Part 8: First Aid

We define first aid as helping behaviors and initial care provided to a person for an acute illness or injury.

The goals of a first aid provider include preserving life, alleviating suffering, preventing further illness or injury, and promoting recovery.

First aid can be initiated by anyone in any situation and includes self-care.

First aid assessments and interventions should be medically sound and based on scientific evidence or, in the absence of such evidence, on expert consensus.

First aid competencies include, at any level of training,

• Recognizing, assessing, and prioritizing the need for first aid
• Providing care by using appropriate knowledge, skills, and
• behaviors Recognizing limitations and seeking additional care when needed

The scope of first aid is not purely scientific; it is influenced by both training and regulatory constraints. The definition of scope is therefore variable and should be defined according to circumstances, need, and regulatory requirements.

Education and training in first aid can be useful to improve morbidity and mortality from injury and illness. (Class 2a, LOE C-LD)(link opens in new window) {LINK: 2015 Part 15}(link opens in new window)(link opens in new window)

We recommend that first aid education be universally available. (Class 1, LOE C-EO)(link opens in new window) {LINK: 2015 Part 15}(link opens in new window)(link opens in new window)

First aid providers will likely encounter persons with a previous diagnosis of asthma and prescribed inhaled medication who have acute difficulty breathing and/ or wheezing.

It is reasonable for first aid providers to be familiar with the available inhaled bronchodilator devices and to assist as needed with the administration of prescribed bronchodilators when a person with asthma is having difficulty breathing. (Class 2a, LOE B-R)(link opens in new window)(link opens in new window) {LINK: 2015 Part 15}(link opens in new window)(link opens in new window)

Stroke outcomes improve with the prompt recognition of stroke signs and early access to time-sensitive interventions.

First aid providers can use weakness in the face (eg, droop), arm, or grip on one side of the body or speech disturbance to identify signs of potential stroke and activate emergency services immediately when an individual exhibits any of these symptoms.

After activating emergency services, first aid providers who are able to measure blood glucose may do so and report this number to emergency services.

To recognize a possible stroke, first aid providers can use the signs of weakness in the face (eg, droop), arm or grip on one side of the body or speech disturbance and should active emergency services as quickly as possible if any of these signs are present. (Class: 2a, COR C-LD)(link opens in new window) {LINK: 2020 First Aid}(link opens in new window)

First aid providers who are trained and equipped to measure capillary blood glucose may do so in individuals with suspected stroke and report those values to emergency services. Blood glucose measurement should not delay the initial call for emergency services. (Class: 2b, COR CL-D)(link opens in new window) {LINK: 2020 First Aid}(link opens in new window)

It can be very difficult to differentiate chest pain of cardiac origin, such as a heart attack or myocardial infarction, from other origins.

Common warning signs of a possible heart attack include chest discomfort, discomfort in other areas of the upper body (including pain or discomfort in one or both arms, the back, neck, jaw or stomach), shortness of breath and other signs such as nausea, sweating (ie, breaking out in a cold sweat), and light headedness. 

Call EMS immediately for anyone with chest pain or other signs of heart attack, rather than trying to transport the person to a healthcare facility yourself. (Class 1, LOE C-EO)(link opens in new window) {LINK: 2015 Part 15}(link opens in new window)

While awaiting the arrival of emergency services, first aid providers may encourage alert adults experiencing nontraumatic chest pain to chew and swallow aspirin unless the person experiencing pain has a known aspirin allergy or has been advised by a healthcare provider not to take aspirin. (Class: 2b, LOE: C-EO)(link opens in new window) {LINK: 2020 First Aid}(link opens in new window)

The suggested dose of aspirin is 1 adult 325-mg tablet, or 2 to 4 low-dose “baby” aspirins (81 mg each), chewed and swallowed. {LINK: 2015 Part 15}(link opens in new window)(link opens in new window)

If a person has chest pain that does not suggest that the cause is cardiac in origin, or if the first aid provider is uncertain or uncomfortable with administration of aspirin, then the first aid provider should not encourage the person to take aspirin. (Class 3: Harm, LOE C-EO)(link opens in new window) {LINK: 2015 Part 15}(link opens in new window)

The decision to administer aspirin in these cases may be deferred to an EMS provider with physician oversight.

Most allergic reactions do not require epinephrine, but a small portion of reactions can progress to anaphylaxis.

Epinephrine is recommended for anaphylaxis, and persons at risk are typically prescribed and carry an epinephrine autoinjector.

An anaphylactic reaction involves 2 or more body systems and can be life-threatening.

Symptoms may include:

• respiratory difficulty (such as wheezing),
• cutaneous manifestations (such as hives or swelling of the lips and eyes),
• cardiovascular effects (such as hypotension, cardiovascular collapse, or shock),
• gastrointestinal cramping and diarrhea.

People who suffer from anaphylactic reactions know their signs and symptoms and many carry a lifesaving epinephrine auto-injector.

With proper training, people can learn to correctly use an auto- injector to administer epinephrine in anaphylactic emergencies.

First aid providers should also know how to administer the auto-injector if the victim is unable to do so, provided that the medication has been prescribed by a physician and state law permits it. (Class 2b, LOE B)(link opens in new window)(link opens in new window) {LINK: 2010 Part 17}(link opens in new window)(link opens in new window)(link opens in new window) The recommended dose of epinephrine is 0.3 mg intramuscularly for adults and children greater than 30 kg, and 0.15 mg intramuscularly for children 15 to 30 kg, or as prescribed by the person’s physician.

First aid providers should call 9-1-1 immediately when caring for a person with suspected anaphylaxis or a severe allergic reaction. (Class 1, LOE C-EO)(link opens in new window)(link opens in new window) {LINK: 2015 Part 15}(link opens in new window)(link opens in new window)(link opens in new window)

When a person with anaphylaxis does not respond to the initial dose, and arrival of advanced care will exceed 5 to 10 minutes, a repeat dose may be considered. (Class 2b, LOE C-LD)(link opens in new window)(link opens in new window) {LINK: 2015 Part 15}(link opens in new window)(link opens in new window)(link opens in new window)

The general principles of first aid management of seizures are to:

• Ensure an open airway
• Prevent injury

Do not restrain the victim during a seizure. Do not try to open the victim’s mouth or try to place any object between the victim’s teeth or in the mouth. Placing an object in the victim’s mouth may cause dental damage or aspiration. (Class 2a, LOE C)(link opens in new window) {LINK: 2010 Part 17}(link opens in new window)(link opens in new window)

It is not unusual for the victim to be unresponsive or confused for a short time after a seizure.

Hypoglycemia can manifest as a variety of symptoms, including:

• confusion
• altered behavior
• diaphoresis
• tremulousness

Diabetics who display these symptoms should be assumed by the first aid provider to have hypoglycemia.

If the person is unconscious, exhibits seizures, or is unable to follow simple commands or swallow safely, the first aid provider should call for EMS immediately. (Class 1, LOE C-EO)(link opens in new window) {LINK: 2015 Part 15}(link opens in new window)

For an individual with suspected hypoglycemia who is awake and able to swallow, the first aid provider should encourage the individual to swallow glucose (eg, tablets, liquid, gel). Emergency services should be activated if symptoms do not resolve within 10 minutes or symptoms worsen. (Class 1, LOE C-LD)(link opens in new window) {LINK: 2020 First Aid}(link opens in new window)

It is reasonable to use dietary sugars* as an alternative to glucose tablets (when not available) for reversal of mild symptomatic hypoglycemia. (Class 2a, LOE B-R)(link opens in new window) {LINK: 2015 Part 15}(link opens in new window)

*Orange juice (unsweetened, from concentrate), Jelly beans, Sucrose candy (Skittles), Glucose 71%/oligosaccharides 29% candy (Mentos), Fructose (fruit leather, such as Stretch Island), Whole milk

For children with suspected hypoglycemia who are awake but unwilling or unable to swallow glucose, it may be reasonable to apply a slurry of granulated sugar and water under the tongue. (Class 2b, LOR C-LD)(link opens in new window) {LINK: 2020 First Aid}(link opens in new window)

For diabetics with symptoms of hypoglycemia, symptoms may not resolve until 10 to 15 minutes after ingesting glucose tablets or dietary sugars (Table 1)(link opens in new window).

First aid providers should therefore wait at least 10 to 15 minutes before calling EMS and re-treating a diabetic with mild symptomatic hypoglycemia with additional oral sugars. (Class 1, LOE B-R)(link opens in new window) {LINK: 2015 Part 15}(link opens in new window)

If the person’s status deteriorates during that time or does not improve, the first aid provider should call EMS. (Class 1, LOE C-EO)(link opens in new window) {LINK: 2015 Part 15}(link opens in new window)

For an individual with suspected hypoglycemia who is not awake or not able to swallow, it is not recommended to administer glucose orally; it is not recommended to administer glucose orally; for these individuals, emergency services should be active immediately. (Class 3: Harm, LOE C-EO)(link opens in new window) {LINK: 2020 First Aid}(link opens in new window)

Syncope is a transient loss of consciousness that results from global cerebral hypoperfusion. It can lead to falls and injuries. Many victims of syncope have recurrent episodes.

Vasovagal and orthostatic syncope are responsible (combined) for about one-third of all syncope. The underlying physiology of both conditions is decreased blood return to the heart, leading to decreased cardiac output, decreased global cerebral perfusion, and subsequent loss of consciousness.

The symptoms preceding loss of consciousness are known as presyncope and can last for a few seconds before onset of vasovagal and orthostatic syncope. Associated signs and symptoms include:

• Pallor
• Sweating
• Lightheadedness
• visual changes and
• weakness

Presyncope presents recognizable signs and symptoms and a period during which rapid first aid treatment could improve symptoms or prevent syncope from occurring.

Victims of vasovagal and orthostatic syncope can be taught to recognize signs of presyncope and apply physical counter-pressure maneuvers (see Table 2)(link opens in new window)(link opens in new window), including handgrip, arm tensing, abdominal muscle tensing, leg crossing with tensing, squatting, and neck flexion. These maneuvers may reduce symptoms of presyncope and prevent syncope.

If a person experiences signs or symptoms of presyncope (including pallor, sweating, lightheadedness, visual changes, and weakness) of vasovagal or orthostatic origin, the priority for that person is to maintain or assume a safe position such as sitting or lying down. Once the person is in a safe position, it can be beneficial for that person to use physical counterpressure maneuvers to avoid syncope. (Class 2a; LOE C-LD)(link opens in new window)(link opens in new window)(link opens in new window)(link opens in new window) {LINK: 2019 First Aid}(link opens in new window)(link opens in new window)(link opens in new window)(link opens in new window)

If a first aid provider recognizes presyncope of suspected vasovagal or orthostatic origin in another individual, it may be reasonable for the first aid provider to encourage that person to perform physical counterpressure maneuvers until symptoms resolve or syncope occurs. If no improvement occurs within 1 to 2 minutes or if symptoms worsen or reoccur, providers should initiate a call for additional help. (Class 2b; LOE C-EO)(link opens in new window)(link opens in new window)(link opens in new window)(link opens in new window) {LINK: 2019 First Aid}(link opens in new window)(link opens in new window)(link opens in new window)(link opens in new window)

If there are no extenuating circumstances, lower-body physical counterpressure maneuvers are preferable to upper body and abdominal physical counterpressure maneuvers. (Class 2b; LOE C-LD)(link opens in new window)(link opens in new window)(link opens in new window)(link opens in new window) {LINK: 2019 First Aid}(link opens in new window)(link opens in new window)(link opens in new window)(link opens in new window)

The use of physical counterpressure maneuvers is not suggested when symptoms of a heart attack or stroke accompany presyncope. (Class 3: Harm; LOE C-EO)(link opens in new window)(link opens in new window)(link opens in new window)(link opens in new window) {LINK: 2019 First Aid}(link opens in new window)(link opens in new window)(link opens in new window)(link opens in new window)

Vigorous exercise, particularly in hot and humid environments, can lead to significant dehydration with loss of water and electrolytes through sweat.

Ingestion of 5% to 8% carbohydrate-electrolyte solutions facilitates rehydration after exercise-induced dehydration and is generally well tolerated.

In the absence of shock, confusion, or inability to swallow, it is reasonable for first aid providers to assist or encourage individuals with exertional dehydration to orally rehydrate with carbohydrate electrolyte drinks. (Class 2a, LOE B-R)(link opens in new window) {LINK: 2015 Part 15}(link opens in new window)(link opens in new window)

For individuals with severe dehydration with shock, confusion or symptoms of heat stroke, immediately activate the EMS system then begin immediate cooling, preferably by immersing the victim up to the chin in cold water. Heat stroke requires emergency treatment with intravenous fluids. Do not try to force the victim to drink liquids. See Heat Emergencies, below.

Other beverages, such as coconut water and 2% milk, have also been found to promote rehydration after exercise-associated dehydration, but they may not be as readily available. If these alternative beverages are not available, potable water may be used. (Class 2b, LOE B-R)(link opens in new window) {LINK: 2015 Part 15}(link opens in new window)(link opens in new window)

It can be beneficial to rinse eyes exposed to toxic chemicals immediately and with a copious amount of tap water for at least 15 minutes or until advanced medical care arrives. (Class 2a, LOE C-LD)(link opens in new window)(link opens in new window) {LINK: 2015 Part 15}(link opens in new window)(link opens in new window)(link opens in new window)

If tap water is not available, normal saline or another commercially available eye irrigation solution may be reasonable. (Class 2b, LOE C-LD)(link opens in new window)(link opens in new window) {LINK: 2015 Part 15}(link opens in new window)(link opens in new window)(link opens in new window)

First aid providers caring for individuals with chemical eye injury should contact their local poison control center or, if a poison control center is not available, seek help from a medical provider or 9-1-1. (Class 1, LOE C-EO)(link opens in new window)(link opens in new window) {LINK: 2015 Part 15}(link opens in new window)(link opens in new window)(link opens in new window)

Superficial wounds and abrasions should be thoroughly irrigated with a large volume of warm or room temperature potable water with or without soap until there is no foreign matter in the wound. (Class 1, LOE A)(link opens in new window) {LINK: 2010 Part 17}(link opens in new window)

Cold water appears to be as effective as warm water, but it is not as comfortable. If running water is unavailable, use any source of clean water.

Wounds heal better with less infection if they are covered with an antibiotic ointment or cream and a clean occlusive dressing. (Class 2a, LOE A)(link opens in new window) {LINK: 2010 Part 17}(link opens in new window)

Apply antibiotic ointment or cream only if the wound is an abrasion or a superficial injury and only if the victim has no known allergies to the antibiotic.

Management of an open chest wound in out-of-hospital settings is challenging and requires immediate activation of EMS.

Improper use of a dressing or device could lead to air trapping in the lung and fatal tension pneumothorax.

We recommend against the application of an occlusive dressing or device by first aid providers for individuals with an open chest wound. (Class 3: Harm, LOE C-EO)(link opens in new window)(link opens in new window) {LINK: 2015 Part 15}(link opens in new window)(link opens in new window)(link opens in new window)

In the first aid situation, it is reasonable to leave an open chest wound exposed to ambient air without a dressing or seal. (Class 2a, LOE C-EO)(link opens in new window)(link opens in new window) {LINK: 2015 Part 15}(link opens in new window)(link opens in new window)(link opens in new window)

If a nonocclusive dressing, such as a dry gauze dressing, is applied for active bleeding, care must be taken to ensure that saturation of the dressing does not lead to partial or complete occlusion.

The classic signs of concussion after head trauma include feeling stunned or dazed, or experiencing:

• headache,
• nausea,
• dizziness and unsteadiness (difficulty in balance)
• visual disturbance,
• confusion, or loss of memory (from either before or after the injury)

The various grades and combinations of these symptoms make the recognition of concussion difficult.

Changes in symptoms may be subtle and yet progressive.

First aid providers are often faced with the decision as to what advice to give to a person after minor head trauma: an incorrect decision can have long-term serious or even fatal consequences.

Any person with a head injury that has resulted in a change in level of consciousness, has progressive development of signs or symptoms as described above, or is otherwise a cause for concern should be evaluated by a healthcare provider or [by] EMS personnel as soon as possible. (Class 1, LOE C-EO)(link opens in new window)(link opens in new window) {LINK: 2015 Part 15}(link opens in new window)(link opens in new window)(link opens in new window)

Using any mechanical machinery, driving, cycling, or continuing to participate in sports after a head injury should be deferred by these individuals until they are assessed by a healthcare provider and cleared to participate in those activities. (Class 1, LOE C-EO)(link opens in new window)(link opens in new window) {LINK: 2015 Part 15}(link opens in new window)(link opens in new window)(link opens in new window)

The terms spinal immobilization and spinal motion restriction have been used synonymously in the past. Because true spinal immobilization is not possible, the term spinal motion restriction is now being used to describe the practice of attempting to maintain the spine in anatomical alignment and minimize gross movement, with or without the use of specific adjuncts such as collars.

With a growing body of evidence showing more actual harm and no good evidence showing clear benefit, we recommend against routine application of cervical collars by first aid providers. (Class 3: Harm, LOE C-LD)(link opens in new window)(link opens in new window) {LINK: 2015 Part 15}(link opens in new window)(link opens in new window)(link opens in new window)

If a first aid provider suspects a spinal injury, he or she should have the person remain as still as possible and await the arrival of EMS providers. (Class 1, LOE C-EO)(link opens in new window)(link opens in new window) {LINK: 2015 Part 15}(link opens in new window)(link opens in new window)(link opens in new window)

Cardiopulmonary arrest is the primary cause of immediate death from electrocution.

Cardiac arrhythmias, including ventricular fibrillation, ventricular asystole, and ventricular tachycardia that progresses to ventricular fibrillation, may result from electric injuries.

Respiratory arrest may result from electric injury to the respiratory center in the brain or from tetanic contractions or paralysis of respiratory muscles.

When current traverses the body, thermal burns may be present at the entry and exit points and along its internal pathway.

Do not place yourself in danger by touching an electrocuted victim while the power is on. (Class 3, LOE C)(link opens in new window)(link opens in new window) {LINK: 2010 Part 17}(link opens in new window)(link opens in new window)(link opens in new window)

Turn off the power at its source; at home the switch is usually near the fuse box.

Immediately notify the appropriate authorities (eg, 911 or fire department) in case of high-voltage electrocutions caused by fallen power lines,

Do not enter the area around the victim or try to remove wires or other materials with any object, including a wooden one, as all materials conduct electricity if the voltage is high enough. Wait to approach the victim until the power has been turned off by knowledgeable personnel.

Once the power is off, assess the victim, who may need CPR, defibrillation, and treatment for shock and thermal burns.

All victims of electric shock require medical assessment because the extent of injury may not be apparent.

Dental avulsion injury can damage both the tooth and the supporting soft tissue and bone, resulting in permanent loss of the tooth.

Immediate reimplantation of an avulsed tooth is believed to result in the greatest chance of tooth survival.

In situations that do not allow for immediate reimplantation, it can be beneficial to temporarily store an avulsed tooth in a variety of solutions shown to prolong viability of dental cells. (Class 2a, LOE C-LD)(link opens in new window) {LINK: 2015 Part 15}(link opens in new window)

If an avulsed permanent tooth cannot be immediately replanted, it can be beneficial to place the tooth in Hanks’ Balanced Salt Solution or in oral rehydration salt solutions or wrap the tooth in cling film to prevent dehydration and improve the likelihood of successful replantation by a dental professional, which should be done as soon as possible. (Class 2a, LOE C-LD)(link opens in new window) {LINK: 2020 First Aid}(link opens in new window)

If an avulsed permanent tooth cannot be immediately replanted and neither Hanks’ Balanced Salt Solution, oral rehydration salt solutions, nor cling film is available, storage of the tooth in cow’s milk or saliva may be considered. (Class 2b, LOE C-LD)(link opens in new window) {LINK: 2020 First Aid}(link opens in new window)

An avulsed permanent tooth should not be stored in tap water. (Class 3: Harm, LOE C-LD)(link opens in new window) {LINK: 2020 First Aid}(link opens in new window)

Viability of an avulsed tooth stored in any of the above solutions is limited. Reimplantation of the tooth within an hour after avulsion affords the greatest chance for tooth survival.

Following dental avulsion, it is essential to seek rapid assistance with reimplantation. (Class 1, LOE C-EO)(link opens in new window) {LINK: 2015 Part 15}(link opens in new window)

Heat-induced symptoms, often precipitated by vigorous exercise, may include heat cramps, heat exhaustion, and heat stroke.

Heat cramps are painful involuntary muscle spasms that most often affect the calves, arms, abdominal muscles, and back. First aid for heat cramps includes rest, cooling off, and drinking an electrolyte-carbohydrate mixture, such as juice, milk, or a commercial electrolyte-carbohydrate drink. Stretching, icing, and massaging the painful muscles may be helpful. Exercise should not be resumed until all symptoms have resolved.

Heat exhaustion is caused by a combination of exercise-induced heat and fluid and electrolyte loss through sweat. Signs and symptoms may start suddenly and include:

• nausea
• dizziness
• muscle cramps
• feeling faint
• headache
• fatigue
• heavy sweating

Heat exhaustion is a serious condition because it can rapidly advance to heat stroke which can be fatal. Treat heat exhaustion vigorously by having the victim lie down in a cool place, take off as many clothes as possible, cooling with a cool water spray, and encouraging the victim to drink cool fluids, preferably containing carbohydrates and electrolytes.

Heat stroke and exertional hyperthermia are emergency condition characterized by a core temperature greater than 40°C (104°F) (severe hyperthermia) and central nervous system dysfunction (eg, confusion, seizures, coma). For these individuals, it is important to bring the body’s temperature down as quickly as possible to reduce the risk of organ injury or death. Immediately activate the EMS system and begin immediate cooling.

For adults and children with exertional hyperthermia or heat stroke, first aid providers should move the individual from the hot environment, remove excess clothing, limit exertion, and activate emergency services. (Class 1, LOE C-EO)(link opens in new window) {LINK: 2020 First Aid}(link opens in new window)

For adults with exertional hyperthermia or heatstroke, it is reasonable to initiate immediate active cooling by using whole-body (neck down) cool- to cold-water immersion techniques (1°C–26°C [33.8°F–78.8°F]), when safe, until a core body temperature of <39°C (102.2°F) is reached or neurological symptoms resolve. (Class 2a, LOE C-LD)(link opens in new window) {LINK: 2020 First Aid}(link opens in new window)

For adults with exertional hyperthermia or heatstroke, it may be reasonable to initiate other forms of active cooling, including commercial ice packs, cold showers, ice sheets and towels, cooling vests and jackets, evaporative, fanning, or a combination of techniques, when water immersion is not available. (Class 2b, LOE C-LD)(link opens in new window) {LINK: 2020 First Aid}(link opens in new window)

For children with exertional hyperthermia or heatstroke, it may be reasonable to initiate immediate active cooling by using whole-body (neck down) cool- to cold-water immersion techniques (1°C–26°C [33.8°F–78.8°F]), when safe, until a core body temperature of <39°C (102.2°F) is reached or neurological symptoms resolve. (Class 2b, LOE C-EO)(link opens in new window) {LINK: 2020 First Aid}(link opens in new window)

For children with exertional hyperthermia or heatstroke, it may be reasonable to initiate other forms of active cooling, including commercial ice packs, cold showers, ice sheets and towels, cooling vests and jackets, evaporative cooling, fanning, or a combination, when water immersion is not available. (Class 2b, LOE C-EO)(link opens in new window) {LINK: 2020 First Aid}(link opens in new window)

Methods of preventing drowning include:

• isolation fencing around swimming pools (gates should be self-closing and self-latching)
• use of personal flotation devices (life jackets) while in, around, or on water
• never swimming alone
• avoiding swimming or operating motorized watercraft while intoxicated.

Outcome following drowning depends on the duration of the submersion, the water temperature, and how promptly CPR is started.

Remove the victim rapidly and safely from the water, but do not place yourself in danger.

If you have special training, you can start rescue breathing while the victim is still in the water, providing that it does not delay removing the victim from the water.

Do not waste time trying to remove water with abdominal or chest thrusts as there is no evidence that water acts as an obstructive foreign body. In addition, the abdominal thrusts may result in expulsion of stomach contents that can be aspirated. In addition, the expelled stomach contents can obstruct the upper airway, interfering with delivery of rescue breaths.

Start CPR and, if you are alone, continue with about 5 cycles (about 2 minutes) of chest compressions and breaths before activating EMS.

If 2 rescuers are present, send 1 rescuer to activate EMS immediately, and retrieve emergency equipment, including an AED, if one is nearby.

The Poison Help hotline of the American Association of Poison Control Centers (1-800-222-1222) is an excellent resource in the United States for information about treating ingestion of, or exposure to, a potential poison.

Further information is available at www.aapcc.org(link opens in new window).

When phoning a poison control center or other emergency medical services, know the nature and time of exposure and the name of the product or toxic substance.

Brush powdered chemicals off the skin with a gloved hand or piece of cloth.

Remove all contaminated clothing from the victim, making sure you do not contaminate yourself in the process. In case of exposure to an acid or alkali on the skin or eye, immediately irrigate the affected area with copious amounts of water. (Class 1, LOE B)(link opens in new window)(link opens in new window)(link opens in new window)(link opens in new window)(link opens in new window) {LINK: 2010 Part 17}(link opens in new window)(link opens in new window)(link opens in new window)(link opens in new window)(link opens in new window)(link opens in new window)

For chemical injuries to the eye, see “Toxic Eye Injuries,” above.