to prevent
injury to the eye and seek hospital care, if necessary.
TREATING A FOREIGN OBJECT IN THE EYE
Foreign object in the eye
1Examine eye
• Sit the victim down so that she
is facing the light.
• Using two fingers, gently separate
the upper and lower eyelids so that
you can examine the eye.
SIGNS & SYMPTOMS
• Eye pain or discomfort
• Blurred vision
• Red or watering eye
3Lift off object
• If flushing does not work, use
the corner of a clean, dampened
handkerchief or tissue to lift the
foreign object off the eye.
• Do not use any pressure.
5Seek medical help
• If all your efforts to remove the
foreign object are unsuccessful,
take the victim to the hospital.
4Inspect
upper eyelid
• Look under the upper eyelid to see
if a foreign object has lodged there.
To remove it, ask the victim to
grasp the upper lashes and pull
the eyelid over the lower one.
• If this fails to help, bathe the eye in
water and ask the victim to blink.
Page 37 of 260
FOREIGN OBJECT IN THE EYE • CHEMICALS IN THE EYE 37
When splashes of chemicals get into the eyes, they
can cause serious damage, resulting in scarring
and even blindness. The primary aim of first-aid
treatment is to effectively irrigate the eye, or flush it
with water, in order to disperse hazardous substances.
The next step is to dress the eye, and then seek
hospital care for the victim.
TREATING CHEMICALS IN THE EYE
Chemicals in the eye
SIGNS & SYMPTOMS
• Eye redness and swelling
• Watering of the eye
• Sharp pain in the eye
• Signs of chemicals nearby
1Rinse eye
• If the victim cannot open his
eye, use your finger and thumb to
gently separate the two eyelids.
• Hold the affected eye under
gently running cold water for
at least 10 minutes.
• Be careful that water being rinsed
from the injured eye does not
drain into the other eye or splash
either you or the victim.
• If it is easier, use a jug or glass
to pour water onto the eye.
2Seek medical help
• Ask the victim to hold a sterile
pad, or one made from clean,
nonfluffy material, such as a
handkerchief, over the injured eye.
• If possible, identify the chemical.
• Take or send him
to the hospital.
Cover
eye with
clean pad
Wash eye
with cold
water for
10 minutes
Wear
protective
gloves
!Important
• Do not touch the affected eye or allow the
victim to touch it.
• If chemical spray is the irritant, face the
victim into the wind. Do not attempt to flush
it out using water.
• Wear gloves to protect yourself.
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Page 38 of 260
38 FIRST AID
Important
• Do not wash the mouth out, as this
may disturb a clot.
• If the wound is large, or if it is still
bleeding after 30 minutes of pressure,
consult a dentist or doctor.
1Replant tooth
• If an adult tooth is knocked out,
replant it in its socket as soon as
possible and tell the victim to see
a dentist right away.
• If you cannot replant the tooth,
keep it in milk or water until the
victim reaches a dentist or doctor.
• If a baby tooth is knocked out, do
not attempt to replant it.
Damage to a tooth and cuts to the mouth lining, lips, or tongue are common
causes of bleeding from the mouth. The aim of first-aid treatment is to control
severe bleeding; large amounts of blood, if swallowed, can cause vomiting,
while inhalation of blood can cause choking.
TREATING BLEEDING FROM THE MOUTH
Bleeding from the mouth
1 Control bleeding
• Ask the victim to sit
with his head tilted
forward. This
helps the blood to
drain away. Give
him a bowl to
spit into.
• Press a gauze pad
on the wound for up
to 10 minutes to stop
the bleeding.
2 !
2Monitor wound
• If the wound continues to bleed,
take a fresh gauze pad and reapply
pressure for 10 more minutes.
• Encourage the victim to spit out
blood rather than swallow it.
TREATING A KNOCKED-OUT TOOTH
Control bleeding
• If the knocked-out tooth cannot
be found, place a thick gauze pad
across the socket, making sure
that the pad stands higher than the
teeth on either side of the gap.
• Tell the victim to bite on the pad.
Reposition missing adult
tooth in its socket
Press a pad
on the wound
Page 39 of 260
Clean gently
with cotton
BLEEDING FROM THE MOUTH • NOSEBLEED 39
Important
• Do not allow the victim to lie down or tilt
her head back; the blood could trickle
down her throat and cause vomiting.
• If the blood is thin and watery, this indicates a
fractured skull. Seek medical help immediately.
2Assess situation
• After 10 minutes, release the
pressure on the victim’s nose.
• If the bleeding continues when
the pressure is released, pinch
her nose for 10 more minutes.
• If, after 30 minutes, the nose is
still bleeding, take her to the
hospital. Keep her leaning forward.
A nosebleed is most often caused by the rupturing of blood vessels inside the
nostrils. This can happen following a blow to the nose, sneezing or blowing
the nose. Nosebleeds occur more frequently during bouts of cold or flu when
the blood vessels are more fragile. The aims of first-aid treatment for a
nosebleed are to control the bleeding and to comfort the victim. A child,
in particular, may find the sight and smell of the blood upsetting.
TREATING A NOSEBLEED
Nosebleed
1 Control bleeding
• Seat the victim with her head
leaning forward over a bowl.
• Ask her to pinch her nose just
below the bridge and to breathe
through her mouth. If the victim
is a child, pinch it for her.
• Tell her to avoid coughing, spitting,
sniffing, swallowing, or speaking,
since any of these actions could
disturb a blood clot.
!
3Clean victim
• When the bleeding has stopped,
clean the blood away with
lukewarm water, ensuring that the
victim is still leaning forward.
• Tell the victim to rest for a while.
• Advise her not to blow her nose
as it could disturb the blood clots.
Pinch her
nostrils
together for
10 minutes
Tell her to spit
into a bowl
Page 40 of 260
40 FIRST AID
Childbirth is rarely an emergency, since the very nature of labor means that it
usually lasts for hours, therefore there is generally plenty of time to summon
medical help. In the event that you do have to care for a woman who is about to
give birth, however, your aims should be to call for medical help, to support the
woman and keep her calm, and to care for the baby when he or she is born.
TREATING EMERGENCY CHILDBIRTH
Emergency childbirth
3Prepare equipment
• Assemble as many of the following
items as possible: disposable
gloves; face mask or piece of
cotton material; sanitary napkins;
plastic bags; warm water; plastic
sheeting or newspapers; clean
towels; pillows; blankets.
• Wash your hands and nails
thoroughly, even if you will be
wearing disposable gloves.
• Put on a face mask or improvise
one out of clean cotton material.
• Cover whatever surface the mother
is laying on with plastic sheeting or
newspapers. Add a layer of towels
on top for comfort and absorbency.
1Summon help
• Dial 911 or call EMS, telling
the dispatcher the name of the
hospital where the woman is due
to give birth, her expected delivery
date, and any other relevant
information.
2Make woman
comfortable
• Try to make the woman reasonably
comfortable as she copes with the
contractions. She may want to sit
propped up, with her knees drawn
up, or she may prefer to kneel,
with her upper body leaning on
some pillows or folded blankets.
It is best to take the lead from
her as to what is comfortable.
• Encourage her to breathe slowly
during and after the contractions.
Regular breathing should calm her
and help with the pain; it also
gives her something to
concentrate on.
Support her
with pillows
Leaning forwards
from a kneeling
position can help
to reduce back ache
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Page 42 of 260
42 FIRST AID
A convulsion, or major seizure, is the result of an
electrical disturbance in the brain and consists of
muscular spasms and loss of body control. Seizures
that are recurrent usually indicate the brain disorder
epilepsy. The aims of first-aid treatment for major
seizures are to protect the victim from injuring
herself and to summon medical help if necessary.
TREATING MAJOR SEIZURES
Major seizures
SIGNS & SYMPTOMS
• Rigid body with arched
back and clenched jaw
• Eyes rolled upwards
• Convulsive shaking
• Seizure followed by sleep
1Protect victim
• If you see the victim falling at
the beginning of the seizure, try
to prevent injury as she falls.
• Do not move her while she is
having the seizure.
• Loosen the clothing around her
neck and try to protect
her head with something
soft, such as a piece of
folded clothing.
2Monitor victim
• After the seizure, the victim may
fall into a deep sleep. Check her
breathing (p.14), open her airway,
and be prepared to resuscitate her.
• If the victim is breathing, place her
in the recovery position (pp.14–15).
3Summon help
• If you know the victim has
epilepsy, and she only has one
seizure at this time, stay with her
until she has recovered.
• If you are not certain that the
victim is susceptible to epileptic
seizures, dial 911 or call EMS.
• If the victim remains unconscious
for more than 10 minutes or
convulses for more than 5 minutes,
or if she has repeated seizures, dial
911 or call EMS.
• Monitor the victim’s breathing
(p.68 for an adult, p.71 for a
child or baby), pulse (p.68 for
an adult, p.70 for a child
or baby), and level of
consciousness
(p.12)
until help
arrives.
!Important
• Move sharp objects away from the victim.
• Do not use force to restrain the victim.
• Do not put anything in the victim’s mouth.
Protect the
victim’s head
Do not try to restrain the
victim during the seizure
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Page 43 of 260
MAJOR SEIZURES • FEBRILE SEIZURES 43
Important
• Do not use force in an attempt to restrain
the child.
• Do not put anything in the child’s mouth.
2Cool child
• Remove clothing or bedcovers
to cool the child down.
• Working from the head down,
sponge the child’s body all over
with tepid water.
• Do not dry the child; instead,
allow the moisture to evaporate
from her skin.
• Do not let her get too cold.
Seizures that occur in young children as a result
of a very high temperature are known as febrile
seizures. Children under the age of 5 are most likely
to suffer from a seizure, which is alarming to watch
but is rarely dangerous to the child. The aims of first- aid treatment are to lower the child’s temperature,
protect her from injury, and summon medical help.
Febrile seizures
1Protect child
• Place pillows, rolled-up blankets,
towels, or clothing around the
child to help protect her from injury.
• Do not move the victim while she
is having a seizure.
SIGNS & SYMPTOMS
• Arched back, clenched fists,
stiff legs and arms
• Eyes rolled upwards
• Head and body jerking
• High fever
!
3Get help
• Dial 911 or call EMS.
4Monitor victim
• Monitor the child’s temperature
at regular intervals (p.70).
• Give the recommended dose
of acetaminophen liquid when
the seizures have stopped.
• Stop cooling her down as soon
as her temperature reaches a
normal 98.6°F (37°C).
Use rolled-up
towels or pillows
to protect the child
Sponge the child with
tepid water until her
temperature falls
TREATING FEBRILE SEIZURES
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Page 48 of 260
48 FIRST AID
A burn that affects all the layers of the skin or covers
a large area of the body is a severe burn. The aim of
first-aid treatment is to cool down the affected area
rapidly to minimize damage and loss of body fluids,
and therefore reduce the risk of developing shock.
Any burn larger than the palm of the victim’s hand,
whatever the depth, needs hospital treatment.
TREATING SEVERE BURNS
Severe burns
SIGNS & SYMPTOMS
• Skin that is red, brown
and charred, or white
• Blisters
• Unconsciousness
• Clear fluid dripping from skin
• Signs of shock (p.27)
1Put out fire
• If the victim’s clothing is on fire,
force her to the ground and use
a wool or cotton blanket, rug, or
coat to smother the flames (p.182).
• If possible, have someone dial 911
or call EMS for medical help and,
if necessary, the fire department.
2Cool burn
• Immerse the burn in cool water,
douse it with water, or cover it
with cold, wet towels for at least
10 minutes.
• If there is no water, use cold milk
or a canned drink to cool the burn.
5
3Expose injury
• Gently remove any clothing, shoes,
belts, or jewelry near the burn, but
leave anything that is stuck to it.
• Cover the burn with a sterile wound
dressing or clean nonfluffy material.
4Make victim
comfortable
• Lay the victim down, keeping the
burn away from the ground and, if
possible, above heart level.
• Dial 911 or call EMS if help is not
already on the way.
Monitor victim
• Monitor the victim’s breathing
(p.68 for an adult, p.71 for a child
or baby), pulse (p.68 for an adult,
p.70 for a child or baby), and level
of consciousness (p.12) every 10
minutes while waiting for help.
• Watch for signs of shock (p.27).
Important
• Do not apply any ointments to the burn.
• Do not touch the burn or burst any blisters.
• Do not put ice or iced water on the burn.
!
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Page 60 of 260
60 FIRST AID
Having the correct supplies can make a big difference in an emergency, so you
should always keep a selection of essential first-aid materials at home and in
your car. Store the items in a first-aid box or in a similar type of airtight
container in a dry place. The box should be easily accessible in an emergency
but kept away from other medicines and out of reach of children. Ideally,
the box should be small and light enough for you to carry easily. Check and
replenish the first-aid kit regularly so that the contents are kept up to date.
First-aid equipment
Applicator
Bandage
HOME FIRST-AID KIT
TWEEZERS
for removing
splinters
WOUND DRESSING
sterile dressings that
combine bandage and
dressing in one
CREPE ROLLER BANDAGES
for applying pressure to a
wound or to support a
strain or sprain
GAUZE ROLLER
BANDAGES
for holding dressings in
place on any part of the body
TRIANGULAR BANDAGES
for use as a sling to
support and immobilize
an injured limb
ADHESIVE
BANDAGES
for covering small
cuts and scrapes
COLD PACK
for reducing
swelling in sprains
and strains
DISPOSABLE GLOVES
for protection from cross- infection when touching
body fluids
ANTISEPTIC CREAM
used on cuts and scrapes
to help prevent infection
MICROPOROUS TAPE
breathable, low-tack
tape for holding
dressings in place
ANTISEPTIC WIPES
for cleaning wounds
SCISSORS
for cutting dressings
and bandages
SAFETY PINS
for securing bandages
and slings
GAUZE DRESSINGS
light dressings for use
directly on wounds
CALAMINE LOTION
for treating sore and
sunburned skin
TUBULAR BANDAGE
used with a special
applicator to secure
dressings on fingers or toes
FACE SHIELD
for protection from cross- infection when giving
rescue breaths
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Page 61 of 260
FIRST-AID EQUIPMENT 61
2Bandage in place
• Secure the pad in place by winding
the short end of the bandage once
around the dressing and limb.
• Keep hold of the short end and
wind the bandage roll around
the dressing and limb. Continue
winding the bandage until the
pad is completely covered.
APPLYING A WOUND DRESSING
1 Apply dressing pad
• Wash your hands thoroughly and
wear disposable gloves, if available.
• Choose a dressing with a pad that
will cover an area 1 in (2.5 cm)
beyond the edges of the wound.
• Unroll the bandage until the pad
is visible, leaving a short “free”
end on one side of the pad and
a roll of bandage on the other.
• Place the dressing pad directly
on the wound.
1 Apply pressure
• Immediately after bandaging a limb,
check the circulation in the fingers
or toes beyond the bandage.
• Press on a nail or on the skin
until the area turns pale, then
release the pressure. The color
should return immediately.
3Secure bandage
• Tie the ends of the bandage
together over the pad.
• Check the circulation (see below)
and, if necessary, loosen the
bandage and reapply.
• If blood seeps through, apply
another dressing over the top. If it
seeps through the second dressing,
remove both and start again.
3Monitor casualty
• Every 10 minutes, check fingers
or toes for signs of poor circulation
such as pale, cold skin, or numbness.
Loosen the bandage and reapply
if necessary.
CHECKING CIRCULATION
2Loosen bandage
• If the skin color does not return
immediately, the bandage is too
tight and should be loosened.
• Undo a few turns of the bandage.
Wait for the color to return to the
skin, and reapply the bandage more
loosely. Check circulation again.
Hold the
short end
Make turns
with the main
bandage
Page 62 of 260
62 FIRST AID
APPLYING A HAND OR FOOT BANDAGE
1Start at wrist
• Place the end of the bandage on the
underside of the wrist at the base
of the thumb (or ankle for a foot
bandage); secure the end by making
a straight turn around the wrist.
• Bring the bandage diagonally across
the back of the victim’s hand in
the direction of the little finger.
• Take the bandage under and across
the fingers so that the upper edge
touches the index finger about half
way up its length.
2Repeat layers
• Take the bandage diagonally
across the back of the hand, then
around the wrist and back over
the hand towards the little finger.
• Continue, covering two-thirds of the
previous layer with each new turn.
• When the hand is covered, make
two straight turns around the wrist
(or ankle) and secure the bandage.
• Check the circulation in the fingers
and toes beyond the bandage (see
p.61) and loosen it if necessary.
Bring bandage
diagonally
across hand
Leave
fingertips and
thumb free
1 Apply first layer
• Cut a length of tubular gauze
bandage two-and-a-half times the
length of the injured finger or toe.
• Push the gauze on to the applicator,
and gently place the applicator over
the finger.
• Hold the gauze in place at the base
of the finger and pull the applicator
off, leaving a layer of gauze behind.
• Hold the applicator just beyond
the fingertip and twist
it twice.
2Apply second layer
• Push the applicator back over the
injured finger, until the finger is
covered with the rest of the gauze.
• Remove the applicator.
Secure bandage
• Secure the end of the gauze to the
finger with a piece of adhesive tape,
leaving a gap in one place.
• Make sure the bandage is not too
tight. If the victim complains of
pale cold skin, numbness, or an
inability to move the finger or toe,
remove the bandage and hold the
dressing in place by hand.
3
APPLYING A TUBULAR BANDAGE
Page 63 of 260
FIRST-AID EQUIPMENT 63
2Form sling
• Bring the lower half of the bandage
up over the forearm to meet the
other end of the bandage at the
shoulder on the injured side.
• Position the
forearm so
that the hand
is slightly
higher than
the elbow.
TYING AN ARM SLING
1Support arm
• Support the injured arm under
the forearm or ask the victim to
support it with his other arm.
• Pass one end of the bandage under
the victim’s elbow on the injured
limb and pull the bandage across
to the opposite shoulder, so that
the longest edge is parallel with
his uninjured side.
3Secure sling
• Tie a knot at the hollow over the
victim’s collarbone on the injured
side of the body.
• Tuck both ends
of the bandage
under the knot
to act as
padding.
4Secure at elbow
• Fold the point of the bandage
forwards at the elbow and tuck
any loose bandage underneath it.
• Secure the point of the bandage
to the front of the bandage with
a safety pin, or twist the corner
and tuck it into the sling.
• Check the circulation in the fingers
after securing the sling, and again
every 10 minutes (see p.61). If
necessary, remove the sling and
straighten the arm.
Support
forearm
Leave
fingers
exposed
Longest
edge of
bandage
Fold point
forwards
Tie knot over
collarbone
Use safety
pin to
secure
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Page 67 of 260
HOW TO USE THIS SECTION 67
Contact the doctor, day
or night, by telephone.
Dial 911 or call EMS if you
fail to make contact within
1 hour.
It is important that the
symptoms are assessed by
a doctor within 24 hours
of their onset.
The condition may require
medical treatment, but a
reasonable delay is unlikely
to lead to problems.
!
DIAL 911 OR CALL EMS
SEE YOUR DOCTOR
WITHIN 24 HOURS
CALL YOUR DOCTOR NOW
For minor infections, such as a sore throat or runny
nose, use self-help measures, first aid, or over-the- counter remedies to relieve discomfort. Always
consult your doctor if you are unsure whether a
remedy is suitable and read the manufacturer’s
instructions before taking medication.
TRY SELF-HELP MEASURES
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
ACTION PANELS
At the end of every pathway you will find a
possible diagnosis, advice on what to do, and
whether or not you need to seek medical help.
There are five possible levels of attention, ranging
from DIAL 911 OR CALL EMS, for the most serious
conditions, to TRY SELF-HELP MEASURES, for minor
complaints. It is important to note, however,
that even apparently minor complaints should
receive medical attention when they occur in
the elderly or in people who are undergoing
cancer treatment.
SPECIAL BOXES
• Red danger signs and warning
boxes alert you to situations in
which emergency medical help
may save a life. These boxes
highlight advice that applies in
particular medical circumstances.
• Blue information panels tell you
how to gather the information
you need to answer the questions
in the chart.
Danger signs
Dial 911 or call EMS for
the emergency services.
If there is a delay in
obtaining an ambulance,
go to the hospital by car.
HEADACHE 85
W
h
ACTION
CALL YOUR DOCTOR NOW
Acute glaucoma (a
painful, rapid rise
in fluid pressure in the
eye) is a possibility,
particularly if the pain
is around your eye.
Over one or
both temples
Elsewhere
Where is the
pain?
ACTION
CALL YOUR DOCTOR NOW
You may have temporal
arteritis (inflammation
of blood vessels in the
head), particularly if
you are over 50 and
are not feeling well.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
Your symptoms may
be side effects of the
medication.
•Stop taking any over- the-counter medicines
but continue to take
prescribed medication
unless advised to stop
by your doctor.
Have you had
this type of
headache
before?
Yes
No
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
if you cannot identify
a possible cause for
your headache from
this chart.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
A recurrent headache
for which there is no
obvious cause, such
as drinking too much
alcohol, should always
be investigated fully
by your doctor.
Medication
No medication
Are you taking
any medication?
Possible cause not identified
If your symptoms do not suggest a
diagnosis, the chart recommends
that you see a doctor.
Safe alcohol limits
One unit of alcohol equals
half a pint of beer, a small
glass of wine or sherry, or one
measure of hard liquor.
•The maximum
recommended limit for men
is 3 units a day.
•The maximum
recommended limit for
!
!Recurring attacks
of vertigo
If you have been experiencing
attacks of vertigo, it is very
important to avoid certain
activities that are potentially
hazardous to you and to
other people. You should not
climb ladders or steep flights
of stairs, operate machinery,
Checking a red rash
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Page 69 of 260
ASSESSING SYMPTOMS (ADULTS) 69
1Examine yourself
in a mirror
• The best time to check your breasts
is just after your menstrual period.
• Stand in front of a mirror and
look closely for
dimpled skin and
any changes to
your nipple or
to the size or
shape of your
breasts.
2Feel each breast
• Lie down with one arm behind
your head and firmly press each
breast in small circular movements.
• Feel around the entire breast,
armpit area, and nipple.
• If you discover
a lump or any
changes, consult
your doctor.
TESTES: SELF-EXAMINATION
1Look for changes
• The best time to examine your
testes is just after a bath or shower
when the scrotum is relaxed.
• Check the skin of your scrotum
for changes in appearance.
2Feel for lumps
• Feel across the entire surface of
each testis by rolling it slowly
between fingers and thumb.
• Check for lumps and swellings.
• Consult your doctor immediately
if you detect any change in
appearance or texture.
Feel the breast and
up into the armpit
BREASTS: SELF-EXAMINATION
Check whether you are
a healthy weight by using
the graph (right). Trace
a vertical line from your
height and a horizontal
line from your weight.
The point at which the
lines cross is your body
mass index (BMI), which
indicates whether or not
you are within a healthy
range. Being a healthy
weight decreases the
risk of cardiovascular
disease and many other
health problems.
144 146 148 150 152 154 156 158 160 162 164 166 168 170 172 174 176 178 180 182 184 186 188 190 192 194 cm
lb kg
57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 75 in
UNDERWEIGHT
(BMI < 20)
HEALTHY WEIGHT
(BMI 20-25)
OVERWEIGHT
(BMI > 25)
HEIGHT/WEIGHT GRAPH FOR MEN AND WOMEN 210 95
200 90
190 85
180 80
170
75
160
70
150
65
140
60 130
120 55
110 50
100 45
90 40
HEIGHT
WEIGHT
ASSESSING WEIGHT
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Page 71 of 260
ASSESSING SYMPTOMS (CHILDREN) 71
Find your child’s age on the bottom and
follow a vertical line up, then find the
height or weight on the left and follow a
horizontal line across. Mark the point
where the lines cross. The shaded band
shows the normal range of growth, and
the 5th, 50th, and 95th percentile lines
indicate lower, middle, and upper limits
respectively. If your child’s measurements
fall outside the band, see your doctor.
140
120
100
80
60
40
20
70
60
50
40
30
20
10
0
0 1 2 3 4 5 6 7 8 9 10 11 12
lb kg BOYS’ WEIGHT
AGE (years)
95th percentile
50th percentile
5th percentile
140
120
100
80
60
40
20
70
60
50
40
30
20
10
0
0 1 2 3 4 5 6 7 8 9 10 11 12
lb kg GIRLS’ WEIGHT
95th percentile
50th percentile
5th percentile
ASSESSING HEIGHT AND WEIGHT
70
65
60
55
50
45
40
35
30
25
20
180
170
160
150
140
130
120
110
100
90
80
70
60
50
40
0 1 2 3 4 5 6 7 8 9 10 11 12
in cm BOYS’ HEIGHT
AGE (years)
95th percentile
50th percentile
5th percentile
70
65
60
55
50
45
40
35
30
25
20
180
170
160
150
140
130
120
110
100
90
80
70
60
50
40
0 1 2 3 4 5 6 7 8 9 10 11 12
in cm GIRLS’ HEIGHT
AGE (years)
95th percentile
5th percentile
1 Count breaths • Place your hand on the
child’s chest or back so
that you are able to
feel the breaths.
• Count the number of
breaths he or she takes
in 1 minute.
2Assess result
• Compare the child’s breathing rate
with the maximum rate for his or
her age shown in the table below.
• Note the quality of the breathing:
if it is fast or slow, easy or labored.
CHECKING BREATHING RATE
AGE BREATHS PER MINUTE
Under 2 months Maximum of 60 breaths
2–11 months Maximum of 50 breaths
1–5 years Maximum of 40 breaths
Over 5 years Maximum of 30 breaths
AGE (years)
50th percentile
Use your hand to
feel how fast the
baby is breathing
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Page 72 of 260
72
Not feeling well
There may be times when don’t feel well but are
unable to pinpoint a precise symptom. This feeling
is commonly caused by the onset of a minor viral
illness, psychological pressures, or simply an
unhealthy lifestyle. You should always consult
your doctor if the feeling persists because there
may be a more serious underlying problem.
FAMILY ILLNESS
Do you have
a fever – a
temperature of
100.4°F (38°C)
or above?
Fever
No fever
START
ACTION
GO TO ANOTHER CHART
Fever (adults), p.74 or
Fever (children), p.76
Have you lost
more than
10 lb (4.5 kg)
over the past
10 weeks
without
changing your
eating habits?
Lost over 10 lb
(4.5 kg)
Lost under 10 lb
(4.5 kg) or
gained weight
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
There are a number
of possible causes for
rapid weight loss, and
it is important to see
your doctor to rule
out potentially serious
conditions such as
diabetes mellitus.
Do you have
any of the
following?
Feeling
constantly
on edge
Difficulty
sleeping
Inability to
concentrate
or to make
decisions
None of
the above
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
Your symptoms may
be a side effect of the
medication.
•Stop taking any over- the-counter medicines
but continue to take
prescribed medication
unless advised to stop
by your doctor.
Safe alcohol limits
One unit of alcohol equals
half a pint of beer, a small
glass of wine or sherry, or
one measure of hard liquor.
•The maximum
recommended limit for
men is 3 units a day.
•The maximum
recommended limit for
women is 2 units a day.
Medication
No medication
Are you taking
any medication?
Page 73 of 260
NOT FEELING WELL 73
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
if you cannot identify
a possible cause for
not feeling well from
this chart.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
Your symptoms may
be due to an anxiety
disorder or depression.
• Try physical exercise
or some relaxation
techniques (p.169);
they may help to
alleviate the symptoms.
Possibly
pregnant
Not pregnant
Might you be
pregnant?
Are you
feeling more
tired than
usual?
More tired
No change
ACTION
TRY SELF-HELP MEASURES
Body changes that
occur soon after
conception can make
you feel unwell.
Symptoms include
fatigue, feeling faint,
and nausea/vomiting.
• Eat frequent small
meals throughout the
day rather than a few
larger meals. If you
suffer from morning
sickness, eat a snack
before getting up.
• Lie down if you are
feeling faint or tired.
•If you are not sure
whether you are
pregnant, use a home
pregnancy test or
consult your doctor.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
for advice about
reducing the amount
of alcohol you drink.
Regularly drinking too
much alcohol can
make you not feel well.
ACTION
TRY SELF-HELP MEASURES
You may have a mild
digestive upset as a
result of infection or
having eaten something
that disagrees with you.
Your symptoms are not
likely to be dangerous,
but severe diarrhea can
cause dehydration,
particularly in the
elderly or very young.
• Avoid rich or spicy
foods and drink plenty
of clear fluids.
CONSULT YOUR DOCTOR
if you do not feel better
within 2 days or sooner
for a child.
Do you have
any of the
following?
Loss of appetite
Nausea and/or
vomiting
Diarrhea
None of
the above
Within the limit
Do you regularly
drink more
than the
recommended
limit of alcohol
(see box opposite)?
More than
the limit
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
if your fatigue is
persistent or severe and
has no obvious cause.
Page 76 of 260
76
Fever (children)
For adults and children over 12, see p.74
A fever is a temperature of 100.4°F (38°C) or above.
If your child is not feeling well, you should take his
or her temperature because a high fever may need
urgent treatment. If a feverish child becomes
unresponsive, dial 911 or call EMS. In all cases,
follow the advice for bringing down a fever (p.164).
! Danger signs
Dial 911 or call EMS if your
child’s temperature rises
above 102°F (39°C) and he
or she has any of the
following symptoms:
•Abnormally rapid breathing
(see p.71).
•Abnormal drowsiness.
•Severe headache.
•Dislike of bright light.
• Refusal to drink for more
than 6 hours.
FAMILY ILLNESS
Under 6 months
6 months
or over
How old is START your child?
Rash
No rash
Does your
child have
a rash?
ACTION
GO TO ANOTHER CHART
Rash with fever, p.96
ACTION
CALL YOUR DOCTOR NOW
Fever in young babies
is unusual unless it
occurs within 48 hours
of immunization. Fever
may indicate an illness
that could be serious.
Severe
headache
Dislike of
bright light
Neck pain on
bending the
head forwards
None of
the above
Abnormal
drowsiness,
irritability,
or confusion
Does your
child have
any of the
following?
ACTION
!
DIAL 911 OR CALL EMS
Your child may have
meningitis.
• Follow the advice
for bringing down a
fever (p.164).
Is your child
reluctant to
move an
arm or leg?
Yes
No
ACTION
CALL YOUR DOCTOR NOW
Your child could have
an infection in a bone,
such as osteomyelitis,
or a joint infection.
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
Your child may have
acute otitis media
(middle-ear infection).
• Give liquid acet- aminophen to relieve
pain and reduce fever.
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Page 79 of 260
EXCESSIVE SWEATING 79
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
You may have a chronic
infection, such as
tuberculosis, or a cancer,
such as lymphoma
(cancer of the
lymphatic system).
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
for advice about
reducing the amount
of alcohol you drink.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
Your symptoms may
be a side effect of the
medication. •Stop taking any over- the-counter medicines
but continue to take
prescribed medication
unless advised to stop
by your doctor.
ACTION
TRY SELF-HELP MEASURES
Being overweight can
lead to excessive
sweating, particularly
after physical exertion. • Adopt a sensible
weight-reducing diet. • Wash away sweat
regularly and wear
comfortable loose
clothing made from
natural fibers.
CONSULT YOUR DOCTOR
if your symptoms do
not improve.
ACTION
TRY SELF-HELP MEASURES
Excessive sweating of
the hands and feet is a
common problem. • Wash off sweat
regularly and wear
socks made from
natural fibers. Try to
go barefoot whenever
possible.
CONSULT YOUR DOCTOR
if your symptoms do
not improve.
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
if you cannot identify
a possible cause from
this chart.
Medication
No medication
Are you
currently taking
any medication?
Do you regularly
drink more
than the
recommended
limit of alcohol
(see box below)
?
More than
the limit
Within the limit
Overweight
Underweight
Ideal weight
Is your weight
within ideal
limits?
Is the sweating
limited to
certain parts
of the body?
Mainly hands
Mainly feet
Other parts
affected
Safe alcohol limits
One unit of alcohol equals
half a pint of beer, a small
glass of wine or sherry, or
one measure of hard liquor. •The maximum
recommended limit for
men is 3 units a day.
•The maximum
recommended limit for
women is 2 units a day.
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Page 80 of 260
80
Lumps and swellings
Enlarged lymph nodes (glands) are often the cause
of lumps and swellings under the skin, particularly
in the neck, under the arms, or in the groin. These
glands usually become swollen due to an infection.
The swelling subsides shortly after the infection clears
up. If the lumps are painful or if they are persistent
but painless, you should consult your doctor.
! Painless lumps or
swellings
Any painless lump or swelling
that does not disappear
within 2 weeks should be
seen by a doctor. Although
in most cases the cause is not
serious, a painless lump may
be a sign of cancer. Early
treatment can be lifesaving.
FAMILY ILLNESS
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
You may have an
abscess or a boil.
• Relieve pain by
putting a clean cloth
soaked in hot water
on the affected area
for 30 minutes four
times a day.
Rash
No rash
Do you have
a rash?
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
You may be suffering
from infectious
mononucleosis,
especially if you’re
generally not
feeling well.
• Drink plenty of
cool fluids.
• Take acetaminophen
to reduce your fever.
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
A viral infection is
the most likely cause.
Lymphoma (cancer of
the lymphatic system) or
an AIDS-related illness
are also possibilities.
What are the
characteristics
of the lump
or swelling?
Red and painful
Other
START
Are the lumps
or swellings
in more than
one area?
One area only
Several areas
Do you have
a fever – a
temperature of
100.4°F (38°C)
or above?
Fever
No fever
Page 81 of 260
LUMPS AND SWELLINGS 81
Testis
Breast
Sides or back
of neck
Other
Groin
Where is
the lump or
swelling?
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
A number of viral
illnesses can cause
swollen glands and a
rash. Lyme disease (an
infection that causes
a rash and flulike
symptoms) is another
possibility, particularly
if you think you may
have been bitten by a
tick recently.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
if you cannot identify a
possible cause for your
lumps or swellings
from this chart.
ACTION
GO TO ANOTHER CHART
Testes and scrotum
problems, p.151
ACTION
GO TO ANOTHER CHART
Breast problems, p.154
ACTION
GO TO ANOTHER CHART
Sore throat, p.103
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
You may have a hernia.
ACTION
TRY SELF-HELP MEASURES
An injury is likely to
cause some swelling as
a result of damage to
the tissues. An infected
wound or a rash can
also cause nearby
lymph nodes to swell.
•Make sure the
wound is clean and
protect it with a
bandage or dressing.
CONSULT YOUR DOCTOR
if there is any pain,
redness, or pus around
the wound, or if the
swelling persists after
the wound has healed.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
Lymph nodes in the
groin often become
swollen in response
to an infection.
Sore throat
No sore throat
Do you have a
sore throat?
What happens
to the swelling
if you press
on it or if you
lie down?
It disappears
It reduces
in size
No change
Do you have a
recent injury
near the site of
the swelling?
Injury
No injury
Page 82 of 260
82
Feeling faint/passing out
A sensation of dizziness or lightheadedness may
be followed by passing out (loss of consciousness).
The cause is usually lack of food or a reduction in
blood flow to the brain. A brief episode of feeling
faint without other symptoms is not a cause for
alarm, but you should consult your doctor if such
episodes recur or if you have passed out.
! Unconsciousness
If someone remains
unconscious for more than
a minute or so, whatever the
suspected cause, you should
get emergency medical help.
•If you need to leave the
person to call for help,
first lay him or her in the
recovery position (pp.14–15).
•Do not move the person
if you suspect spinal injury.
FAMILY ILLNESS
ACTION
!
DIAL 911 OR CALL EMS
You may have had
a stroke.
ACTION
!
DIAL 911 OR CALL EMS
You may have some
bleeding within the
digestive tract, perhaps
from a stomach ulcer
(an eroded area of the
stomach lining) or
from an inflammation
in the colon.
ACTION
CALL YOUR DOCTOR NOW
You may have had
a mini-stroke.
Bloodstained
vomit
Black, tarry
feces
None of
the above
Red blood in
the feces
Have you
noticed any of
the following?
ACTION
!
DIAL 911 OR CALL EMS
if this is your first
attack. You may have
had a seizure, possibly
due to epilepsy.
CONSULT YOUR DOCTOR
if you have had
previous similar attacks.
Are any of the
symptoms still
present?
Disturbed vision
Confusion
Difficulty
speaking
None of
the above
Numbness,
weakness,
or tingling
Have you had
any of the
following?
Symptoms
present
Symptoms no
longer present
Did any of the
following occur
when you
passed out?
You twitched
uncontrollably
You bit your
tongue
You urinated
None of
the above
START
Page 83 of 260
FEELING FAINT
/PASSING OUT 83
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
if you passed out, or in
the next few days even
if you did not pass out.
The most likely cause
is a temporary drop in
blood pressure due to
a change in position.
ACTION
CALL YOUR DOCTOR NOW
You may have low
blood pressure due to
an irregular heartbeat
or worsening of an
existing heart condition.
ACTION
CALL YOUR DOCTOR NOW
Low blood sugar (which
may be due to excessive
insulin treatment)
could be the cause. • Eat or drink
something sugary now.
You have had
chest pain or
you have a
heart condition
You have had
palpitations
Does either of
the following
apply?
Neither
Do you have
any of the
following?
Shortness
of breath
Paler skin
than normal
Inordinate
fatigue
None of
the above
You have
diabetes
Neither
You had not
eaten for several
hours before
passing out
Does either of
the following
apply?
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
Fainting is common in
early pregnancy. If you
are not sure whether
you are pregnant, do a
home pregnancy test.
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
You may be anemic.
This can be confirmed
by a blood test.
Possibly
pregnant
Not pregnant
Might you be
pregnant?
ACTION
CALL YOUR DOCTOR NOW
if you passed out
and cannot identify
a possible cause from
this chart.
SEE YOUR DOCTOR
WITHIN 24 HOURS
if you cannot identify
a possible cause for
feeling faint.
ACTION
TRY SELF-HELP MEASURES
Sudden shock can lead
to feeling faint or even
passing out. • Rest and ask someone
to stay with you until
you feel better. • Follow the first-aid
advice for treating
fainting (p.53)
CONSULT YOUR DOCTOR
if it happens again.
Did you feel
faint or pass out
immediately
after either of
the following?
Emotional
shock
Getting up
suddenly
Neither
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Page 85 of 260
HEADACHE 85
ACTION
CALL YOUR DOCTOR NOW
You have probably a
migraine, particularly
if any visual problems
occurred before the
headache. However,
the slight chance of a
more serious disorder,
such as a stroke, needs
to be ruled out if this
is your first migraine. • Take an analgesic
and sips of water. • Rest in a darkened,
quiet room until the
pain subsides.
If you have had any
previous attacks, try
to identify and avoid
potential triggers, such
as chocolate.
The pain is felt
chiefly in the
areas above and
below the eyes
Neither
You have recently
had a runny or
stuffy nose
Does either of
the following
apply?
ACTION
CALL YOUR DOCTOR NOW
Acute glaucoma (a
painful, rapid rise
in fluid pressure in the
eye) is a possibility,
particularly if the pain
is around your eye.
Over one or
both temples
Elsewhere
Where is the
pain?
ACTION
CALL YOUR DOCTOR NOW
You may have temporal
arteritis (inflammation
of blood vessels in the
head), particularly if
you are over 50 and
are not feeling well.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
Your symptoms may
be side effects of the
medication. •Stop taking any over- the-counter medicines
but continue to take
prescribed medication
unless advised to stop
by your doctor.
Have you had
this type of
headache
before?
Yes
No
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
if you cannot identify
a possible cause for
your headache from
this chart.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
A recurrent headache
for which there is no
obvious cause, such
as drinking too much
alcohol, should always
be investigated fully
by your doctor.
Medication
No medication
Are you taking
any medication?
Blurred vision
Unchanged
Disturbed in
other ways
How is your
vision?
Page 86 of 260
86
Vertigo
The unpleasant sensation that your surroundings
are moving around you is known as vertigo. It is
often associated with nausea and vomiting. Healthy
people may experience vertigo temporarily after a
ride at an amusement park or after drinking too
much alcohol. You should consult your doctor if
you develop vertigo for no obvious reason.
!Recurring attacks
of vertigo
If you have been experiencing
attacks of vertigo, it is very
important to avoid certain
activities that are potentially
hazardous to you and others.
You should not climb ladders
or steep flights of stairs,
operate machinery, or drive
until the cause of your
symptoms has been
diagnosed and treated.
FAMILY ILLNESS
Have you
experienced
either of the
following?
Nausea or
vomiting
Difficulty
keeping your
balance
Neither
ACTION
!
DIAL 911 OR CALL EMS
You may have had
a stroke.
ACTION
CALL YOUR DOCTOR NOW
You may have had a
mini-stroke.
ACTION
!
DIAL 911 OR CALL EMS
You may have had a
stroke. Your symptoms
may also be caused by
labyrinthitis (inflamed
inner ear).
• You can minimize
the symptoms of
labyrinthitis by lying
down or trying to
move around as little
as possible.
Numbness,
tingling, or
weakness
Confusion
Difficulty
speaking
None of
the above
Disturbed vision
Have you had
any of the
following?
START
Hearing loss
Neither
Ringing in
the ears
Have you
noticed either of
the following?
Symptoms
present
Symptoms no
longer present
Are any of these
symptoms still
present?
Page 87 of 260
VERTIGO 87
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
if you cannot identify a
possible cause for your
vertigo from this chart.
ACTION
CALL YOUR DOCTOR NOW
Your symptoms may
be a side effect of your
medication.
•Stop taking any over- the-counter medicines
but continue to take
prescribed medication
unless advised to stop
by your doctor.
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
You could be suffering
from Ménière’s disease
(a disorder of the inner
ear, which contains
the organs of balance
and hearing).
•Lie still in a darkened
room with your eyes
closed and avoid noise.
Acoustic neuroma
(a noncancerous tumor
of the nerve that
connects the ear to the
brain) is another,
although less likely,
possibility.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
Your vertigo may be
caused by osteoarthritis
affecting the bones
and cartilage of the
upper spine (cervical
spondylosis). This can
cause pressure on the
blood vessels of the
areas of the brain that
affect balance.
•Try to avoid making
any sudden or extreme
head movements.
ACTION
TRY SELF-HELP MEASURES
Your symptoms are
most likely to be
caused by drinking
more alcohol than
usual or drinking on
an empty stomach.
• The effects of
alcohol should wear
off within a few hours.
• Meanwhile, drink
plenty of water.
CONSULT YOUR DOCTOR
if the sensation persists
for more than 12 hours.
50 or over
Under 50
How old
are you?
Yes
No
Have you
been drinking
alcohol?
Medication
No medication
Are you
currently taking
any medication?
Does turning
or raising your
head bring on
vertigo?
Brings on
vertigo
No noticeable
effect
Page 88 of 260
88
Numbness and/or tingling
Almost everyone has experienced numbness, the
loss of sensation in a part of the body, after sitting
or lying in an awkward position for some time.
Tingling, a prickly feeling, often occurs as sensation
returns to a numb area. You should consult this
chart if you experience numbness and/or tingling
for which there is no obvious cause.
!
FAMILY ILLNESS
Did the
numbness
and/or
tingling occur
in either of
the following
circumstances?
After sitting
in one position
for a long time
On waking
from a
deep sleep
Neither
START
ACTION
TRY SELF-HELP MEASURES
Pressure on nerves or
on the blood vessels
that supply them is
the most likely cause.
• Change position and
massage the affected
area. Normal sensation
should return within a
few minutes.
CONSULT YOUR DOCTOR
if the numbness or
tingling feeling persists
for longer than 1 hour.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
You may have cervical
spondylosis (a type of
osteoarthritis that
affects the upper spine).
Danger signs
Dial 911 or call EMS if the
numbness and/or tingling is
accompanied by any of the
following symptoms:
•Feeling faint or passing out.
•Disturbed vision.
•Confusion.
•Difficulty speaking.
•Weakness in a limb.
Hand or arm
Elsewhere
Where is the
numbness
and/or tingling?
No stiff neck
Stiff neck
Numbness and/or
tingling is worse
at night
Neither
Pain shoots
into palm
of hand
Does either of
the following
apply?
Have you
noticed any
stiffness in
your neck?
Page 89 of 260
NUMBNESS AND/OR TINGLNG 89
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
You may be suffering
from Raynaud’s
phenomenon, in which
there is intermittent
narrowing of blood
vessels in the hands or,
rarely, the feet.
• Keep your hands
and/or feet warm.
•If you smoke, stop.
ACTION
CALL YOUR DOCTOR NOW
You may have had a
mini-stroke.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
if you cannot identify
a possible cause for
your numbness and/or
tingling from this chart.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
This type of numbness
is most likely caused
by hand–arm
syndrome, which is
associated with the
long-term use of
vibrating machinery.
• Avoid using
vibrating machinery.
• Keep warm.
•If you smoke, stop.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
You probably have
carpal tunnel syndrome
(tingling and pain in
the hand and forearm
due to a compressed
nerve at the wrist).
• Avoid positions that
worsen the symptoms.
Are the affected
areas on only
one side of
the body?
One side only
Both sides
Feeling faint
or passing out
Confusion
Difficulty
speaking
Weakness
in a limb
None of
the above
Disturbed vision
Have you had
any of the
following
symptoms?
Do your fingers
become numb
and white or
blue in either
of the following
circumstances?
In cold weather
When using
vibrating
machinery
Neither
ACTION
!
DIAL 911 OR CALL EMS
You may have had
a stroke.
Are any
of these
symptoms
still present?
Symptoms
present
Symptoms no
longer present
Page 90 of 260
90 FAMILY ILLNESS
Facial pain
Over one or
both temples
Elsewhere
In or around
the eye
Where is
the pain?
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
You may have
trigeminal neuralgia
(severe pain due to
an irritated nerve).
• Try to avoid triggers
if possible.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
OR DENTIST
You may have a
disorder in the joint
between the jaw and
the skull.
• Take acetaminophen
to relieve the pain.
• Hold a wrapped
heating pad against the
affected area.
ACTION
GO TO ANOTHER CHART
Eye pain or
irritation, p.98
ACTION
CALL YOUR DOCTOR NOW
You may have temporal
arteritis (inflammation
of blood vessels around
the head), especially if
you are over 50.
Stabbing pain
when touching
the face or
chewing
Dull aching
around one
or both
cheekbones
None of
the above
Aching pain
on chewing
and/or yawning
Which of the
following
describes
your pain?
ACTION
TRY SELF-HELP MEASURES
You probably have
sinusitis, especially if
you have recently had
a cold and both sides of
your face are affected.
If only one side is
affected, a dental
problem, such as an
abscess, is more likely.
• Take an analgesic
such as acetaminophen.
• Try inhaling steam
from a bowl of hot
water (p.165) if you
think you have sinusitis.
CONSULT YOUR DOCTOR
OR DENTIST
if you do not feel
better within 2 days.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
if you cannot identify
a possible cause for
your facial pain from
this chart.
START
Pain in the face may be sharp and stabbing or dull
and throbbing, and is most often caused by an
inflammation of structures in the face, such as the
sinuses or teeth. Facial pain is usually short-lived,
but some types, such as neuralgia, may persist.
Consult your doctor if the pain is persistent,
unexplained, or is not relieved by analgesics.
Your scalp is
sensitive to touch
Pain comes on
when chewing
None of
the above
You don’t feel
well
Do any of the
following
apply?
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Page 93 of 260
FORGETFULNESS OR CONFUSION 93
ACTION
CALL YOUR DOCTOR NOW
Lack of oxygen to
the brain caused by
the worsening of an
existing heart or
lung disease may
cause confusion.
ACTION
CALL YOUR DOCTOR NOW
Confusion may indicate
low or very high blood
sugar levels in someone
with diabetes.
• Eat or drink
something sugary now.
Diabetes
mellitus
Lung disease
None of
the above
Heart disease
Do you suffer
from any of
the following?
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
for advice about
reducing the amount
of alcohol you drink.
Drinking too much
alcohol can cause
confusion and, more
seriously, can also lead
to loss of memory.
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
Your symptoms may
be a side effect of
medication or drugs.
•Stop taking any over- the-counter medicines
but continue to take
prescribed medication
unless advised to stop
by your doctor.
Have you been
drinking alcohol
within the past
few hours?
Yes
No
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
These symptoms may
indicate a decline in
mental function due
to a condition such as
dementia. Depression
may also cause
similar symptoms. Personality
change
Reduced
attention to
personal hygiene
Inability
to manage
everyday
problems
None of
the above
Is gradually
increasing
forgetfulness
and confusion
in an elderly
person
accompanied
by any of the
following?
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
if you cannot identify
a possible cause for
your forgetfulness
and/or confusion from
this chart.
Medication
No medication
Are you
currently taking
any medication?
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Page 97 of 260
RASH WITH FEVER 97
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
You may have measles,
which is a potentially
serious illness. • Follow the advice
for bringing down a
fever (p.164).
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
if you cannot identify
a possible cause for
your rash and fever
from this chart.
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
You may have a viral
illness, but scarlet
fever is a possibility. • Follow the advice
for bringing down a
fever (p.164).
Severe
headache
Dislike of
bright light
Neck pain when
bending head
forward
Nausea or
vomiting
None of
the above
Drowsiness
or confusion
Do you have
any of the
following?
Have you
noticed any of
the following
symptoms in the
past few days?
Runny nose
Cough
Red eyes
None of
the above
Yes
No
Do you have
a severe
sore throat?
ACTION
!
DIAL 911 OR CALL EMS
You may have
meningitis (inflamed
membranes around
the brain).
ACTION
CALL YOUR DOCTOR NOW
This type of rash may
be due to a severe
allergic reaction to a
drug such as penicillin.
It could also be the
result of a blood
disorder that causes
bleeding into the skin. •Stop taking any over- the-counter medicines
but continue to take
prescribed medication
unless advised to stop
by your doctor.
Checking a red rash
If you develop a dark red rash,
check if it fades on pressure by
pressing the side of a drinking
glass onto it. If the rash is
visible through the glass, it
may be a form of purpura, a
rash caused by bleeding from
tiny blood vessels in the skin
either because blood vessels
are damaged or because of
an abnormality in the blood.
Purpura can be caused by one
of several serious disorders,
including meningitis, and needs
prompt medical attention. Dial
911 or call EMS if you have a
high fever, severe headache,
or any of the other danger
signs listed opposite.
Page 98 of 260
98
Eye pain or irritation
Injury, infection, and allergy are the most common
causes of discomfort or irritation of the eye and
eyelids. A painless red area in the white of the eye is
likely to be a burst blood vessel and should clear up
without treatment. However, you should see your
doctor if your eyes are sore. Consult your doctor
immediately if your vision deteriorates.
!Contact lens wearers
If you wear contact lenses
and experience any kind of
eye pain or irritation:
• Remove your lenses
without delay.
•Do not use them again
until the problem has been
identified and treated. If the
pain is caused by grit under
the lens, there is a risk that
the cornea will be scratched.
•Make an appointment to
see your ophthalmologist.
FAMILY ILLNESS
ACTION
CALL YOUR DOCTOR NOW
Your pain may be
caused by a minor eye
injury.
• Follow the first-aid
advice for dealing with
eye wounds (p.35).
ACTION
!
DIAL 911 OR CALL EMS
A serious eye injury
is possible. Expert
help may be needed
to prevent permanent
damage to the eye.
ACTION
TRY SELF-HELP MEASURES
A foreign object in
your eye is likely to
cause pain and redness.
• Follow the first-aid
advice for dealing with
a foreign object in the
eye (p.36).
SEEK EMERGENCY HELP
AT THE HOSPITAL
if a foreign object is
embedded in the eye.
ACTION
TRY SELF-HELP MEASURES
You may have a stye
(infected hair follicle)
or a chalazion (infected
gland in the eyelid).
• Hold a clean, warm,
damp cloth on the
eyelid for 20 minutes
several times a day.
CONSULT YOUR DOCTOR
if your eye does not
improve within 3 days.
Pain in and
around the eye
Tender red
lump on the
eyelid
The eye
feels gritty
None of
the above
Itching or
irritation of
the eyelid
What is
the main
symptom?
You have
something in
your eye
You have
injured your eye
Does either of
the following
apply?
Neither
START
Yes
No
Has your vision
deteriorated
since the injury?
Page 99 of 260
EYE PAIN OR IRRITATION 99
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
You may have so-called
cluster headaches or
uveitis (inflammation
of the iris), especially
if the eye is red and/
or watery. • Take an analgesic
such as acetaminophen
to relieve symptoms. • Rest in a quiet,
darkened room.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
if you cannot identify a
possible cause for your
eye pain or irritation
from this chart.
ACTION
CALL YOUR DOCTOR NOW
You may have acute
glaucoma (painful,
rapid rise in fluid
pressure in the eye),
which could damage
vision permanently.
ACTION
TRY SELF-HELP MEASURES
You may have
blepharitis (inflamed
eyelid), especially if
the skin is scaly and
inflamed. • Relieve symptoms by
holding a warm, damp
cloth on the eyelid. •If you have dandruff
too, using an antifungal
shampoo will improve
both conditions.
CONSULT YOUR DOCTOR
if self-help measures
do not help.
Blurred
Not blurred
Is your vision
blurred?
Eyelid turned
inward
Appears normal
Eyelid turned
outward
Is your eyelid
turned inward
or outward?
Watery
discharge
No discharge
Sticky discharge
Is there any
discharge from
the eye?
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
Entropion (turning
inward of the upper or
lower eyelid, or both)
is a possible cause of
your symptoms.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
Ectropion (turning out
of the lower eyelid) is
a possible cause of
your symptoms.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
You probably have
conjunctivitis (inflamed
membrane covering
the eye). • Wipe the discharge
away from your eye
with clean, moist
cotton. • Use artificial tears,
available over the
counter, to relieve
symptoms.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
You may have
keratoconjunctivitis
sicca (dry eye), in
which the eye fails to
produce enough tears. • Use artificial tears,
available over the
counter, to relieve
symptoms.
Page 101 of 260
DISTURBED/IMPAIRED VISION 101
ACTION
!
DIAL 911 OR CALL EMS
You may have
blockage of a blood
vessel that supplies the
brain or eye. Another
possibility is a detached
retina, which needs
prompt treatment.
ACTION
!
DIAL 911 OR CALL EMS
This may be due to
bleeding in the brain,
such as with a stroke
or subarachnoid
hemorrhage (ruptured
artery near the brain).
Another possibility is a
weakness or paralysis
of the muscles that
control the movement
of the eyes, causing
double vision.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR
OPHTHALMOLOGIST
You may be developing
presbyopia (gradual
loss of the eyes’ ability
to focus on near
objects).
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
if you cannot identify
a possible cause for
your disturbed or
impaired vision from
this chart.
ACTION
CALL YOUR DOCTOR NOW
if you cannot identify
a possible cause for
your disturbed or
impaired vision from
this chart.
ACTION
CALL YOUR DOCTOR NOW
You may have a
migraine. However,
the possibility of
another disorder needs
to be ruled out.
• Rest in a darkened
quiet room until
symptoms improve.
•If you also have
a headache, take an
analgesic such as
acetaminophen.
CONSULT YOUR DOCTOR
if you have had
previous migraines.
• Avoid red wine,
chocolate, and mature
cheese – all possible
migraine triggers.
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
Your symptoms may
be a side effect of the
medication.
•Stop taking any over- the-counter medicines
but continue to take
prescribed medication
unless advised to stop
by your doctor.
What is the
nature of your
disturbed or
impaired vision?
Sudden loss of all
or part of the
vision in one or
both eyes
Blurred vision
Seeing flashing
lights or
floating spots
Double vision
None of
the above
Medication
No medication
Are you
currently taking
any medication?
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Page 102 of 260
102 FAMILY ILLNESS
Earache
Pain in one or both ears is a distressing symptom,
especially for children. Earache is usually caused
by an infection in the outer or middle ear. Mild
discomfort, however, may be due to wax blockage.
Consult your doctor if you suffer from earache,
particularly if it is persistent. A severe or recurrent
middle-ear infection may damage hearing.
Does pulling
the earlobe
make the
pain worse?
Increases pain
Pain is no worse
Is there
a discharge
from the
affected ear?
Discharge
No discharge
ACTION
TRY SELF-HELP MEASURES
A cold may often be
accompanied by mild
earache. Persistent or
severe earache is likely
to be due to otitis media
(middle-ear infection).
• Take a decongestant
to relieve stuffiness and
an analgesic, such as
acetaminophen, to
relieve discomfort.
CONSULT YOUR DOCTOR
if the pain is severe
or if it persists for
longer than 2 days.
START
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
Your earache is
probably due to otitis
externa (infection of
the outer ear) or a boil
in the ear canal.
• Take an analgesic
such as acetaminophen.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
if the discomfort
persists for longer than
24 hours. Barotrauma
(ear damage or pain
caused by pressure
changes) may be the
cause of your pain.
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
You may have otitis
media (middle-ear
infection) with a
perforated eardrum;
otitis externa (outer- ear infection) is
another possibility.
• Take an analgesic
such as acetaminophen.
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
if you cannot identify a
possible cause for your
earache from this chart.
Did the pain
start during or
immediately
after an airplane
flight?
During or
immediately
after flight
Unrelated to
air travel
Yes
No
Do you have
a runny or
stuffy nose?
Page 103 of 260
EARACHE • SORE THROAT 103
Sore throat
A raw or rough feeling in the throat is a symptom
that most people have from time to time. A sore
throat is often the first sign of a common cold and is
also a feature of other viral infections. You can treat
a sore throat yourself at home unless you also have
other, more serious symptoms. However, if your
sore throat persists or is severe, consult your doctor.
ACTION
TRY SELF-HELP MEASURES
Activities such as
smoking or breathing
smoke, shouting, and
loud singing are likely to
cause throat irritation.
• Follow the advice
for soothing a sore
throat (p.164).
CONSULT YOUR DOCTOR
if your symptoms
worsen, change, or are
no better in 2 days.
ACTION
TRY SELF-HELP MEASURES
You probably have
a severe cold or flu.
• Follow the advice
for bringing down a
fever (p.164).
CONSULT YOUR DOCTOR
if your symptoms
worsen, change, or are
no better after 2 days.
ACTION
TRY SELF-HELP MEASURES
You may have a cold.
• Follow the advice
for soothing a sore
throat (p.164).
CONSULT YOUR DOCTOR
if you are no better
within 2 days.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
You may have either
tonsillitis or pharyngitis
(inflamed throat).
• Follow the advice
for soothing a sore
throat (p.164).
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
You may be suffering
from infectious
mononucleosis.
Do you have
a fever – a
temperature of
100.4°F (38°C)
or above?
Fever
No fever
Do you have
swelling in your
groin and/or
armpits ?
Yes
No
Before the onset
of your sore
throat, had you
been doing any
of these?
Smoking heavily
or breathing
smoke
Shouting or
singing loudly
None of
the above
START General
aches and pains
Headache
Cough
None of
the above
Runny nose
Do you have
any of these?
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Page 107 of 260
COUGHING (ADULTS) 107
Sputum
No sputum
Have you
coughed up
sputum?
Runny nose
Sore throat
Neither
Do you have
either of the
following?
ACTION
TRY SELF-HELP MEASURES
You may have acute
bronchitis. • Take acetaminophen
to reduce your fever
and chest pain. •Drink plenty of fluids. •If you smoke, stop.
CONSULT YOUR DOCTOR
if your symptoms
worsen or if you are
no better within 2 days.
ACTION
TRY SELF-HELP MEASURES
You may have a viral
illness such as a severe
cold or flu. • Follow the advice
for bringing down a
fever (p.164). • Try inhaling steam
from a bowl of hot
water (p.165) to relieve
your symptoms.
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
if you are no better
in 2 days or if other
symptoms develop.
ACTION
TRY SELF-HELP MEASURES
You probably have a
viral infection, such
as a cold. • Try inhaling steam
from a bowl of hot
water (p.165) to relieve
your symptoms.
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
if you are no better
in 2 days or if other
symptoms develop.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
Asthma or possibly
heart failure may be
the cause of your
symptoms. •If you smoke, stop.
ACTION
TRY SELF-HELP MEASURES
Smoke can irritate
the lungs. • Move into a well- ventilated area.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
You may have chronic
lung damage from
smoking or possibly
lung cancer. •Stop smoking.
Pain on
breathing
Neither
Shortness
of breath
Do you have
either of the
following?
ACTION
CALL YOUR DOCTOR NOW
You may have
pneumonia. •Take acetaminophen
to help reduce your
fever and pain.
ACTION
CALL YOUR DOCTOR NOW
Inflammation of the
airways can result
from breathing in any
of these substances.
Have you
inhaled any of
these in the last
few hours?
Particle of food
Tobacco smoke
Dust, fumes, or
smoke from a fire
None of
the above
Page 108 of 260
108
Coughing (children)
For adults and children over 12, see p.106
Coughing is a normal reaction to irritation in the
throat or lungs. Most coughs are due to minor
infections of the nose and/or throat, but a sudden
onset of coughing may be caused by choking.
Coughing is unusual in babies less than 6 months
old and may indicate a serious lung infection.
! Danger signs
Dial 911 or call EMS if your
child is coughing and has any
of the following symptoms:
• Blue-tinged lips or tongue.
•Abnormal drowsiness.
•Inability to produce sounds.
•Inability to drink.
•Excessively rapid breathing.
FAMILY ILLNESS
Started
suddenly a few
minutes ago
Started more
than a few
minutes ago
How long has
your child been
coughing?
START
ACTION
TRY SELF-HELP MEASURES
An inhaled object may
be the cause of the
coughing. Follow the
first-aid advice for
choking (pp.22–24).
!
DIAL 911 OR CALL EMS
if the object is not
dislodged immediately.
Under 6 months
6 months
or over
How old is
your child? ACTION
CALL YOUR DOCTOR NOW
Your baby may have
a serious lung infection
such as bronchiolitis
(inflamed small
airways in the lungs).
• Keep your baby
sitting up, if possible
in a steamy bathroom.
ACTION
GO TO ANOTHER CHART
Breathing problems
(children), p.112
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
Your child may
have pertussis
(whooping cough).
Does the cough
have either
of these
characteristics?
Comes in fits
ending with
a whoop
Is accompanied
by vomiting
Neither
Is it possible that
your child is
choking on food
or a small object?
Possible
Unlikely
Is your child’s
breathing
abnormally
rapid or noisy
(see p.71)?
Abnormally
rapid
Noisy
Neither
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Page 109 of 260
COUGHING (CHILDREN) 109
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
if you cannot identify
a possible cause for
your child’s cough
from this chart.
ACTION
TRY SELF-HELP MEASURES
Your child’s cough
may be a response
to being in a smoky
atmosphere or to his
or her own smoking. • Make sure that no
one smokes in the
house and avoid
taking your child into
a smoky atmosphere. •If you suspect that
your child may be
smoking, encourage
him or her to stop.
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
Your child’s symptoms
may be due to asthma. • Discourage your
child from activities
that provoke coughing. • Avoid unnecessary
exposure to dust,
pollen, or animal fur.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
Your child may have
an allergy or possibly
enlarged adenoids.
Most of the time
or very often
No runny nose
Has developed
a runny nose
within the past
few days
Does your
child have a
runny nose?
Mainly at night
When out in
the cold
None of
the above
After exercise
When does
the coughing
occur?
Does your child
have a fever –
a temperature
of 100.4°F (38°C)
or above?
Fever
No fever
Are there
smokers in the
home or might
your child have
been smoking?
Smokers in
the home
Child might
smoke
Neither
ACTION
TRY SELF-HELP MEASURES
Your child probably
has a viral illness, such
as a cold or flu. • Follow the advice
for bringing down a
fever (p.164). •Try inhaling steam
from a bowl of hot
water (p.165) or sitting
in a steamy bathroom.
CONSULT YOUR DOCTOR
if symptoms worsen, if
your child is no better
in 2 days, or if other
symptoms develop.
ACTION
TRY SELF-HELP MEASURES
Your child probably
has a cold. •Try inhaling steam
from a bowl of hot
water (p.165) or sitting
in a steamy bathroom.
CONSULT YOUR DOCTOR
if symptoms worsen, if
your child is no better
in 2 days, or if other
symptoms develop.
Page 110 of 260
110
Shortness of breath (adults)
For children under 12, see p.112
Feeling short of breath is to be expected after strenuous
exercise. Breathing should return to normal after
resting. If you are short of breath at rest or following
normal activities, such as getting dressed, you
should consult your doctor because your symptom
may be due to a serious heart or lung disorder.
! Danger signs
Dial 911 or call EMS if either
you or someone you are
with has one or both of
the following symptoms:
•Sudden and severe
shortness of breath.
• Blue-tinged lips.
While waiting for medical
help, loosen any restricting
clothing and help the
person sit upright.
FAMILY ILLNESS
Painful
Not painful
Is breathing START painful?
Wheezing
No wheezing
Have you been
wheezing?
Gradually,
over a few days
or longer
Suddenly,
within the past
48 hours
How quickly did
the shortness of
breath start?
ACTION
GO TO ANOTHER CHART
Wheezing, p.114
ACTION
!
DIAL 911 OR CALL EMS
You may have a
pulmonary embolism
(blood clot in the lung).
ACTION
GO TO ANOTHER CHART
Chest pain, p.134
Swollen ankles
Neither
Cough with
sputum on
most days
Do you have
either of the
following?
Do any of the
following
apply?
You have recently
been immobile
due to injury or
a long trip
You have had a
baby within the
past 2 weeks
None of
the above
You have recently
had surgery Waking at
night feeling
breathless
Frothy pink or
white sputum
Temperature
of 100.4°F
(38°C) or above
None of
the above
Do you have
any of the
following?
There was a problem loading this page.
Page 112 of 260
112
Breathing problems (children)
For adults and children over 12, see p.110
Noisy or rapid breathing and shortness of breath
indicate breathing problems. Such problems may
not be obvious in children, who may simply avoid
exertion. A child with severe difficulty breathing
needs urgent hospital treatment. Breathing problems
that occur suddenly also need immediate attention.
! Danger signs
Dial 911 or call EMS if your
child’s breathing rate is
excessively rapid (see advice
on checking your child’s
breathing rate, p.71) and
if breathing problems are
accompanied by any of the
following symptoms:
• Blue-tinged lips or tongue.
•Abnormal drowsiness.
•Inability to swallow, talk,
or produce sounds.
FAMILY ILLNESS
How long has
your child had
breathing
problems?
Started
suddenly, a few
minutes ago
Started more
than a few
minutes ago
START
Is it possible
that your child
is choking on
food or a small
object?
Possible
Unlikely
Are any of the
danger signs
listed in the
box above
present?
Danger signs
present
No danger signs
ACTION
!
DIAL 911 OR CALL EMS
Your child may have
a serious respiratory
problem.
•If your child stops
breathing, follow the
first-aid advice for
giving rescue breaths
(pp.16–17).
ACTION
TRY SELF-HELP MEASURES
An inhaled object may
be causing difficulty
breathing. Follow the
first-aid advice for
choking (pp.22–24).
!
DIAL 911 OR CALL EMS
if object is not
dislodged immediately.
ACTION
CALL YOUR DOCTOR NOW
The cause of these
symptoms could be a
serious lung infection
such as bronchiolitis
(inflamed small
airways in the lungs).
• Keep your baby
sitting up, if possible
in a steamy bathroom.
Under 6 months
6 months
or over
How old is
your child?
There was a problem loading this page.
Page 113 of 260
BREATHING PROBLEMS (CHILDREN) 113
ACTION
CALL YOUR DOCTOR NOW
Your child may have a
lung infection, such as
pneumonia. Another
possible cause is
bronchiolitis (inflamed
small airways in the
lungs), particularly
in young children.
• Give your child
liquid acetaminophen
to reduce fever.
• Offer frequent drinks.
•Increase the humidity
in your child’s room by
putting a bowl of water
near a radiator.
ACTION
CALL YOUR DOCTOR NOW
These symptoms may
be due to croup
(inflammation of the
windpipe).
•Sit with your child
in a steamy bathroom
to relieve breathing
difficulties.
• Encourage your child
to drink plenty of fluids.
• Ensure that your
child sits quietly and
avoids exertion.
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
Your child may have
developed asthma.
• Keep your child
rested and warm.
• Minimize contact
with any possible
triggers, such as dust,
pollen, or animal fur.
• Avoid exposing your
child to smoke.
• Avoid using perfume
and air fresheners.
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
if you cannot identify
a possible cause for
the breathing problems
from this chart.
Noisy breathing
Shortness
of breath
None of
the above
Barking cough
Does your child
have any of
the following?
Does your child
have a fever –
a temperature
of 100.4°F (38°C)
or above?
Fever
No fever
Does your
child suffer
from repeated
episodes of
any of the
following?
Wheezing
Coughing
at night
Coughing after
exercise
Coughing after
going out in
the cold
None of
the above
There was a problem loading this page.
Page 114 of 260
114 FAMILY ILLNESS
Wheezing
For children under 12, see p.112
A whistling or rasping sound on exhaling occurs
when the air passages become narrowed. The most
common causes are inflammation due to infection,
asthma, or inhaled dust. In rare cases, a narrowing
of the airways may be due to a tumor. If you have
persistent wheezing, you should see your doctor.
Most days
Seldom
or never
Do you cough
up sputum?
Short of breath
Not short
of breath
Are you short
of breath?
Has the
wheezing come
on suddenly
within the past
few hours or
gradually over
days or weeks?
Sudden onset
Gradual onset
START
Frothy pink or
white sputum
Waking at
night feeling
breathless
Neither
Do you have
either of the
following?
ACTION
CALL YOUR DOCTOR NOW
There is a possibility
of fluid on the lungs
caused by heart failure.
ACTION
CALL YOUR DOCTOR NOW
You could be having
an asthma attack.
•If you have a reliever
inhaler, use it now.
•Stay calm and sit in
a comfortable position.
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
You may be having
a mild asthma attack.
• Use a reliever drug
if you have one.
• Try to avoid polluted
or smoky atmospheres.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
Your symptoms may
be caused by chronic
bronchitis or lung
damage from smoking.
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
if you cannot identify a
possible cause for your
wheezing from this chart.
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
You may have acute
bronchitis.
• Take acetaminophen
to reduce your fever.
•If you smoke, stop.
Do you have
a fever – a
temperature of
100.4°F (38°C)
or above?
Fever
No fever
Page 115 of 260
WHEEZING • DIFFICULTY SWALLOWING 115
Difficulty swallowing
Any difficulty swallowing is usually the result of a
sore throat due to infection. Self-treatment should
ease the soreness and allow normal swallowing.
However, persistent difficulty swallowing may be
due to a disorder of the stomach or esophagus, the
tube connecting the throat to the stomach, and
should be investigated by your doctor.
ACTION
CALL YOUR DOCTOR NOW
Something may have
either scratched your
throat or become
lodged in it.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
Anxiety disorders
may be a cause of
this type of difficulty
swallowing.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
You probably have an
inflamed esophagus
due to acid reflux.
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
You may have a
narrowed esophagus
caused by acid reflux,
but cancer of the
esophagus is possible.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
if you cannot identify a
possible cause for your
difficulty swallowing
from this chart.
Sore
Not sore
Is your START throat sore?
Is it possible
that you have
swallowed
something
sharp, such as
a fish bone?
Possible
Unlikely
Do you get a
burning pain
in the center
of the chest in
either of these
situations?
When you
bend forward
When you
lie down
Neither
Food seems to
stick high up in
the chest
Neither
You have
a feeling of
something being
stuck in the throat
Which of the
following
applies?
ACTION
GO TO ANOTHER CHART
Sore throat, p.103
The difficulty
swallowing is
getting worse
Neither
You have
lost weight
Does either of
the following
apply?
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Page 116 of 260
116
Vomiting (adults)
For children under 12, see p.118
Irritation or inflammation of the digestive tract is the
most common cause of vomiting. But vomiting may
also be triggered by conditions affecting the brain
or by an inner-ear disorder, or it can be a side effect
of medication. If you suffer from frequent episodes
of vomiting, you should consult your doctor.
! Danger signs
Dial 911 or call EMS if your
vomit contains blood, which
may appear in any of the
following forms:
• Bright red streaks.
• Black material that
resembles coffee grounds.
• Blood clots.
FAMILY ILLNESS
Have you
suffered from
other episodes
of vomiting?
Previous
episodes
Single episode
Severe pain
No pain
Mild pain
Do you have
pain in the
abdomen?
ACTION
CALL YOUR DOCTOR NOW
You could have a
serious abdominal
condition, such as
appendicitis.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
You may have a
digestive tract disorder.
Eye pain
No eye pain
Do you have
pain in or
around an eye?
ACTION
CALL YOUR DOCTOR NOW
You may have acute
glaucoma (a painful,
rapid rise in fluid
pressure in the eye),
especially if your
vision is also blurred.
ACTION
!
DIAL 911 OR CALL EMS
You may have had a
stroke. Your symptoms
may also be caused by
labyrinthitis (inflamed
inner ear).
• You can minimize
the symptoms of
labyrinthitis by lying
down or moving as
little as possible.
Headache
No headache
Do you have
a headache?
Temperature of
100.4°F (38°C)
or above
Dizziness
None of
the above
Diarrhea
Do you have
any of the
following?
START
Page 118 of 260
118
Vomiting (children)
For adults and children over 12, see p.116
Children vomit as a result of many illnesses,
including ear infections and urinary and digestive
tract disorders. Anxiety or excitement may also
cause vomiting. Rarely, vomiting may be due to
an infection or injury to the brain. If vomiting is
persistent, consult your child’s doctor urgently.
! Danger signs
Dial 911 or call EMS if
your child’s vomiting is
accompanied by any of
the following symptoms:
•Greenish yellow vomit.
•Abdominal pain for 4 hours.
•Flat, dark-red or purple
spots on skin that do not
fade when pressed.
• Refusal to drink or feed
(in babies) for over 6 hours.
•Abnormal drowsiness.
•Sunken eyes.
•Dry tongue.
•Not urinating during
the day for 3 hours (if child
is under 1 year old) or 6
hours (in an older child).
• Black or bloodstained feces.
FAMILY ILLNESS
Head injury
No head injury
Has your child
had a recent
head injury?
Severe
headache
Dislike of
bright light
Pain when
bending neck
None of
the above
Drowsiness
or confusion
Does your child
have any of
the following?
ACTION
!
DIAL 911 OR CALL EMS
Your child may have
meningitis (inflamed
membranes around
the brain).
ACTION
!
DIAL 911 OR CALL EMS
Your child may have
a concussion.
• Do not allow your
child to eat or drink.
ACTION
CALL YOUR CHILD’S
DOCTOR NOW
These symptoms may
indicate a serious
abdominal condition. ACTION
CALL YOUR CHILD’S
DOCTOR NOW
These symptoms may
have numerous causes.
However, any infant
under 3 months who
does not seem well and
vomits needs prompt
medical attention.
Under 3 months
3 months
or over
How old is
your child?
Yes
No
Does your child
seem to have
abdominal pain?
START
Apart from the
vomiting, is your
baby generally
not well, i.e.
feverish or
drowsy?
Not well
Well
Page 119 of 260
VOMITING (CHILDREN) 119
ACTION
CALL YOUR CHILD’S
DOCTOR NOW Your
child may have a lung
infection such as
pertussis, bronchiolitis,
or pneumonia.
ACTION
BRING YOUR CHILD TO
THE DOCTOR WITHIN
24 HOURS This type of
vomiting in an infant
may be the result of a
digestive tract problem,
such as pyloric stenosis,
in which the stomach
outlet becomes
abnormally narrowed.
ACTION
BRING YOUR CHILD TO
THE DOCTOR WITHIN 24
HOURS He may have a
urinary tract infection. • Give plenty of fluids
to drink.
ACTION
BRING YOUR CHILD TO
THE DOCTOR WITHIN
24 HOURS Your child
may have an infection
such as acute otitis
media (an infection of
the middle ear) or a
urinary tract infection. • Give liquid
acetaminophen to
relieve pain and fever.
ACTION
BRING YOUR CHILD TO
THE DOCTOR WITHIN
24 HOURS if you cannot
identify a cause for
your child’s vomiting
from this chart.
ACTION
TRY SELF-HELP MEASURES
Babies often vomit for
no particular reason. It
is no cause for concern
if the baby seems well
and is gaining weight. • Be sure to burp your
baby after each feeding.
CONSULT YOUR CHILD’S
DOCTOR if your baby
seems sick or vomits
frequently.
ACTION
TRY SELF-HELP MEASURES
This type of vomiting
is rarely serious and has
several possible causes. •Always burp your
baby after feeding.
CONSULT YOUR CHILD’S
DOCTOR if your infant
does not seem well or
is failing to gain weight.
ACTION
CALL YOUR CHILD’S
DOCTOR NOW if your
child is under 6 months
old. He may have a
case of gastroenteritis. • Make sure older
children drink plenty
of clear fluids.
CONSULT YOUR CHILD’S
DOCTOR if your child is
no better within 24
hours or if any other
symptoms develop.
Diarrhea
No diarrhea
Does your
child have
diarrhea?
Pain when
urinating
Temperature
of 100.4°F
(38°C) or above
None of
the above
Renewed
bedwetting
or daytime
“accidents”
Does your child
have any of
the following?
Followed
coughing
No coughing
Did vomiting
follow violent
coughing?
Frequent and
effortless after
feeding
Occasional, not
associated with
feeding
Forceful after
several feedings
What are the
characteristics of
the vomiting?
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Page 121 of 260
ABDOMINAL PAIN (ADULTS) 121
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
You may have cystitis
or a urine infection
that has spread to one
or both kidneys. • For both conditions,
take an analgesic such
as acetaminophen. • Drink 1 pint
(500 ml) of fluid
every hour for 4 hours. • Drinking cranberry
juice may relieve the
burning sensation.
ACTION
GO TO ANOTHER CHART
Chest pain, p.134
ACTION
GO TO ANOTHER CHART
Abdominal pain
(women), p.122
ACTION
CALL YOUR DOCTOR NOW
You may have kidney
stones, especially if you
have been vomiting. • Drink plenty of
fluids to flush the
stones into the urine. •Save any urine you
pass, particularly if
you pass a stone. • Take acetaminophen
to relieve discomfort.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
You may have
nonulcer dyspepsia (a
recurrent and persistent
form of indigestion) or
gastroesophageal
reflux, in which acid
from the stomach is
regurgitated into the
esophagus. • Eat small meals at
regular intervals. • Avoid eating shortly
before going to bed. •Reduce your intake of
alcohol, coffee, and tea. •If you smoke, stop.
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
if you cannot identify
a possible cause for
your abdominal pain
from this chart.
Pain is related
to eating
Pain comes on
when lying or
bending over
None of
the above
Pain is relieved
by antacids
Do any of the
following
apply?
Pain when
urinating
Neither
Urinating more
often than
usual
Do you have
either of the
following?
Female
Male
Are you
female or
male?
What kind of
pain have
you been
experiencing?
Pain that starts
in the back and
may move to
the groin
Pain in the
center of the
upper abdomen
Pain in the
upper right
abdomen that
may spread to
the back
Pain mainly
below the waist
None of
the above
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Page 122 of 260
122
Abdominal pain (women)
First refer to abdominal pain, p.120
Several disorders specific to women can cause
discomfort or pain in the lower abdomen. Many of
these conditions are related to the reproductive tract
(ovaries, uterus, or fallopian tubes) or to pregnancy.
Abdominal pain that occurs during pregnancy
should always be taken seriously.
! Abdominal pain
during pregnancy
Intermittent, mild abdominal
pains are common throughout
pregnancy due to stretching
of the muscles and ligaments
of the abdomen. Abdominal
pain that occurs in early
pregnancy can be due to
complications, such as
miscarriage or an ectopic
pregnancy. In later pregnancy,
pain is most commonly caused
by the onset of labor. Rarely,
partial separation of the
placenta from the wall of
the uterus may occur.
•If you develop severe pain,
call your doctor at once.
FAMILY ILLNESS
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
You may have cystitis.
• Take an analgesic
such as acetaminophen.
• Drink 1 pint
(500 ml) of fluid every
hour for 4 hours.
• Drinking cranberry
juice may help relieve
the burning sensation.
ACTION
CALL YOUR DOCTOR NOW
You could be having
a late miscarriage or
placental abruption
(separation of the
placenta from the
wall of the uterus).
• Rest in bed until you
receive medical advice.
ACTION
CALL YOUR DOCTOR NOW
Pain at this stage may
indicate a threatened
miscarriage or an
ectopic pregnancy.
• Rest in bed until you
receive medical advice.
More than 14
weeks pregnant
Do not
think so
Less than 14
weeks pregnant
Are you
pregnant?
Yes
No
START
Have you
had sexual
intercourse
in the past
3 months?
Yes
No
Did your last
menstrual period
occur at the time
you expected?
On time
Missed or late
Do you have
pain when you
urinate?
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Page 156 of 260
Are your
menstrual
periods more
painful than
usual?
No worse
than usual
Worse
than usual
Have you had an
unusual vaginal
discharge
between periods?
No discharge
Discharge
Do you have
an intrauterine
contraceptive
device (IUD)?
IUD
No IUD
Have your
menstrual periods
become heavier
or longer?
Heavier
Longer
Neither
156 FAMILY ILLNESS
Menstrual period pain
Many women experience mild cramping pain in the
lower abdomen during menstruation. This pain is
considered normal unless it interferes with everyday
activities; it can usually be relieved by an analgesic.
If you regularly have severe pain or if your periods
become unusually painful, consult your doctor to
rule out the possibility of infection or disorder.
START
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
You could have pelvic
inflammatory disease,
which causes infection
in the reproductive
organs.
ACTION
TRY SELF-HELP MEASURES
Some pain experienced
during your menstrual
period is quite normal.
• Take an analgesic
such as ibuprofen.
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
if pain interferes with
normal activities.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
An increase in
menstrual pain is a side
effect of some IUDs.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
You may have fibroids
(noncancerous tumors
in the uterus) or
endometriosis. This is
a condition in which
the tissue that usually
lines the uterus
becomes attached to
other organs in the
abdomen and bleeds
during menstruation.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
if you cannot identify
a possible cause for
your menstrual pain
from this chart.
Lower abdominal
pain between
menstrual periods
Fever
None of
the above
Lower back pain
between periods
Have you had
any of the
following?
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Page 157 of 260
Are your
menstrual
periods more
painful than
usual?
More painful
The same or
less painful
Are your
menstrual
periods heavier
or longer than
usual?
About the same
Heavier
or longer
Do you have
an intrauterine
contraceptive
device (IUD)?
IUD
No IUD
Have you had a
single heavy
menstrual period
that was later
than usual?
Yes
No
MENSTRUAL PERIOD PAIN• HEAVY MENSTRUAL PERIODS 157
Heavy menstrual periods
If you bleed between periods, see p.158
Some women lose more blood than others during
their menstrual periods. If normal sanitary protection
is not sufficient, if bleeding lasts longer than 5 days,
or if you notice that you are passing blood clots, the
bleeding is probably excessive. If you are concerned
about heavy menstrual periods, consult your doctor.
START
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
Some women regularly
have heavy menstrual
periods, sometimes
accompanied by pain
in the lower abdomen.
However, the loss of
significant quantities
of iron through heavy
bleeding could make
you susceptible to iron- deficiency anemia.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
Some IUDs can cause
menstrual periods to be
heavier than normal.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
if you cannot identify
a possible cause for
your heavy menstrual
periods from this chart.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
Heavy, painful periods
may be an indication
that you have fibroids
(noncancerous tumors
in the uterus) or
endometriosis, which
causes the tissue that
usually lines the uterus
to become attached to
other organs in the
abdomen and bleed
during menstruation.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
if you are concerned
about the cause of
your late period. Late
periods may be heavier
than usual. However, if
you are sexually active
there is a possibility
that you have had an
early miscarriage.
Page 158 of 260
158
Abnormal vaginal bleeding
Vaginal bleeding is considered abnormal if it occurs
outside the normal menstrual cycle, during pregnancy,
or after menopause. Although there is often a simple
explanation, you should always see your doctor if
you have any abnormal vaginal bleeding. If you
are pregnant and you notice bleeding, you should
consult your doctor immediately.
!Bleeding in
pregnancy
If you have any vaginal
bleeding during pregnancy,
you should contact your
doctor immediately. If the
bleeding is heavy, dial 911
or call EMS. Although some
causes of bleeding are not
serious, it is important to rule
out miscarriage or problems
such as a low-lying placenta
or partial separation of the
placenta from the wall of
the uterus.
FAMILY ILLNESS
More than 14
weeks pregnant
Not pregnant
Less than 14
weeks pregnant
Are you
pregnant?
Do you have
unusual pain
in the lower
back or
abdomen?
Lower
back pain
Abdominal pain
Neither
START
ACTION
CALL YOUR DOCTOR
IMMEDIATELY
Bleeding at this stage
of pregnancy could be
due to a problem with
the placenta (see box
above right).
• Rest in bed until you
receive medical advice.
ACTION
CALL YOUR DOCTOR
IMMEDIATELY
You may be having a
miscarriage or you
could have an ectopic
pregnancy.
• Rest in bed until you
receive medical advice.
ACTION
CALL YOUR DOCTOR
IMMEDIATELY
Bleeding at this stage
of pregnancy could be
the first sign of a
threatened miscarriage.
• Rest in bed until you
receive medical advice.
Is the bleeding
similar to
that of a
normal period?
Like a period
Different
How long
has it been
since your last
menstrual
period?
Less than
6 months
More than
6 months
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Page 160 of 260
160 FAMILY ILLNESS
Vaginal discharge
If the discharge contains blood, see p.158
A thin, clear or whitish discharge from the vagina
is normal. This discharge will vary in consistency
and quantity with the stage of the menstrual cycle,
during sexual arousal, and during pregnancy. An
abnormal discharge is usually caused by infection
and should be investigated by your doctor.
Thick and white
Normal
appearance but
heavier than usual
Greenish yellow
What are the
characteristics of
your discharge?
None of
the above
ACTION
SEE YOUR DOCTOR
WITHIN 24 HOURS
You could have pelvic
inflammatory disease
(an infection of the
reproductive organs).
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
if you cannot identify
a possible cause for
your discharge from
this chart.
ACTION
TRY SELF-HELP MEASURES
You may have thrush,
particularly if you also
have genital irritation.
•If you have had these
symptoms before, try
an over-the-counter
product recommended
by a pharmacist.
CONSULT YOUR DOCTOR
if this is the first time
you have had these
symptoms.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
or go to a clinic that
specializes in sexually
transmitted diseases.
You may have a
vaginal infection such
as bacterial vaginosis.
ACTION
CONSULT YOUR DOCTOR
if you are concerned
or if you develop
genital irritation. These
forms of contraception
sometimes cause an
increase in normal
vaginal secretions.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
if you are concerned or
if you develop genital
irritation. Increased
vaginal secretion is
normal in pregnancy.
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR
Cervical erosion, which
causes fragile tissue to
form on the surface of
the cervix, may be the
cause of your discharge.
Fever
Neither
Lower
abdominal pain
Do you have
either of the
following?
You are taking
oral contraceptives
You are
pregnant
None of
the above
You have
an IUD
Do any of the
following
apply?
START
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Page 163 of 260
COMPLEMENTARY REMEDIES
HOME MEDICINE CHEST 163
• Take homeopathic pilules no less
than 30 minutes before or after food,
and avoid drinking coffee and eating
strongly flavored foods during a
course of medication.
• Ensure that only the person taking
the homeopathic remedy touches it;
otherwise, it may lose its potency.
• Keep the remedies away from any
other medications and strong smells.
USING CONVENTIONAL MEDICINES
• Never give your own prescribed
medicines to another person, even
if you think that his or her
symptoms are similar to yours.
• Do not use any medicine that is past
its sell-by date or that shows signs of
deterioration. Dispose of out-of-date
medicine by flushing it down the toilet
or returning it to the pharmacist.
• Complete the whole course of any
prescribed medication, even if your
symptoms have disappeared.
USING COMPLEMENTARY REMEDIES
ALLIUM
This is a standard
homeopathic
remedy for hay
fever
NUX VOMICA
This homeopathic
remedy treats
indigestion and
upset stomachs
GRAPHITES
This homeopathic
remedy is used to
relieve eczema
and dermatitis
ARNICA CREAM
This homeopathic
remedy aids the
healing of bruises
and sprains
CHAMOMILE
This homeopathic remedy
soothes teething pains
and treats stress, nausea,
and vomiting
• Take herbal remedies for short
periods only, because the effects of
long-term use are not yet known.
• Avoid complementary medicines if
you are pregnant or breastfeeding.
• Some remedies may interact with
conventional medicines; consult your
doctor before taking them.
• If you have any doubts, consult a
homeopath or herbalist for advice.
• Do not stop taking a prescription
medicine unless advised to do so
by your doctor.
• Never give a child more than the
stated children’s dose of a medicine,
and do not give a child even a small
amount of a drug that is intended
only for adults, unless advised to
do so by a doctor.
• Tell your doctor if you have taken
or are taking any homeopathic or
herbal remedies.
ECHINACEA
Use this herb to protect
against infection and to
relieve the symptoms of
colds, coughs, and flu
LAVENDER OIL
This aromatherapy oil
eases headaches and
aids relaxation
VALERIAN
This herbal remedy
aids relaxation and
induces sleep
GARLIC
Garlic is a herbal remedy
that wards off infection
and maintains a healthy
heart and circulation
Page 164 of 260
164 FAMILY ILLNESS
2Relieve fever
• Drink plenty of cool fluids.
• Reduce temperature and relieve
discomfort with an over-the-counter
analgesic such as acetaminophen.
• Give babies over 3 months of age
and children under 12 years liquid
acetaminophen (not aspirin).
• Cool young children by removing
most of their clothing, wiping
them with a washcloth moistened
with tepid water, and fanning them,
but do not let them get too cold.
• Children under 5 years old
are susceptible to febrile
seizures (p.43) if they
have a high fever
and should
be watched
very closely.
Caring for a sick person
When looking after a sick person at home, whether a child or an adult, your
main concerns will be to ensure that he or she is comfortable and drinking plenty
of fluids, that you provide the correct medication at the right time, and that any
new or worsening symptoms are dealt with correctly. A sick child or baby can
be more demanding, but loving, patient care is one of the best aids to recovery.
BRINGING DOWN A FEVER
SOOTHING A SORE THROAT
• Rest your voice by speaking as little
as possible.
• Drink plenty of fluids, especially
hot or very cold drinks.
• Eat ice cream and icicles; they help
ease a tickly throat.
• Take analgesics, such as acetaminophen
or ibuprofen, in the correct doses.
• Suck throat lozenges containing a
local anesthetic (these are suitable
only for adults).
• Gargle warm salt water (half a
teaspoon of salt in a glass of water).
• Install a humidifier or place bowls
of water near radiators to keep the
air moist.
Provide
cool
fluids
Use fan to
keep room
cool
Remove
clothing and
bedclothes
Check temperature
• A fever is a body temperature that
is above 100.4 ̊F (38 ̊C). See pp.68
and 70 for advice on the different
ways of measuring a temperature.
• If you or your child develops a
fever, look at the charts on pp.74
and 76 to check whether medical
help is required or whether the
cause can be treated at home.
1
Wipe skin with
tepid washcloth
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Page 165 of 260
CARING FOR A SICK PERSON 165
PREVENTING DEHYDRATION
• If you have a fever or are suffering
from vomiting and diarrhea, drink
plenty of fluids every 1–2 hours,
such as diluted orange juice, weak
sweetened tea, or an over-the-counter
rehydration solution, which contains
essential minerals and glucose.
• Do not give milk to adults, children,
or bottle-fed babies if they are
suffering from diarrhea or vomiting.
• If a breastfed baby is affected,
continue to breastfeed and offer
the baby extra fluids.
Give fruit- flavored
rehydrating
fluids to drink
RELIEVING ITCHINESS
RELIEVING A BLOCKED NOSE
• For itchiness caused by dry skin,
moisturize the skin by applying
emollients, such as aqueous cream
and petroleum jelly, after washing
and bathing.
• To soothe severe itching caused by
chicken pox, apply calamine lotion
to the spots.
• For severe itching, apply topical
corticosteroids sparingly to the area.
Always follow the manufacturer’s
instructions with corticosteroids.
• Fill a bowl or basin with hot water
and lean over it with a towel pulled
over your head. Breathe deeply.
• Alternative methods are to rub a
vapor ointment on the chest or to
use decongestant capsules that are
filled with menthol and other
strong-smelling oils.
Soothe itchy skin
by dabbing with
calamine lotion
Important
• Do not give steam inhalation treatment to
young children.
• Older children should undergo steam
inhalation treatment only if supervised.
!
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Page 168 of 260
DEALING WITH A PANIC ATTACK
168 FAMILY ILLNESS
GIVING LIQUID MEDICINES TO CHILDREN
1Measure dose
• Use a syringe or dropper to avoid
spillage and to ensure that you
give the correct dose.
• If you are unsure how to use the
syringe or dropper, ask your doctor
or a pharmacist to show you how
to measure and give a dose of
medicine to a baby or child.
• Always measure out the dose
before you pick up the child
or baby; otherwise, you may not
be able to do the job.
1Calm person
• Stay calm yourself and
take the person
to a quiet
place.
2Reassure child
or baby
• Hold the child or baby securely on
your lap to give reassurance and
prevent possible struggling.
• Have a drink ready in case the taste
is unpleasant to the child or baby.
• If the child or baby is nervous
about taking the medicine, explain
that the drug will help him feel
better and stress that it will all
be over very quickly.
4Deliver dose
• Slowly press the plunger or squeeze
the dropper, allowing the child or
baby time to swallow. Do not aim
directly down the child or baby’s
throat; this could cause choking.
• If the child or baby spits out the
medicine, wait until he has calmed
down and then try again.
• Mix the medicine with a little jam,
if this helps, but do not add it to a
drink because it may stick to the
sides of the cup.
Place in mouth • For a child, place the tip of
the syringe or dropper well
inside the mouth and angle
it toward a cheek.
• For a baby,
touch his
lips with the
syringe or
dropper to
encourage
him to open
his mouth.
2Treat
hyperventilation
• If the person feels tingling in the
fingers, it may be caused by too
much carbon dioxide in the blood.
• Encourage her to breathe more
slowly and to imitate you.
• Try holding a paper bag against
her mouth, so that she rebreathes
her own expired air, until her
symptoms stop.
3
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Page 170 of 260
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Page 174 of 260
174 HOUSEHOLD EMERGENCIES
• If you have a water heater in the
kitchen, make sure that the flue is
kept clear. If you use gas, install a
carbon monoxide alarm in the
kitchen, as close to the water heater
as possible (p.173).
• Unplug or switch off electrical
appliances at the wall when they
are not being used. Kettles, electric
knives, and blenders are particularly
hazardous.
• Use a ladder to reach high shelves
instead of standing on a stool, which
could tip over.
• Never leave a skillet or deep fryer
unattended on the stove (p.183).
• Ensure that work surfaces and sinks
are well lit so you can work safely.
• If you have young children, install
simple security latches on cabinets
and drawers that contain hazardous
liquids or objects.
• Store matches, sharp items, and
household chemicals well out of
the reach of children.
• Try to keep young children out of
the kitchen when you are cooking.
• Turn pan handles toward the wall
so that children cannot grab them
or accidentally knock them.
• Install guard rails around the stove
to keep children away.
• Warn children that stovetops –
especially electric burners, which
may show no signs of being hot –
can burn even when the power is off.
• Store sharp knives well out of the
reach of children, ideally in a
wooden knife block.
• Always switch off the electric iron
and move it out the reach of
children when it is unattended.
• Wipe up spills as soon as possible.
MAKING YOUR KITCHEN SAFE
Turn pan handles
away from the
front of the stove
Keep appliances near the
wall and unplugged when
not in use
Store knives
safely in a
knife block
Wipe up spilled
liquids immediately
and make sure that
floors are dry before
walking on them
Keep a fire blanket and fire
extinguisher in the kitchen
and make sure that you
know how to use them
Use the back burners
of the stove in
preference to the
front ones
Page 175 of 260
HOME SAFETY 175
• Avoid running electric wires across
the floor: these could be tripped on.
• Never run wires under a carpet
where people walk; with wear, the
carpet may expose bare wires.
• Check all electrical wiring regularly:
frayed insulation can cause fires.
• Don’t overload electric sockets
with multi-point adaptors. Use an
extension cable with four or six
socket outlets instead.
• If you have an open fire, make sure
that you use a fire guard, especially
when children are present.
• Secure carpets and rugs firmly so
that people cannot trip on them.
If you have polished wooden floors,
place nonslip mats underneath rugs
so that they do not move.
• Always check an open fire before
going to bed at night and make
sure that a fire guard is in place.
• Install a carbon monoxide detector
beside a gas fire (p.173).
• Unplug or switch off electric fires and
televisions at the wall socket at night.
• Empty all ashtrays and dispose of
their contents safely at night.
• Ensure that halls and stairways are
well lit – especially if children or
elderly people are likely to use them.
• Leave a nightlight on at night.
• If you have young children,
install safety gates at the stairway
entrances, and keep them closed.
• Check for worn areas of carpet,
which could cause trips or falls.
• Mats and rugs on parquet or
polished wood flooring can be
dangerous. Place nonslip mats
underneath them to prevent them
from sliding.
• Install extra grab rails on the stairs
to assist elderly people.
• Keep the areas at the top and bottom
of the stairs clear at all times.
MAKING YOUR HALL AND STAIRS SAFE
Put nonslip mats
under rugs to
Put children’s toys prevent slipping
away after use
Do not let electric
wires trail across the
floor or under the
carpet
Do not overload
electrical outlets
Keep fire guards
around the fire
at all times
Secure bookcases
and other heavy
furniture to the walls
to prevent them
from falling over
MAKING YOUR LIVING ROOM SAFE
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176
MAKING YOUR BATHROOM SAFE
• Secure a grab rail on the wall above
the bathtub to provide extra support
– especially for elderly people.
• Run the cold water first when
preparing a bath for young children.
• Never leave young children on their
own in a bath.
• Make sure that shower units are
fitted with efficient thermostatic
controls, so that there is no risk of
anyone being scalded.
• Store medicines in a locked cabinet
out of the reach of children.
• Never use an electrical appliance,
such as a hairdryer or radio, in
a bathroom.
• Never touch an electrical item with
wet hands.
• Make sure that bathroom lights and
wall-mounted heaters are controlled
by pull-cord switches or switches
outside the room.
• Check gas water heaters regularly
to ensure that flues remain clear.
Install a carbon monoxide detector
or alarm (p.173).
• Never mix two types of household
chemicals, such as bleach and
bathroom cleaner. The combination
can produce poisonous fumes.
• Keep all such chemicals out of the
reach of children.
• Service electric blankets regularly
and check their wiring for wear
and deterioration.
• Never leave electric blankets on
overnight unless the instructions
make it clear that it is safe to do so.
They may overheat and catch fire.
• Keep a flashlight and your cellular
phone (if you have one) by the bed
at night, for use in an emergency.
• Never smoke in bed. You could fall
asleep with a lit cigarette.
• Never drape a cloth over a bedside
light to reduce glare. The heat from
the bulb could cause a fire.
• Keep bedroom floors clear of clutter,
especially if elderly people or young
children may get up to use the
bathroom at night.
• If bedroom windows have locks, keep
the keys nearby – you may need to
use windows as emergency exits. If
possible, leave bedroom windows
unlocked at night.
MAKING YOUR BEDROOM SAFE
Always test the water
temperature before
getting into a shower
Install electrical
outlets in the
bathroom for
electric razors only
Use non-slip mats
in the shower
and bathtub
Install a firm grab
rail over the bathtub
Control wall-mounted
bathroom lighting by
pull-cord switches
HOUSEHOLD EMERGENCIES
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178
PREVENTING ACCIDENTS IN THE YARD
• Remove or fence off any poisonous
plants or trees in your yard.
• Keep children and animals away
from any area that has been sprayed
with weedkiller.
• Cover outside drains with metal
grills so that children’s feet will not
get caught inside them. Grills will
also help prevent garbage from
blocking drains.
• Fence off ponds, swimming pools,
and any other water features in the
yard if the space is used by children.
• Do not attempt to use a wheel- barrow to move heavy equipment;
it will be very unstable. It is much
safer to use a cart instead.
• Don’t risk injuring your back by
lifting a heavy load on your own –
ask someone to help you.
• Never run a powerline along a fence
or bury it underground when
running electricity to a shed or
workshop. Use special shielded cable
underground, or run cable overhead,
supported by a special wire. When
in doubt, consult an electrician.
• For outside lighting and water- feature pumps, use a 12-volt system
with a transformer and house it in a
dry shed or other outdoor building.
• When you are operating electrical
power tools, such as lawnmowers
or hedge clippers, always secure a
circuit breaker between the piece
of equipment and the power source.
Make sure that you wear the
appropriate safety gear, such as
safety goggles, protective gloves
and if necessary ear protectors.
HOUSEHOLD EMERGENCIES
Yards and outside buildings present many hazards, so safety is an essential part
of yard maintenance. Check that garden yard boundaries are secure, especially
if children or animals are likely to be outside; that paths and patios are free of
debris; and that toolsheds and equipment are securely locked. Gardening itself
can be a dangerous pastime, so make sure that you also take the necessary
precautions when working with tools and machinery.
Yard safety
Water danger
• Young children can drown in as little
as a few inches of water. Even a
bucket of water poses a danger.
• If you have a pond, take the precaution
of stretching strong plastic netting
over the pond and securing it firmly
with wooden pegs.
• For complete peace of mind, consider
filling in a pond and choosing a
safer water feature, such as a
small fountain.
• Make sure that any water barrels
have secure lids.
!
Wear safety
goggles to
protect eyes
Wear ear protectors
if tools are noisy
Choose protective
gloves for yard
work
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180
Statistics show that once fire takes hold, you have less than 3 minutes to escape
the flames and toxic smoke, and get to safety. With such a limited period of
time, it is vital to have organized safe escape routes from your home and to have
regular fire drills with the whole family. Install fire ladders to give you a better
chance of escaping from upper floors. If a fire is small, try to put it out yourself
using water, a fire extinguisher, or a fire blanket. However, if the flames are still
burning after 30 seconds, you should leave the building immediately. To give
yourself advance warning of a fire, install smoke alarms on every floor of the
house and make sure that they are tested regularly.
Fires in the home
HOUSEHOLD EMERGENCIES
ACTION PLAN
ACTION
OPEN WINDOWS AND
DOORS TO CLEAR
REMAINING SMOKE.
Yes
No
Do you have a
fire blanket or
extinguisher
that you know
how to use?
ACTION
EVACUATE BUILDING
AND DIAL 911 OR CALL
THE FIRE DEPT
(see Escaping from a
domestic fire, p.181).
Yes
No
Have you
managed to
put out
the fire within
30 seconds?
Yes
No
Can you safely
enter the room
to assess
the fire?
Yes
No
Are you in the
same room as
the fire?
START
Yes
No
Is the fire
small?
Page 181 of 260
2Evacuate building
• If possible, close internal doors
and windows as you go, to confine
the spread of smoke and fire.
• Do not open a door without first
touching the door or its knob with
the back of your hand to see if it is
hot. Heat indicates fire within that
room, so choose another route.
• If there is thick smoke, place a
handkerchief over your mouth and
nose, and crawl as low as possible.
• If fire or smoke blocks your escape
route, find another way out.
• Once you are out of the building,
meet at your agreed assembly point
and check that no one is missing.
1 Alert the family
• A smoke alarm may warn you of
smoke or fire, or you may see a
fire start. Check that everyone in
the home is aware of the fire and
is leaving quickly.
• Follow the escape
route chosen in
your evacuation
plan (p.173).
181
DO’S AND DON’TS
DO
• Feel doors and door
handles with the back
of your hand before
opening them.
• Close doors and
windows behind you.
• Keep keys by all
locked windows.
ESCAPING FROM A HOUSE FIRE
!
3Dial 911 or call the
fire department
• Tell the dispatcher your address, if
anyone is still inside the building,
and if anyone is injured.
DON’T
• Use elevators.
• Jump from upstairs
windows unless forced
or told (by the fire
department) to do so.
• Underestimate the
speed at which a fire
can spread.
FIRES IN THE HOME
If you are trapped
upstairs
• Move into a room where rescuers will
be able to see you.
• Close the door and wedge a blanket
at its base to prevent smoke from
entering.
• Open a window and shout for help.
• Use a fire ladder (see box below).
!
Close doors
behind you
Guide
children
to safety
USING FIRE LADDERS
• Following the instructions, extend and attach
the ladder to the building’s facade. If possible,
attach the ladder so that it does not pass over
lower windows; otherwise, there is a risk that
you might climb down into flames.
• Help the elderly and children get onto the
ladder and climb down safely. Reassure them
and tell them not to look down.
• Use the children’s harness that accompanies
the fire ladder for a baby or young child.
Page 182 of 260
182
PUTTING OUT CLOTHES ON FIRE
HOUSEHOLD EMERGENCIES
USING FIRE EXTINGUISHERS
AND BLANKETS
• Point the nozzle of a dry chemical fire
extinguisher at the base of the flames and
sweep it from side to side. OR
• Take the fire blanket out of its container and
give it a shake to open it up.
• Hold the blanket up so that it shields
your hands from
the fire.
• Drop the blanket
onto the flames
and leave it
there until the
fire is out.
1Prevent flames
from rising
• If someone else’s clothes are on
fire, force the person to the ground
so that the flames do not rise up
and burn his face and air passage.
• If your own clothes are on fire,
lie down immediately to
prevent the flames from
rising up and burning your
face and air passage. If you
try to run for help, the
movement will simply
fan the flames.
1Sound the alarm
• Do not attempt to put out a fire
yourself unless the fire is small,
you discover it early, and you have
a fire extinguisher or fire blanket.
• If you have doubts, dial 911 and,
if necessary, evacuate.
2Smother flames
• Wrap yourself or the victim in a
thick wool or cotton blanket, rug,
or coat to smother the flames.
Do not use materials that contain
synthetic fibers to tackle the fire.
• Roll yourself or the victim around
on the ground until you are
sure that the flames
are extinguished.
2Protect yourself
• Make sure that you can retreat
quickly and safely from the area if
the fire gets out of control.
• If the fire is still burning after 30
seconds, evacuate the house at
once and dial 911.
Use a thick woolen
rug or blanket to
smother the flames
TACKLING A FIRE
Roll the victim on
the ground to ensure
the flames are out
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Page 185 of 260
2
3Check for leak
• Check all gas appliances and turn
off the gas supply at the main
(next to the meter) or on the gas
cylinder for bottled gas.
• Send family members outside until
the smell of gas has disappeared.
4Summon help
• If you cannot identify the source
of the leak, or can identify it but
realize you should not attempt to
fix it, evacuate the home.
• Call your regional gas supplier’s
emergency number from outside
your house.
• Keep the family out of the home
until the gas company advises you
that the danger has passed.
• Warn neighbors that you have
detected a gas leak.
• Once repairs are complete, do not
forget to relight all the pilot lights
in the house.
1Avoid danger
of explosion
• As soon as you smell gas, or if
you suspect that a gas appliance
is leaking but you cannot smell
anything, immediately extinguish
any flames, such as cigarettes
or candles.
• Switch off any electric fires.
• Do not touch any other electrical
appliances, including light
switches. Operating anything
electrical could create a spark that
could ignite a concentration of gas.
185
DO’S AND DON’TS
DO
• Extinguish any flames
and cigarettes.
• Ventilate the room.
• Check gas appliances
and pilot lights.
• Turn off the gas supply
at the main or on the
gas cylinder.
IF YOU SUSPECT A GAS LEAK
DON’T
• Turn on any lights or
electrical appliances.
• Use your home or
cellular telephone
until you are outside.
• Forget to relight pilot
lights once the leak
has been fixed.
GAS LEAKS
Ventilate room
• If you find a gas jet left on, turn
it off immediately. Open windows
and any external doors.
!Carbon monoxide alert
• Carbon monoxide detectors either set off
alarms or they change color when they
sense the presence of the gas in the air.
These detectors should be installed near
boilers or other appliances using gas,
such as gas stoves.
• When the siren sounds or the detector
changes color, ventilate the room by opening
external doors and windows.
• Switch off the leaking appliance (or turn off
the gas at the main if you are unsure of the
source). Call a professional to repair it.
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186
Water in the wrong places can cause considerable damage, but the ability to
make emergency repairs can prevent a minor problem from becoming a disaster.
In a plumbing crisis, knowing the basics, such as where to find your main
shutoff valve and how to drain the system, can make the difference.
Plumbing problems
HOUSEHOLD EMERGENCIES
ACTION PLAN
ACTION
GO UP TO THE ATTIC
AND CHECK FOR A
BURST PIPE OR
DAMAGE TO A WATER
TANK. REPAIR IF
NECESSARY (see Burst
pipe, p.188, or Fixing
a leaking water tank,
p.187). CHECK THE
ROOF AND REPAIR
LEAK (see Leaking
roof, p.206)
ACTION
CALL THE BUILDING
SUPERINTENDENT
OR CONTACT YOUR
LOCAL WATER
DEPARTMENT
ACTION
IF A DISHWASHER OR
WASHING MACHINE IS
LEAKING, CHECK
DOOR SEALS, SUPPLY
AND DRAIN PIPES
ACTION
IF THE RADIATOR IS
LEAKING, REPAIR IT
(see Radiator leaking,
p.193). IF A PIPE HAS
BURST, REPAIR IT (see
Burst pipe, p.188)
ACTION
IF YOU ARE STILL NOT
SURE OF THE CAUSE OF
THE LEAK, TURN OFF
THE WATER AT THE
MAIN SHUTOFF VALVE,
DRAIN THE TANK, AND
CALL A PLUMBER
ACTION
GO UPSTAIRS AND
CHECK THAT ALL THE
UPSTAIRS FAUCETS ARE
TURNED OFF Yes
No
Is water
leaking from
the ceiling?
Yes
No
Is water leaking
from a kitchen
appliance?
Yes
No
Is a radiator
or pipe
leaking?
Yes
No
Is water coming
from the attic
or roof?
Yes
No
Do you have
access to the
floor above?
START
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187
LEAKING CEILING
1Turn off water main
• Go to the main shutoff valve and
turn off the water.
2Drain system
• Turn off the boiler to keep the
pipes from overheating.
• Run the faucets upstairs and flush
toilets fed by the water tank to
reduce the water level in the tank.
4Find source of leak
• If the water is coming through the
ceiling, check the room or the
apartment above.
• If the water is coming from the
attic area, check for a burst pipe
or damage to the water tank and
fix any leak (p.188 and below).
If the pipes and tank are sound,
look for holes in the roof itself
and repair if necessary (p.206).
3Relieve pressure
• Use a bucket to catch water
leaking from the ceiling.
• If there is a hairline crack, enlarge
it with a screwdriver to increase
the flow and reduce the weight
of water on
the ceiling.
• If the ceiling is
bulging, put
more buckets
in place, then
punch a hole.
PLUMBING PROBLEMS
ESSENTIALS
• Pipe repair tape
• Pipe-thread seal
tape
• Pipe wrench
• Sink plunger
• Vise grips
• Closet auger
• Bolts with rubber
and metal washers
• Epoxy resin sealant
PLUMBING TOOL KIT
Dangers of water
and electricity
• If water is dripping from a light fixture or
onto an electrical appliance, do not touch
the switch, the light fixture, or the appliance.
Turn off the power at the circuit breaker or
fuse box and call an electrician immediately.
!
FIXING A LEAKING COLD WATER TANK
Some homes have a tank with
a pump for constant house
pressure. Others may have a
repairable reservoir in the attic
or basement.
• Shut the main valve. Arrange
for disposal of cold water.
• Close the hot water valve at
the hot water tank. Then
open the drain valve of the
cold water tank.
• Flush toilets, then open all
cold water faucets.
• Plug a small hole by drilling
and inserting a bolt with
rubber stops on either side.
For corner hole, wipe dry;
use an epoxy resin sealant.
Put rubber and
metal washers
on both sides
of the hole
Insert a bolt
into the hole
Enlarge the crack in
the ceiling with a
screwdriver
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190
LEAKING FAUCET
HOUSEHOLD EMERGENCIES
1Turn off water
• A leaking faucet is both a nuisance
and a waste of valuable water.
• In cold weather, dripping water
can freeze in the pipes overnight,
which may cause pipes to burst.
• In hard water areas, a faucet that
keeps dripping may stain sinks
and baths with mineral deposits.
• Before starting on any repair
work, turn off the water supply.
• Close the “speedy” on the pipe,
if it has one.
2Call plumber
• Most leaking faucets are caused
by faulty washers.
• You will need to remove the faucet
cover to replace a washer, which
may be tricky if you have modern
faucets that are complex in design.
If you feel unsure about tackling
the job, call a plumber.
AIRLOCK IN PIPE
1
2Turn on faucets
• If you cannot find the air lock in
this way, turn all the faucets on
full to try to drive out the air.
3Use garden hose
• If this fails, connect one end
of a garden hose to the faulty
faucet and the other end to a
main-fed faucet, such as the
kitchen sink faucet.
• Turn on the faulty faucet, then
the main-fed one. The pressure
of the main water as it enters the
faulty faucet should drive the air
lock out of the pipe.
• When the pipe stops banging,
turn off the faucets and remove
the hose from the main faucet.
• Drain off the water in the hose,
then disconnect the hose from
the faulty faucet.
• If air locks occur repeatedly, call
a plumber.
Release air
• If no water comes out and the pipe
makes a banging noise when you
turn on a faucet, there is probably
an air lock in the pipe.
• You may be able to release the air
by using a rubber mallet to
tap along the
pipe leading
from the
faucet.
SILENCING DRIPS
• Until a faucet can be repaired, silence the
noise by tying a piece of string around its
spout. Put the other end of the string in
the drain. The water should now trickle
down the string and into the drain.
Tap the pipe
gently to dislodge
the airlock
Page 191 of 260
191
BLOCKED TOILET
1
2Try water force
• If this fails, bail some water out
of the bowl to reduce the level.
• Pour a bucket of water into the
toilet. If the blockage is minor,
the force of the water rushing
down into the bowl can be
enough to dislodge it.
3Use plunger
• If the toilet is still blocked, get
a toilet plunger or improvise by
tying a plastic bag around the
head of an old mop.
• Pump the plunger up and down
in the bowl, but be careful not to
use too much force: you risk
cracking the bowl.
• If the toilet
remains blocked,
or you prefer
not to try
any of these
techniques,
call a plumber.
PLUMBING PROBLEMS
Try to clear toilet
• If the contents of the toiletbowl do
not flow away when the toilet is
flushed, the toilet is blocked.
• Do not keep flushing in the hope
that this will remove the blockage:
water may build up in the bowl
and overflow.
• Use a bent wire coat hanger or a
snake to remove a blockage just
beyond the bend.
DRIPPING OVERFLOW PIPE
1
3Call plumber
• If the valve is broken, you will
need to call a plumber to repair it.
2Check float valve
and float
• Check the float valve first. If the
washer is worn, water will continue
to trickle into the tank or cistern
even when the float has reached
its uppermost position.
• Examine the float to see if it
is leaking. Give it a shake to see
whether there is water inside.
• If necessary, buy a new washer or
float to replace the faulty one.
Locate problem
• A dripping overflow pipe from
a water tank or toilet cistern
indicates that the correct water
level is not being maintained.
• Do not ignore a dripping overflow:
the drip could suddenly turn into a
serious leak, which could cause a
flood, or the water may freeze and
result in a burst pipe.
• Look in the water tank or lift
the cover of the cistern. Floating
on the water is an object attached
to the tank or cistern side. This
float is joined to a float valve,
which should close off the supply
from the main when the tank or
cistern is full.
Plunge firmly but
carefully so that you
do not crack the bowl
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192
A hot-water heating system – which is composed of a boiler and circulator,
radiators or baseboard, and an expansion tank – can stop working if the
circulator jams, or if a radiator develops a leak or has air trapped in it.
Dealing with these problems is usually straightforward. Use the action
plan to identify the problem, then follow the instructions on the opposite
page. Alternatively, call a plumber or heating specialist.
Central-heating problems
HOUSEHOLD EMERGENCIES
ACTION PLAN
ACTION
RESET THERMOSTATS
OR TIMER
ACTION
BLEED RADIATOR
(see Radiator not
working, p.193)
ACTION
CHECK VALVE IS OPEN
(see Radiator not
working, p.193)
Yes
No
Is the circulator
pumping
water?
Yes
No
Is any part of
the radiator
warm?
Yes
No
Are the timer
and thermostats
set correctly?
ACTION
CALL IN A PLUMBER
TO FIX YOUR SYSTEM
ACTION
TRY RELEASING AN AIR
LOCK IN THE PUMP
(see Circulator
jammed, p.193)
ACTION
REPAIR JOINT (see
Radiator leaking,
p.193)
Single radiator
not working
No radiators
working
Radiator or
joint leaking
What is your
heating
problem?
START
ACTION
SEAL HOLES IN
RADIATOR (see Radiator
leaking, p.193)
Joint
Radiator
Is the joint or
the radiator
itself leaking?
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193
RADIATOR NOT WORKING
CENTRAL-HEATING PROBLEMS
1 Check valve
• Check that the valve at the bottom
of the radiator is fully open.
2Check thermostats
• Look at the main central heating
thermostat and the radiator’s
own thermostat (if present) to
check that both are set correctly.
3Bleed radiator
• Install an air bleed key on the air
bleed valve at one end of the top
of the radiator.
• Hold a cloth underneath the valve
and turn the key counterclockwise
until you hear air hissing out.
• Turn the key clockwise as soon as
water, which may be hot, starts
dripping out.
1Find leak
• Pinpoint the source of the leak.
Water can escape through a loose
joint between the pipe and radiator;
or through tiny holes in the
radiator, caused by corrosion.
2Repair joint
• Tighten the nut with a pipe wrench.
• If water still leaks, turn off the
heating and call a plumber.
3Seal small hole(s)
• Run a hose from the central
heating drain valve (usually under
the boiler or on the last radiator
in the system) to a drain or sink,
then drain the system. The sealant
flows through and seals the leak.
• The sealant is only a temporary
repair, so replace the radiator soon.
RADIATOR LEAKING
1Find valve
• Turn off the circulator (this will
be near the boiler) and find the
bleed valve.
• Place a screwdriver
in the bleed valve
and have a cloth
ready to catch the
water that will be
released when the
air lock is released.
2Release air lock
• Expel any air from the circulator
as if you were bleeding a
radiator (see above).
• If the circulator is
still jammed, call a
plumber or central
heating specialist.
CIRCULATOR JAMMED
Turn bleed valve
to release air lock
Page 194 of 260
194
Air-conditioning problems
ACTION PLAN
There are two main types of air conditioning: central systems and single-room
units. Both circulate clean air that is cool in the summer and warm in the winter.
Problems with central air conditioners are generally best dealt with by an air- conditioning specialist, but you can usually perform basic maintenance of
room units yourself, such as checking thermostat settings, cleaning the filter,
repositioning the sensor, and cleaning the condenser.
ACTION
THE SENSOR OF A
ROOM UNIT MAY
NEED REPOSITIONING
OR THE CONDENSER
MAY NEED CLEANING
(see Air conditioner
cuts out, p.195).
ACTION
SUSPECT THAT A FUSE
HAS BLOWN. CHANGE
THE FUSE (p.197).
ACTION
THE THERMOSTAT MAY
NEED RESETTING
(see Inefficient air
conditioner, p.195).
Yes
No
Are the doors
and windows
open?
Yes
No
Is the system
or unit
humming?
Yes
No
Is the fan
blowing?
ACTION
CLOSE THEM.
ACTION
THE FILTER MAY
NEED CLEANING
(see Inefficient air
conditioner, p.195).
ACTION
IF YOU STILL HAVE NOT
SOLVED THE PROBLEM,
ASK A SPECIALIST TO
CHECK THE SYSTEM
OR UNIT.
START
Yes
No
Does the
system or unit
cut out or have
short cycles?
Yes
No
Is the
thermostat
set correctly?
HOUSEHOLD EMERGENCIES
Page 195 of 260
195
INEFFICIENT AIR CONDITIONER
AIR CONDITIONER CUTS OUT
AIR-CONDITIONING PROBLEMS
2Remove filter
• If the fan is working efficiently
but the room or house is still too
warm, the filter may need either
cleaning or replacing (depending
on the type of air conditioner).
• For a central system, ask an air- conditioning specialist to clean or
replace the filter, as appropriate.
• For a room unit, unplug the unit
at the wall. Remove or lift up the
front panel, depending on the
design, and remove the filter.
3Clean filter
• Clean the filter with some warm
water containing a mild detergent,
then rinse it in clean water and
dry it thoroughly.
• Replace the filter and turn the
unit back on.
4Install new filter
• If your unit has a disposable filter,
check its condition. If it has turned
black, is warped, or has holes in
it, then it needs replacing.
• Remove the old filter and replace
it, following the manufacturer’s
instructions. Then replace the front
panel, and turn the unit back on.
1 Reset thermostat
• If the air conditioner is switched
on but the fan is not blowing,
check the temperature setting on
the thermostat. If the thermostat
is set too high for the current
conditions, the air conditioner
will not be stimulated to operate.
• Reset the thermostat to a lower
temperature. The fan should start
to work right away.
1 Reposition sensor
• For a room unit, unplug the unit
at the wall. Remove the front
panel and filter.
• Check the thermostatic sensor; it
should be near, but not touching,
the evaporator coils. Move it away
from the coils if necessary.
• Replace the filter and front panel
and plug in the unit.
• For a central system, get an
air-conditioning specialist to
reposition the sensor for you.
2Clean condenser
• For a wall-mounted room unit,
remove the condenser (the part
of the unit outside the room) first.
The condenser in a window- mounted room unit can be
cleaned in place.
• Use a vacuum cleaner to remove
the dust and lint that has collected
on the condenser.
• For a central system, get an air- conditioning specialist to clean the
condenser for you.
Clip filter back
into place after
cleaning
Page 196 of 260
196
Electrical problems
ACTION PLAN
ACTION
PLUG A WORKING
APPLIANCE INTO THE
OUTLET. IF APPLIANCE
FAILS, REPLACE THE
OUTLET (p.199)
ACTION
CHECK THE CIRCUIT
BREAKER BOX FOR A
BLOWN FUSE OR
“OFF” CIRCUIT (p.198)
ACTION
REPLACE FUSE OR
REWIRE PLUG IF
NECESSARY (p.197)
ACTION
CALL AN ELECTRICIAN
ACTION
THERE IS PROBABLY
A LOCAL POWER
FAILURE. REPORT
PROBLEMS TO YOUR
ELECTRICITY SUPPLIER
Yes
No
Do your
neighbors
have power?
ACTION
TURN ON MAIN
SWITCHES AND
CIRCUIT BREAKERS
Several
One
Has one
electrical
appliance or
several failed?
Yes
No
Are lights or
appliances in
only one area
affected?
Yes
No
Have you
checked both
the plug and
fuse (p.197)?
Yes
No
Have you lost
electricity
throughout
the house?
No
Yes
Are the main
switches and
circuit breakers
switched on?
START
We all take electricity for granted – flick a switch and a light comes on, plug
in the television and it works – but fuses can blow, electrical equipment can
malfunction, and wiring can become damaged or overheated, posing a potential
fire hazard. By equipping yourself with some basic electrical knowledge, you will
be able to rectify common problems quickly when they occur.
HOUSEHOLD EMERGENCIES
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Page 197 of 260
197
FAULTY APPLIANCE
1Check plug
• Loosen the large screw between the
pins and remove the plug cover.
• Check the wiring inside the plug
for loose connections.
• Check that each wire is securely
attached to the correct terminal –
black to Hot, white to Neutral, and
brown (if present) to Ground (see
Rewiring a plug, below).
• If the plug is a sealed unit, you will
have to call an electrician to check
why the appliance is not working.
2Check fuse
• Turn off appliances on the circuit,
if known.
• Locate the fuse box and examine
the filament strips visible through
the mica window of each fuse.
• A blown fuse has a melted strip,
seen through a halo of smoky
metallic residue.
• Unscrew the threaded ceramic fuse
from its receptacle, and replace it
with one of the same amperage.
• Turn fixtures and appliances on
again, one by one.
DO’S AND DON’TS
DO
• Turn off appliances
at the wall outlet
when not in use.
• Switch off the wall
outlet and remove
the plug before you
attempt to repair
an appliance
• Have your wiring
checked by a
professional at least
once every 5 years.
DON’T
• Touch plugs, outlets,
or switches if your
hands are wet.
• Replace a blown fuse
with one of higher
amperage: this can
result in overheated
wiring and fire.
• Attempt electrical
work unless you are
confident that you
know what to do.
ESSENTIALS
ELECTRICITY TOOL KIT
• Flashlight and batteries
• Spare plugs
• Plug fuses
• Fuse wire (for rewirable fuses) or cartridge
fuses (for replaceable fuses)
• Outlet analyzer
• Voltage tester (for checking whether live
electricity is present)
• Small screwdriver
• Wire cutters/strippers
REWIRING A PLUG
• Remove the plug cover,
loosen the terminal screws,
and ease out the cord.
• Position the cord on the
plug with the wires placed in
their correct positions to
gauge whether you need to
remove any of the cord’s
outer insulation.
• If necessary, use wire strippers
to cut away 2 in (50 mm) of
the outer insulation, then
reposition the cord.
• Cut each wire to length (each
one should be long enough
to reach its terminal) and use
wire strippers to remove 1
⁄4 in
(6 mm) of insulation from
the end of each wire.
• Replace the cord in the
plug, fit the cord grip
loosely, and push each wire
carefully into its terminal.
• Tighten each terminal screw
down on to its wire and refit
the plug cover.
ELECTRICAL PROBLEMS
Neutral
wire (white)
Ground wire
(brown)
Hot wire
(black)
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Page 200 of 260
200
Structural problems
HOUSEHOLD EMERGENCIES
Most structural problems can be prevented by performing regular internal
and external maintenance checks. Look at the condition of your windows,
doors, roof, walls, fences, and drains, and deal with minor defects immediately
before they become major problems. Even in a well-maintained home, however,
there is plenty that can go wrong – windows get broken, doors stick, roof tiles
fall off, and holes appear in gutters – but the advice here will help you at least
make a temporary repair before seeking expert advice.
SECURING BROKEN PANE OF GLASS
1Make cracks safe
• If the glass is cracked, cover the
crack(s) with clear, self-adhesive
waterproof repair tape on both
sides of the glass to hold it
together temporarily.
• Either replace the
pane yourself (see
opposite) or get a
glazier to do the
job for you.
2Cover shattered
pane
• If the glass is shattered, cover the
outside of the hole with a sheet of
polyethylene and secure it to the
frame with battens and
pins or strong tape.
• For greater security,
screw a sheet of 1
⁄2-in
(12-mm) thick ply- wood over the inside
of the broken door or
window pane.
• If you feel that you
can do the job, replace
the glass yourself (see
opposite), or ask a
glazier to do it for you.
CHOOSING AND MEASURING FOR REPLACEMENT GLASS
• Safety glass is reinforced in manufacture and must
be used when glazing a very large area, such as
a patio door or picture window, where it could
be mistaken for an opening, or where glass will
be fitted within 31 in (80 cm) of the floor.
• There are three types of safety glass: toughened
glass, laminated glass, and wired glass. If you
need to use safety glass, discuss with your glass
merchant which type is most suitable for the
window or door in question.
• If the glass is patterned, take a piece to match
with the new glass.
• Measure the height and width of the opening,
going right into the groove cut for the glass in
the frame. Cut away any old putty or remove
old bead to make sure. Since the cavity may not
be square, take two measurements on each
dimension and use the mid-point as your figure.
• Measure the two diagonals of the opening.
If they are not the same, make a cardboard
template to give to your glass supplier.
• Buy a pane of glass that is 1
⁄8 in (3 mm) smaller
than the cavity on each dimension; also buy
some putty and some glazing points.
Tape over the
cracks carefully
to avoid breaking
the glass
Page 201 of 260
STRUCTURAL PROBLEMS 201
2Insert new glass
• Wet your hands and then knead
some putty to make it pliable.
Working on the outside of the
window, press a continuous putty
line all around the edge where the
glass will rest using your thumb.
• Place the glass, lower edge first,
on to the putty and press it firmly
into place, leaving a 1
⁄8-in (3-mm)
gap all around.
3Secure new glass
• Fix the glass into position with
glazing points spaced about 20 cm
(8 in) apart. Tap them gently into
the frame with a small hammer,
ideally a pin hammer.
• Remove any surplus putty on the
inside edge of the glass with a wet
putty knife (a small, pointed,
wide-bladed knife).
• Roll some more glazing putty into
a thin sausage and press it into the
join between glass and frame all
around the outside of the window.
• Smooth it by holding the putty
knife at a 45° angle to the frame,
with the flat of its blade on the
putty, and pulling it along. Miter
the corners.
• Allow the putty to dry for at least
2 weeks before painting.
• If the glass is held by beading, apply
a strip of self-adhesive plastic foam
around the outside edge of the glass
before pinning on the beading.
• Repaint the frame, brushing a
1
⁄8-in (3-mm) margin of paint onto
the glass to ensure that rainwater
will not get behind the putty and
into the wood frame.
REPLACING DAMAGED PANE OF GLASS
1Remove old glass
• Put on strong protective gloves
and safety glasses.
• If the glass is only cracked, run a
glass cutter around the edge about
1 in (25 mm) from the frame. Place
self-adhesive tape across the cracks,
then tap the glass with a hammer.
It should come away in one piece.
• If the glass is shattered, sweep up
the debris, then pry out any loose
pieces still in the frame. Use an old
chisel and hammer to remove pieces
from around the edges, with the
old putty. Work from the top of
the frame downward.
• Use pliers to extract the glazing
sprigs (the tiny nails used to hold
the glass in place), then brush the
frame to remove small fragments.
• Dispose of the broken glass safely.
Keep the hammer head parallel
to the pane of glass
Press until the
putty squeezes
out on the
inside of
the glass
Press around
the edges, not
in the middle
Page 202 of 260
202
DOORS AND WINDOWS THAT STICK
DAMAGED WINDOW JOINTS
HOUSEHOLD EMERGENCIES
1Remove paint
layers
• A build-up of paint layers can
cause doors and windows to stick.
• Strip off all the paint back to bare
wood, then repaint.
2Plane door
• If a door or window catches
as you close it, take it off
its hinges, plane a
little off the top,
bottom, or side,
depending on
where it catches,
then rehang it.
3Prevent dampness
• A door that is sticking in damp
weather but fits perfectly well in
dry weather is absorbing moisture,
probably through an unpainted
top or bottom edge. Ideally, wait
for dry weather before painting it.
• If the bottom edge of a door is
unpainted, take the door off its
hinges, then paint all
the surfaces and
rehang it.
• If this does not solve
the problem, plane the
sticking edge, smooth
it with sandpaper, if
necessary, then paint
and rehang as before.
Plane to bare wood on
the edge that is sticking
Place the joint
in a pipe clamp
and leave until
the adhesive
has dried
1 Make temporary
repair
• Joints that shrink as the wood dries
out can cause a window to sag.
• A sash window will need to be
removed for repairs (see step 2).
• A prominent casement window can
be temporarily repaired in place
until you have time to make
a permanent repair (see step
2). If the window is not in a
prominent position, most
repairs can be done in place.
• Unscrew the frame a little
and then pry the loose joint
open slightly. Squeeze some
PVA woodworking
adhesive into the gap.
• Screw an L-shaped metal
bracket across the joint to
hold it together.
2Make permanent
repair
• For a permanent, and more sightly,
repair, remove the window and
unscrew the frame.
• Pry the loose joint open and
squeeze some PVA woodworking
adhesive into the gap.
• Hold the joint in an adjustable
sash clamp until it has set, then
replace the window.
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Page 204 of 260
204
DEALING WITH WOOD ROT
2Treat cause of
wet rot
• Before repairing damaged wood,
try to find out why the wood has
become damp. Check for a leaky
pipe or blocked drain.
• Fix the cause of the dampness and
let the wood dry.
1Assess damage
• Rotten wood at the foot of doors or
around window frames is usually
caused by wet rot.
• Wet rot occurs when wood gets
damp, often when water has seeped
through damaged paint. A first
sign is often peeling paint.
• If you can detect a strong, musty,
mushroomy smell indoors, or see a
white, cottonlike material below
kickboards or through floor- boards, you may have dry rot.
• Dry rot affects wood in badly
ventilated confined spaces, and
it spreads rapidly. Call in rot
treatment specialists immediately. 5Fill hole
• For extensive damage, use new
wood, treated with preservative,
to fill the main gap.
• For smaller gaps, use a special
two-part wood filler, following
the manufacturer’s instructions.
Use wood filler also to fill any
gaps around new wood.
• Once the filler is dry, rub it down
with sandpaper until smooth, then
paint, stain, or varnish.
3Cut away
damaged wood
• Chisel out all the decaying material
until you reach sound, solid wood.
• Coat the sound wood and
surrounding woodwork with
a chemical wet rot treatment.
4 Apply wood
hardener
• Brush a coat of wood hardener
on to the exposed wood. This
varnishlike liquid binds the loose
fibers of wood together and seals
the surface, making it ready for
replacement wood or filler.
HOUSEHOLD EMERGENCIES
A sign of wet rot is
wood that is dark
brown and crumbly
when dry
A cotton-wool like
material and rust- colored spores
indicate dry rot
Page 205 of 260
STRUCTURAL PROBLEMS 205
BROKEN OR UNSTABLE FENCING
BROKEN OR UNSTABLE GATE
1
1 Replace post
• A rotten gate post should be
replaced by a new wooden post
(see Replace post, above).
3Secure hinges
• If a gate is sagging, the hinges may
need to be secured using longer or
thicker screws.
2Make gate stable
• If a gate is generally unstable,
check the diagonal brace on its
back. If the brace is not sound,
replace it with a new one.
• Alternatively, if a joint is loose,
open the joint slightly and squeeze
some waterproof adhesive into it.
Use a metal bracket to keep the
joint together, fixed with 1-in
(25-mm) galvanized or alloy screws.
2Replace post
• If a fence post wobbles, it is rotten
at the base and needs replacing.
• Detach the fencing on either side.
If the fence is closeboarded, wedge
strong wood props under the top
edge to hold the fence in place
while you work on the post.
• For a post set in concrete, cut it
off at ground level, drive a metal
repair socket into the centre of the
stump, then insert a new post cut
to the right length. Reattach the
fencing panels on either side.
• For a post not set in concrete, dig it
out and replace it with a new one.
• Before inserting the new post, soak
it in chemical preserver overnight
to protect it against rot.
• Anchor the new post firmly into
the ground then reattach the
fencing panels on either side.
Replace panel
• If a fence panel has been damaged
by an impact, blown over by high
winds, or is in a state of disrepair,
you will need to replace it.
• For a panel supported by wooden
posts or recessed concrete posts,
remove the nails or angle brackets
holding the panel in place at each
end and remove the panel. Hold a
new panel in place and reattach it.
• For a panel supported by grooved
concrete posts, slide the old panel
out and slide a new one in.
Slot the fence
panel into the
grooved
concrete post
Reattach the hinges
with stronger screws
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Page 206 of 260
206 HOUSEHOLD EMERGENCIES
LEAKING ROOF
1Inspect the roof
• Look at your roof from the ground,
using binoculars if necessary, to
see if you can spot any slipped or
missing tiles or slates.
• Go to the loft with a flashlight and
inspect the roof from the inside.
• If the roof is lined, check the lining
for damp stains.
• If the roof is unlined, look for rays
of daylight between tiles.
• Check roof timbers for dampness.
• If the source of the leak is at a
junction between the roof and
other parts of the building, such
as a wall or chimney, inspect the
metal strips (flashing) that seal
the join from the outside.
• Once you have identified the source
of the leak, make a temporary
repair from inside (see box) if you
can. Then call a roofing contractor
to make a permanent repair.
2
3Install new
tile or slate
• Slide the new tile or slate into
place on a builder’s trowel until the
two nibs on the back of the tile or
slate hook on to the roof battens.
• Remove the wedges that were
propping up the surrounding
tiles or slates.
4Repair flashing
• If flashing has deteriorated, it needs
to be replaced by a roofing contrac- tor. Cracks or shrinkage, however,
can be repaired relatively easily.
• If the edge of the flashing has come
away from the wall, push it back
into the mortar course and apply
new mortar to secure it.
• If the flashing is cracked, cover
it with aluminum self-adhesive
flashing tape, following the
manufacturer’s instructions.
TEMPORARY ROOF REPAIR
Use the lower edge of the
plastic sheet to drain
water away from the roof
Push the plastic under
the damaged area
Secure sheeting
Push the lower edge of
the plastic out over the
lower edge of the hole, so
that it directs water down
the roof. Secure it with
strong waterproof tape.
Patch the hole
Cut a sheet of strong
plastic, at least 12 in
(30 cm) larger than the
hole. Slide it between
the roof battens and
the tiles surrounding the
missing or damaged tile.
Remove tiles/slates
• Wedge up the tiles or slates that
overlap the damaged one, then rock
it loose and slide it out carefully.
• Buy a matching tile or slate from
your local construction store.
Page 207 of 260
STRUCTURAL PROBLEMS 207
LEAKING GUTTERS AND LEADERS
1
2
Check gutters
and pipes
• If rainwater is overflowing from
the gutter, check both the gutter
and the leader leading from
it for blockages. Obstructions are
commonly caused by a build-up
of leaves, birds’ nests or balls
falling into leaders.
• If water is leaking through the
gutter, check the dripping area
of the gutter for cracks, holes,
or bad joints.
• If the gutter is not damaged, check
to see if it is sagging, which
prevents it from draining properly.
Clear blockages
• Put on protective gloves, and clear
the gutter of leaves and debris so
that water can flow freely.
• Clear both ends of the leader.
• If the blockage is caused by a bird’s
nest, make a hook out of a length
of stiff galvanized wire. Slide the
wire down one side of the nest to
hook it up and out of the pipe.
• For a blockage that is out of reach,
use a long, flexible rod to clear it.
Good maintenance
• If leaves are a nuisance, secure protective
mesh over the gutter and in the mouth
of the leader. You will need to ensure
that there is no build-up of leaves over
the mesh, as this could cause rainwater
to pour over the edge of the gutter.
• Repaint metal drains and gutters
frequently to prevent them from rusting
and developing holes or cracks.
!
3Repair faulty
gutter
• If the gutter is plastic, seal a
leaking joint by wrapping gutter
repair tape around it. If the gutter
is cracked, place tape over the
crack inside the gutter.
• Repair a
sagging gutter
temporarily by
hammering a
wooden wedge
in between the
gutter and each
bracket to hold
each section
in place.
• If the gutter is metal, scrape off
any rust, then paint the leaking
area with a sealing compound.
Protect the repair until the sealant
has dried, then repaint.
• To treat holes in metal gutters,
first put on safety goggles, then
wire-brush away any loose rust.
• Apply a rust-proof primer, then
seal small holes with a sealing
compound and large holes with a
special glass-fiber filler. To finish,
apply tar or gloss paint.
Page 209 of 260
209
MICE AND RATS
BEES, WASPS, AND HORNETS
INSECTS AND PESTS
1 Block entry holes
• Small pellet-shaped droppings in
your home indicate mice.
• Look for any obvious entry holes
into your home and block them.
3Set traps
• Set three or four baited mouse
traps where droppings are
found in the house.
• Use peanut butter, chocolate, or
cooked bacon as bait for traps.
2Put down bait
• Put down poisoned mouse bait
wherever you find droppings. Be
prepared to repeat if necessary.
4 Call rodent control
• Larger droppings indicate rats; call
your local health department.
1Stay safe
• If you see a swarm of bees close to
your house, get everybody inside
and shut all doors and windows.
• Contact an exterminator.
3Treat stings
• Try not to antagonize bees, wasps,
or hornets by spraying them with
insecticide; they are more likely
to sting you if they are angry.
• If you are stung, refer to p.59
for treatment. Bee stingers can be
removed, but wasps do not leave
a stinger. If you develop a minor
allergic reaction, seek medical help.
• If you develop symptoms of
anaphylactic shock (p.28), seek
medical help immediately.
2Have nest sprayed
• If wasps or hornets bother you
often, there is probably a nest.
• Contact an exterminator to
deal with the nest.
WOODWORM
1Identify signs
• If you spot 1
⁄16-in (2-mm) holes in
furniture or structural timbers,
you have woodworm. Sawdust is
a sign that woodworm are active.
• Minor woodworm attacks are
easy to treat (see step 2), but if
an infestation is severe, you
should seek professional help.
2Treat infestation
• Brush surfaces with woodworm
fluid. On furniture, use an aerosol
with a nozzle to inject the fluid.
• To treat structural timbers
effectively, use a large sprayer.
• To treat flooring, lift every third
or fourth floorboard and spray
thoroughly underneath.
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Page 212 of 260
4Install window
security devices
• Windows are popular points of
entry for burglars.
• Secure windows with locks or
deadbolts to prevent the catches
being released through a smashed
window. There are several types
for metal and wood windows.
5Assess lighting
• If you install security lighting to
help you unlock your door on dark
nights, remember that this could
be equally useful to a burglar.
Consider an alarm
• For the best security, either install
a burglar alarm yourself or have
one installed professionally.
212
By identifying vulnerable areas of your home and taking adequate precautions,
you can dramatically reduce the risk of being burglarized. Installing additional
locks and bolts is an effective way of deterring thieves. Security devices such as
peepholes, door chains, and alarms are also easy to install; and they not only
safeguard your property but also provide peace of mind, particularly when you
are away from home.
Home security
ASSESSING YOUR HOME SECURITY
1Identify
vulnerable areas
• Check all your doors and windows
for strength and security. Imagine
that you have locked yourself out:
which window or door would you
choose to force open or break?
• Look at your house again and
reassess your security.
• Contact your local police
department for advice.
3Install patio door
locks
• Install locks and deadbolts (p.214)
at the top and bottom of patio
doors and French windows
to prevent them from being
forced open.
2Install main door
security devices
• Install locks on the front, back, and
any side doors. For added security,
you should install heavy bolts at
the top and bottom of the inside
of each door.
• Back and side doors must have
sturdy locks because they are often
hidden from view and badly lit,
which means that a burglar can
attempt entry unobserved.
• For security when answering the
door, install a strong door chain
and peephole (p.213).
• If a door opens outward, install
hinge bolts to the back edge
(p.214) so that the door cannot be
levered open on the hinge side.
6
HOUSEHOLD EMERGENCIES
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Page 216 of 260
216
DEALING WITH INTRUDERS
2Make a noise
• If you do enter your home and meet
an intruder, run out and shout or
scream as loudly as you can.
• Don’t try to apprehend him or her.
3Stay calm
• If you must face the intruder, keep
calm and try not to provoke a
reaction by making threats.
• Try to memorize as much as you
can of the intruder’s appearance,
mannerisms, and speech so that
you can provide the police with
an accurate description.
4Call the police
• Dial 911 or call your local police
station.
• Try to give the police as much
information as possible.
HOUSEHOLD EMERGENCIES
• If you are woken in the night by unusual
noises or the sound of breaking glass,
call the police.
• Keep your cellular phone turned on by
the bed so that you can still call for help
if the telephone line has been cut.
• If you are alone in the house, talk loudly
as if you have a companion in the room.
You could also switch on the lights and
make a lot of noise. Most intruders will
leave as soon as they hear noise.
• Do not go downstairs to investigate.
• Do not keep an offensive weapon or
try to defend your property. No items,
however valuable, are worth serious
injury or death.
• If you meet the intruder, stay calm and
try to memorize his or her appearance.
1 Be vigilant
• If you arrive home and see anyone
loitering outside, pass by your
house and ask a neighbor to
accompany you to the door.
• If you return home to find that
the front door is open, do not
enter your home. Move a safe
distance away and, if you have
a cellular phone, call the police.
Alternatively, go to a neighbor’s
and phone the police from there.
• If you come home and your key
won’t open the door, it could mean
that an intruder has secured the
door from inside so as not to be
disturbed. Move away quickly
and call the police.
• If you return home to find that
your home has been ransacked,
call the police immediately. Do
not touch anything until the police
arrive so as not to destroy any
fingerprints left by burglars.
Responding to a disturbance
When you dial 911, you will be advised on whether
to make a noise or to pretend that you are asleep.
Stay in bed until the police arrive.
DEALING WITH A NIGHT INTRUDER
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220
If you live in an area that is prone to certain types of natural disaster, planning
and preparing for an emergency will help protect you and your family. Take
steps to safeguard your home and property. Choose a safe place indoors to
take shelter. If hurricanes are a threat, find out where your local shelter is,
and assemble essential equipment that may help you survive the aftermath.
Planning for disaster
NATURAL DISASTERS
ACTION PLAN
ACTION
PREPARE A KIT FOR
THE TYPE OF DISASTER
YOUR AREA FACES.
ACTION
PROTECT YOUR FAMILY.
ACTION
CONTACT YOUR
CITY/TOWN COUNCIL.
Yes
No
Do you know
if any disasters
are likely
(p.221)?
Yes
No
Have you
protected
your property
(p.222)?
START
Yes
No
Do you
have a disaster
emergency kit
(pp.224–5)?
Yes
No
Do you have an
evacuation plan
(p.224)?
No
Yes
Have you
sought
information on
the disaster(s)?
No
Yes
Have you
protected
your family
(p.223)?
ACTION
MAKE SURE YOU AND
YOUR FAMILY KNOW
WHAT TO DO.
ACTION
PROTECT YOUR
PROPERTY.
ACTION
CHECK AND REPLENISH
SUPPLIES REGULARLY.
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221
1 2
ASSESSING YOUR RISK
PLANNING FOR DISASTER
Be informed
• Contact your town/city council to
find out whether your area is prone
to any specific types of disaster. Ask
for information about each type.
• If your area is prone to flooding,
contact your city/town council to
find the height to which a flood
could rise.
• Before moving or traveling abroad,
find out about potential disaster
risks in that area.
• Learn about the effects of disasters
that may strike your area.
• Volcanic eruptions and earthquakes
occur around geological fault lines;
both can produce tsunamis.
• Hurricanes mostly affect areas
around the Atlantic basin and the
Pacific basin, where they are known
as tropical cyclones. They are often
accompanied by tornadoes.
• Flooding can occur almost anywhere,
although the most serious floods are
usually caused by very high tides.
• Wildfires occur in many countries –
80 percent are started by humans.
• Extreme cold occurs in much of the
Northern Hemisphere but many
countries experience freezes in winter.
Reduce risk
• Take steps now to protect your
property against natural disasters.
Your home will be less vulnerable
if you take sensible precautions
and carry out routine building
maintenance (p.222).
• Protect your family by coming up
with a family disaster plan (p.223)
and making sure that you are all
prepared for evacuation (p.224).
• Always keep abreast of the weather
situation and local plans regarding
shelters and evacuation.
High risk of seismic
activity (volcanic
eruptions, earthquakes,
tsunamis)
High risk of severe
climatic conditions
(hurricanes, tornadoes,
coastal flooding)
Areas at risk of
extreme cold
Tectonic plates
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224
EVACUATING SAFELY
1Follow instructions
• Prepare to evacuate if you are told
to do so by your city/town council
or emergency services, or if you
feel in danger in your own home.
• Follow evacuation instructions
carefully: there may be limits on
what you can take with you.
2Consider extras
• If your area is at risk of a major
disaster, you may well have to
survive outside for several days.
Plan to take water-purifying tablets.
Have garbage bags and a plastic
bucket with a lid (to be used as a
toilet) and rolls of toilet paper.
• If you live near a volcano, add a
disposable dust mask and goggles
for each family member.
• If you have a small pet, keep a
pet carrier.
3Take precautions
• If high winds are forecasted, bring
children’s play equipment and
garden furniture indoors (p.222).
• Call the friend/relative whose home
serves as your second point of
contact in your evacuation plan.
Explain where you are going.
• Use telephones and cellular phones
only if it is essential to get in touch
with family or friends; otherwise,
keep lines free for emergency calls.
• Always turn off the gas, electricity,
and water before leaving.
• Close and lock all your external
doors and windows as you leave,
including doors to outbuildings.
4 Be a good
neighbor
• Make sure that your neighbors are
aware of the need to evacuate.
• Help elderly or disabled neighbors
who may be unable to evacuate
without your assistance.
2Gather family
members
• Assemble family members quickly,
collect your disaster emergency kit
(p.225), and decide whether you
should leave by car or go on foot.
• Help the elderly and children
evacuate. Leaving home in a
disaster situation is distressing, so
remain calm and be reassuring.
Older people might require
particular help, such as the aid
of a wheelchair.
• Put small pets into pet carriers;
take dogs with you in the car or put
them on leashes if you are on foot.
1Organize basic
items
• List the items you would need to
take with you in an evacuation (see
p.225 for suggestions).
• The amount of equipment you will
need depends on the type and extent
of disaster likely to affect your area.
• Assemble these items.
• Encourage your children to help
with the planning and packing of
your family emergency kit.
PREPARING A DISASTER EMERGENCY KIT
NATURAL DISASTERS
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2
228
For SEVERE STORM see p.226 For TSUNAMI see p.242
Heavy rainfall, melting snows, rivers changing course, dams collapsing, and high
tides in coastal areas can all cause floods. If you live in an area prone to flooding,
know the difference between a “flood watch” (flooding is possible), a “flood
warning” (flooding is expected), and a “severe flood warning” (severe flooding
is expected). Take the necessary measures to protect your family and home.
Flood
PREPARING FOR A FLOOD
NATURAL DISASTERS
1Plan ahead
• Contact your city/town council to
find out the height to which a
flood could rise.
• Be alert to flood warnings issued
by weather forecasters and the
Environmental Protection Agency.
• Keep enough bricks with which
to raise wooden or upholstered
furniture off the floor and out
of the flood water.
• Buy sandbags and sand if water is
likely to rise above door level.
• Keep your important documents in
plastic wallets in a safe place.
Using sandbags
Lay the second row of bags in place, staggering the
bags over the first row in a brickworklike formation.
• Use sandbags to seal entry points around doors and
vents. Also seal windows if the water is likely to rise
that high.
• Half-fill the sandbag casings with sand. If you run out
of casings, make your own from plastic shopping
bags, pillow cases, or even stockings.
• Place the first row of bags in position, butting them
up against each other, end to end, and then stomp
down on them to mould the ends together.
• Lay the second row on top, staggering the bags, and
stomping down on them to mould them into the row
below. This will prevent seepage through gaps.
• If your wall of sandbags needs to be three or four
layers, lay two rows side by side, followed by a second
double row, then one or more single rows on top.
PROTECTING YOUR HOME WITH SANDBAGS
Prepare home
• Block all gaps under and around
external doors with sandbags (see
box below).
• If flood water is expected to rise
up to window height, place
sandbags along windowsills too.
• Take up your carpets and store
them upstairs along with all the
valuables you can move.
• Fill clean baths, sinks, and plastic
bottles with cold water.
• Turn off electricity and gas supplies;
flooded wiring can cause fires.
• Use bricks to raise furniture.
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242
PREPARING FOR A TSUNAMI
For FLOOD see p.228 For EARTHQUAKE see p.238
An earthquake, volcanic eruption, or underwater landslide can cause a tsunami: a
series of underwater waves that sweep towards shore, sometimes rising to heights
of over 100 ft (30 m), and causing immense damage. A “tsunami advisory”
indicates that a tsunami is possible; a “tsunami watch” that a tsunami may
be 2 hours away; and a “tsunami warning” that giant waves may be imminent.
If you live within 2 miles (3.2 km) of the shore and your house stands less than
100 ft (30 m) above sea level, evacuate as soon as you receive a “tsunami
warning” and move to high ground as far inland as you can go.
Tsunami
NATURAL DISASTERS
UNDERSTANDING TSUNAMIS
Sea-borne disaster
Vast sea waves crash onto the shore,
causing damage and claiming lives.
• Earthquakes, underwater
landslides, or volcanic
eruptions can cause tsunamis.
• Each tsunami consists of a
series of waves travelling at
speeds of up to 600 mph
(970 km/h).
• These waves are hundreds of
miles (kilometers) long but
only a few feet (about a
meter) “tall” as they travel
the ocean floor. Hence, they
cannot be detected from the
air or at sea until they near
the shore.
• Seismic activity may be the
only advance warning of an
approaching tsunami.
• As the tsunami nears the
coast, the waves slow down
and increase in height.
• Before the first wave reaches
the shore, the sea may be
dramatically “sucked” away
from the shoreline.
• Successive waves appear at
intervals of 5 to 90 minutes.
• The first wave is usually not
the largest; the following ones
cause the most damage.
2Take precautions
• Keep your car filled with fuel so
that you can drive to safety at a
moment’s notice.
• If a “tsunami watch” turns into
a “tsunami warning,” prepare to
evacuate your home.
• Coastal areas within 1 mile (1.6 km)
of the sea and less than 25 ft
(7.5 m) above sea level are most at
risk; make an early assessment of
the best route to higher ground.
1 Be aware
• Keep alert for a “tsunami advisory”
or “tsunami watch,” and listen to
local radio stations for updates.
• Check that your planned escape
route is clear.
• Familiarize yourself with warning
signs, such as a sudden change in
the level of coastal waters.
• Tsunamis often cause severe floods;
make sure that you are prepared
to cope (p.228).
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247
3Create shelter
• If you cannot find shelter, try to
build something with materials
you have or find.
• You need to build a structure that
will provide adequate protection
from the wind, rain, and sun.
• If you are in the countryside, you
could use vegetation and branches
to construct a lean-to shelter.
• If you are in a town, hunt
around for sheets of metal,
plastic sheeting, pieces of wood,
or anything else that could be
used to create a shelter.
• Involve all family members in
constructing the shelter. Not only
will the work be done more quickly,
but it will keep you all occupied.
5Build fire
• If it is cold, build a fire. If you are
in the countryside, use twigs and
small branches, but be aware of
the dangers of starting a wildfire.
If you are in a town, use whatever
materials are available.
• If you have suitable containers
with you, you may be able to heat
up some of your
emergency food.
4Keep positive
• Unpack your disaster emergency
kit and find places for everyone
to spread out their sleeping bags.
Make your shelter as comfortable
as possible.
• Comfort young children by telling
them how exciting your “camping”
experience will be.
• Try to keep up morale with the
thought that you are all safe and
that this is only a temporary
situation until help arrives.
POST-DISASTER SURVIVAL
Find something
water-resistant to
use as a floor
Make a roof out of
vegetation strapped
to a wooden frame
6Conserve food
and water
• If you are unable to reach safety
or help fails to arrive within 2
days, think about conserving your
supplies of food and water.
• Restrict adult rations but give
children, the elderly, and pregnant
women normal supplies, if possible.
• Be aware that water is more vital
than food: a healthy adult can
survive without food for a week
with no serious health effects, but
more than 1–2 days without water
can be highly dangerous.
• If water supplies run low, collect
rainfall to drink.
• Alternatively, find the cleanest- looking source you can and purify
water to make it drinkable (p.249).
• Do not drink water from streams
or damaged pipes: it could be
contaminated and could seriously
damage your health.
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