Injuries, environment and psychological first aid

1Burns, wounds and fractures

Burn: cool immediately with clean, cool water for at least 20 minutes; remove rings and clothing that is not stuck; cover with cling film or a clean non-stick dressing. Never butter, oil, toothpaste or ice; do not burst blisters. Large burns, burns to the face, hands or genitals, or burns in a child: medical advice.

Simple wound: wash with clean water and soap, cover with a clean dressing; check tetanus vaccination. Embedded object: do not remove it; hold it in place with dressings around it.

Fracture or sprain: do not try to put the bone back in place; immobilise in the position found (improvised splint, sling) and check the colour and feeling of the fingers or toes. Open fracture: cover the wound with a clean dressing.

Head and spine: after a fall or road accident, limit head and neck movement in a conscious casualty. Loss of consciousness, repeated vomiting, confusion or drowsiness after a blow to the head: medical evacuation.

2Heat, cold and dehydration

Heatstroke (very high temperature, confusion, hot skin, sometimes seizures) is life-threatening. Cool immediately, preferably by immersion in cold water up to the neck if possible; otherwise, soak the person and fan them, in the shade. Heat exhaustion (fatigue, cramps, sweating): rest in the shade and a rehydration solution.

Hypothermia: get the person to shelter, remove wet clothing, insulate from the ground, cover (survival blanket), rewarm gradually and handle gently.

Diarrhoea and dehydration: give oral rehydration salts (ORS) in small, frequent sips; continue breastfeeding infants. Danger signs requiring medical care: a child who is lethargic or unable to drink, sunken eyes, blood in the stool, profuse watery diarrhoea (think of cholera).

3Bites, stings, seizures and sudden illness

• Snakebite: calm the casualty and lay them down, immobilise the limb, remove rings and bracelets, and transport them to a facility with antivenom. No tourniquet, no cutting, no suction, no ice.
• Animal bite (dog, monkey, bat): wash the wound for 15 minutes with soap and water, then seek care quickly for rabies prevention.
• Seizures: protect from surrounding objects, put nothing in the mouth, do not restrain movements; note the duration; afterwards, recovery position. Call for help if the seizure lasts more than 5 minutes or recurs.
• Low blood sugar in a person with diabetes who is conscious and able to swallow: sugar, juice or a sweet drink.
• Severe allergic reaction (swelling of the face, difficulty breathing): help the person use their adrenaline auto-injector if they have one, and call for help.

4Psychological first aid

After a violent event, most people have normal reactions (fear, tears, shock, anger). Psychological first aid (WHO, 2011) offers humane, practical support without forcing anyone to talk.

• Look: safety, urgent needs, people in serious distress.
• Listen: introduce yourself, offer help, listen without judging, help the person calm down.
• Link: to basic needs (water, shelter, news of loved ones), information and services (health, mental health, protection).

Avoid promising what you cannot deliver, forcing someone to talk or giving your own interpretation. Look after yourself too: after a difficult intervention, talk to a colleague or to your organisation's psychological support.