Basic First Aid

Use the following format to cite this article:

Basic first aid. (2012). Farm and Ranch eXtension in Safety and Health (FReSH) Community of Practice. Retrieved from http://www.extension.org/pages/66375/basic-first-aid.

 

Farm and ranch owners and managers, as well as family members working on a farm or ranch, should receive first aid training. Having personnel trained in first aid who can respond appropriately to an accident can improve the outcome for a victim of an agricultural accident.

First Aid Training

To obtain first aid training, check local hospitals, schools, emergency medical services (EMS), and similar resources for upcoming first aid classes. Sign up for a first aid or first responder class or organize a class for workers or local agricultural organizations. Several state and national organizations, including those listed below, may have courses or trainers available in your area:

• American Red Cross: Input your zip code on the website to find a local Red Cross office.
• National Safety Council: Choose the type of class you wish to take and identify your area to locate an instructor.

Note that many institutions also offer online training courses. 

Basic First Aid

Agricultural incidents can result in a wide variety of injuries. Below are some basic first aid instructions for common injuries and emergency situations that occur on farms and ranches.

Anaphylaxis

Anaphylaxis is a life-threatening allergic reaction that can cause shock, breathing difficulties, and a drop in blood pressure. Triggers of anaphylaxis include medications (such as penicillin), foods (such as peanuts or shellfish), and stings from insects (such as bees, fire ants, and so on). Anaphylactic reactions can include the following symptoms:

• Skin reactions, such as hives
• Swelling of the face, eyes, lips, and throat
• Airway constriction
• Weak and rapid pulse
• Nausea
• Dizziness
• Unconsciousness

Take the following actions to assist a person experiencing anaphylaxis:

• At the first sign of anaphylaxis, contact 911 or local EMS.
• A person aware of his or her anaphylactic tendency may carry an epinephrine autoinjector such as an EpiPen to treat this type of attack. Depending on his or her condition, ask the person experiencing the reaction whether he or she needs assistance in using the autoinjector on his or her thigh.
• While waiting for EMS, have the person experiencing the reaction lie on his or her back. Loosen any tight-fitting clothing the person is wearing, and cover the person with a blanket. 
• Should the person begin to vomit, turn the person on his or her side.
• Cardiopulmonary resuscitation (CPR) can be administered if the person shows no signs of breathing, coughing, or movement. (Click here to be directed to CPR instructions.)

Note that a person experiencing an anaphylactic reaction should not try to drink. Do not give water to a person suffering anaphylaxis.

For a short video by EpiPen on anaphylactic shock and the use of an epinephrine injector, click the image below.

A person experiencing anaphylaxis should be treated with an epinephrine injector only if he or she has been prescribed one by a physician or if the injection is administered by a licensed EMS provider. Complications can arise if epinephrine is used on some patients, especially patients with a history of cardiac problems. EMS responders should be called to manage a person having symptoms of anaphylaxis if the person does not have his or her own injector.

Animal Bites

The most common animal bites are from domestic animals such as dogs and cats. Bites that result in puncture wounds have the greatest chance of becoming infected. Anyone who receives an animal bite that punctures the skin should be seen by a physician or go to the local emergency room.

Take the following actions to assist a person who receives an animal bite:

• When a person receives a bite that punctures the skin, wash the wound completely with soap and water for three to five minutes.
• When a bite is more serious and involves deep punctures or badly torn skin and bleeding, apply pressure to the wound with a clean, dry cloth.
• After the bite has been treated, watch the area for any signs of infection, such as swelling, redness, excessive pain, or oozing. If the site becomes infected, seek medical attention.

Depending on the bite, a physician may recommend that the person bitten get an updated tetanus shot (if his or her last injection was more than five years ago).

Amputation/Severed Body Part

Take the following actions when a body part is cut or torn from a person’s body in an agricultural accident:

1. Call 911 or contact local EMS.
2. Locate the body part, wrap it in sterile gauze or a clean cloth, and place it in a plastic bag.
3. Place the bag with in a cooler with ice and bring it or have it transported to the hospital.

Do not freeze the body part.

Burns

The three burn classifications are first-, second-, and third-degree.

• A first-degree burn is the least serious, affecting only the outer layer of skin. A minor sunburn is considered a first-degree burn. Most first-degree burns should be treated as minor burns, unless a burn covers a substantial part of a person’s body.
• A second-degree burn occurs when the first and second layer of skin have been burned. Such burns can result in blisters; red, splotchy skin; pain; and swelling. Treat a second-degree burn as a minor burn if it is three inches or smaller.
• Third-degree burns always require professional medical treatment because these burns can affect all layers of skin and tissue and may extend to muscles, ligaments, tendons, nerves, and bone. Initially, a third-degree burn may be less painful than a first- or second-degree burn because the nerves are usually burned. Excruciating pain from a third-degree burn may occur later. 

Treating a minor burn

Take the following steps to treat a minor burn: 

1. Ensure that the victim is no longer in contact with the source of the burn.
2. Have the burned person cool the burned area by holding it under cool (not cold) running water for approximately 10 to 15 minutes. 
3. Cover the affected area loosely with a sterile gauze bandage. 

Never use ice, butter, or ointment on a burn, and do not break blisters.

Treating a third-degree or major burn

Treatment for a third-degree or major burn includes the following steps:

1. Call 911 or contact local EMS.
2. Ensure that the victim is no longer in contact with the source of the burn.
3. Check the victim for signs of circulation (breathing, coughing, or movement). If the victim is not breathing, begin CPR.
4. Cool the burn site with water or cool, moist sterile bandages.
5. Cover the burned area loosely with a sterile dressing.

Never remove burned clothing that is stuck to a burned area; rather, cool the material and cut or tear around the area. Do not immerse large, severely burned areas in cold water. You may pour cool water on large burns if you can do so within 20 minutes of the victim receiving the burn. A doctor may recommend a tetanus shot for individuals who sustain third-degree burns. 

Watch the following video by the Health and Safety Institute to learn more about first aid for a major burn:

Chemical Burns

A chemical burn occurs when living tissue comes in contact with a corrosive substance such as an acid, a base, an oxidizer, a solvent, a reducing agent, or an alkali. In agriculture, such substances are found in pesticides, lime and fertilizers, fuels, detergents, and sanitizers.

Treating a liquid chemical burn

Take the following actions to assist a person who has sustained a liquid chemical burn:

1. Remove the source of the burn and remove clothing or jewelry that may have been contaminated by the corrosive substance. 
2. Rinse the affected area for 15 to 30 minutes with cool, gently running water. 
3. Loosely wrap the burned area with dry, sterile dressing or a clean cloth.
4. If the victim continues to experience a burning sensation, rewash the area.

Treating a dry chemical burn

When a person sustains a dry chemical burn, brush away the excess chemical with a gloved hand or a towel. Then follow the directions for threating a liquid chemical burn.

Contact 911 or local EMS if any of the following conditions apply:

• The victim shows signs of shock.
• The victim has a second-degree burn larger than three inches.
• The victim has uncontrollable pain.
• The burn involves the eyes, hands, feet, face, groin, buttocks, or major joints. 

An updated tetanus shot may be recommended by the attending physician if the injury requires a visit to the emergency room.

Chemical burns to the eye

A person can receive a chemical burn to the eye when a chemical liquid is splashed in his or her eye or when the person rubs his or her eye after touching a chemical. Products at work and in the home that can cause chemical burns to the eye include cleaners, solvents, disinfectants, fertilizers, and pesticides.

Take the following steps to treat a chemical burn to the eye:

• Get emergency care for the injury.
• Flush the victim’s eyes with lukewarm tap water for a minimum of 20 minutes.
  • Have the victim keep his or her eyes wide open during flushing.
  • When flushing, rinse each eye from the nose outward to reduce the risk of chemical residue washing into the other eye.
  • Use only water or saline rinse (for contact lenses) to flush the eyes.
  • Water irrigation to the eyes should begin immediately and should be continued while the victim is en route to treatment.
  • The victim should expect additional flushing upon arrival at the hospital. 
• Thoroughly wash your hands to remove possible chemical residue.
• Note the name of the chemical or take the chemical container to the emergency department. 

Never allow the victim to rub his or her eyes. Note that chemical burns to the eye may cause light sensitivity, so the victim may need to wear sunglasses when going for emergency care.

Electrical Burns

An electrical burn burns from the inside of the body outward. Although an electrical burn may appear to be minor and may not even be visible on the skin, damage can occur deep in tissue. Strong electrical currents going through a person’s body can cause internal damage (such as heart-rhythm disturbance or cardiac arrest) or burn a person’s nerves, blood vessels, tissues, or organs. 

When a person may have an electrical burn, first evaluate the scene to determine whether the person is still in contact with the electrical source. Do not touch the person until you have first turned off the source of electricity. Then take the following actions:

1. Call 911 or local EMS.
2. Check the person for injuries, and begin CPR if the victim is not breathing.
3. Cover the burn area with dry, sterile gauze bandages.
4. Keep the person from getting chilled, and do not cool the burned area with water.

Choking

Choking occurs when a foreign object becomes lodged in a person’s throat or windpipe, hindering air flow as the person tries to breathe. If the choking victim is conscious, ask him or her whether he or she is choking and whether you can help him or her. If the victim cannot cough, speak, or breathe, contact 911 or local EMS. Then begin administering abdominal thrusts, also known as the Heimlich maneuver:

1. Stand behind the victim and place the thumb side of your fist against the middle of the victim’s abdomen.
2. Place your other hand on your fist and give five quick, upward thrusts to dislodge the object. 
3. If the victim is pregnant, position your fist slightly higher, by the base of the breastbone.

Do not administer abdominal thrusts if the person is coughing, but rather encourage him or her to continue coughing to dislodge the object.

Embedded Objects

If you encounter a person with an object embedded in his or her skin, do not remove the item. Removal of the impaled object could cause uncontrollable bleeding or damage to nerves and blood vessels near the injury site. Make sure that the object remains in place by putting clean dressings or gauze around the object. Once the object is immobilized, wrap the area with gauze and get emergency medical treatment for the injury.

Fracture or Musculoskeletal Injuries

A fracture is a complete break, chip, or crack in a bone. All bone fractures require medical attention. Contact 911 or local EMS if any of the following conditions apply:

• The injured person has sustained an injury to the head, neck, or back.
  • Do not move the person if the injury involves the head, neck, or back. 
• The injured person shows signs of unresponsiveness.
• The injured person is unable to move or use the injured body part without pain.

While you are waiting for EMS responders, attempt to stop any bleeding, immobilize the area, apply ice packs to decrease swelling and relieve pain, and treat the victim for shock (if applicable).

If you need to transport the victim, you should first immobilize the injured body part with a soft, rigid, or anatomical splint.

• Soft splints, which have some flexibility, can be made from items such as pillows or blankets.
• Rigid splints, which are difficult to bend, can be made from boards or rolled up newspapers.
• Anatomical splints are made from body parts adjacent to the the injury.  For example, if an person has injured his or her leg, the injured leg could be splinted against the other leg.

If fractures occur between two joints, a splint should extend to cover both joints. Likewise, if a fracture occurs on a joint, the splint should extend to cover the bones above and below the joint. Once the splint is complete, apply ice and elevate the injured body part. Do not put ice directly on the skin; place a towel between the ice and the person’s body. 

Frostbite

Frostbite occurs when the skin and underlying tissue freeze due to exposure to cold. The severity of frostbite depends on temperature, exposure time, and wind. Areas typically affected by frostbite include the hands, feet, arms, legs, nose, and ears. Common frostbite symptoms include skin discoloration (white or grayish-yellow); cold skin temperature; skin that feels hard or waxy; and skin that is itchy, burned, or numb. Frostbite is categorized by degree of severity: frost nip, superficial frostbite, and deep frostbite. Skin may be red and painful when the area thaws. 

If you experience frostbite, you should seek medical attention as soon as possible. Take the following actions while awaiting treatment:

1. Protect yourself from further exposure by warming the frostbitten body part—by putting your hands in your arm pits, for example—but do not rub or massage a frostbitten area.
2. Go inside and remove wet clothes and anything that may constrict blood flow.
3. Gradually warm the frostbitten area with warm water, and loosely wrap affected areas in dry, sterile dressings or a warm blanket. Place cotton or gauze between frostbitten fingers or toes. 

Head Trauma

If a person sustains a moderate or severe head injury, contact 911 or EMS immediately. Symptoms of head injury include the following:

• Head, nose or facial bleeding
• Severe headache
• Changes in consciousness
• Confusion
• Loss of balance
• Weakness or inability to use limbs
• Vomiting
• Slurred speech
• Seizure

In the event of a severe head trauma, keep the injured person still and calm while you are waiting for EMS responders. Do not move the injured person unless absolutely necessary. Try to stop any bleeding by applying firm pressure to the wound with a sterile bandage. Do not, however, apply direct pressure to a severe head wound. If the bandage becomes soaked with blood, do not remove the bandage, but rather place an additional bandage on top. If there is any debris in the wound, leave it in place for medical professionals to remove. Begin CPR if the person exhibits no signs of breathing or circulation. 

Severe Bleeding

An adult has approximately 12 pints of blood in his or her body, so loss of even a pint of blood can be serious. Bleeding can be internal or external. When a person has  internal bleeding, others may not be able to see or do anything to treat the source of the bleeding.

Follow the instructions below to provide first aid to a person who has external bleeding: 

1. Contact 911 or EMS responders immediately. 
2. When possible, before you attempt to stop severe bleeding, thoroughly wash your hands and put on disposable gloves to reduce the risk of infection.
3. Using a sterile bandage, dressing, or clean cloth, apply direct pressure to the wound for about 20 minutes to stop the bleeding.
   • Depending on the remoteness of your location and availability of resources, you may not have a clean bandage. In such a situation, you can use a towel or shirt when applying direct pressure. Although such fabric is not sterile, its use is acceptable because the main priority is to stop the bleeding.
   • If the bleeding will not stop, have the person lie down, and elevate the wounded area. If necessary, apply pressure on the appropriate pressure point—pressure points are identified during first aid training—to slow the blood rate through the artery. 
4. Remove any visible dirt or debris from the wound, but do not disturb large or embedded items.
5. Maintain pressure on the wound by wrapping the injured area with a clean cloth or adhesive tape.
6. If bleeding continues, do not remove the gauze or bandage, but rather place additional gauze on top of the injured area.
7. Once you have stopped the bleeding, immobilize the injured body part.

Shock

Shock occurs when a person is not getting adequate blood or oxygen to his or her organs. In such a situation, the body responds by entering a survival state with the purpose of counteracting such life threatening conditions as excessive loss of blood. A person can experience shock as a result of an injury, heatstroke, severe burn, and so on. Symptoms of shock vary, but common signs include the following:

• Whole-body weakness
• Cool and clammy skin
• Weak and rapid pulse
• Increased breathing rate
• Nausea
• Staring
• Unconsciousness

If you think a person is in shock, call 911 or your local EMS. While waiting for EMS, have the person lie down, and check for signs of circulation, keep the person comfortable and warm (but not overheated), and raise the person’s legs 10 to 12 inches (as long as doing so will not cause the injured person discomfort or pain). Do not give the injured person food or liquids even if the person asks for something to eat or drink; shock can shut down blood flow to the stomach, hampering digestion.

Resources

For more information about preparing your farm or ranch personnel for an agricultural incident, here to be linked to the article “Basic CPR” and here to be linked to “First Aid Kits for Production Agriculture.”

 

 

Sources

Community first aid and safety. (2002) San Bruno, CA: The American Red Cross.

First aid and emergencies. (n.d.) WebMD. Retrieved from https://www.webmd.com/first-aid/default.htm.

Hill, D. (2004) Emergency first aid care for farm families: Instructor’s guide. Managing Agricultural Emergencies.

Mayo clinic staff. (n.d.) First aid. Mayo Clinic. Retrieved from http://www.mayoclinic.com/health/FirstAidIndex/FirstAidIndex.

Murphy, D., Pollock, J., Smith, G., Bean, T., & Sailus, M. (1989) First on the scene. National Resource, Agriculture, and Engineering Service. Retrieved from http://host31.spidergraphics.com/nra/doc/Fair%20Use%20Web%20PDFs/NRAES-12_Web.pdf.