The first few minutes of a household emergency are handled by whoever is present, not by a doctor. What they do in that time frequently determines the outcome.
Several widely used traditional first aid measures actively cause harm, which makes knowing the correct approach doubly important.
Burns and Scalds
Kitchen burns are among the most common household injuries, and the traditional responses are among the most damaging.
What to do: run cool, not cold, running water over the burn for twenty minutes. This is the single most important action and it works even if started up to three hours later. Remove rings, watches and tight clothing before swelling starts, but do not remove clothing stuck to the burn. Cover loosely with cling film or a clean non fluffy cloth. Give paracetamol for pain.
What never to apply: toothpaste, ghee, oil, butter, turmeric, ice, or any ointment. These trap heat, introduce infection and make cleaning the wound far more painful later.
Go to hospital for: burns larger than the person's palm, any burn to the face, hands, feet, genitals or across a joint, burns in children or older adults, chemical or electrical burns, deep burns that look white or leathery, and any burn where the skin is charred.
Choking
The response differs by age and by whether the person can cough.
If they can cough forcefully, encourage coughing. Do not intervene, as an effective cough is more powerful than anything you can do.
If they cannot speak, cough or breathe, act immediately. For an adult or child over one: five sharp back blows between the shoulder blades with the heel of your hand, leaning them forward. If unsuccessful, five abdominal thrusts, standing behind them with a fist above the navel, pulling sharply inward and upward. Alternate five and five.
For an infant under one: never use abdominal thrusts. Lay them face down along your forearm, head lower than body, and give five back blows. Then turn them over and give five chest thrusts with two fingers on the breastbone.
If they become unconscious, begin CPR and call for help.
Never perform a blind finger sweep in the mouth, which pushes the object deeper.
Severe Bleeding
Direct pressure controls almost all bleeding, and it is applied too gently far too often.
- Apply firm continuous pressure directly on the wound with a clean cloth
- Press hard and keep pressing for at least ten minutes without lifting to check
- If blood soaks through, add more cloth on top rather than removing the first layer
- Raise the injured limb above heart level if possible
- Do not apply a tourniquet unless bleeding is catastrophic and cannot be controlled by pressure
- Do not remove an embedded object, which may be plugging the vessel. Pad around it
Lifting the cloth every thirty seconds to check disrupts the clot that is forming and is the most common mistake.
Seizures
Witnessing a seizure is frightening and the instinctive responses are usually wrong.
What to do: note the time it starts. Clear objects away from the person. Place something soft under the head. Turn them onto their side once the jerking stops. Loosen tight clothing at the neck. Stay with them until they recover fully.
What never to do: do not put anything in the mouth, including a spoon, cloth or your fingers. It is impossible to swallow the tongue, and objects in the mouth break teeth and injure the person putting them there. Do not restrain the person. Do not put keys, onions or footwear near the nose, which does nothing.
Call for emergency help if: the seizure lasts more than five minutes, a second occurs without full recovery, it is the person's first seizure, they are injured, they are pregnant or diabetic, or they do not regain consciousness.
Poisoning and Ingestion
Household chemical ingestion is common in young children, and the traditional response of inducing vomiting is dangerous.
Do not make the person vomit. Corrosive substances such as acids, alkalis, bleach and toilet cleaners burn the oesophagus a second time coming up. Petroleum products such as kerosene can be aspirated into the lungs.
What to do: take the container or a photograph of it to hospital. Wipe out the mouth if there is residue. Give small sips of water for corrosives if the person is fully conscious and can swallow. Go to hospital immediately.
Do not give milk, salt water, or any home antidote unless advised by a doctor.
Prevention matters here: store chemicals in their original containers, never in drink bottles, and keep them out of reach and locked where possible.
Snake Bite
Snake bite remains a significant cause of death in India, and traditional first aid contributes to it.
What to do: keep the person calm and still, as movement speeds venom spread. Immobilise the bitten limb with a splint and keep it below heart level. Remove rings and tight items. Get to a hospital with antivenom as fast as possible. Note the appearance of the snake if it can be done safely, but do not attempt to catch it.
What never to do: do not apply a tight tourniquet, which causes limb damage. Do not cut the wound. Do not attempt to suck out venom. Do not apply ice or chemicals. Do not give alcohol. Do not go to a traditional healer first, which is the single greatest cause of delay and death.
Antivenom is the only effective treatment and it must be given in a hospital. Our emergency department is equipped for this.
Fainting, Heat Illness and Fractures
Three more common situations.
Fainting: lay the person flat and raise the legs. Loosen tight clothing. They should recover within a minute. If not, or if they are unresponsive, treat as an emergency. Recurrent fainting, or fainting during exertion, needs cardiac assessment.
Heat exhaustion and heat stroke: in Chennai summers this is a genuine risk. Move to shade, remove excess clothing, cool with wet cloths and fanning, and give fluids if conscious. Heat stroke, indicated by confusion, absent sweating and very high temperature, is a medical emergency requiring rapid cooling and immediate transport.
Suspected fracture: do not attempt to straighten the limb. Immobilise it in the position found, using a splint and padding. Apply ice over clothing for swelling. Do not give food or water in case surgery is needed.
The Home First Aid Kit
A basic kit, kept somewhere everyone knows, covers most situations.
- Sterile gauze pads and adhesive dressings in several sizes
- Roller bandages and adhesive tape
- Antiseptic solution
- Scissors and tweezers
- Disposable gloves
- Digital thermometer
- Paracetamol for adults and children, dosed by weight
- Oral rehydration salts
- Cling film for burns
- A torch
- Written emergency numbers and a list of household members' medications and allergies
Check expiry dates twice a year. Keep the emergency numbers written down rather than only in a phone, since phones are not always available or charged.
The most valuable things to remember are what not to do: no toothpaste or ghee on burns, nothing in the mouth during a seizure, no induced vomiting after poisoning, and no tourniquet or cutting after snake bite. Cool running water, firm sustained pressure, and getting to hospital quickly cover most of the rest.
Our emergency department at T. Nagar operates around the clock.
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