The classic first-aid curriculum organizes its content around "seven areas" — wounds and bleeding, burns, fractures and sprains, poisoning, environmental injury, medical emergencies, and shock. The framework dates to mid-20th-century industrial first aid. It is not wrong, but it is incomplete for the household operator who needs to manage care for hours rather than minutes, across a population that includes children, older adults, and people with chronic disease, under conditions where 911 is the start of the response and not the end of it. This brief rebuilds the seven areas on modern doctrine — Red Cross, AHA Heartsaver, Wilderness Medical Society, and JTS Prolonged Casualty Care — and adds the eighth area that the original framework missed.

This is Field Brief 06 from MED-TAC's Prepper & Survival Med series. Field Brief 04 covered the drug cabinet and Field Brief 05 covered the trauma kit. This one covers the knowledge layer — what the operator needs in their head, organized around the categories of injury and illness the household actually faces.

Section 01Why the Old Framework Falls Short

The seven-areas framework was designed for a workplace first-aid responder whose job was to stabilize an injured worker until ambulance arrival, typically within 5–15 minutes. The framework optimized for breadth, not depth, and for layperson skill, not prolonged-care competence. In that context it worked, and large parts of it still work for the same scenario.

The household operator scenario is different. Three structural differences matter:

1. Duration. The household operator may be the primary care provider for hours or days — natural disaster, isolation, infrastructure failure, mass-casualty event with overloaded EMS, or simple geographic remoteness. Stabilization is not the deliverable; prolonged management is.
2. Population. The workplace responder typically managed working-age adults. The household includes infants, children, pregnant household members, older adults with chronic disease, and people on multiple medications. The framework needs age- and population-specific guidance the original didn't carry.
3. Threat profile. The original framework heavily emphasized industrial trauma. The household threat profile is dominated by medical emergencies (cardiac, stroke, allergic, respiratory), environmental injury (heat, cold, drowning), pediatric injury (falls, ingestions, burns), and behavioral-health crises. The trauma is real but it is one bucket among several.

The rebuild keeps the categories that work, expands the ones that need depth, and adds behavioral health as the eighth area — because the failure mode the original framework missed is the one that increasingly dominates household and prepper-scenario medical events.

Section 02Area 01 — Wounds and Bleeding Control

The first area is also the most time-critical. The doctrine in detail is in Field Brief 05; the household-level summary follows.

Hierarchy of intervention

• Direct pressure first. Most external bleeding controls with adequate direct pressure to the source. The technique is firm pressure with the heel of the hand or a folded dressing, applied for 3–5 minutes without lifting to check.
• Wound packing if direct pressure fails. For deep wounds in compressible areas (extremity wounds, junctional zones not on the torso), pack the wound cavity tightly with a CoTCCC-recommended hemostatic gauze and maintain pressure on the source. Two chemistry families earn cabinet space: kaolin-impregnated agents like QuikClot Combat Gauze activate the intrinsic coagulation cascade (Factor XII) on contact with blood with a 3-minute compression hold, and chitosan-based agents like Chitogauze XR and Celox Rapid form a mucoadhesive plug independent of the coagulation system. The chitosan distinction matters operationally: it keeps working in patients on anticoagulants or with coagulopathy, which describes a substantial fraction of older household members. For deep narrow cavities where rolled-gauze packing is mechanically awkward — high-velocity penetrating wounds, junctional bleeds from groin or axilla, deep stab wounds — the Celox A applicator delivers chitosan granules directly into the wound through a pre-loaded plunger.
• Tourniquet for life-threatening extremity hemorrhage. Spurting arterial bleeding, bleeding that has soaked through multiple dressings, or any extremity bleeding the operator judges to be exsanguinating — apply a CoTCCC-recommended tourniquet high and tight on the proximal third of the limb, never across a joint. The Combat Application Tourniquet (CAT) GEN 7 is the most widely deployed CoTCCC-recommended windlass tourniquet across U.S. military and civilian programs and is the standard MED-TAC carries. Time of application written on the windlass strap or directly on the patient.
• Pressure dressing over packed wounds. Once a wound is packed, an emergency bandage maintains the force needed to keep the hemostatic agent in contact with the bleeding vessel. The Persys Safeguard Emergency Bandage — the modern descendant of the original Israeli bandage — has an integrated pressure bar that concentrates force at the wound site and an elastic wrap that maintains that force while immobilizing the dressing. Standard overwrap on hemostatic-packed wounds.
• Vented chest seal for penetrating chest trauma. Technically an R-phase (respiratory) intervention rather than pure hemorrhage control, but the chest seal lives in the same wound-management workflow because chest wounds present as bleeding. A CoTCCC-recommended vented chest seal — the Hyfin Vent Chest Seal is the field standard MED-TAC distributes — has one-way valves that allow air to escape from the pleural space while preventing air entry, reducing the risk of converting an open pneumothorax into a tension pneumothorax. Two-pack standard: chest wounds are often paired (entry and exit), and a failed first seal needs immediate replacement.

Wound assessment and definitive care thresholds

Not every wound that bleeds needs an ER. The thresholds that matter:

• Send for definitive care: wounds deeper than the dermis, wounds that gape open when relaxed, wounds with visible fat or muscle, wounds on the face or in cosmetically significant areas, wounds that may have damaged a nerve or tendon (loss of distal function), animal or human bites (high infection risk), wounds with retained foreign material, puncture wounds from contaminated sources, wounds in patients with comorbidities (diabetes, immunosuppression, anticoagulation).
• Manage at home: superficial abrasions, minor lacerations that approximate cleanly with bandages or steri-strips, simple puncture wounds with good drainage and irrigation, intact-skin contusions.

Tetanus and infection considerations

Wounds with elevated tetanus risk — puncture wounds, contamination with dirt or animal material, bites, deep tissue injury — warrant verification of tetanus immunization status. Adult tetanus booster (Tdap or Td) is given every 10 years, with a booster after 5 years for high-risk wounds if the last booster was more than 5 years ago. This is a documented household record, not a guess.

Section 03Area 02 — Thermal and Chemical Burns

The original framework lumped all burns together. Modern doctrine distinguishes by depth, mechanism, and percentage of body surface area, because each variable changes the treatment.

Depth assessment

• Superficial (1st degree): red, painful, no blistering. Skin intact. Heals in days without scarring. Sunburn is the prototype.
• Partial thickness (2nd degree): red, blistered, painful — pain is intense because nerve endings are intact and exposed. Damage extends through the epidermis into the dermis. Heals in 1–3 weeks, may scar.
• Full thickness (3rd degree): charred or waxy white, leathery, painless to direct touch (nerve endings destroyed). Damage extends through the full dermis into subcutaneous tissue. Requires surgical management; will not heal without intervention.
• 4th degree: involvement of muscle, bone, or deep tissue. Limb-threatening or life-threatening.

Initial management

• Stop the burning. Remove the source, remove burning clothing not stuck to skin, irrigate chemical burns with copious water for 20+ minutes (alkaline burns longer than acid burns).
• Cool the burn. Cool (not iced) water irrigation for 10–20 minutes provides analgesia and may limit progression. Ice and freezing temperatures cause additional tissue damage; avoid.
• Cover the burn. Clean dry dressing, no creams, no butter, no toothpaste, no traditional remedies. Aloe vera gel on superficial burns only. Petroleum-based dressings (Vaseline gauze) and hydrogel dressings are appropriate for partial-thickness burns.
• Pain management. Acetaminophen or ibuprofen at standard doses. Opioids if available and indicated for severe burns.
• Hydration. Burn patients lose fluid through the damaged skin. Oral rehydration salts or fluids for any burn over a few percent body surface area.

Send-for-definitive-care thresholds

Send to a burn center or ER for: any partial-thickness burn over 10% body surface area (use the rule of palms — palm of patient's hand is ~1%), any full-thickness burn, any burn on face, hands, feet, genitalia, or major joints, any electrical or chemical burn, any inhalation injury (singed nasal hair, soot in airway, hoarseness, stridor), any burn in a child or older adult that exceeds 5% BSA.

Specific burn types

Chemical burns: Continuous water irrigation, no neutralizing agents (the chemistry of acid-base reactions generates additional heat and tissue damage). Document the agent if possible. Electrical burns: The visible skin burn underestimates the internal damage. Cardiac monitoring is essential; arrhythmias can occur hours after the event. Inhalation injury: Suspect in any burn that occurred in an enclosed space, particularly with smoke. Airway can rapidly become unmaintainable as edema progresses; transport immediately, do not wait for symptoms to develop.

Section 04Area 03 — Fractures, Sprains, and Musculoskeletal Injury

Most musculoskeletal injuries at the household level are sprains, strains, and minor fractures. The framework that survives audit is RICE for soft-tissue injury and the SAM splint for suspected fracture, with specific thresholds for when imaging and definitive care are needed.

The injury assessment

The Ottawa Ankle Rules and Ottawa Knee Rules are validated clinical decision rules that identify which patients with ankle or knee injury can be safely managed without imaging. The household operator can use them as a guide:

• Ottawa Ankle: X-ray is needed if there is pain in the malleolar zone and any of: bone tenderness at the posterior edge or tip of the lateral malleolus, bone tenderness at the posterior edge or tip of the medial malleolus, or inability to bear weight both immediately and in the exam (four steps).
• Ottawa Knee: X-ray needed if any of: age over 55, isolated tenderness of the patella, tenderness at the head of the fibula, inability to flex to 90 degrees, or inability to bear weight both immediately and in the exam.

RICE for soft-tissue injury

• R — Rest. Relative rest; complete immobilization is not indicated for most sprains. Protect the injury from further trauma.
• I — Ice. Cold therapy for 15–20 minutes at a time, every 1–2 hours for the first 24–48 hours. Wrap the ice; direct skin contact damages tissue.
• C — Compression. Elastic wrap to limit swelling. Not so tight as to compromise circulation; check distal pulse, capillary refill, and sensation.
• E — Elevation. Above the level of the heart when possible.

Suspected fracture management

If a fracture is suspected — deformity, point tenderness over bone, crepitus (rare and unreliable as a sign), inability to bear weight, mechanism consistent with fracture — splint the injury in the position found unless circulation is compromised. The SAM splint or improvised splint should immobilize the joint above and the joint below the injury. Reassess distal circulation, sensation, and motor function before and after splinting. Open fractures (bone visible through skin) require sterile dressing, antibiotic coverage at the earliest opportunity, and definitive care.

Special cases

Suspected spinal injury: Selective immobilization per NEXUS or Canadian C-spine criteria — not every trauma patient. Indicators for immobilization: altered mental status, intoxication, distracting injury, focal neurologic deficit, midline spinal tenderness, dangerous mechanism (high-speed collision, fall from height). Suspected dislocation: Reduction is a clinical skill outside the household scope for most dislocations; immobilize in position of comfort and transport. Exception: dislocation that is causing vascular or neurologic compromise may require reduction in the field — this is a trained operator skill, not a layperson skill.

Section 05Area 04 — Poisoning and Toxic Exposure

The original framework lumped all poisoning together. Modern doctrine recognizes that ingestion, inhalation, dermal, and ocular exposures are different problems with different treatments, and that the right answer for many ingestions is now not what older first-aid manuals taught.

What changed

Two major shifts since the older framework:

• Syrup of ipecac is no longer recommended. The American Academy of Pediatrics, AAP, and AACT all retracted ipecac recommendations more than 15 years ago. Induced vomiting causes its own complications (aspiration, esophageal injury) and rarely improves outcomes. Do not stock it; if you have it from older household supplies, dispose of it.
• Activated charcoal indications narrowed. Single-dose activated charcoal is now reserved for specific acute oral poisonings within a 1–2 hour window, with airway intact and not for corrosives, hydrocarbons, alcohols, heavy metals, or ionic compounds. See Field Brief 04 for the full pharmacology.

First-action algorithm

• Call Poison Control: 1-800-222-1222 in the US. Free, 24/7, staffed by clinical toxicologists. The single highest-yield action in any poisoning scenario. Have the substance container, time of exposure, amount, and patient weight ready. Do not delay the call to research the substance yourself.
• Ingestion: Identify the substance; preserve the container. Do not induce vomiting. Do not give activated charcoal without Poison Control or clinical guidance — the substance category determines whether it helps.
• Inhalation: Remove the patient to fresh air. Carbon monoxide and other inhaled toxics may require oxygen and definitive care. Suspect CO in any patient with unexplained altered mental status, headache, nausea who was in an enclosed space with a combustion source.
• Dermal exposure: Remove contaminated clothing. Irrigate with copious water for 20+ minutes (most exposures), specific decontamination for known agents.
• Ocular exposure: Continuous water or saline irrigation for at least 15–20 minutes, longer for alkaline exposures (which penetrate deeper and continue damage). Do not use neutralizing agents.

Common household poisoning patterns

Pediatric ingestions: cleaning products, medications (especially blood pressure medications and iron supplements — both are lethal in small pediatric doses), button batteries (esophageal injury within hours, surgical emergency), magnets (intestinal injury if two or more are swallowed), household cosmetics. Carbon monoxide: combustion appliances, vehicle exhaust, generators run indoors — the prepper-scenario CO exposure pattern is well documented after every hurricane.

Section 06Area 05 — Environmental Injury (Heat, Cold, Water, Altitude, Lightning)

Environmental injury is one of the largest categories of preventable death in austere and disaster scenarios. The category divides into heat illness, cold injury, water emergencies, altitude, and lightning — each with its own physiology and management.

Heat illness spectrum

Heat illness is a continuum from heat cramps (benign muscle cramping from electrolyte depletion) through heat exhaustion (volume depletion with intact thermoregulation) to heat stroke (failure of thermoregulation with core temperature over 40°C / 104°F and altered mental status). The progression is fast in vulnerable populations.

Heat exhaustion management: Move to cool environment, remove excess clothing, oral rehydration with electrolyte solution, passive cooling (fan, wet skin). Heat stroke management: Life-threatening medical emergency. Aggressive active cooling — ice-water immersion is the gold standard if available; ice packs to neck, axillae, groin if immersion is not available; evaporative cooling with fans and wet skin. Cool first, transport second; minutes of hyperthermia produce permanent neurologic injury. Send to ER regardless of apparent recovery.

Cold injury spectrum

• Frostbite: Localized freezing injury. Numb, white, hard tissue. Rewarm in 37–39°C water (just warmer than body temperature) for 15–30 minutes. Do not rub the tissue; rubbing causes mechanical damage to the frozen cells. Do not partially rewarm and refreeze — that is worse than continued freezing. Pain management is essential during rewarming.
• Hypothermia: Core temperature below 35°C. Mild (32–35°C): confused, shivering. Moderate (28–32°C): shivering stops, depressed mental status. Severe (under 28°C): unresponsive, cardiac arrhythmia risk. Management: Remove wet clothing, insulate, active rewarming for moderate-severe cases. Handle severe hypothermia patients gently — rough movement can precipitate ventricular fibrillation. The trauma triad principle from Field Brief 05 applies: hypothermia is a resuscitation problem, not an afterthought.

Water emergencies

Drowning: The 2002 Utstein guidelines redefined drowning as "respiratory impairment from submersion in liquid" — there is no distinction between "near-drowning" and "drowning"; the term is drowning regardless of survival outcome. Management: rescue from water with attention to potential cervical spine injury in diving accidents, CPR if pulseless (with 5 initial rescue breaths in drowning-protocol CPR), oxygen, transport. All symptomatic drowning patients need ER evaluation — delayed pulmonary edema can develop hours after the event.

Altitude illness

Acute mountain sickness, high-altitude pulmonary edema, high-altitude cerebral edema. Onset typically above 2,500 meters. Management: descent is the definitive treatment for moderate-severe cases. Pharmacologic adjuncts (acetazolamide for prevention and mild AMS, dexamethasone for cerebral edema, nifedipine for pulmonary edema) are clinical-level interventions.

Lightning injury

Reverse triage — apparently dead lightning patients with respiratory arrest may have intact cardiac function and respond to airway/ventilation support. Manage cardiac arrest patients first in a multi-casualty lightning event; apparently dead patients second.

Section 07Area 06 — Medical Emergencies (Cardiac, Stroke, Allergic, Respiratory, Diabetic)

This is the area the original framework most underweighted. Medical emergencies dominate adult household scenarios. Five major categories.

Suspected acute coronary syndrome

Recognition: Chest pain, pressure, or discomfort lasting more than a few minutes; pain radiating to arm, jaw, neck, or back; shortness of breath; diaphoresis; nausea. Female patients, diabetic patients, and older patients may present atypically (epigastric pain, isolated jaw pain, isolated dyspnea, fatigue). Action: Call 911. Chew 324 mg aspirin (four 81-mg baby aspirin) unless contraindicated. Patient sits or lies comfortably; do not have them walk to the car. Prepare to perform CPR with AED if cardiac arrest occurs.

Suspected stroke

The FAST framework is the household-level screen: Face droop (one side of the face droops or numbs on smile), Arm weakness (one arm drifts down when both are held out), Speech difficulty (slurred or absent speech, or inability to repeat a simple sentence), Time (note the time of last known well; time-to-treatment determines whether tPA or thrombectomy is feasible). Call 911. Do not give food, drink, or medications by mouth — aspiration risk. Time of symptom onset is the single most important piece of information for the receiving stroke team.

Anaphylaxis

Severe systemic allergic reaction with airway, breathing, or circulation involvement, or skin involvement plus GI involvement, or skin involvement plus respiratory involvement. The first-line treatment is intramuscular epinephrine — 0.3 mg adult, 0.15 mg pediatric, in the lateral thigh, through clothing if necessary. Diphenhydramine and corticosteroids are adjuncts after epinephrine, not substitutes. A second epinephrine dose may be needed 5–15 minutes after the first if symptoms persist or recur. All anaphylaxis patients need ER evaluation after field treatment; biphasic reactions occur in roughly 5% of patients hours after apparent resolution.

Severe asthma exacerbation

Recognition: severe shortness of breath, inability to speak in full sentences, tripod positioning, accessory muscle use, decreased breath sounds, altered mental status. Management: Patient's own short-acting beta-agonist inhaler (albuterol) with spacer, repeated dosing every 20 minutes as needed. Oxygen if available. Position of comfort, usually sitting upright leaning forward. Call 911 for any severe exacerbation that doesn't improve with the first inhaler treatment, any patient with altered mental status, any patient with previous near-fatal asthma history.

Diabetic emergencies

Hypoglycemia (low blood sugar): Confusion, sweating, tremor, hunger, behavioral changes; in severe cases, unconsciousness or seizure. Conscious patient: 15 g rapid-acting carbohydrate (glucose tablets, juice, regular soda). Unconscious patient: do not give anything by mouth; glucagon IM if available, transport. Hyperglycemia / DKA: Polyuria, polydipsia, fruity breath, abdominal pain, nausea, deep rapid breathing (Kussmaul). Transport; this is an inpatient management problem.

Section 08Area 07 — Shock and Prolonged Resuscitation

Shock is the final common pathway of multiple injuries and illnesses — inadequate tissue perfusion with cellular oxygen debt. The original framework treated it as a discrete topic; modern doctrine treats it as a syndrome with multiple etiologies, each with different management.

Shock types and recognition

• Hypovolemic: Volume loss from hemorrhage, dehydration, burns. Cool clammy skin, tachycardia, hypotension late.
• Distributive (septic, anaphylactic, neurogenic): Vasodilation. Warm flushed skin early, hypotension, tachycardia (or bradycardia in neurogenic).
• Cardiogenic: Pump failure. Cool clammy skin, hypotension, signs of left or right heart failure (pulmonary edema, JVD).
• Obstructive: Mechanical obstruction to cardiac output. Tension pneumothorax, cardiac tamponade, massive pulmonary embolism.

Generic shock management at household level

Position the patient supine (Trendelenburg position is no longer recommended — the head-down tilt does not improve outcomes and may worsen breathing and ICP). Maintain airway, support breathing, control any external bleeding. Maintain warmth — the trauma triad applies to all shock, not just hemorrhagic shock. Withhold oral fluids in patients with altered mental status. Transport.

Prolonged field care principles

JTS Prolonged Casualty Care guidelines provide the framework for sustained-care scenarios:

• Continuous patient monitoring (vital signs, mental status, intervention efficacy).
• Reassessment of every intervention every 15–30 minutes initially, then hourly as stable.
• Documentation — every dose, every intervention, every change in patient status, on paper if necessary.
• Comfort care — pain management, hydration, hygiene, position changes, psychological support.
• Resource preservation — IV fluids, hemostatic agents, batteries, oxygen are finite. Use them strategically.
• Evacuation planning — even if evacuation is not currently possible, plan for it continuously. The window may open without notice.

Section 09Area 08 — Behavioral Health and Psychological First Aid

The eighth area, missing from the original framework, is the area that increasingly dominates household and prepper-scenario medical events. Behavioral-health crises — acute psychiatric emergencies, suicidal ideation, panic, dissociation, acute grief, intoxication-related psychiatric presentations, dementia-related emergencies — present at high rates in households, and they rise dramatically in disaster and prolonged-stress scenarios.

Psychological First Aid (PFA) framework

The WHO and SAMHSA Psychological First Aid framework provides a doctrinal structure for the household operator. The core components:

• Contact and engagement. Approach calmly, identify yourself, ask permission to help. Tone matters more than words in acute distress.
• Safety and comfort. Move the person away from the precipitating stressor if possible. Address immediate physical needs — water, blanket, quiet space.
• Stabilization. For disoriented or overwhelmed individuals, simple grounding techniques: orient them to time, place, person; ask them to name objects they see; slow controlled breathing.
• Information gathering. Ask about immediate needs and concerns. Avoid forced disclosure of the precipitating event.
• Practical assistance. Help with one or two immediate problems. Concrete actions reduce psychological overwhelm.
• Connection to social supports. Identify and engage family, friends, faith community, professional supports.
• Information on coping. Brief, calm explanation of normal acute stress responses.
• Linkage to collaborative services. Connection to professional behavioral-health care.

Specific scenarios

Suicidal ideation: Direct, non-judgmental questioning is not harmful and does not "plant the idea" — that myth has been disproven repeatedly. Asking "are you thinking about hurting yourself" or "are you thinking about ending your life" opens the conversation that can save it. The 988 Suicide and Crisis Lifeline in the US (call or text 988) is staffed by trained counselors 24/7. Means restriction — removing access to firearms, large medication supplies, and other lethal means during a crisis — is one of the highest-yield interventions available to households. Acute psychosis: Calm low-stimulus environment, do not argue with delusions, do not promise treatment outcomes, do not approach in a way that could be perceived as threatening. 911 if there is risk of harm to self or others. Dementia-related agitation: Familiar environment, familiar voices, low stimulation, validation rather than reorientation in moderate-severe dementia.

Operator self-care

Sustained-care scenarios are physically and psychologically taxing on the operator. The household-level corollary of professional EMS and military mental-health doctrine is: monitor your own functioning, build in rest and rotation if multiple capable people are available, use peer support, and recognize that the operator who is exhausted, hungry, or dysregulated makes worse decisions. Operator self-care is patient care.

Section 10The Knowledge Audit — What Every Household Operator Should Have Practiced

Knowledge that hasn't been practiced is not knowledge — it is reading. The audit pattern that survives contact with real events:

Hands-on skills with documented practice

• CPR (adult, child, infant) — every household member age-appropriate.
• AED use — every household member who is age-appropriate.
• Choking response (Heimlich, infant back-blow / chest thrust).
• Tourniquet placement on a training limb — high and tight, proximal third, never across a joint.
• Wound packing on a training task trainer.
• Epinephrine auto-injector use on a trainer device.
• Bag-valve mask ventilation if applicable to operator scope.
• Recovery position placement.
• SAM splint application.

Written reference materials

• Allergy and medication list for every household member, updated annually.
• Emergency contact list, including primary care, specialty care, Poison Control (1-800-222-1222), local poison center, 988 Suicide and Crisis Lifeline.
• FAST stroke screen, anaphylaxis recognition, MI recognition — printed quick-reference cards.
• Pediatric dosing chart for age-relevant household members.
• Local hospital and ER addresses with route notes.

Recurring training

• CPR/AED recertification on the standard biennial cycle.
• Stop the Bleed course completion for every adult household member.
• Annual review of medication list, allergy documentation, and tetanus status.
• Quarterly inventory and rotation of medical supplies.
• Family-level scenario discussion — what if X happens, who does what, where is the kit.

The skill that hasn't been practiced is the skill that fails under stress. The household with documented training is operationally different from the household with the same equipment and no documentation.

Section 11Bottom Line for the Operator

Eight principles, distilled:

1. The original seven-areas framework is a starting point, not a finished doctrine. The threat profile has changed, the population has changed, and the duration of care has changed. The framework needs eight areas, not seven.
2. Behavioral health is not optional. It is the area that increasingly dominates household medical events, and the area where layperson skill matters most because professional response is often delayed or unavailable.
3. Modern wound care is direct pressure, packing, and tourniquet — in that order. The hierarchy of intervention is doctrinal. Skipping steps wastes resources; over-applying tourniquets to non-life-threatening bleeding is its own failure mode.
4. Cool the burn, cover the burn, get to a burn center if it's bad. Ice damages tissue. Creams trap heat. Send-thresholds are clearly defined; use them.
5. Ipecac is dead. Activated charcoal is narrow. Poison Control is free, 24/7, and the highest-yield call. The old poisoning doctrine has been replaced. Update accordingly.
6. FAST, MI recognition, anaphylaxis recognition. The recognition skills for the four medical emergencies that account for most adult household deaths are simple, learnable, and the difference between survival and not.
7. Shock is a syndrome, not a diagnosis. The etiology determines the management. Maintain airway, support breathing, control bleeding, maintain warmth, transport. Trendelenburg is obsolete.
8. Practice is the deliverable. Equipment and knowledge without practiced application are storage. Every adult household member with documented training is the operational unit that matters.

That's the brief.

ReferenceFrequently Asked Questions