First aid that fits in a pocket, written for the moment when help is far away. — a paper copy belongs beside the first-aid kit it describes.
This page is a reference, not a doctor. It is the well-established basics, for when no professional can be reached. Real care beats this page every time it exists: call emergency services first wherever they still answer, and see a professional after every serious event — even one that seems to end well.
The ladder — what kills first, treated first
Danger — you cannot help anyone if the same thing takes you. Scene safe? Traffic, fire, wire, water, the thing that hurt them?
Breathing — not breathing or only gasping → CPR now. Unconscious but breathing → recovery position.
Bleeding — blood that spurts or pools → pressure now. Everything else waits behind these.
Then breaks, burns, and everything below. Reassess the top of the ladder often — it changes.
❤️ CPR — when they are not breathing
Shake and shout. No response → shout for help, send someone to call/fetch whatever help exists.
Tilt the head back, lift the chin. Look and listen for breathing — no more than 10 seconds. Gasping is NOT breathing.
Hands stacked, heel on the centre of the chest (the breastbone). Push hard and fast: 100–120 per minute, a third of the chest deep (5–6 cm on an adult). Let the chest fully rise back between pushes.
If trained and willing: 30 pushes, then 2 breaths (head tilted, nose pinched, a full second each). Not trained → pushes alone, without stopping, are far better than nothing.
Do not stop until they breathe, help takes over, or you physically cannot continue. Swap rescuers every 2 minutes if you can — good CPR is exhausting.
Children: same rhythm, one hand (a baby: two fingers), and if you're alone give one minute of CPR before leaving to get help.
😴 The recovery position — unconscious but breathing
Kneel beside them. Nearest arm out at a right angle, palm up.
Far arm across the chest, back of their hand against their near cheek — hold it there.
Pull the far knee up, then roll them toward you onto their side, top knee bent as a kickstand.
Tilt the head back a little so the airway stays open; the mouth points slightly down so fluid drains out, not in.
Check breathing every minute. This position is the whole treatment — it keeps the airway from killing them while you wait.
🩸 Serious bleeding
Press. Hard. Now. Cloth, clothing, a bare hand — directly on the wound, all your weight if needed. Pain is expected; keep pressing.
Do not lift the cloth to look. Soaked through → add more on top and keep pressing.
Tie the dressing firmly in place. A limb wound: raise it above the heart while pressing.
A limb bleed that pressure cannot stop: a tourniquet 5–8 cm above the wound (never on a joint) — a strap or folded cloth, wound tight with a stick until the bleeding stops. Write down the time. It will hurt; that is normal. Once on, it stays on until real care takes over.
Treat for shock. Small wounds later: wash with clean water, cover with clean dressing, change daily.
Infection watch, day 2+: growing redness, heat, swelling, pus, red streaks toward the body, fever. A wound that worsens is an emergency again.
🌫 Shock — the quiet killer after the loud one
Signs: pale/grey, cold sweat, fast weak pulse, fast shallow breathing, thirst, confusion, "just let me sleep."
Lay them flat. Raise the legs ~30 cm (not with head/chest/leg-break injuries).
Stop what's causing it (usually bleeding). Loosen tight clothing.
Keep them warm — blanket under as well as over. The ground steals heat.
Nothing to eat or drink (wet the lips if they beg). Reassure, stay, keep checking the ladder.
🫁 Choking
Coughing means air. Encourage coughing — touch nothing yet.
Silent, clutching the throat, going grey: 5 back blows — lean them forward, heel of hand hard between the shoulder blades.
Still stuck: 5 abdominal thrusts — stand behind, fist above the navel, other hand over it, pull sharply in-and-up. Alternate 5 and 5.
They go limp → lower them down and start CPR; look in the mouth between sets and remove anything you can SEE (never sweep blind).
A baby: face-down along your forearm, head low — 5 back blows, then flip and give 5 two-finger chest pushes. Never abdominal thrusts on a baby.
🔥 Burns
Cool running water, 20 full minutes. This is the treatment. Start it before anything else; it helps up to 3 hours after the burn.
Remove rings and tight things near the burn before it swells — not clothing stuck to the skin.
Cover loosely with clean non-fluffy cloth (or plastic wrap laid on, not wound around).
Big burn = shock risk: keep the person (not the burn) warm.
Never: ice, butter, oil, toothpaste, or bursting blisters. Never cool a large burn with icy water — cool the burn, not the person. Burns on face/hands/groin, burns bigger than their palm, or any deep white/charred burn: real care, as fast as it can be found.
🦴 Breaks and sprains
Suspect a break: deformity, can't bear weight, grating, rapid swelling, pain at one precise spot.
Immobilize where it lies. Splint with anything stiff, padded, tied above and below the break — snug, never tight. Straighten nothing.
Check past the splint: fingers/toes stay warm and pink? If they go white/blue/numb, loosen it.
A sprain: Rest, Ice (wrapped, 20 min on/off), Compression, Elevation. If it can't bear weight after — treat as a break.
Neck or back suspected (fall from height, dive, crash + numbness/tingling): do not move them unless the scene itself is lethal. Hold the head still and wait.
🌡 Too cold, too hot
Hypothermia — shivering, mumbling, clumsiness; then the shivering stops (that is worse). Get them dry and out of wind, insulate from the ground, warm the CORE with dry layers, warm sweet drinks if fully awake, another person's body heat wrapped together. Slowly. Never alcohol, never rubbing limbs, never a hot bath — cold blood from the limbs can stop a rewarming heart. Handle the badly-cold gently.
Heat exhaustion — sweaty, weak, headachy, nauseous: shade, sips of water with a pinch of salt (or the ORS), cool wet cloths. Recovered in 30 min or getting worse → next line.
Heat stroke — hot skin (sweating may have STOPPED), confusion, staggering, collapse: this kills. Cool aggressively NOW: soak them, fan hard, cold packs to neck/armpits/groin, immerse to the neck in cool water if you can. Nothing by mouth if confused.
💧 Dehydration & the oral rehydration drink
Diarrhoea and vomiting kill by drying, especially children. Rehydration is the treatment.
The drink (WHO recipe): 1 litre safe water + 6 level teaspoons sugar + ½ level teaspoon salt. Stir. It should taste no saltier than tears — saltier means you mis-measured: remake it.
Small frequent sips, as much as they'll take: a cup per loose stool for adults; for a child, sips every few minutes without stopping, even if vomiting continues (some stays in).
Keep feeding a child who will eat. Breastfed babies: keep nursing, more often.
Danger signs — sunken eyes, no tears, no urine for 8+ hours, skin-pinch that stays tented, floppy or unwakeable: real care, urgently.
👶 A baby coming with no one to help
Birth mostly runs itself. Your job: clean hands, a clean surface, warmth, calm, and patience.
Let the mother choose her position. Never pull the baby, never press the belly, never tell her when to push — her body knows.
As the head delivers, support it gently. Cord around the neck: hook a finger and lift it over — gently.
Baby out: dry them briskly with clean cloth, then skin-to-skin on the mother's chest, both covered. A vigorous cry is the goal; rub the back firmly if slow to start.
The cord can wait. No rush at all. If help is coming, leave it. If none will come: after it stops pulsing, tie it tightly twice (clean string, 10 and 15 cm from the baby) and cut between with a clean blade.
The afterbirth follows within an hour — let it, keep it (a professional will want to see it whole). Steady heavy bleeding after: rub the top of the womb (below the navel) firmly in circles until it hardens; put the baby to the breast — both slow the bleeding.
🐍 Bites & stings
Snake: calm and STILL — the calmer the body, the slower the venom. Splint the bitten limb, keep it below the heart, remove rings, mark the swelling's edge and the time. Carry them, don't let them walk, toward real care.
Never: cut, suck, tourniquet, ice, or chase the snake. A photo from distance if trivial, else nothing.
Animal/human bite: wash hard with soap and running water for 5 full minutes — the washing IS the treatment (rabies and infection). Cover; real care for anything deep, on hands/face, or from an unknown animal.
Sting with spreading rash, face/lip swelling, wheeze: severe allergy — their epinephrine auto-injector NOW if one exists (outer thigh, hold 3 seconds), lie them down, and treat as the top of the ladder.
Tick: fine tweezers at the skin, pull straight and slow. Watch the spot for a spreading ring-rash over the next weeks — that needs a professional.
Distilled from long-standing, universally-taught first-aid doctrine (the WHO/IFRC family of guidance); written fresh for the Sanctuary — provenance in docs/product/DATA-SOURCES-AND-LICENSES.md. Wrong or unclear? 🔔 ring the bell — this shelf must be trustworthy or it is nothing. Part of the Ark.