Save Your Own Life

How a chair, rocks, aspirin, and a scarf can keep you alive in 12 do-or-die emergencies.
By Pamela F. Gallin, MD From Reader's Digest

How to Survive ...
Weʼve all heard the miracle stories: The Boy Scout who survived for four days in the mountains of North Carolina. The Montana couple who fought off a bear. The guy in Utah who cut off his arm to free himself from under a fallen boulder. Youʼve probably read many stories like this in Readerʼs Digest (like the one on page 102 about a couple stranded in the snow) and wondered what youʼd do in the same situation, but you always assumed freak accidents would never happen to you. And youʼd be wrong. While your odds of having a heart attack are much higher than finding yourself in most of these scenarios, strange things happen every day. For example, almost 2.5 million people called poison centers for help in 2006. In 2004, 112,000 people died of injuries from falls, drownings, and other accidents. In 2006, search-and-rescue rangers in our national parks responded to nearly 4,000 calls, more than a third of them for people who were also sick or injured. Every year, around 3,000 succumb to choking. Another 400 are struck by lightning, and 67 of those die from it. How do you keep yourself out of the statistics? Besides calling 911, hereʼs what to do in 12 life-threatening emergencies when no oneʼs around to help. LOST IN THE WILDERNESS To avoid becoming the lead story on the evening news, be prepared. Before you head out on a hike, check the weather (you can find forecasts for many wilderness areas at wunderground.com), take plenty of water, and make sure someone knows where youʼll be and when youʼll be back. Bring clothes to keep you warm when wet, like a water-repellent jacket, says Laurence Gonzales, author of Deep Survival: Who Lives, Who Dies, and Why. Avoid cotton, which traps moisture. “The search-and-rescue people call it death cloth,” he says. “Expect to get lost, and check often to make sure youʼre still on the trail,” says John Dill, a search-and-rescue ranger at Yosemite National Park in California. “The minute you think you might not be on the trail, stop.” “First, youʼve got to acknowledge youʼre in trouble,” adds Gonzales. If youʼre not alone, focusing on the needs of others can help hold your own fears at bay. Other keys to survival: staying observant and remembering to rest. Keeping a sense of humor helps too—it reduces stress and promotes creative thinking. The surest way to get out alive is to take basic precautions, such as stowing a survival kit in your car. Gonzalesʼs includes waterproof matches and chunks from fake fireplace logs for starting a fire, a folding saw for cutting branches, and a plastic tarp and cord for making

shelter. Donʼt forget an emergency blanket, a good knife, a first-aid kit, a flashlight, batteries, snacks, and water. In general, people who try to find their own way out fare worse than those who stay put, says Richard N. Bradley, MD, of the American Red Cross. Find shelter before dark, and try to keep dry. Stay visible so anyone searching can see you. In a wide-open area, make a signal with colorful gear, make a big X out of rocks, or dig a shallow trench, says Dill. “The top layer of soil is a different color. Scrape it away and make straight lines, which are easy to spot from above.” You can go several days without eating, so in most cases, youʼre better off not foraging for food, since there are lots of poisonous plants in the wild, says Dr. Bradley. You need to stay hydrated, so if you run out of water, itʼs usually better to drink from a stream with suspect water than to go without. If youʼre stranded in your car, stay there: Youʼre more visible to rescuers, and the car provides shelter. CHOKING Richard Stennes, MD, was home alone in La Jolla Shores, California, eating a steak, when the phone rang. The 64-year-old gulped down the bite still in his mouth and answered the call. But the hunk of steak was stuck, and he couldnʼt talk or breathe. He put his finger down his throat to grab the meat, but he couldnʼt reach it. Gagging didnʼt help either. So he walked over to the couch and forcefully thrust his abdomen on the hard arm of the couch, sending the meat flying and allowing him to breathe again. An emergency physician, Dr. Stennes knew that if done right, this would have the same effect as the Heimlich maneuver. If youʼre ever in the same situation, quickly find a chair or other piece of furniture or a kitchen counter, says Maurizio Miglietta, MD, chief of trauma at NewYork-Presbyterian Hospital/Columbia University Medical Center. Aim to hit the top of the chair or edge of the counter against your upper abdomen, in the soft part below the bony upside-down V of the ribs. Thrust up and inward. If you still canʼt breathe after six tries, call 911 from a landline, even if you canʼt talk. Theyʼll find you. Write the word choking somewhere nearby, and leave the line open until help arrives. HEART ATTACK If youʼre experiencing crushing chest pain with or without pain in your left arm, are short of breath, or have a sense of impending doom, you may be having a heart attack. (Women are more likely to have atypical symptoms like severe fatigue, nausea, heartburn, and profuse sweating.) Call 911 and chew one 325 mg uncoated aspirin, to get it into your bloodstream fast. This will thin your blood, often stopping a heart attack in its tracks. While waiting, lie down so your heart doesnʼt have to work as hard, says Sandra Schneider, MD, a spokeswoman for the American College of Emergency Physicians. If you think you might pass out, try forcing yourself to cough deeply. It changes the pressure in your chest and can have the same effect as the thump given in CPR, says Dr. Schneider. “Sometimes it can jolt the heart into a normal rhythm.” If someone else goes into cardiac arrest, note that the American Heart Association now recommends CPR without the mouth-to-mouth: Call 911, then push hard and fast on the personʼs chest until help comes. IMPALEMENT This doesnʼt happen only in horror movies. Tornadoes and hurricanes can fling debris for miles, and even recreational hobbies like fishing or archery can be hazardous. Just ask James Bertakis. The 81-year-old Florida man fared better than Crocodile Hunter Steve Irwin, who was killed in 2006 when a stingray struck him in the heart. Bertakis was impaled when a stingray jumped into his boat and hit him directly in the chest. He didnʼt remove the

barb but piloted the boat to land and got help. If you have something stuck in any body part, including your eye, donʼt remove the object, says Richard OʼBrien, MD, a spokesman for the American College of Emergency Physicians. “The object may be compressing an artery that would otherwise start bleeding like crazy.” If youʼve been struck by a branch or some other hefty object, try to trim it, breaking off the part thatʼs protruding from your body, but donʼt pull it out. SWIMMING EMERGENCIES Riptide: Dr. Stennes is either extremely lucky or has a knack for putting his life in danger. In addition to surviving choking, he also saved his own life in a riptide in Acapulco, Mexico. “I was swimming in the ocean, and all of a sudden a strong current took me away,” he says. “There were no lifeguards, so I was waving to people on the shore, who just waved back at me. I began to think, Iʼm in a bad situation here. Iʼm not a great swimmer, and I canʼt go against that riptide, so what am I going to do?” He floated for a while, then did exactly what the experts recommend: He swam slowly, parallel to the beach, until he was out of the current. You know youʼre in a riptide when you feel yourself being pulled away from the shoreline, says Dr. Bradley of the Red Cross. “Your natural reaction is to head toward the shore, but itʼs very difficult to swim against a riptide.” Luckily, these currents are fairly narrow, so you just have to swim along the shore, in either direction. Cramps: If youʼre in deep water, take a breath, lie on your back, and float. If youʼve got a muscle cramp (they often hit the calves), float facedown, grab your toes, and pull them toward you, stretching your calf until the pain goes away. If itʼs a stomach cramp, lie on your back, spread your arms and legs, and float until you can swim back to shore.

BEAR ATTACK
If you surprise a bear, donʼt run away. That invites an attack. Instead, stand up and back away slowly, without looking the bear in the eyes. Speak softly to the animal (no loud shouting). If it does charge at you, try to make yourself look as large as possible: Stick out your chest, raise your arms, and spread your legs. Now you can yell at the bear, to frighten it. If itʼs going to attack, lie facedown, with your hands clasped behind your neck. Play dead and donʼt get up until youʼre sure the bear is gone. Leave the area immediately in case it returns. If youʼre in bear country, carry a bear-deterrent pepper spray (find one at epa.gov). Make sure the wind isnʼt blowing toward you, and spray for one to two seconds when the bear is 30 to 40 feet away. POISONING The most common reasons for calls to poison centers? Unintentional or intentional drug overdoses (painkillers, sedatives, and antidepressants are high on the list) and exposure to cleaning products. No matter how little youʼve ingested, call a poison center before you do anything. The national number is 1-800-222-1222.

Donʼt make yourself throw up or give yourself ipecac, the vomit-inducing antidote that used to be a staple in first-aid kits, says Alvin C. Bronstein, MD, medical director of the Rocky Mountain Poison & Drug Center in Denver. “Ipecac has never been proven beneficial,” he says. “We rarely use it today. Itʼs gone the way of the horse and buggy.” Ipecac can leave you throwing up for hours. Plus, if you ingested something that burned going down and you force yourself to vomit, it will burn on the way back up too. And say you accidentally took a few extra sedatives. If you take ipecac when youʼre overly sleepy and your gag reflex isnʼt working well, you can turn a manageable overdose into something much worse. Colorless, odorless carbon monoxide is a deadly poison that kills nearly 500 unsuspecting people a year. Make sure you have a working detector in your home. If youʼve inhaled something (bleach or ammonia are common culprits), get away from the toxic area. If itʼs something that got on your skin, like a cleaning product, wash it off, then call a poison center and follow the specialistʼs advice. SEVERE BLEEDING Youʼre gushing blood—and getting scared. Forget about tourniquets, says Dr. Schneider of the American College of Emergency Physicians. Use your hand or a clean cloth, paper towels, a scarf, or any fabric you can grab, and push down on the wound until the bleeding stops. Tourniquets, which every Boy Scout learned how to make back in the day, are now a first-aid no-no. “If you have a cut on your upper leg and you put pressure on it, youʼre just closing that vessel. But if you put a tourniquet on, youʼre going to close the vessels to the entire leg,” says Dr. Schneider. “You could lose your foot.” The only time to use a tourniquet, says Charles Pattavina, MD, chief of emergency medicine at St. Joseph Hospital in Bangor, Maine, is when you know that everything below the wound is beyond repair (say, the accident has amputated your finger, arm, or leg). RISING WATER Rule No. 1: Never drive through standing water. As thousands of stranded motorists can attest, what looks like a small puddle can be much deeper. “It takes just 12 inches of water to carry a car away,” says Robert Sinclair, Jr., of AAA New York. If you do get stuck, step out of the car, which will likely stall when the water reaches the vehicleʼs electronic controls. If the water is higher than the bottom of your knees or is moving too quickly for you to wade through, climb on top of your car and wait for help. Otherwise, get to higher ground. If you suddenly become immersed (say, you drive off a bridge or into a lake or river), roll down the windows as soon as you can. Yes, it allows water to rush in, but thatʼs a good thing, says Sinclair. It equalizes the pressure, so you can open the door or swim out the window. Do it quickly, though, as the electrical systems on automatic windows can get damaged and stop working when wet. A LifeHammer can shatter automotive glass and cut through seat belts; Sinclair keeps one between the driverʼs seat and the center console in case of such emergencies. Break the side windows (windshields are usually thicker and harder to crack), and swim toward high, dry land. In a hurricane or storm with heavy winds, hide in a closet or pantry. Donʼt try to wade through floodwater outside—it can knock you over. If water is rising in your house, climb to the roof (as long as itʼs safe to do so) after the heavy rain and wind stop, says Lt. Ana Wisneski of the U.S. Coast Guard. Bring plenty of water to drink, sun protection, a flashlight, vital medications, and white sheets or colorful towels to signal rescuers. Then wait for help.

ALLERGIC REACTION Bee stings, food allergies, and medications can be deadly, even if you think you donʼt have allergies. Symptoms include itching in one spot or all over your body, sometimes accompanied by a rash, swelling, and, in the extreme, swelling of the airways, which hampers your ability to breathe. If you know you have a life-threatening allergy, form an action plan with your doctor, who will probably prescribe an EpiPen, which comes in child and adult doses. It delivers the drug epinephrine, which keeps the heart pumping, improves breathing, and gives you about 20 minutes to get to a hospital. Even if you donʼt have severe allergies, you can still be prepared for a spontaneous reaction. Slip a few maximum-strength antihistamines, like Benadryl Allergy capsules, into your wallet. The fast-acting tablets will begin to fight an allergic reaction while you wait for help to arrive. But since antihistamines can make you drowsy, donʼt drive yourself to the ER. TRAPPED IN A BURNING BUILDING If youʼre in an office building and canʼt get out, donʼt panic. “In any emergency situation, the difference between survivors and nonsurvivors is that survivors remain calm and fight through their fear to find out, What can I do?” says Dr. Schneider. So think back to those fire-safety lessons you learned in grade school. Call 911. Close yourself in a smoke-free room and place a wet towel underneath the door to prevent any smoke from entering, says Dan McBride, a firefighter in New York City. Then get low to the ground, where you can breathe and see better, until help arrives. If youʼre in a house, get as low as you can and crawl outside as fast as possible. Donʼt stop until youʼre well away from the fire. Then call for help.

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