Medical Emergency

First aid includes assessments and treatments that can be performed by a layperson (the patient or a bystander) with minimal or no medical equipment. First aid should never delay the activation of the emergency medical services (EMS) system or other medical assistance, if needed.

This first aid guide is derived from “Guidelines for First Aid”, published on November 2, 2010 jointly by the American Heart Association and the American Red Cross and appearing in Circulation. 2010; 122:S934-S946.

Calling for Help

In a medical emergency, activate the emergency medical services (EMS) system by calling the University Police at x66911.

Body Substance Isolation

It is recognized that some infections may be carried and transmitted in a person’s body substances, including blood, saliva, urine, feces and tears. While intact skin is a generally effective barrier against outside contagions, it is recommended that any provider, lay or professional, avoid direct contact with the body substances of another person. Keep in mind that you can be exposed by touching, splashing, spraying (i.e. a sneeze or cough), and that exposure may occur by skin contact or contamination in the eyes, mouth or nose. Body Substance Isolation refers to the practice of wearing or using barriers such as medical gloves or a CPR mouth-to-mouth barrier device.

Positioning the Victim

It is best to allow only trained rescuers to move a victim. Especially important: a victim that may have a spinal injury could be paralyzed if moved improperly. There are, however, a few notable exceptions:

  • If there is immediate peril to you and the victim, it may be necessary to relocate the victim to a safer place.
  • If you need to perform CPR it may be necessary to roll the victim onto their back.

Medical Emergencies

Breathing Difficulties

Difficulty breathing may be caused by a number of medical problems, including asthma or allergic reaction. This is a serious emergency and requires the immediate activation of EMS.

  • Call the University Police at x66911 to activate EMS
  • You may be able to assist the victim under the following conditions:
    • The victim states he/she is having an asthma attack and has medication or an inhaler.
    • The medication is prescribed to the victim.
    • The victim identifies his/her medication but is unable to administer it without assistance.
  • Allow the victim to sit upright, or in the position that is most comfortable.

Allergic Reaction (Anaphylaxis)

A victim of an allergic reaction may experience swelling (especially of the face), breathing difficulty, an itching rash, shock and even death. The victim may have a history of allergic reactions and may carry an epinephrine auto-injector (also known as an EpiPen™) or the allergic reaction could be the victim’s first.

  • Call the University Police at x66911 to activate EMS.
  • You may be able to assist a victim who has an epinephrine auto-injector under the following conditions:
    • The medication is prescribed to the victim.
    • The victim identifies his/her medication but is unable to administer it without assistance.
  • Allow the victim to sit upright, or in the position that is most comfortable.

Seizures (Convulsions)

The objectives during a seizure are to prevent further injury and to help maintain an open airway. Most seizures will stop on their own after a few seconds.

  • Call the University Police at x66911 to activate EMS.
  • Do not restrain the victim during the seizure. Move furniture away to protect the head.
  • Do not place anything in the victim’s mouth. Tongue biting, which may be typical of a seizure, occurs at the beginning. Placing something in the victim’s mouth is futile to prevent tongue injury, and may cause the victim to choke.
  • After a seizure the victim may be unconscious, confused or lethargic. Place the victim on their side to allow oral secretions to drain out, and reassure the victim.

Heart Attack

A heart attack is normally characterized as severe chest pain, but may be indicated by a number of other, more subtle signs. Heart attacks affect men and women. Learn to recognize the signs, and activate EMS immediately if you suspect someone may be suffering from a heart attack.

  • Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
  • Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
  • Shortness of breath with or without chest discomfort.
  • Other signs may include breaking out in a cold sweat, nausea, vomiting or lightheadedness.

As with men, women’s most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain.

Take action:

  • Call the University Police at x66911 to activate EMS.
  • Allow the victim to sit up, or in the position that is most comfortable.
  • Reassure the victim that help is on the way.
  • Monitor the victim and perform CPR if the victim becomes unresponsive or lacks normal breathing.

Stroke

A stroke is a blood clot or bleeding in the brain and is a serious medical emergency. Learn to recognize the signs of a stroke, and activate EMS immediately if you believe someone may be suffering from a stroke. Remember FAST:

  • Facial weakness – can the person smile? Is there drooping of the mouth or one or both eyes?
  • Arm weakness – can the person raise both arms?
  • Speech problems – can the person speak clearly and understand what you say?
  • Time is critical – call the University Police at x66911 to activate EMS.

Injuries

Injuries sustained at the workplace may require the victim’s supervisor to file certain reports with Environmental Health & Safety and the Office of Risk Management & Insurance Worker’s Compensation Program. These reports, as well as additional information, are available at http://publicsafety.tufts.edu/
accident/.

Bleeding

Control of bleeding is one of the few first aid actions by which you can have a major positive effect on outcome.

  • Call  the University Police at x66911 to activate EMS.
  • Control bleeding by applying direct pressure over the bleeding area until bleeding stops or EMS rescuers arrive.
  • Avoid contact with another person’s blood by using medical gloves.
  • Apply pressure firmly and for a long time.

It is best to apply manual pressure on a gauze bandage or other piece of cloth placed over the bleeding source. If bleeding continues, do not remove the gauze; add more gauze on top and continue to apply pressure.

Cuts and Scrapes

Clean the wound with clean, running tap water with or without soap for at least 5 minutes. Application of an antibiotic ointment and a dressing after cleaning has been shown to help wounds heal better. However, do not apply an antibiotic ointment if the victim has known allergies to the antibiotic.  Call for EMS or seek medical attention if necessary.

Burns

Burns Caused by Heat
Immediately cool the burn in cold, running water and continue at least until pain is relieved. Do not use ice, as this may freeze skin and cause more damage. Do not pop burn blisters, do loosely cover them with a sterile dressing. Call for EMS or seek medical attention if necessary. Always activate EMS for burns of a large area, or for burns affecting the face, hands or genitals.

Burns Caused by Electricity
Electrical burns are usually internal, and only a small outside burn may mask a large area of damage inside the victim.

  • Call the University Police at x66911 to activate EMS.
  • Consider your own safety first! Do not approach or touch the victim until the power has been turned off.
  • Once the power is off, assess the victim to determine if CPR is needed.

Burns Caused by Chemicals

  • Call the University Police at x66911 to activate EMS.
  • Brush powdered chemicals off the skin with a gloved hand or piece of cloth.
  • Remove contaminated clothing, being careful not to contaminate yourself in the process.
  • In the case of acid or alkali exposure (low pH or high pH) to the skin or eye, immediately irrigate with water, and continue to irrigate until EMS arrives.
  • It is also helpful to provide EMS with a copy of the Material Safety Data Sheet (MSDS) for the chemical involved.

Sprains, Strains, Bruises and Broken Bones

  • Call the University Police at x66911 to activate EMS.
  • Do not attempt to move or reposition a victim with a serious muscular, bone or joint injury.
  • Apply a mixture of ice and water to the injured area, being sure to place a thin towel or other cloth between the mixture and the skin to prevent freezing of skin. Apply ice for 10-20 minutes at a time, to prevent skin from becoming too cold.
  • If the injury includes open skin, cover the wound with a dressing. Do not attempt to push protruding bones or tissue back into the skin.

Dental Injuries

Dental injuries include chipped teeth or a tooth that is knocked out.

  • Seek medical attention at a dentist or emergency room, or activate EMS.
  • Handle knocked-out teeth by the part of the tooth that touches chewed food. Avoid touching the root, or the part of the tooth that’s normally embedded in the gums.
  • A knocked-out tooth could be a choking hazard.
  • Clean wounds inside the mouth with water. Avoid swallowing blood.
  • Stop bleeding by applying pressure with a piece of clean cotton.
  • Do not scrub knocked-out teeth. Rinse it in water, then place it in milk or clean water if milk is not available. Bring the tooth with you to the emergency room or dentist.

Environmental Emergencies

Cold Emergency

Hypothermia
Hypothermia is the lowering of body temperature. The seriousness depends on the length of the victim’s exposure and their body temperature.

  • Call the University Police at x66911 to activate EMS.
  • Begin warming the victim by moving them to a warm place and removing wet clothing. Wrap them with dry clothes, blankets, towels, etc.

Frostbite
Frostbite is damage to the skin caused by extreme cold or long period of exposure. Usually affecting extremities such has hands, feet, nose, ears, frostbite is characterized by discoloration of the skin and may include numbness or intense pain.

  • Call the University Police at x66911 to activate EMS or seek medical attention.
  • Do not attempt to re-warm the affected body part if you are close to medical care or if there is a chance the affected body part could re-freeze.
  • Prevent the onset of hypothermia by moving them to a warm place and removing wet clothing. Wrap them with dry clothes, blankets, towels, etc.
  • Minor frostbite (frostnip) can be treated with rapid re-warming using skin-to-skin contact such as a warm hand.

Heat Emergency

Illnesses brought on by heat may include heat cramps, heat exhaustion and heat stroke. Most heat related emergencies can be prevented by drinking water often during hot weather, and staying indoors during the hottest parts of the day.

  • Get the victim to a cool place – shade, indoors, or an air conditioned car.
  • Loosen or remove clothing and cool the victim with a cool water spray or fan the victim.
  • Offer the victim cool electrolyte-carbohydrate mixture (juice, milk, etc.)  to drink, only if they are awake and alert.
  • If the victim is confused, sweating, nauseous or vomiting or refuses water, call the University Police at x66911 to activate EMS.

Poison Emergency

Poisons may be ingested, inhaled or absorbed through the skin, eyes or mucus membranes. Treatment for different types of poisons varies, and there is no general recommendation that can be made other than activating EMS and contacting the Poison Help hotline of the American Association of Poison Control Centers.

  • Call the University Police at x66911 to activate EMS.
  • Contact the Poison Help hotline at 800.222.1222.
  • Do not give the victim anything to drink or eat unless directed to do so by the Poison Help hotline.
  • Do not cause the victim to vomit unless directed to do so by the Poison Help hotline.

Public Health Emergency

A public health emergency exists when campus air, drinking water, or food is contaminated with one or more hazardous agents such as chemicals or pathogens that could or will result in disease or injury impacting large numbers of people. Likewise, other campus wide incidents such as pest infestations or failure of the sewage system also have the potential to result in disease or injury that would be significant to communities.

Actions will be taken to notify the Tufts community of these conditions as soon as Tufts University becomes aware of an outbreak of such an emergency.

The following types of outbreaks or epidemics represent public health emergencies:

  • Communicable disease: widespread disease for which vaccination is not available;
  • Foodborne disease: gastrointestinal illness;
  • Waterborne disease: microbiological or chemical agents;
  • Injuries resulting from infestation with insects, rodents or other pests (e.g. bedbugs);
  • Infectious disease resulting from contact with sewage or other human wastes.

Student Health Services, Public and Environmental Safety and Facilities Services each have a responsibility to be aware of the public health significance of utility failures, reports of unusual diseases or injuries, or an unusual frequency of certain diseases and injuries. Tufts University will work closely with local and state agencies such as the Massachusetts Department of Public Health to respond quickly and effectively to public health emergencies that occur at Tufts University or in the neighboring community.