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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

9–11 High Street, Hampton,

Middlesex TW12 2SA

Project Editor • Alison Bolus

Senior Designer • Tish Mills

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Managing Editor • Amanda Lebentz

DORLING KINDERSLEY

Senior Managing Editor • Jemima Dunne

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Senior Art Editor • Marianne Markham

DTP Designer • Julian Dams

DK PUBLISHING

Senior Editor • Jill Hamilton

Senior Art Editor • Susan St. Louis

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

All rights reserved under International and Pan-American Copyright Conventions. No part of this

publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any

means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written

permission of the copyright owner.

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

Printed and bound in Singapore by Star Standard Industries (Pte.) Ltd.

See our complete product line at

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LONDON, NEW YORK,

MUNICH, MELBOURNE, AND DELHI

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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

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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

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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

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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.

!

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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 64 of 260

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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?

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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?

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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

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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 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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Page 193 of 260

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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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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Page 242 of 260

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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Page 247 of 260

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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