Be Prepared: Emergency Do's and Don'ts
by Constance Young

Most people know they should call 911 if they have severe chest pain, profuse bleeding, or trouble breathing. Even tiny tots and some companion animals (especially assistance-trained dogs) have saved lives by dialing this number at the first hint of an emergency. The Associated Press reported one such case in 1996: Tipper the Tampa cat saved his own life when choking on a flea collar by hitting the number 1 with his paw on the telephone key pad that his owners had programmed to dial 911.

If children and dogs can be taught this trick, let this be a lesson to you—emergency preparedness saves lives.

When to Call 911
Dialing 911 can certainly be lifesaving, but there is more to an emergency than just dialing the magic number. Before dialing 911, try to assess quickly whether the problem is a minor crisis or a life-threatening emergency. (Upper abdominal pain could result from simple indigestion, poisoning, or more ominously, it could be an early sign of a heart attack.) This is not always an easy decision, and a quick call to your doctor or the ER could help you decide—but don't delay calling 911 if they are not readily available.

The initial minutes after an injury or medical crisis are the most important. Not every bleeding cut requires stitches, nor does every burn require advanced medical treatment—but it is always best to err on the side of caution. For example, if you are having signs or symptoms of a stroke (see sidebar) prompt treatment with the clot-busting drug tPA within 3 hours of the brain attack can prevent disability. So too it is best not to delay when experiencing possible symptoms of a heart attack, such as squeezing pain, pressure or fullness around the chest—possibly radiating to the arm, shoulder, neck or jaw. Other heart attack symptoms can include dizziness, sweating, shortness of breath, nausea, or vomiting.

The number 911 is designed for true emergencies such as these—not for annoyances like barking dogs, power outages, or test calls. True emergencies also include getting help from the police or fire departments. The call is free so you don't need to search for a quarter when using a pay phone. Children should be notified of this fact and taught to dial 911 for the police, fire, or medical help.

Of course until recently people managed to survive emergencies in many Hudson Valley communities with no 911 system either by calling an ambulance or driving to the Emergency Department (ER) of the nearest hospital. It's fine to keep those phone numbers in a convenient place for reference, but only the 911 system is designed to meet the true needs of the emergency situation.

What To Do—and Not To Do
During those frantic moments before the ambulance arrives, there are some things you can do—and a few things you should not do.

Burns: ER nurse Gail Alonge cautions against putting butter or margarine on a heat burn. "Butter or margarine allow the burn to continue. To stop the burn, apply a cool cloth." Moreover, they can contaminate the wound.

For injuries from chemicals, try not to contaminate yourself with the chemical. Dispose of contaminated items, such as clothing, and mechanically remove as much of the chemical as you can — for example by blowing away any powder or dust. Once you feel confident that the chemical has been removed, irrigate the area with cold water to get rid of the chemical as thoroughly as possible. In the case of chemical (as opposed to heat) burns, you should flood the affected area with water for about 20 minutes, continuing even on the way to the hospital..

Breathing disorders: Try to position the afflicted person to keep the airways open. Place one hand on the person's forehead, gently tilt the head backwards and lift the chin with your fingertips. Rush to the ER, or call 911. If the person is a known asthmatic, if possible get that person to take any prescribed medication.

Bleeding: It is important to stop the bleeding by applying direct pressure to the wound. After the bleeding stops clean the wound with soap and water. If available, apply an antibiotic, and cover the wound with a bandage. If the bleeding doesn't stop go to the ER; you may need stitches or to have the wound closed using special hospital glue.

Eye injuries: All eye injuries are potentially serious. Do not attempt to remove anything embedded in the eye. Wash out the eye with clean water to remove any loose material. If chemicals are involved, flush the eye with water or sterile fluid for at least 10 minutes while gently holding the eyelids open. Hold a pad over the injured eye and hurry to the hospital.

Possible stroke or heart attack. Don't delay; call 911 immediately. The paramedics may tell the potential heart attack victim to take a low dose of aspirin while awaiting the ambulance.

Other injuries or fractures: If you are tending to someone who may have a broken neck, or a fracture of the spine or back, do not move the injured person unless there is immediate danger (for example in a roadway where cars are coming). If the injury is of a leg or arm, try to apply a splint to stabilize the extremity.

Question: Call or Drive?
Ask yourself the following questions before deciding whether to call for an ambulance or drive to the ER yourself. Could the person's condition worsen and become life threatening on the way to the hospital? Does the person need the skills or equipment of paramedics or emergency medical technicians? Would distance or traffic conditions cause delays in getting the person to the hospital? If you answered yes to any of these questions it is best to call 911 or an ambulance.

Emergency Preparedness
Being prepared means keeping a list of emergency numbers (for police, fire, poison control, local hospitals and ambulance service, and your family doctor) by the phone. Being prepared also means making a list of all the important prescription medications you and your family take and their dosages and a list of any allergies. And take the list with you when you go to the emergency department. Keep a first aid kit at home and in the car.

The American College of Emergency Physicians has a free Home Medical Organizer that you can get by calling 1-800-446-9776.

Symptoms of A Stroke

(Treatment with the clot-busting drug tPA within 3 hours of an attack can prevent disability.)

• Symptoms usually on one side of the body only.
• Include sudden weakness or numbness of the face, arm or leg.
• Sudden dimness or loss of vision.
• Difficulty talking or understanding speech.
• Sudden severe headache.
• Unexplained dizziness or sudden falls.