Bleeding
Get out that tourniquet and tighten it down hard. Well, only if the concept of an amputation is appealing. While profuse bleeding in an extremity is frightening, a tourniquet is truly a last resort. It can permanently damage nerves, blood vessels and tissues, and lead to the new nickname: "Peg Leg." In virtually every case, direct hand pressure over a clean cloth will stop even severe bleeding anywhere on the body. However, if bleeding does not stop within three minutes, call 911. (You've only got 12 pints to start with.) If a cut isn't too deep and less than a half inch long, you're probably OK treating it yourself. Clean the cut with plain water (no soap), apply a triple antibiotic ointment, and cover with a Band-Aid or small bandage. However, if the cut looks deep, don't play the tough guy. Head to the emergency room. You'll probably need stitches. In this case, don't put on ointment or use antiseptic spray. Just wash with water and use a bandage.

You Cut Something Off
You just chopped off your finger with the hedge trimmer. Don't pack it in ice. That will do more harm than good. Also resist the temptation to wash off the dirt and grass with soapy water. The soap will damage the exposed tissues. Instead, just rinse in cool water and wrap in gauze. Then saturate the gauze with water and put your "package" in a ziplock bag or plastic container. You can put some ice cubes in the water. Get somebody with a clean license to drive you to an emergency room. If there's any day a speeding ticket will be worth it, it's today. You need to get to the ER within three hours or the probability of a successful reattachment falls off markedly (yes, I'm trying to be funny...). Fortunately, advances in microsurgery mean many amputated or avulsed (partially severed) body parts can be reattached. Fingers, toes, ears are commonly done, but people have had entire hands, arms, legs, and noses successfully reattached. Even the penis can be put back in good working order after an "incident."

Knocked Out Tooth
Time is even more critical if a tooth has been knocked out. You have only a half-hour to reach the ER or a dentist before the tooth dies. The stupid trick here is putting the tooth in a glass of water. That will only hasten its demise. Find a small container or use the corner of a plastic bag. Try to generate enough saliva to cover the tooth. Failing that, use dairy milk. Don't let the tooth dry out. If you don't have anything to contain the tooth, try to place it back in position in your mouth. Just don't swallow it.

Burns
Don't shmear butter or any other food item on a burn. A burn is thermal damage. A greasy coating will only trap the heat and make things worse. Usually, the best thing to do is immediately run cold water over the burn. That'll draw out the heat, and have an anesthetic effect. When you think you've run it long enough, you haven't; keep it under for another ten minutes. However, don't apply ice directly to a burn; it could contribute to additional tissue damage. Another stupid trick is popping blisters. A blister is nature's band-aid. Without it, the tissue beneath is exposed to infection. For anything beyond a superficial first/second degree burn, head on over to your doctor. Without proper treatment, you could develop a really nasty infection. A trip to the emergency room is in order if any of these things have happened:

• Your burn is bleeding.
• A child or elderly person received a second degree burn (not just red, but showing actual blisters).
• You've been burned by a sticky substance such as tar or asphalt or hot-melt glue.
• You burned your face or your groin (don't ask).
• You've been scalded by boiling water or live steam.
• The burn girdles (goes all around) a limb.

Seizures
If a person is having an epileptic or other seizure, don't try to pry his or her mouth open. It's quite difficult to do, and you'll probably hurt yourself trying. It's unlikely to help *unless* the person is having difficulty breathing. A blocked airway is absolutely a life-threatening condition, and in that case, you have to try to clear it. Otherwise, your job in this situation is to prevent the person from hurting him or herself. If you see the start of the seizure, catch the person and help him/her down to the floor. Don't move him/her after that or try to restrict motion. You could cause a fracture or muscle tear if you try. Move surrounding objects out of the way. Loosen his necktie and possibly his belt to facilitate breathing. There's a chance the person could vomit. In this case, you should roll him on his side to prevent aspiration of the vomitus. Of course, you should call 911, or better yet, stay with the person and direct a specific individual to make the call. However, if the person is a known epileptic (look for the MedicAlert bracelet or locket), you can wait about five minutes before summoning the paramedics. Epileptic seizures are normally brief and don't require medical attention unless an injury was sustained during the episode.

Car Accident
It's hard to gauge injury after a car crash, especially on yourself. Even a slow-speed accident can cause trauma. It's tempting to jump right out of the car and survey the damage to your vehicle. Forget the car. It can be repaired. You might not. It's best to stay put and determine if you have pain especially in your head, neck, or back. If you do have pain there, do not move. Wait for the paramedics to arrive, and then insist they immobilize you. This is absolutely the time to err on the side of caution. If you come on the scene of an accident, the only time you should attempt to extract a victim is if the vehicle is on fire and you don't hear sirens. Otherwise, let the professionals handle it.

If it's you that's been in the accident, and you don't detect any obvious injuries, you have a decision to make: whether to go to the hospital or not. You'd be stupid not to go if you lost consciousness after the crash, even for a moment. Likewise, if you were thrown into the steering wheel or banged hard into the car interior, go. If the "Jaws of Life" had to be used to get you out of the car, go. If anybody else in the car had injuries and is going to the hospital, you too should go and get yourself checked out.

The Biggest Stupid Trick: Doing Nothing

We're all busy. Nobody wants to spend the evening in an emergency room. Well, ignoring certain symptoms can land you a much longer stay in a rehab center or nursing home. For example, if you detect some weakness on one side of your body, possibly accompanied by confusion, headache, or mild slurring of speech, what could that be a symptom of? A stroke perhaps? Prompt treatment could prevent severe irreversible brain damage. How about chest or abdominal pain? Could be indigestion. Could also be a heart attack. Clot-busting drugs could save your life… but only if you get to a place where they have them. Difficultly breathing? Could be anxiety or something entirely else. You should seek immediate medical help. Likewise, sustained (more than one hour) high fever (over 101F for adults or over 104F for children) can lead to serious complications. Prolonged vomiting and/or diarrhea means something's very wrong. You need professional medical help.

So go. Get yourself examined. Play it safe. I want you alive and kicking, and reading the August 2057 issue of the Urbach Letter.