Bites, whether by animals or humans, can be dangerous. This is because the mouth may be full of organisms that cause infection.

What should you do?

• All bites should be thoroughly washed with soap and water. What this does is wash off as many germs as possible.
  
  
• A bite from a dog, cat, wolf, fox or monkey could cause rabies. Unless you know for sure that the animal causing the bite has been vaccinated against rabies, inoculation must start at once, because rabies always results in death. Inoculation means the patient will need a series of anti-rabies injections, which will have to continue over a period of a few weeks.

Don’t

• Cover the bite
• Stitch a bite up as it may lead to a festering infection.

If a part of any limb has been cut off, it may be possible to reattach it to the body.

What should you do?

• You should carry the cut off part also to the hospital.
• Put it inside a clean polythene bag and place this bag in another bag with cold water.
• You can put some ice in the water to keep it cold.
• Make sure that the limb does not get soaked in the water. If nothing else is available, carry the amputated part in a clean cloth quickly to the hospital.
• Just cover the wound with a clean cloth and tie a pressure bandage quickly. If possible, keep the limb raised. The earlier a large wound is treated, the lesser the chances of infection.

Don’t

• In big injuries or wounds, where the injury caused a limb to get crushed or in amputations you should not try to wash or clean the wound. Washing such an injury only means that more blood will be lost. When the wound is large, the damaged blood vessels are also much larger, so bleeding is harder to stop. In any case some of the dirt is washed off by the bleeding itself.
• Never use raw cotton wool (as opposed to cotton cloth) to cover a wound, as raw cotton fibres stick to the wound, become difficult to remove and delay healing.

Under normal circumstances, the body's protective mechanisms come into play to stop bleeding. These are clotting of blood and narrowing of blood vessels, along with several other processes. However, it takes a little time for bleeding to stop naturally. If the wound is large or deep it may take longer. As a first-aider you can help stop the bleeding while the body is also doing its best.

What should you do?

• The easiest way to stop bleeding is to apply direct pressure on the wound. This can be done with any clean folded cloth like a clean handkerchief, or any cloth torn from clean garments.
• Since you will have to keep up the pressure for at least ten minutes, it is less tiring to lean on the wound with the heel of the hand than to try to squeeze it with your fingers.
• If the wound is on the arm or the leg, the limb may be raised. This reduces the blood flow to the wounded area, as the blood would have to move against the force of gravity.
• If movement of the limb or local pressure causes severe pain this could be a sign of a fracture, or of a dislocation. If there is a fracture, direct pressure may cause more pain. You will have to use a splint, combined with a gentle pressure bandage.
• When you apply pressure on a wound to reduce bleeding, you should keep up the pressure continuously for about 10 minutes for bleeding to stop. If you stop pressing and the wound still bleeds, then keep pressing. If after a while bleeding is still too much and blood soaks through the cloth, get a fresh piece of cloth and throw away the used cloth.
• You can tie the cloth pad firmly in place with a bandage made from any piece of cloth. This becomes what is known as a pressure bandage, which is always tied over the wound itself, to reduce bleeding.
• If the patient is unconscious, you will have to use your own judgement about how tight to tie the pressure bandage.

Don’t

• Often injured patients who are bleeding, complain of thirst. This is the body's way of warning that the blood loss is significant enough to stimulate the thirst centre in the brain. Though you may feel good giving water to someone who is seriously hurt, it is safer not to give the patient anything to eat or drink. This is to protect the patient from vomiting in case he needs anaesthesia and surgery, or has a head injury.
• It is not safe to get someone else's blood on you, as blood could contain other infections, which might be passed on. Use any barrier between your hand and the patient's body. Even a piece of polythene or a large leaf will do.
• Do not elevate a limb that has an obvious fracture or a dislocation.
• A cloth soaked with blood would be too spongy to pass on proper pressure to the wound.
• A pressure bandage should never be so tight as to cut off the blood supply lower down the limb. Too tight a bandage would hurt the patient very badly exactly where he has a wound. If the bandage is too tight the patient will start feeling "pins and needles" as the fingers and toes become numb, or the fingers and toes will turn blue.
• Do not ever tie the tight bandage known as a "tourniquet". A tourniquet is different from a pressure bandage in that it is tied higher on the limb, and not on the actual wound. Its purpose is to reduce bleeding by compressing the major blood vessels that feed the limb. Some patients have ended up losing limbs, because tourniquets have cut off the blood supply to their limbs for too long. If tourniquets have to be used, it is best done by a trained person.

A black eye is caused by bleeding underneath the skin around the eye. It can also be associated with more serious injuries like a skull fracture and bleeding within the eye. If there is blood within the white and coloured parts of the eye, or if there are vision problems seek medical advice immediately.

What should you do?

• Apply a cold pack or a cloth filled with ice to the area around the eye as soon as possible after the injury to reduce swelling.
• Continue using ice or cold packs for 24 to 48 hours.

Don’t

• Take care not to press on the eye itself.

Whenever our skin gets burned, the nerves become irritated, and this causes pain.
At first our skin becomes red, because heat dilates the skin’s blood vessels. This is called a "first degree burn".

As the temperature of our skin goes up, blisters form, and it hurts. This is called a "second degree burn".

In worse burns, even the nerves get burned, and the skin gets charred and leathery. This does not hurt, because the nerves have been destroyed. This is called a "third degree burn". The surrounding area in a third degree burn may, however be very painful. If a burn hurts and the skin is red, or blisters form, it is a sign that the burn is not so severe.

Deeper burns do need the help of a surgeon. When there is a burn, the body loses fluids from the burnt area. The amount of fluid lost is in proportion to the area of skin that is burnt. This is a bit like bleeding from wounds, except that it is not blood leaking out, but clear body fluids. This can also lead to shock, just as bleeding can lead to shock. So all patients with large burns, especially burns in many places should be taken to the hospital as early as possible. Children and old people are less able to cope with burns. In a child, any burn larger than the size of the palm of the hand should be treated in a hospital

What should you do?

• Water is the best medicine for first aid treatment of burns. The best way to bring down the temperature of burns is cold water. A burn should be kept in cold water for at least ten minutes, so that the burnt area cools down completely. The patient can guide you in this, as she may like to keep the burned area in cold water, as this greatly reduces the pain.
• On parts of the body, which cannot be dipped in cold water, apply a damp cloth and keep wetting the cloth. This also helps to cool the burn.
• Large burns may be covered with a clean cloth, for the same reason as you would cover a large wound.
• Burns of the face, hands or feet should also be treated by a surgeon as these burns can easily lead to disability. If the patient has burns on the face it is possible that he might have inhaled smoke and fumes, and this may have damaged his airway and lungs. Shift all such patients safely and quickly to a hospital.
  

Don’t

• Do not apply ice directly to burns because the ice itself will cause pain after sometime and possibly make the affected area numb.
• Do not apply any paste or oil on a burn. Do not apply any ointment sold from a pharmacy, even if the tube says it is meant for burns. These only make it difficult to examine the burn later, and add to the possibility of infection. Do not apply any antiseptic on a burn. The heat that caused the burn would in any case have killed most of the germs in that area.
• Do not apply any raw cotton wool to the burned area as cotton fibres stick to the wound and are difficult to remove.
• Try not to break open a blister, or peel off the skin, as this may bring in infection. However, you may have to break open very large blisters, as they may break on their own if they hit something. But you must make sure that this is done with a sterile instrument.
• Do not peel off the skin, as the skin can act as a dressing.
• Do not try to peel off cloth and other materials sticking to the burn, because you may remove skin along with the cloth, and hurt the patient more.

Whatever be the cause of the wound, healing is a process, which the body does naturally. There is no way to make the body heal wounds faster. The job of the person conducting first aid, or that of any medical professional, is to remove or reduce these problems so that the body can heal itself efficiently. All wounds need rest for healing to take place.

What should you do?

• The most important thing you can do is keep the wound clean. The easiest way to keep small wounds clean is to wash them with running water. Antiseptics and antibiotics are not required if the wound is clean.
• Sometimes splinters, thorns and pieces of glass that caused the wound may still be inside the wound. If you do not remove these they could cause serious infection, and the wound will not heal. These are easy to remove with a pair of tweezers.

Don’t

• Do not apply any fats, oils, ointments or any other pastes on the wound as these only delay healing and make it difficult for the doctor or nurse to properly examine the wound later.

A note on firearm injuries

Firearm injuries may have a small entry wound, but because of the high velocity, or speed, with which bullets enter the body, they cause serious damage inside. The greater the energy causing an injury, the more serious the damage it causes. Firearm wounds should always be shown to a surgeon.