First Aid
Why This Matters
In a world without hospitals, ambulances, or pharmacies, a deep cut can kill you through blood loss or infection. A broken bone that heals wrong can cripple you permanently. A burn that gets infected can turn septic. The knowledge in this article is the difference between a recoverable injury and a fatal one. You are now the emergency room.
Core Principle: Clean Hands, Clean Water, Clean Materials
Infection is the number one killer in post-medical-infrastructure scenarios. Every first aid intervention starts with the same imperative: make it as clean as possible.
- Wash your hands before touching any wound, even if you can only rinse with clean water
- Use clean water for wound irrigation (see Water Purification)
- Use the cleanest available cloth for bandages — boiled fabric is best
- When in doubt, leaving a wound open and clean is better than wrapping it in dirty material
What You Need
Basic first aid supplies (scavenge or improvise):
- Clean water (boiled and cooled)
- Clean cloth strips (torn shirts, sheets — boil if possible)
- Straight, rigid sticks (for splints)
- Cordage or fabric strips (for securing splints)
- Honey (natural antibacterial for wound dressing, if available)
- Alcohol or strong spirits (wound cleaning, NOT for drinking during an emergency)
- A sharp, clean knife or blade
Improvised supplies:
- Sphagnum moss — naturally antibacterial, absorbs 20x its weight in fluid, historically used as wound dressing
- Spider webs — contain antimicrobial compounds, used as wound covering for millennia (gather from clean areas, not dusty corners)
- Clean plastic bags — for burn coverage, waterproof wound protection
- Charcoal paste — activated charcoal for potential poisoning
Bleeding Control
Blood loss is the most immediately life-threatening injury you will encounter. The priority is stopping the bleeding, fast.
Minor to Moderate Bleeding
Step 1 — Expose the wound. Cut or remove clothing to see what you are dealing with. Do not pull out objects embedded in the wound — they may be plugging a blood vessel.
Step 2 — Apply direct pressure. Place a clean cloth pad over the wound and press firmly with your hand. Press HARD. Pressure that feels uncomfortable is probably about right. Do not lift the pad to check — this disrupts clotting.
Step 3 — Maintain pressure for a minimum of 15 minutes without lifting. If blood soaks through the first pad, add another pad ON TOP — do not remove the first one.
Step 4 — Once bleeding slows or stops, secure the pad with a bandage or cloth strip tied firmly but not so tight it cuts off circulation below the wound. You should be able to slip a finger under the bandage.
Step 5 — If the wound is on a limb, elevate it above heart level to reduce blood pressure at the wound site.
Severe / Life-Threatening Bleeding
If blood is spurting (arterial bleeding) or flowing fast enough that direct pressure alone cannot control it:
Step 6 — Apply a tourniquet. This is a LAST RESORT for limbs only — a tourniquet cuts off ALL blood flow below it, risking limb loss. But a dead person does not need their limb.
- Use a strip of cloth, belt, or rope at least 4 cm wide (narrow cords cut into tissue)
- Place it 5-8 cm above the wound (between the wound and the heart), NEVER on a joint
- Wrap it around the limb and tie a half-knot
- Place a stick on the half-knot and tie a full knot over the stick
- Twist the stick (windlass) until bleeding stops
- Secure the stick so it cannot unwind
- Mark the time on the patient’s forehead or write it down. A tourniquet should not stay on longer than 2 hours without medical assessment
Warning
Never apply a tourniquet to the neck, chest, or abdomen. Tourniquets are for limbs only.
Wound Care and Infection Prevention
Step 1 — Once bleeding is controlled, irrigate the wound with clean water. Use pressure — squirt water from a squeezed bottle or pour from height to flush out dirt and debris. This hurts, but it prevents infection.
Step 2 — Remove visible debris (dirt, splinters, cloth fragments) with clean fingers or tweezers. Do NOT remove deeply embedded objects — stabilize them in place.
Step 3 — If available, apply a thin layer of raw honey to the wound. Honey is hygroscopic (draws moisture from bacteria, killing them) and has been used medically for thousands of years. Alternatively, a dilute alcohol rinse works but causes significant pain.
Step 4 — Cover with a clean dressing. Change dressings daily or whenever they become wet or dirty. Inspect the wound each time for signs of infection.
Step 5 — Watch for infection signs in the following days:
- Increasing redness spreading outward from the wound
- Swelling that worsens rather than improves
- Warmth around the wound
- Pus (yellow, green, or cloudy discharge)
- Red streaks extending from the wound toward the heart (lymphangitis — this is an emergency)
- Fever, chills, general feeling of illness
If red streaks appear or fever develops, the infection has entered the bloodstream. Without antibiotics, this can be fatal. Herbal antiseptics (garlic poultice, honey, yarrow) may help but are not reliable for systemic infection.
Fractures and Splinting
A broken bone that heals badly can leave someone unable to walk or use a hand. Proper splinting keeps the bones aligned while they heal.
Step 1 — Assess the injury. Signs of a fracture: severe pain, swelling, deformity (limb at an unusual angle), crepitus (grinding feeling), inability to bear weight or use the limb.
Step 2 — DO NOT try to straighten a badly deformed fracture unless circulation is cut off below the break (no pulse in the hand/foot, or fingers/toes turning blue). Moving bone ends can sever blood vessels and nerves.
Step 3 — Splint the limb in the position you find it. A splint needs to immobilize the joint ABOVE and the joint BELOW the fracture.
- Find two rigid objects longer than the injured area: sticks, boards, trekking poles, rolled magazines, bark slabs
- Pad between the splint and the skin with cloth, moss, or clothing
- Place splints on opposite sides of the limb
- Secure with cloth strips, cordage, or tape at multiple points, above and below the fracture
- Do NOT tie directly over the break
Step 4 — Check circulation after splinting. Can the person feel their fingers/toes? Are they warm and pink? Can they wiggle them? If circulation is compromised, loosen the bindings slightly.
Step 5 — For arm fractures, create a sling from a large triangle of cloth. The sling supports the weight of the arm and prevents movement.
Burns
Step 1 — Remove the source. Get away from the heat, remove hot clothing, put out flames (stop-drop-roll works).
Step 2 — Cool the burn with clean, cool (not ice-cold) running water for at least 10-20 minutes. Start immediately — the sooner you cool it, the less tissue damage occurs.
Warning
NEVER use ice on a burn. Ice causes vasoconstriction and can worsen tissue damage. Cool water only. NEVER apply butter, oil, toothpaste, or egg whites. These trap heat and increase infection risk.
Step 3 — Assess severity:
| Degree | Appearance | Feeling | Treatment |
|---|---|---|---|
| 1st (superficial) | Red, dry, no blisters | Painful | Cool water, aloe if available, will heal on its own |
| 2nd (partial thickness) | Red, blistered, wet-looking | Very painful | Cool water, do NOT pop blisters, cover loosely |
| 3rd (full thickness) | White, brown, or charred; leathery | Little to no pain (nerves destroyed) | Cover loosely, do NOT remove stuck clothing, monitor for shock |
Step 4 — Do NOT pop blisters. The fluid inside protects against infection. If a blister breaks on its own, clean it gently and cover.
Step 5 — Cover the burn loosely with a clean, non-stick dressing. Do not wrap tightly — burns swell. Change dressing daily. Watch for infection signs.
CPR Basics (Hands-Only)
CPR is the attempt to manually pump blood through the body when the heart has stopped. Without a defibrillator, long-term success rates are low, but immediate CPR can buy time and occasionally restart the heart.
Step 1 — Check responsiveness. Tap the person’s shoulders firmly and shout. No response? Check for breathing — look for chest movement for 10 seconds.
Step 2 — If the person is not breathing or only gasping, begin chest compressions immediately. Place the heel of one hand on the center of the chest (on the breastbone, between the nipples). Place your other hand on top, fingers interlocked.
Step 3 — Push hard and fast. Compress the chest at least 5 cm (2 inches) deep. Rate: 100-120 compressions per minute (the tempo of “Stayin’ Alive” by the Bee Gees, if that reference means anything to you).
Step 4 — Allow the chest to fully recoil between compressions. Don’t lean on the chest between pushes.
Step 5 — If you know rescue breathing: after 30 compressions, tilt the head back, lift the chin, seal your mouth over theirs, and give 2 breaths (1 second each, watching for chest rise). Then resume compressions. Cycle: 30 compressions, 2 breaths.
Step 6 — Continue until the person starts breathing, you are physically unable to continue, or it has been 30+ minutes with no response (at which point, survival is extremely unlikely without advanced medical equipment).
Shock Management
Shock is the body’s response to severe injury, blood loss, or trauma. Blood pressure drops, organs don’t get enough oxygen, and death follows if untreated.
Signs of shock:
- Pale, cool, clammy skin
- Rapid, weak pulse
- Rapid, shallow breathing
- Confusion, anxiety, or unresponsiveness
- Thirst
- Nausea
Step 1 — Lay the person flat on their back. If no spinal injury is suspected, elevate the legs 20-30 cm to direct blood flow to vital organs.
Step 2 — Keep them warm. Cover with blankets, coats, or anything available. Prevent heat loss to the ground with insulation underneath them.
Step 3 — Do NOT give food or water (they may need surgery, and full stomachs complicate things — though in a survival scenario without surgical access, small sips of water are reasonable for conscious patients).
Step 4 — Treat the underlying cause: stop bleeding, splint fractures, calm and reassure the patient. Shock is worsened by fear and pain.
Step 5 — Monitor continuously. If the person vomits or becomes unconscious, roll them onto their side (recovery position) to prevent choking.
When NOT to Move Someone
Moving an injured person can cause paralysis or death if they have a spinal injury.
Do NOT move the person if:
- They fell from a height
- They were in a vehicle crash or struck by something heavy
- They complain of neck or back pain
- They cannot feel or move their arms or legs
- They are unconscious from trauma (assume spinal injury)
Move them ONLY if:
- They are in immediate danger (fire, flood, collapsing structure)
- You cannot access them to provide first aid
- They need to be repositioned to open their airway
If you must move them, support the head, neck, and spine as a single unit. Log-roll technique: keep the body straight and roll as one piece, with one person stabilizing the head.
Improvised Bandages and Materials
| Need | Improvised With |
|---|---|
| Bandage strips | Torn t-shirts, sheets, or pillowcases (boil first if possible) |
| Wound packing | Sphagnum moss, clean cotton, sanitary pads |
| Antiseptic | Raw honey, dilute alcohol, garlic poultice, yarrow leaves crushed |
| Splint material | Sticks, bark, rolled magazine/newspaper, trekking poles, cardboard |
| Sling | Large triangle of cloth, buttoned shirt worn over the arm |
| Tourniquet | Belt, strip of cloth 4 cm+ wide, rubber tubing |
| Tweezers | Two thin sticks used as chopsticks, or fire-sterilized thorns |
| Suture (emergency) | Fishing line with a curved needle (fire-sterilize); butterfly closures from tape |
Common Mistakes
| Mistake | Why It’s Dangerous | What to Do Instead |
|---|---|---|
| Removing embedded objects | May be plugging an artery; removal causes uncontrolled bleeding | Stabilize the object in place, bandage around it |
| Applying ice to burns | Causes vasoconstriction, worsens tissue damage, risks frostbite | Cool running water for 10-20 minutes |
| Using a narrow tourniquet (wire, thin cord) | Cuts into tissue, damages nerves and blood vessels | Use material at least 4 cm wide |
| Straightening a broken limb | Can sever blood vessels and nerves at the break site | Splint in the position found unless circulation is lost |
| Not irrigating wounds | Debris and bacteria cause infection even in clean-looking wounds | Flush with pressurized clean water every time |
| Removing blood-soaked bandages | Disrupts clotting, restarts bleeding | Add new layers on top of old ones |
| Popping burn blisters | Removes nature’s sterile bandage, invites infection | Leave blisters intact; clean and cover if they break naturally |
| Moving a spinal injury patient | Bone fragments can sever the spinal cord, causing paralysis | Stabilize in place unless immediate danger requires moving |
What’s Next
First aid keeps people alive today. For longer-term medical care:
- Herbal Medicine — natural antiseptics, pain relief, and treatments from plants
- Surgery — wound closure, abscess drainage, and advanced procedures
- Water Purification — clean water is the foundation of wound care and hygiene
- Sanitation and Hygiene — preventing disease is easier than treating it
Quick Reference Card
First Aid — At a Glance
Always start with: Clean hands, clean water, clean materials.
Bleeding: Direct pressure (15 min, no peeking) → Bandage → Elevate → Tourniquet ONLY if life-threatening
Burns: Cool water (10-20 min) → NO ice, NO butter → Don’t pop blisters → Cover loosely
Fractures: Splint in position found → Immobilize joints above and below → Check circulation after
CPR: 30 compressions (5 cm deep, 100-120/min) → 2 breaths → Repeat
Shock: Lay flat → Elevate legs → Keep warm → Treat the cause → Monitor
Infection signs: Spreading redness, warmth, pus, red streaks, fever = EMERGENCY
When NOT to move: Falls, crashes, neck/back pain, unconscious from trauma — assume spinal injury
Golden rule of wound care: A clean wound that is left open heals better than a dirty wound that is closed.