15
BASIC FIRST (AND IN YOUR CASE, ONLY) AID
If you fracture your shin, don’t worry: things are probably going tibia okay.
First aid is designed to be effective at stabilizing injured people before medical personnel arrive, which in your particular case may take several million years. Here’s what you can do when various bad things happen! But first, a word of warning: while the techniques described here are better than doing nothing, they are not without risk, and done incorrectly can make things worse. If you happened to travel back in time with a nurse or doctor, always defer to their medical knowledge. (And also, wow, that was really lucky for you.)
CHOKING
The Heimlich maneuver*—named after the man who first maneuvered his body in this way toward deliberate ends in 1974 CE—should be deployed when you see someone choking. Stand them up, position yourself behind them, put your fist just above their belly button, put your other hand on top, and pull in and up suddenly, as if you’re trying to lift them. You’re putting pressure on the lungs and effectively creating an artificial cough, which will hopefully expel whatever’s stuck in their throat. You can even perform this maneuver on yourself, so take that, society.
BREATHING BUT UNCONSCIOUS
If someone is lying on their back breathing but unconscious, they risk choking on their own tongue, saliva, blood, vomit, or other equally embarrassing substances and/or muscly organs. Since 1891 CE (the year humans finally realized, “Hey, it would be cool if we could spend some time unconscious and not have to worry about suffocating on our own tongues”), knocked-out people have been moved into what’s called the “recovery position,” which keeps their position stable while preventing their airway from becoming blocked. Here’s how you do it.
First, kneel beside the victim. Move the arm nearest you so it’s at a right angle to their body, bent at the elbow, palm up. Take their other arm and move it across their chest so that the back of their hand is against their cheek, the one nearest to you. Hold it there. With your other arm, pull up their far knee so their foot is flat on the floor. Now, roll the victim toward you, which will move them onto their side. When you do this, the victim’s arm you’re holding will support their head, and their foot and knee you raised will move onto their side, preventing the victim from rolling backward. Move the nearest leg in front of their body, which also stabilizes their position. Now, gently lift their chin to tilt their head back, which will open up their airway and allow any fluids to drain out. Finally, open their mouth and look inside, just to double-check there’s nothing blocking it. If there is, and you can remove it, you should do so. The final position should look like this:
Figure 57: The recovery position.
If the victim stops breathing, you’ll want to perform CPR, which is described next.
NOT BREATHING
CPR (“cardiopulmonary resuscitation”) was invented in the 1950s CE, but built on earlier efforts.* It’s employed when someone has stopped breathing (usually due to their heart stopping), and the goal is to keep oxygenated blood moving to their brain and other organs until they recover and begin breathing again. If you have someone who’s not breathing, you can try CPR as a last-resort treatment. Keep in mind it usually breaks some ribs, so don’t do it just for funsies.
To perform CPR, you’ll want to put your patient on their back and regularly push down hard in the center of the patient’s chest, between the nipples, at about 100 compressions per minute. An easy way to hit that mark is to perform compressions in time to a song, usually but not necessarily sung inside your head. See the sidebar on this page for a list of popular songs drawn from the late twentieth and early twenty-first centuries: a true golden age for CPR-friendly music.
The CPR you’ve probably seen in movies involves mouth-to-mouth resuscitation; that’s no longer recommended except in cases of drowning. If you’re not doing mouth-to-mouth, keep up chest compressions on your target until someone more qualified arrives (unlikely, given your present circumstances), your subject begins breathing, or they die. If you are including mouth-to-mouth in your resuscitation efforts, then after every 30 compressions tilt their head back and open their mouth. Listen for normal breathing (not gasping)—if there isn’t any, then pinch their nose shut, cover their mouth with yours, and blow until you see their chest rise. Repeat once (so, two breaths total), then go back to compression. There! Now, without advanced medical training, you’ve literally done all you can!
Sidebar: CPR Songs
BROKEN BONES
When a bone’s broken you’ll want to perform what’s called “traction in position”—which is basically taking any broken or dislocated limb, pulling it out and away, and then letting it snap back into place. This prevents bones from healing in the wrong places and also makes things hurt much less down the road, so that’s two good reasons to do it. Grab the damaged limb both above and below the fracture—the above hand will be holding the limb in place, while the below hand will be applying downward pressure while slowly and gently bringing the limb back to its normal position. Afterward, you can stabilize the injury with a splint: that’s any rigid material, like wood, that’ll hold the broken bone in place while it heals. They should be snug, but not so tight that circulation is impeded. This is another treatment you can administer on yourself, but if it’s one of your own arms that you’ve injured, you’ll have to do it one-handed. Keep in mind that traction in position can be really painful, but setting your own bones is a super badass thing to do, so make sure to tell someone the story when you get a chance.
WOUNDS
The immediate danger from a wound is losing so much blood that you die. If you can raise the wound, do that: it’ll reduce blood flow. Pressure can help stop bleeding: twenty minutes or so of firm pressure is usually enough for blood to start clotting and bleeding to stop. If that fails, you can attempt to find the artery that’s bleeding and put pressure directly on that with a finger. Failing all of that, a tourniquet—an extremely tight bandage—is a last-ditch effort. A tight tourniquet cuts off all blood circulation to everything beyond it—which means the bleeding stops, but after a few hours the tissues in whatever limb has been tourniqueted stop living too—but at least the human that limb is attached to has a chance to not die from blood loss today. For larger wounds, you can consider cauterization—although, again, it’s a last-ditch, traumatic effort. Heat something up (wood, metal) and apply it directly to the bleeding parts of the wound, and you’ll burn the flesh closed. You’ll want to cauterize as little flesh as possible, because not only does this hurt (our apologies if you’re performing a cauterization on yourself live, at the same time you’re reading this paragraph, and were therefore surprised at how much pain you were experiencing just before you reached this parenthetical aside), but it also creates dead flesh inside the wound, which is an easy vector for infection. If a wound is large, you may need stitches to hold it closed. There’s no magic to stitches: just boil thread and whatever you’re using as a needle for twenty minutes to get them clean, wash your hands with soap and water, and sew the wound closed by pulling thread through each side of it in little loops that get tied off in a knot.
INFECTION
Here is the best thing you can do to prevent infection: clean wounds carefully and thoroughly. Yes, even scratches. You’re used to antibiotics (and hopefully you will be again once you start farming penicillin in Section 10.3.1), but without them, infections are incredibly deadly, and they can begin anytime skin is broken. Before antibiotics, more soldiers died of infection than battle, and a single scratch is all it takes. To clean a wound, rinse it thoroughly with (clean, obviously) water, then pour either alcohol or a 2 percent solution of iodine in water (see Appendix C.7) over the wound to kill bacteria. If you have neither of those, honey can work in a pinch: it doesn’t support bacterial growth (which is why you never had to keep honey in your refrigerator, back when you had a refrigerator!).* After that, sew the wound up—unless it’s been more than twelve hours, in which case you’ll need to leave it open and instead pack it with gauze, which will help the wound drain.