Emergencies: What to Do First

The person you are most likely to press on is someone in your own family: 79.2% of cardiac arrests happen at home. When someone does chest compressions, the share who leave the hospital alive rises from 3.9% to 16.1%. If they don't respond and aren't breathing, just start pressing. The spot is the midpoint of the line between the nipples; stack your hands and press hard, 2 times per second, without stopping. Have a second person call 120 and get an AED; don't let your hands stop.

The main thread of this item is older people in your own family and people you know. First check whether they are breathing; if not, do chest compressions as in Item 1 (push hard on the chest). Even if they are breathing, don't pick them up: they may have had a stroke or fainted first and then fallen, and forcing them up can make it worse. Crouch down, call to them, and ask whether they remember how they fell. Anyone with back pain or what looks like a fracture is not moved at all; call 120 where they are.

Drooping mouth, one arm that can't be raised, slurred speech: call 120 right away. Within 3 hours of onset, getting a drug to open up the blocked vessel makes the chance of recovering to the point of basically looking after oneself about 1.75 times that of not getting it. Delayed to 3 to 4.5 hours, it is only 1.26 times. Beyond 4.5 hours, no difference can be seen. Note the exact time the symptoms started. Don't give water or medicine, and don't drive yourself.

Checking only the three signs “face droop, arm raise, speech” misses a bit over one in ten strokes, because some strokes at first neither twist the mouth nor weaken an arm. Count unsteadiness and seeing double or with a part missing as well, and the share missed falls to 4.4%. If the world suddenly spins and you can't stay on your feet, you see double, or your finger can't find the tip of your own nose, likewise call 120, and likewise note the time.

One eye suddenly going dark like a curtain being pulled down means a blood vessel at the back of the eye is blocked; the longer it stays blocked, the less retina can be saved. It is also a form of brain ischemia, and you are prone to a stroke in the following few days. Among people assessed and started on treatment the same day, the rate of another stroke within 90 days fell from 10.3% to 2.1%. Go the same day to the emergency department of a hospital with a stroke center; don't wait until the next day to book an eye clinic.

This is an acute attack of glaucoma. The fluid inside the eye can't drain, and the eye pressure shoots up all at once. The longer it drags on, the more the optic nerve is crushed, and once damaged it doesn't come back. During the Wuhan lockdown, patients waited 241 hours on average before getting treatment, and 21.87% went blind. In the same period the following year, without lockdown, the average wait was 121 hours, and 7.84% went blind.

Pressing pain, heaviness or tightness in the chest that lasts more than 15 minutes without easing: call 120. Of those whose blocked vessel was opened up within 55 minutes of reaching the hospital, 2.8% died within 30 days. Of those over 55 minutes, 9.7%. Every stretch of delay means another piece of heart muscle dies. Don't drive yourself; losing consciousness on the road means a second accident.

Severe, tearing pain that moves from the chest toward the back and on down toward the waist: when you call 120, say straight out “it feels like being torn open, and the pain is moving downward.” Without surgery, on medication alone, this condition has a death rate of 58%. Its treatment is the exact opposite of a heart attack's: only if the doctor thinks of it will they do a contrast-enhanced CT, instead of giving you anticoagulants or clot-dissolving drugs. If the blood pressure differs a lot between the two arms, or the pulse can't be felt on one side, say that too.

What matters is how fast it reaches its worst. Of severe headaches that peak within an hour, about 6% are a burst blood vessel on the surface of the brain. Aged 40 or over, neck pain or stiffness, someone saw you pass out, onset during physical activity, an instant explosive onset, unable to bend your neck forward: if any one applies, go to the emergency department for a head CT. Most people who get checked are fine, but miss it once and a rebleed means death.

After an older person hits their head, the blood usually doesn't build up until the third week. They can be completely fine at the moment of the knock, and may not even remember hitting their head. After surgery for this condition, the recurrence rate can reach 33% and the death rate 32%. If you notice an older person suddenly confused, unsteady on their feet, always sleepy, or weak in one hand, first go back and ask whether they fell and hit their head in the past two or three months, then get a CT.

If one leg suddenly swells up, a size thicker than the other, and hurts when pressed, get a leg vein ultrasound as soon as possible. If sudden breathlessness, chest pain on breathing in deeply, a racing heart or faintness then appears, the clot may already have traveled to the lungs; call 120 directly. Among people diagnosed with pulmonary embolism, 17.4% die within 3 months. Sitting for more than 4 hours roughly doubles the risk, but spread over any one person it is still very low.

First press hard with your hand or with clothing; if that can't control bleeding from a limb, put on a tourniquet, then call 120, and once it is on, don't loosen it. Among battlefield casualties, nine in ten of those who got a tourniquet before going into shock survived, only one in ten of those who got it after shock survived, and all 5 who needed one but didn't get one died. Tie it above the wound, twist until the bleeding stops, and note the time. Don't use shoelaces or string instead. The neck and torso can only be pressed, not tied.

Once rabies symptoms appear, the death rate is almost 100%; washing plus vaccine is the only way. First wash with soapy water and running clean water, alternating, for 15 minutes, and get vaccinated the same day. A bite that goes through the skin, or licking where the skin is broken, is Category III exposure and also needs the passive immunization product. “It's a pet, it's had its shots” doesn't change what you do; the category goes by the wound, not by where the dog came from.

Running cool water over the burn for a full 20 minutes within 3 hours of the injury makes the chance of later needing a skin graft only about six-tenths of what it is without cooling. Cool water, not ice water; ice makes the damage worse. If clothing is stuck to the wound, don't tear it off; after cooling, cover it with a clean cloth and go to the hospital. Don't put on toothpaste, soy sauce, sesame oil or flour. If you only think of it after a while, cooling late, within three hours, still helps.

A sudden rash all over the body, plus trouble breathing or feeling faint: treat it as anaphylactic shock. Call 120 right away and say straight out “suspected anaphylactic shock,” so the ambulance comes with epinephrine. Antihistamines and steroids act slowly and can't stand in for epinephrine. Anyone who has had one episode should get a doctor to prescribe an auto-injector pen; inject into the middle of the outer thigh, and it can be given through trousers.

Move hard objects away from around them, lay them on their side with the mouth facing down, and note the time by a clock or watch. Don't hold them down, don't pry the mouth open, and don't put anything in their mouth; that only injures the teeth and jaw. If it goes on for more than 5 minutes without stopping, another seizure starts soon after it stops, they can't be woken or have trouble breathing afterward, it happens in water, or this is a first-ever seizure, call an ambulance. Wait until the person is fully alert before giving water.

First take 15 grams of sugar; sugar cubes or a small carton of juice will do. Test again after 15 minutes, and if it is still low, do it once more. Blood sugar below 3.0 mmol/L is low blood sugar that medicine takes seriously. Once it gets to the point where someone else's help is needed to deal with it, it can be fatal. Don't give a person who is not fully conscious even a mouthful; it can go down the windpipe. Call 120 directly.

Cut the power first, or push the live source away with something dry such as a wooden stick, before you touch the person. Pull them off with your hands, and one casualty becomes two. If they aren't breathing once they are free of the current, start chest compressions right away as in Item 1 (push hard on the chest); don't be afraid to touch them because it is an electrical injury. Where a high-voltage line has fallen to the ground, or near power substation equipment, don't deal with it yourself; move well back and wait for the power company to cut the power.

If the alarm goes off, or a whole roomful of people get a headache, nausea and dizziness at the same time, first take everyone outside, then make the phone call. Don't stay inside to look for the cause, and don't go back in to shut off the valve. The symptoms look like a cold; “better once outside” is the strongest clue. In 2018 China reported 11523 deaths from carbon monoxide poisoning, most of them in winter, and most of them at home.

If someone swallows a cleaning product, pesticide or medicine by mistake, don't induce vomiting: a corrosive liquid coming back up burns the esophagus a second time. First drink a suitable amount of milk or egg white, then take the bottle and the instructions and go to the hospital right away. If it splashes onto the skin or into the eyes, rinse with plenty of clean water for at least 15 minutes; for the eyes, hold the eyelids open while rinsing, and don't rub. Using disinfectant together with toilet cleaner produces chlorine gas.

Three steps. Step one: immediately take off the clothing, shoes and socks that got splashed; the places the clothing holds against the skin are injured worst. Step two: rinse with plenty of running clean water, at least 15 minutes for both skin and eyes; the Hunan Provincial Department of Emergency Management gives 20 to 30 minutes, so go with the longer one. Step three: for the eyes, hold the eyelids open while rinsing, and after rinsing go straight to an eye department. Use room-temperature water, not hot water.

Hot, red skin, slurred speech and confusion mean heatstroke. Going from dizziness to coma can take only a few dozen minutes, and the death rate is extremely high. Immediately move them to a shady, well-ventilated place, take off their clothes, cool them with cool water and wet towels, and call 120 at the same time. Don't give a person who is not fully conscious even a mouthful of water; they will choke.

Only a person who is lucid should drink. Cool, lightly salted water or a sports drink, in small amounts and often: 500 to 1000 ml an hour. Don't gulp: if they throw up and it goes into the windpipe, that is even more deadly. No alcohol and no high-sugar drinks; they make a person lose more water. First cool them down by wiping the body with cool water and putting ice packs on the neck, armpits and groin, then give fluids. Someone who is confused or slurring their words gets not a single sip.

Get down on the floor and crawl under the smoke toward the exit. Before opening a door, first feel the doorknob and the door itself. If it is hot, or smoke is coming through the gaps, don't open that door; take your second way out. Open doors slowly, and if thick smoke pours in, shut it at once. Take the stairs, not the elevator: if the power cuts out, you are trapped inside. Once you are out, don't go back for anything. If your clothes catch fire, stop, drop and roll, covering your face with your hands.

A drowning person instinctively pushes the rescuer under, and the person who goes in may drown too. The order is: shout for help → call 110/120 → hold out a long pole or a rope → throw a life ring, an empty bucket or a plastic water bottle → once the person is on shore, if they are not breathing, start chest compressions at once. Don't form a hand-in-hand chain and go into the water. About 300,000 people drown worldwide every year; drowning is the fourth leading cause of death for children aged 1 to 4.

First ask, “Are you choking? Can you speak?” If they can still cough or make sounds, let them cough it out themselves. If someone over 1 can't speak, stand behind them and give 5 back blows followed by 5 abdominal thrusts, repeating until the object comes out or the person collapses. If they collapse, start CPR, and get someone to call the emergency number at the same time. For pregnant women and very heavy people, switch to chest thrusts. Don't reach into the mouth for something you can't see.

Stay where you are or by the vehicle; the vehicle is the biggest source of shade. The order is: if you have signal, send your location first, then call → shelter from sun and cold → save water: don't move during the day, move at night once it is cool → don't wander off → signal with a mirror, smoke, or three fires. Before you go in, tell someone your route, destination, return date, and vehicle model and plate number.

When body temperature drops below 35℃, that is hypothermia: the person shivers, slurs their words, stumbles when walking and can't think clearly. Change them out of wet clothes and wrap them in an emergency blanket or dry clothes, warming the trunk first, not the hands and feet first. Give hot sweet drinks, not alcohol; alcohol suppresses shivering. Stopping shivering does not mean they are getting better; it means they are getting worse. If they are unconscious, start CPR.

Sit down and don't move; keep the bitten limb still. First take off rings and watches, because it is going to swell. Get to a hospital that has antivenom as fast as you can: antivenom is the only thing that can reverse most of the toxic effects. Don't cut the wound open, don't suck it with your mouth, don't put ice on it, don't tie a cord around it until it turns purple. Don't drink alcohol, don't run around. If you can take a photo of the snake from a distance, do; don't try to catch it.

First look at what kind of building you are in. In a building built to code after 2001, where you would have to go down stairs or through a lobby to get out, take cover where you are: protect your head and neck, get under a sturdy table, and hold on tight to a table leg. In a single-story house, an old brick house, or a self-built house with no earthquake-resistant design, with the door just a few steps away, get out. In any situation, don't jump from the building, don't take the elevator, and don't go down the stairs while the building is shaking.

Don't run: a bear can run as fast as a racehorse, uphill or downhill. Don't climb a tree either: both black bears and brown bears can climb. Stand still, keep talking to it in a low voice, and once it stops moving, turn sideways and slowly back away. If a brown bear attacks, lie face down and play dead, hands clasped behind your neck and legs spread apart. If a black bear attacks, don't play dead: run for a car or a building, and if you can't get away, fight back with whatever is at hand. If a dog scratches or bites you, wash the wound and get the shots as in Item 13.

There is no safe place outdoors when a thunderstorm is in the area. Get into a hard-topped vehicle or a building; a convertible, a motorcycle, a tent, a pavilion, the space under a tree or under an overhanging rock do not count. Keep away from open ground, ridges and hilltops, tall lone trees, water and iron railings. If a group can't get away, spread out. When you hear thunder, head back; it is safe only 30 minutes after the last thunder has passed.

What counts is how high you sleep, not how high you got during the day. Sleeping at 2450 meters or above already carries a risk of altitude illness. Once you are above 3000 meters, raise the altitude you sleep at by only 500 meters each night, and for every 1000 meters you climb, add an extra day to acclimatize. Headache with nausea, unsteady walking, changes in consciousness, or being out of breath even at rest: go down. Going down comes before oxygen and medication.

With fine-tipped tweezers, grip the tick's head close to the skin and pull it steadily outward. Don't put oil on it, don't burn it, don't twist and yank it: that agitates it into squeezing pathogen-carrying fluid into your skin, and it easily leaves the mouthparts behind in your flesh. After removing it, write down the date. If in the following weeks you get a fever, a rash or fatigue, tell the doctor yourself that a tick bit you.

Every microbe that can make you ill through drinking water dies within seconds at boiling temperature. The extra minute of boiling is just a margin for misjudging whether it has boiled; there is no need to boil longer because you are at high altitude. If you can't boil, use a filter or disinfection tablets; each of these misses some pathogens, so boil whenever you can. Stream water or snowmelt that looks clear may carry parasites just the same.

Give him the money, don't fight, don't talk back. For a few hundred yuan, he is risking a robbery conviction: the starting sentence is three to ten years, and for robbery in a home, with a gun, or causing serious injury or death, it is ten years or more, up to the death penalty. If he takes the money and turns to leave, chasing after him and hitting him no longer counts as legitimate self-defense. Once you get away, immediately note his appearance, accent, license plate and the direction he fled, and call 110.

The moment you lay hands on anyone, breaking up the fight becomes taking part in it. Taking part in a group brawl carries a sentence of up to 3 years; with many people, on the street, or with weapons, it is 3 to 10 years. Onlookers also easily get hurt by accident. What you should do is back off and leave. If you are willing to report it, move to a safe distance and call 110, and say clearly where it is, how many people there are, whether anyone has a knife or club, and whether anyone is lying on the ground not moving.

If you suspect you may have caught HIV, 72 hours is a hard line, and it is best to be taking the medication within 2 hours. The medication has to be taken for 28 days straight. After 72 hours this option is gone, so don't wait until the next day to decide.

If helping someone cost you dearly, you don't have to just write it off as bad luck. People injured while acting bravely for a just cause are treated first and billed later. Medical costs are paid by the perpetrator; if the perpetrator ran off or can't afford to pay, they go through basic medical insurance. Where there is no perpetrator, the person you saved should, by law, give you appropriate compensation. At the same time, apply for recognition as someone who acted bravely for a just cause; if you were injured, benefits are provided on the basis of work-injury insurance benefits.

Pulling it out can cause major bleeding, and it also makes it harder for doctors to judge how deep the injury goes. What to do: call 120, press around the object with your hands or a dressing to stop the bleeding, and pad the object so it is steady and doesn't wobble. If organs are showing through a wound in the belly, don't push them back in; cover them with a clean, moist dressing. If a chest wound is bubbling, don't seal it off with plastic sheeting; sealing it can collapse the lung.

Treat any injury to an arm or a leg as a fracture first; being able to stand or move doesn't rule one out. Keep the injured part still: hold it up with your hands or brace it where it is with a stiff board, and apply cold for no more than 20 minutes at a time. Don't try to straighten it yourself; if the bone is sticking out through the skin, stop the bleeding first and don't push it back in. An X-ray can miss a fracture. If the film is normal but the doctor still suspects a fracture or a ligament injury, do what the doctor says: get rechecked or have an MRI.

The traces left on your body, on your clothes and in the room are the most important evidence for identifying the attacker. So before your injuries are examined, try not to shower, and don't wash your clothes or tidy the room; call 110 as soon as you can. Emergency contraceptive pills are available at pharmacies, and the sooner you take them, the better they work. Go to a hospital within 72 hours and let a doctor judge whether you need HIV-blocking medication.

If the baby can still cough or cry out loud, let them cough it out on their own while you watch closely. If the baby can't cry and their face is turning purple, have someone call 120 while you lay the baby face down along your forearm and give 5 blows between the shoulder blades with the heel of your hand. If it hasn't come out, turn the baby over and give 5 quick presses in the center of the chest; alternate the two, and don't press on the belly. If the baby stops responding, switch to CPR.

If the baby doesn't respond when you tap the soles of their feet and isn't breathing normally, call 120 on speakerphone and keep your hands going. Encircle the chest with both hands and press with two thumbs; if you can't get your hands around it, use the heel of one hand; press down about 4 cm, about 2 times a second. After every 30 presses, cover the baby's mouth and nose with your mouth and give 2 breaths. When a baby's heart stops, it is mostly because the baby couldn't breathe, so with CPR that includes breaths, more babies survive.