Fitness

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Cuts and Scrapes

1. Stop Bleeding

Apply direct pressure on the cut or wound with a clean cloth, tissue, or piece of gauze until bleeding stops.
If blood soaks through the material, don’t remove it. Put more cloth or gauze on top of it and continue to apply pressure.
If the wound is on the arm or leg, raise limb above the heart, if possible, to help slow bleeding.
Wash your hands again after giving first aid and before cleaning and dressing the wound.
Do not apply a tourniquet unless the bleeding is severe and not stopped with direct pressure.

2. Clean Cut or Wound

Gently clean with soap and warm water. Try to rinse soap out of wound to prevent irritation.
Don’t use hydrogen peroxide or iodine, which can damage tissue.

3. Protect the Wound

Apply antibiotic cream to reduce risk of infection and cover with a sterile bandage.
Change the bandage daily to keep the wound clean and dry.

4. When to Call a Doctor

The wound is deep or the edges are jagged or gaping open.
The wound is on the person’s face.
The wound has dirt or debris that won’t come out.
The wound shows signs of infection, such as redness, tenderness, or a thick discharge, or if the person runs a fever.
The area around the wound feels numb.
Red streaks form around the wound.
The person has a puncture wound or deep cut and hasn’t had a tetanus shot in the past five years, or anyone who hasn’t had a tetanus shot in the past 10 years.

Call 911 if:
Bleeding is severe
You suspect internal bleeding
There is an abdominal or chest wound
Bleeding can't be stopped after 10 minutes of firm and steady pressure
Blood spurts out of wound

Blisters 

If a blister isn't too painful, try to keep it intact. Unbroken skin over a blister may provide a natural barrier to bacteria and decreases the risk of infection. Cover it with an adhesive bandage. If you're allergic to the adhesive used in some tape, use paper tape.

Seek medical care if the blister is painful or prevents you from walking or using one of your hands. Consider taking the following self-care measures if medical help is not available.

How to drain a blister

To relieve blister-related pain, drain the fluid while leaving the overlying skin intact. Here's how:

Wash your hands and the blister with soap and warm water.
Swab the blister with iodine.
Sterilize a clean, sharp needle by wiping it with rubbing alcohol.
Use the needle to puncture the blister. Aim for several spots near the blister's edge. Let the fluid drain, but leave the overlying skin in place.
Apply an ointment (Vaseline, Plastibase, other) to the blister and cover it with a nonstick gauze bandage. If a rash appears, stop using the ointment.
Change the dressing every day. Apply more ointment and a bandage.
Blister prevention

To prevent friction blisters on your feet, wear shoes that fit well. It also helps to use moisture-wicking socks. Try the various socks, shoes and insoles that are designed specifically to help reduce blistering. You might also try attaching moleskin to the inside of your shoe where it might rub or dusting the inside of your socks with talcum powder. Gloves help prevent blisters on your hands.

Burns

Minor burns

For minor burns:

Cool the burn to help soothe the pain. Hold the burned area under cool (not cold) running water for 10 to 15 minutes or until the pain eases. Or apply a clean towel dampened with cool tap water.
Remove rings or other tight items from the burned area. Try to do this quickly and gently, before the area swells.
Don't break small blisters (no bigger than your little fingernail). If blisters break, gently clean the area with mild soap and water, apply an antibiotic ointment, and cover it with a nonstick gauze bandage.
Apply moisturizer or aloe vera lotion or gel, which may provide relief in some cases.
If needed, take an over-the-counter pain reliever, such as ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve) or acetaminophen (Tylenol, others).
Consider a tetanus shot. Make sure that your tetanus booster is up to date. Doctors recommend people get a tetanus shot at least every 10 years.
See your doctor if you develop large blisters. Large blisters are best removed, as they rarely will remain intact on their own. Also seek medical help if the burn covers a large area of the body or if you notice signs of infection, such as oozing from the wound and increased pain, redness and swelling.

Major burns

Call 911 or emergency medical help for major burns. Until an emergency unit arrives, take these actions:

Protect the burned person from further harm. If you can do so safely, make sure the person you're helping is not in contact with smoldering materials or exposed to smoke or heat. But don't remove burned clothing stuck to the skin.
Check for signs of circulation. Look for breathing, coughing or movement. Begin CPR if needed.
Remove jewelry, belts and other restrictive items, especially from around burned areas and the neck. Burned areas swell rapidly.
Don't immerse large severe burns in cold water. Doing so could cause a serious loss of body heat (hypothermia) or a drop in blood pressure and decreased blood flow (shock).
Elevate the burned area. Raise the wound above heart level, if possible.
Cover the area of the burn. Use a cool, moist, bandage or a clean cloth.
Is it a minor burn or a major burn?

If it's not clear what level of care is needed, try to judge the extent of tissue damage, based on the following burn categories:

1st-degree burn

A first-degree burn is the least serious type, involving only the outer layer of skin. It may cause:

Redness
Swelling
Pain
You can usually treat a first-degree burn as a minor burn. If it involves much of the hands, feet, face, groin, buttocks or a major joint, seek emergency medical attention.

2nd-degree burn

A second-degree burn is more serious. It may cause:

Red, white or splotchy skin
Swelling
Pain
Blisters
If the second-degree burn is no larger than 3 inches (7.6 centimeters) in diameter, treat it as a minor burn. If the burned area is larger or covers the hands, feet, face, groin, buttocks or a major joint, treat it as a major burn and get medical help immediately.

3rd-degree burns

The most serious burns involve all layers of the skin and underlying fat. Muscle and even bone may be affected. Burned areas may be charred black or white. The person may experience:

Difficulty breathing
Carbon monoxide poisoning
Other toxic effects, if smoke inhalation also occurred

Bites or stings of insects


Most reactions to insect bites and stings are mild, causing little more than redness, itching, stinging or minor swelling. Rarely, insect bites and stings, such as from a bee, a wasp, a hornet, a fire ant or a scorpion, can result in severe reactions. Some insects also carry disease, such as West Nile virus.

For mild reactions

To take care of an insect bite or sting that causes a mild reaction:

Move to a safe area to avoid more bites or stings.
If needed, remove the stinger.
Wash the area with soap and water.
Apply a cool compress. Use a cloth dampened with cold water or filled with ice. This helps reduce pain and swelling. If the injury is on an arm or leg, elevate it.
Apply a cream, gel or lotion to the injured area. Use products containing ingredients such as hydrocortisone, pramoxine or lidocaine to help control pain. Use creams such as calamine lotion or those containing colloidal oatmeal or baking soda to help soothe itchy skin.
Use over-the-counter medications. Try a pain reliever, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others), or an antihistamine (Benadryl, Chlor-Trimeton, others).
Usually, the signs and symptoms of a bite or sting disappear in a day or two. If you're concerned — even if your reaction is minor — call your doctor.

When to seek emergency care

Call 911 or your local emergency number if the injured person experiences:

Difficulty breathing
Swelling of the lips, eyelids or throat
Dizziness, faintness or confusion
Rapid heartbeat
Hives
Nausea, cramps or vomiting
A scorpion sting and is a child
Take these actions immediately while waiting for medical help:

Ask the person if he or she is carrying an epinephrine autoinjector (EpiPen, Auvi-Q, others) to treat an allergic attack.
If the person says he or she needs to use an autoinjector, ask whether you should help inject the medication. This is usually done by pressing the autoinjector against the person's thigh and holding it in place for several seconds.
Loosen tight clothing and cover the person with a blanket. Don't give him or her anything to drink.
Turn the person on a side to prevent choking if he or she is vomiting or bleeding from the mouth.
Begin CPR if the person shows no signs of circulation, such as breathing, coughing or movement.

Ticks

Most tick bites are painless and cause only minor signs and symptoms, such as redness, swelling or a sore on the skin. But some ticks transmit bacteria that cause illnesses, including Lyme disease and Rocky Mountain spotted fever. In general, to transmit disease most ticks need to be attached for at least 24 hours.

To take care of a tick bite

Remove the tick promptly and carefully. Use fine-tipped forceps or tweezers to grasp the tick as close to your skin as possible. Gently pull out the tick using a slow and steady upward motion. Avoid twisting or squeezing the tick. Don't handle the tick with bare hands. Experts don't recommend using petroleum jelly, fingernail polish or a hot match to remove a tick.
If possible, seal the tick in a container. Put the container in a freezer. Your doctor may want to see the tick if you develop new symptoms.
Wash your hands and the bite site. Use warm water and soap, rubbing alcohol, or an iodine scrub.
When to seek emergency care

Call 911 or your local emergency number if you develop:

A severe headache
Difficulty breathing
Paralysis
Heart palpitations
When to contact your doctor

You aren't able to completely remove the tick. The longer the tick remains attached to your skin, the greater your risk of getting a disease from it.
The rash gets bigger. A small red bump may appear at the site of the tick bite. This is normal. But if it develops into a larger rash, perhaps with a bull's-eye pattern, it may indicate Lyme disease. The rash usually appears within three to 14 days.

Also consult your doctor if signs and symptoms disappear because you may still be at risk of the disease. Your risk of contracting a disease from a tick bite depends on where you live or travel to, how much time you spend outside in woody and grassy areas, and how well you protect yourself.

You develop flu-like signs and symptoms. Fever, chills, fatigue, muscle and joint pain, and a headache may accompany the rash.
You think the bite site is infected. Signs and symptoms include redness or oozing.
You think you were bitten by a deer tick You may need antibiotics.
If possible, bring the tick with you to your doctor's appointment.

Venomous snakebite

Most North American snakes aren't dangerous to humans. Some exceptions include the rattlesnake, coral snake, water moccasin and copperhead. Their bites can be life-threatening.

If you are bitten by a venomous snake, call 911 or your local emergency number immediately, especially if the area changes color, begins to swell or is painful. Many emergency rooms stock antivenom drugs, which may help you.

If possible, take these steps while waiting for medical help:

Remain calm and move beyond the snake's striking distance.
Remove jewelry and tight clothing before you start to swell.
Position yourself, if possible, so that the bite is at or below the level of your heart.
Clean the wound, but don't flush it with water. Cover it with a clean, dry dressing.

Caution

Don't use a tourniquet or apply ice.
Don't cut the wound or attempt to remove the venom.
Don't drink caffeine or alcohol, which could speed your body's absorption of venom.
Don't try to capture the snake. Try to remember its color and shape so that you can describe it, which will help in your treatment.
Symptoms

Most snakebites occur on the extremities. If the bite is from a nonvenomous snake, typical symptoms are pain and scratches at the site.

Usually, after a bite from a poisonous snake, there is severe burning pain at the site, within 15 to 30 minutes. This can progress to swelling and bruising at the wound, and all the way up the arm or leg. Other symptoms include nausea and a general sense of weakness, as well as an odd taste in the mouth.

Some snakes, such as coral snakes, have toxins that cause neurological symptoms, such as tingling, difficulty speaking and weakness.

Venomous snakes in North America

Most venomous snakes in North America have eyes like slits and are known as pit vipers. Their heads are triangular with a pit between the eye and nostril on either side of the head.

Other characteristics are unique to certain venomous snakes:

Rattlesnakes rattle by shaking the rings at the end of their tails.
Water moccasins' mouths have a white, cottony lining.
Coral snakes have red, yellow and black rings along the length of their bodies. Their heads aren't triangular and the pupils are round.
Copperhead snakes have a copper-colored head and reddish brown bodies with dark bands.

 
Nosebleed 

Nosebleeds are common. Most often they are a nuisance and not a true medical problem. But they can be both.

Nosebleed care

Sit upright and lean forward. By remaining upright, you reduce blood pressure in the veins of your nose. This discourages further bleeding. Sitting forward will help you avoid swallowing blood, which can irritate your stomach.
Pinch your nose. Use your thumb and index finger to pinch your nostrils shut. Breathe through your mouth. Continue to pinch for 10 to 15 minutes. Pinching sends pressure to the bleeding point on the nasal septum and often stops the flow of blood.

If the bleeding continues after 10 to 15 minutes, repeat holding pressure for another 10 to 15 minutes. Avoid peeking at your nose. If the bleeding still continues, seek emergency care.

To prevent re-bleeding, don't pick or blow your nose and don't bend down for several hours after the bleeding episode. During this time remember to keep your head higher than the level of your heart. You can also gently apply some petroleum jelly to the inside of your nose using a cotton swab or your finger.
If re-bleeding occurs, blow out forcefully to clear your nose of blood clots and spray both sides of your nose with a decongestant nasal spray containing oxymetazoline (Afrin, Mucinex Moisture Smart, others). Pinch your nose again as described above and call your doctor.


When to seek emergency care

The bleeding lasts for more than 20 minutes
You feel faint or lightheaded
The nosebleed follows an accident, a fall or an injury to your head, including a punch in the face that may have broken your nose
When to contact your doctor

You experience frequent nosebleeds. You may need a blood vessel cauterized. Cautery is a technique in which the blood vessel is burned with electric current, silver nitrate or a laser. Your doctor may pack your nose with special gauze or an inflatable latex balloon to put pressure on the blood vessel and stop the bleeding.
You're experiencing nasal bleeding and taking blood thinners, such as aspirin or warfarin (Coumadin, Jantoven). Your doctor may advise adjusting your medication dosage.
Using supplemental oxygen administered with a nasal tube (cannula) may increase your risk of nosebleeds. Apply a water-based lubricant to your nostrils and increase the humidity in your home to help relieve nasal bleeding.

Choking

Choking occurs when a foreign object becomes lodged in the throat or windpipe, blocking the flow of air. In adults, a piece of food often is the culprit. Young children often swallow small objects. Because choking cuts off oxygen to the brain, administer first aid as quickly as possible.

The universal sign for choking is hands clutched to the throat. If the person doesn't give the signal, look for these indications:

Inability to talk
Difficulty breathing or noisy breathing
Inability to cough forcefully
Skin, lips and nails turning blue or dusky
Loss of consciousness
If choking is occurring, the Red Cross recommends a "five-and-five" approach to delivering first aid:

Give 5 back blows. First, deliver five back blows between the person's shoulder blades with the heel of your hand.
Give 5 abdominal thrusts. Perform five abdominal thrusts (also known as the Heimlich maneuver).
Alternate between 5 blows and 5 thrusts until the blockage is dislodged.
The American Heart Association doesn't teach the back blow technique, only the abdominal thrust procedures. It's OK not to use back blows, if you haven't learned the technique. Both approaches are acceptable.

To perform abdominal thrusts (Heimlich maneuver) on someone else:

Stand behind the person. Wrap your arms around the waist. Tip the person forward slightly.
Make a fist with one hand. Position it slightly above the person's navel.
Grasp the fist with the other hand. Press hard into the abdomen with a quick, upward thrust — as if trying to lift the person up.
Perform a total of 5 abdominal thrusts, if needed. If the blockage still isn't dislodged, repeat the five-and-five cycle.
If you're the only rescuer, perform back blows and abdominal thrusts before calling 911 or your local emergency number for help. If another person is available, have that person call for help while you perform first aid.

If the person becomes unconscious, perform standard CPR with chest compressions and rescue breaths.

To perform abdominal thrusts (Heimlich maneuver) on yourself:

First, if you're alone and choking, call 911 or your local emergency number immediately. Then, although you'll be unable to effectively deliver back blows to yourself, you can still perform abdominal thrusts to dislodge the item.

Place a fist slightly above your navel.
Grasp your fist with the other hand and bend over a hard surface — a countertop or chair will do.
Shove your fist inward and upward.
To clear the airway of a pregnant woman or obese person:

Position your hands a little bit higher than with a normal Heimlich maneuver, at the base of the breastbone, just above the joining of the lowest ribs.
Proceed as with the Heimlich maneuver, pressing hard into the chest, with a quick thrust.
Repeat until the food or other blockage is dislodged or the person becomes unconscious.
To clear the airway of an unconscious person:

Lower the person on his or her back onto the floor.
Clear the airway. If a blockage is visible at the back of the throat or high in the throat, reach a finger into the mouth and sweep out the cause of the blockage. Be careful not to push the food or object deeper into the airway, which can happen easily in young children.
Begin cardiopulmonary resuscitation (CPR) if the object remains lodged and the person doesn't respond after you take the above measures. The chest compressions used in CPR may dislodge the object. Remember to recheck the mouth periodically.
To clear the airway of a choking infant younger than age 1:

Assume a seated position and hold the infant facedown on your forearm, which is resting on your thigh.
Thump the infant gently but firmly five times on the middle of the back using the heel of your hand. The combination of gravity and the back blows should release the blocking object.
Hold the infant faceup on your forearm with the head lower than the trunk if the above doesn't work. Using two fingers placed at the center of the infant's breastbone, give five quick chest compressions.
Repeat the back blows and chest thrusts if breathing doesn't resume. Call for emergency medical help.
Begin infant CPR if one of these techniques opens the airway but the infant doesn't resume breathing.
If the child is older than age 1, give abdominal thrusts only.

Frostbite

When exposed to very cold temperatures, skin and underlying tissues may freeze, resulting in frostbite. The areas most likely to be affected by frostbite are your fingers toes, nose, ears, cheeks and chin.

If your skin pales or turns red and is very cold, hard or waxy looking, you may have frostbite. You may also experience a prickling feeling or numbness. With severe or deep frostbite, you may experience blistering and pain.

You can treat very mild frostbite (frostnip) with first-aid measures. All other frostbite requires medical attention. First-aid steps for frostbite are as follows:

Check for hypothermia. Get emergency medical help if you suspect hypothermia. Signs and symptoms of hypothermia include intense shivering, slurred speech, drowsiness and loss of coordination.
Protect your skin from further exposure. If you're outside, warm frostbitten hands by tucking them into your armpits. Protect your face, nose or ears by covering the area with dry, gloved hands. Don't rub the affected area and never rub snow on frostbitten skin.
Get out of the cold. Once you're indoors, remove wet clothes.
Gently rewarm frostbitten areas. Soak hands or feet in warm water — 99 to 108 F (37 to 42 C) — for 15 to 30 minutes. If a thermometer isn't available, test the water by placing an uninjured hand or elbow in it — it should feel very warm — not hot.

Don't rewarm frostbitten skin with direct heat, such as a stove, heat lamp, fireplace or heating pad. This can cause burns.

If there's any chance the affected areas will freeze again, don't thaw them. If they're already thawed, wrap them up so that they don't refreeze.
Take pain medicine. If you are in pain, take over-the-counter ibuprofen (Advil, Motrin IB, others) to reduce pain and inflammation.
Don't walk on frostbitten feet or toes if possible. This further damages the tissue.
Know what to expect as skin thaws. If the skin turns red and you feel tingling and burning as it warms, normal blood flow is returning. But seek emergency medical attention if the numbness or pain remains during warming or if blisters develop.

Sunburn

If you have been sunburned, you will experience the signs and symptoms of sunburn within a few hours of exposure to the sun. The affected skin will be painful, red and swollen. In some cases it might blister. You may also have a headache, fever and nausea.

If you have a sunburn

Take a cool bath or shower, which may be soothing. Or apply a clean towel dampened with cool tap water to the affected skin.
Apply moisturizer. An aloe vera lotion or gel may be soothing.
Don't break small blisters (no bigger than your little fingernail). If blisters break, gently clean the area with mild soap and water, apply an antibiotic ointment, and cover the wound with a nonstick gauze bandage.
See your doctor if you develop large blisters. Large blisters are best removed, as they rarely will remain intact on their own. Also seek medical help if you experience immediate complications, such as worsening pain, a headache, confusion, nausea or chills.

If you plan to go in the sun

To help prevent sunburns, use sunscreen with an SPF of 15 or greater and broad-spectrum protection against UVA and UVB rays. The American Academy of Dermatology recommends using a broad-spectrum sunscreen with an SPF of 30 or greater. Reapply it every two hours, or more often if you're swimming or sweating. Stay in the shade, wear clothing that covers your arms and legs, and wear a hat.