Neck and back injuries are equally serious. A broken back can result in paralysis if the spinal cord is damaged. A victim with a back injury should be moved as little as possible to avoid further injury, although first aid to restore breathing or to stop bleeding should be undertaken.

A very common but usually less serious emergency is a broken bone. A bone may be broken (or fractured) in a variety of ways. In a simple or closed fracture, the bone fragments do not pierce the skin. If the bone ends come through the skin, the break is known as a compound or open fracture, and there is a greater risk of infection.

If a fracture is suspected, it is best not to have the victim test it by putting pressure on it --- by walking, for example. Assume that the bone is fractured, and immobilize it until medical help is available.

Fractures must be distinguished from sprains and strains. A sprain is an injury to the ligaments, tendons, and soft tissues in the region of a joint. A strain is a muscle injury from overexertion or stretching. It is often necessary to X-ray the area to determine what kind of injury has occurred because similar symptoms swelling, pain, and tenderness--are common to all three injuries.

Small lacerations (cuts) and simple hematomas (bruises) are not usually serious. but some blood clots (also called hematomas) can be very serious. There are several kinds of cuts and bruises. A contusion is a bruise to the tissue under the skin. An abrasion is a skin wound caused by rubbing or scraping. A puncture is a deep wound by a piercing object. Whenever the skin is broken. the wound should be cleaned well with soap and water to remove foreign objects and dirt. Then it should be disinfected with an antiseptic. if necessary, a tetanus shot or booster should be given, especially if it is a puncture wound. If a cut is extensive. a doctor will use stitches(sutures) to close it. Even if a wound is treated and heals properly, it may still leave a permanent scar. Increasing pain, tenderness, swelling, pus, or red streaks around a wound are all signs of infection, which should be treated with medication. An infection can also cause fever.

Burns can be as trivial as a simple cut or can be cause for real concern. Burns are classified as first, second, or third degree, depending on their severity. A first-degree burn, such as a mild sunburn, involves just the outer surtace of the skin; second-and third degree burns, indicated by swelling, blistering, and a charred black color, involve the tissue below the skin and occasionally even underlying organs. The third-degree burns destroy the ability of the affected epidermis layer to regenerate, and treatment may require skin grafting. A first degree burn can be treated with a cooling lotion or cream, but more serious burns require prompt medical attention and possibly hospitalization to avoid shock and dehydration and to relieve severe pain.

Many household chemicals such as ammonia, bleach, and dishwasher detergent furnish the potential tor serious crises.

The ingestion of these and other poisonous substances frequently creates emergencies, especially among young children. The antidote for each substance is different, so instructions on the container should be followed closely. In some cases, the victim should be forced to vomit; a medicine called ipecac should be given to the patient to induce vomiting. However, with some poisonous substances, vomiting is harmful. In any case, a doctor should be contacted. Many communities have poison control centers where information can be obtained by telephone as to the proper treatment for different poisonous substances. Households with children should keep that phone number handy in case of such an emergency.

Because speed is important in an emergency, it is helpful to have the emergency equipment and medications readily available in a first-aid kit. This kit should contain, ạt a minimum, a thermometer, antiseptic solution, an ace bandage, equipment for making a splint, clean rags for a tourniquet, sterile absorbent cotton for cleaning wounds, and gauze pads with adhesive tape for bandaging them. A stethoscope, a sphygmomanometer for measuring blood pressure, a suture kit, and a tracheotomy kit are also useful to someone trained in their use.

In any medical emergency, first aid is critical, but it is only the first step. Expert advice should be obtained while these measures are being taken. Many communities have mobile emergency medical vehicles operated by trained paramedics, who can render first aid beyond what the layman cạn do until the patient can be seen by a physician.

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