There are two basic types of dysmenorrhea:

• Primary dysmenorrhea
• Secondary dysmenorrhea

Primary dysmenorrhea is the commonest type menstrual cramps. This starts within first two years after attending the puberty. These episodes can be ranged from mild, moderate to severe forms. The abdominal pain begins with menstrual bleeding and last only during menstrual period. Usually there is no identifiable underlying pathology in female reproductive organs (uterus, ovaries, fallopian tubes, uterine cervix and the vagina) of these patients.

Secondary dysmenorrhea starts several years after the menarche (first menstrual period) and it occurs due to some underlying disorder of the reproductive tract. Pain begins few days prior to periods and lasts throughout the periods or even few days after their end.

Common causes for menstrual cramps-

A. Primary dysmenorrhea- occurs usually due to painful uterine contractions. Excessive prostaglandin levels found in uterus causes these violent, hence painful contractions.

B. Secondary dysmenorrhea -

• Adenomyosis- endometrial tissue (tissue that lines the innermost layer in the wall of the uterus) implants within the muscular wall of the uterus and causes severe pain during menstruation due to cyclical bleeding into the muscle rather than into the uterine cavity under normal conditions.

• Fibroids- benign tumors occur within uterine wall and cavity.

• Endometriosis- endometrial tissue implants on pelvic organs, abdominal cavity and elsewhere in body.

• Sexually transmitted diseases.

• Pelvic inflammatory disease – due to infection spreading into the pelvic cavity from reproductive organs.

• Intra uterine contraceptive device (IUCD) –Specially causes dysmenorrhea during first few months after implantation.

• Ovarian tumors.

Symptoms of painful menstrual cramps

• Dull, cramping, throbbing pain in lower abdominal region.

• Pain radiating to back.

• Nausea, vomiting.

• Sweating.

• Dizziness.

• Loose stools.

• Headache.

• Fainting

• Severe pain within first 24 hours of onset of menstruation.

First aid management and home remedies

1. Have adequate rest during first day of periods.

2. Try adopting different postures that eases the pain most. For an example; lying on side while bending knees towards chest wall, or lying on the back and keeping legs elevated by a pillow. These maneuvers will help to ease your abdominal wall muscles and reduce the pain.

3. Apply heat, like hot water bottle, hot water pad on to the lower abdominal wall and massage gently over the back and lower abdomen. Or take a hot water bath. Be careful not to keep warm things on skin for too long at a time or it may cause burns.

4. Drink warm beverages.

5. Exercise, especially prior to menstruation will relieve the pain in some women. This will increase the blood flow to uterus washing the prostaglandins away reliving the pain.

6. Over the counter non-steroidal anti-inflammatory drugs (NSAIDs) – inhibits the formation of prostaglandins in body/uterus. Prostaglandin is the hormone responsible for primary dysmenorrhea. Therefore, NSAIDs are effective in reduction of menstrual pain in patients with primary dysmenorrhea. (E.g. – mefenamic acid, ibuprofen). NSAIDs reduce the menstrual blood loss in addition to pain relief.

7. Take healthy diet with more fresh fruits, vegetables and water. Fiber content of the above foods will clear the excess estrogen. Which will eventually leads to reduction in menstrual cramps.

8. Avoid foods containing caffeine and too much salt and avoid smoking and alcohol as well. Those will worsen the cramps.

9. Keep bladder empty as much as possible.

10. Vitamin E, thiamine and omega- 3 supplements may help in some cases.

11. Practice relaxation techniques like breathing exercises, yoga.

12. Control the body weight if you are overweight.

13. Do not wear too tight clothes.

14. Oral combined hormonal contraceptive pills can be used as the last option of menstrual cramp controlling. Contraceptive pills prevent ovulation and reduce severity of menstrual cramps. Seek medical advice before taking these for the first time.

15. Contact your doctor if associated with fever, sudden severe pain, pain not relived with medications, pain and intra uterine contraceptive device at the same time and there is excessive menstrual bleeding with passage of blood clots.

Online References:

http://www.home-remedies-for-you.com/remedy/Menstrual-Cramps.html

http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Menstruation_dysmenorrhoea

http://www.emedicinehealth.com/menstrual_pain/page6_em.htm#menstrual_cramps_remedies_and_relief

http://women.webmd.com/menstrual-cramps

http://www.mayoclinic.com/health/menstrual-cramps/DS00506

Hypertension is graded as following according to its severity

Hypertension can be broadly classified in to two groups,
• Primary (essential) – hypertension without underlying identifiable cause. 90- 95% of all hypertensive individuals belong to this category.

• Secondary – hypertension arises due to an underlying medical condition (e.g. kidney disease, SLE, blood vessel diseases etc.). 5-10% of hypertensives belong to this category.

Though hypertension runs a chronic cause in majority; sometimes blood pressure goes out of control, rapidly rising over 180/120mmHg within a short time. This is called a hypertensive crisis. Unlike chronically elevated blood pressure this accelerated phase rapidly damages the blood vessels all over the body affecting many systems and bringing about severe consequences.

Causes of hypertensive crisis–

• Missing doses of blood pressure medication
• Stroke
• Renal failure
• Heart failure
• Pre – eclampsia and eclampsia in pregnant.

Signs and symptoms of hypertensive crisis-

• Most of the time asymptomatic
• Lightheadedness
• Vertigo and dizziness
• Severe headache
• Severe chest pain
• Shortness of breathing
• Nausea and vomiting
• Tinnitus
• Fainting episodes
• Seizures
• Severe anxiety
• Loss of consciousness
• Other symptoms related to secondary condition.

These symptoms are non – specific and rarely indicate hypertension as a cause. But first aid training courses should emphasize the value of measuring blood pressure in individuals claim to have these symptoms. Simple handheld electronic blood pressure monitors can be used for this task at community level.

Before measurement of blood pressure patient should rest for 20 minutes. Patient should be seated or lying down with correct sized blood pressure cuff applied to upper arm at the level of heart.

Consequences of hypertensive crisis-

• Heart attack
• Heart failure
• Kidney damage/failure
• Transient ischemic attack
• Stroke – due to rupture of brain aneurysms.
• Progressive vision loss
• Pulmonary edema – fluid buildup on lungs
• Convulsions
• Loss of consciousness

The primary modality of hypertensive crisis treatment is aggressive intravenous anti – hypertensive medication in order to bring blood pressure down. This is carried out in hospital following referral to urgent medical attention in these patients.
Still there is some place in first aid measures that can be used to prevent/manage these complications while waiting for medical help to arrive; increasing the chances of the patient to make a complete recovery without any morbidity.

First aid management-

1. Reassure the patient and call for medical help.

2. Make him/her to lie on the bed and rest adequately.

3. Try to comfort and reduce anxiety, as anxiety alone can increase blood pressure.

4. Keep monitoring breathing, pulse rate, blood pressure, level of consciousness and for any other dangerous signs ( e.g. paralysis of body in stroke, convulsions etc.)

5. Do not allow them to walk about, accompany the patient if it is really needed. Watch out for falls.

6. If the patient is vomiting or having seizures, turn to lateral side to prevent aspiration.

7. If patient complains of difficulty in breathing, prop him/her up using pillows behind upper back.

8. Do not give anything by mouth to eat/drink if there is suspicion of stroke.

9. Specially avoid caffeine or alcohol containing beverages.

10. Meanwhile look for possible cause for hypertensive crisis. If the patient is a known hypertensive and missed medication, consult doctor over the phone and give a dose of medications if instructed.

11. If breathing is unsatisfactory go for basic life support. Mouth to mouth breathing and CPR if needed.

Online Sources

http://www.mayoclinic.com/health/hypertensive-crisis/AN00626

Apart from the injuries to the external structures like skin, muscles and bone, it has to be kept in mind that the brain in its tightly confined space can be damaged directly or indirectly as a result of these forces. As an example a sudden ‘whiplash’ movement of head commonly seen in road traffic accidents can lead to massive intracranial hemorrhage compressing the brain leading to death, with out any visible external head injuries.

On the other hand, a simple fall in an elderly patient can cause rupture of small veins inside skull leading to slowly expanding hematoma (a blood clot) which may present as symptoms like changes in behavior, headache, and drowsiness over weeks until clot enlarges to a degree that cause loss of consciousness and ultimately death.

Most important condition out of all these worth attention is extra-dural hemorrhage (collection of blood between skull and outermost layer of meninges that cover the brain). Here the patient loses consciousness for a very brief period following a blow to head, and then he may appear quite normal for few hours called lucid interval where blood slowly collects inside before losing consciousness for the last time.

Therefore it has to be borne in mind that all head injury patients (who had considerable impact or lost consciousness briefly) should at least be kept under observation at least for 24hrs.

First aid management

Varies according to the pattern of head injury the patient has sustained.

1. Scalp laceration:-
   1. Even a tiny laceration can bleed profusely as skin of the scalp is one of most richly supplied area with blood vessels.
   2. Apply firm pressure over the wound using a clean piece of cloth or if available wads of gauze and then wrap a bandage around head tightly.
   3. Keep partially avulsed pieces of scalp together during above process as these can heal completely due to rich blood supply.
   4. Can use ice, or clothes soaked in cold water to control bleeding.
   5. Call for medical help to suture the wound.
   6. A shot of tetanus booster may be needed.

1. Blow/impact to head/blunt trauma
   1. Injury to head may be associated with damage to cervical spinal cord. Therefore when moving these patients be extremely careful and follow the guidelines on handling such patients.
   2. Use log-roll to turn patient to lateral side to protect the airway if patient is unconscious.
   3. If you are not familiar with handling such cases do not move the patient.
   4. Call 911 immediately if patient is unconscious.
   5. Keep monitoring airway, breathing and pulses and be ready for CPR if needed.
   6. Check for deformities of skull indicating underlying fractures.

2.  If the patient appears normal after a brief episode of loss of consciousness, do not leave him alone but watch for signs of increased intracranial pressure such as

•  severe headache
•  nausea
• vomiting
• altered level of consciousness
• drowsiness
• unequal pupil sizes
• paralysis of a limb/s

3.  It is much better to admit all head injury patients who had considerable trauma, to a head injury observation unit at least for 24hrs.

4. Skull fractures

1. These are very dangerous as the brain and its coverings are exposed to outside environment permitting micro-organisms to enter these vital areas leading to fatal infections.
2. Apart from fractures externally visible, base of the skull can get fractured in head trauma. Suspicious signs of this condition is; leakage of blood or bloodstained fluid (Cerebro-spinal fluid) via nose or ear, loss of smell, loss of vision, loss of hearing and bruising behind ears. Call for emergency medical support if these signs are present after a head trauma.
3. Cover the fractured area with a sterile gauze dressing but do not apply direct pressure on wound.
4. Do not try to wash the area or to remove debris.Keep the patient still as possible until medical help arrives.

Do not give anything to eat or drink to the victim.

A huge number of deaths and impact of injuries can be prevented with First Aid if causalities are treated immediately. This prompt care and attention prior to the arrival of the ambulance or medical help can sometimes mean the difference between life and death or between a full or partial recovery. However, there are some self-limiting illnesses or minor injuries that may only require first aid intervention. In these cases, no further treatment is needed. First aid generally consists of some simple, often life-saving techniques that most people can be trained to perform with minimal equipment.

The aims of First Aid are the reasons for carrying out the first aid measures itself. The aims are related to the Principles of First Aid. Simply said, these are the things that the person giving first aid is trying to achieve. There are three main aims of First Aid and they are as follows:

• The first aim is to preserve life. This is the primary aim, the most important one, of first aid as it involves saving the life of the casualty or any potential casualties within the risk vicinity. This includes the life of the first aid personnel, the casualty (the victim, the injured or sick person), and as well as the bystanders. Consequently, this means that the first aid applied to someone may not be the final medical treatment that the casualty receives, especially if the case is that of a major injury. Instead, this may just be the preliminary treatment and should be followed up by the professional medical team.

• Secondly, prevent further harm. This is also known as preventing the condition from worsening or preventing further damage, as it involves danger of further injury. This includes external factors, such as moving the patient out of harm’s way. And also during the application of first aid techniques, that is to prevent worsening of the condition, like in the instance of applying pressure to stop a massive bleeding. The first aid provided should not make the condition worse.

• The third aim is to promote recovery. First aid is still involved in the recovery phase from the illness or injury, especially in the beginning of its process. Sometimes it can even be involved in completing a treatment, such as in the case of applying a plaster to a small wound.

The other aims of First Aid are: to provide pain relief, to protect the unconscious, and to provide reassurance to the casualty.

The provision of prompt and appropriate first aid can reduce the severity of an injury or illness. It must be noted that there is a limit as to the effectiveness that first aid can provide. If a casualty reaches further medical aid without his condition becoming worse then the person administering first aid has done his job well.

Completing a babysitter course (find a first aid course here) does not only boost your chances at getting a babysitting job, it actually trains you on how to handle emergencies and how to make decisions for the safety of the children. Furthermore, the training course equips you with basic first aid skills which can truly be lifesaving.

Some important things you can learn in a babysitting course include:

• Going through the interview process for the job
• Setting your rate
• Caring for, feeding, dressing and holding a baby
• Dealing with emergency situations (fire, injury, sickness)
• Knowing when and how to call for help
• Performing basic first aid

And there are a lot of valuable life lessons and skills that you can learn in between these modules. Building essential life values such as confidence, camaraderie, volunteerism, discipline, and more.

You might also consider taking a first-aid or CPR class (course list here) so you can learn how to properly handle injuries. Very young children have no value for safety, so it is not uncommon for them to suffer from minor injuries such as bruises, scrapes or cuts. Although not very common, children may also sustain more serious injuries such as choking, burns or drowning. First-aid classes offered by the Red Cross covers care for common childhood injuries. These courses also include infant CPR training to manage children who are not breathing.

Once you have completed the babysitting course, you will get a certificate or card to attest to your proficiency. This will boost your chances of getting a job and prepare you for the real job. It may sound all too simple but actually finding can be quite a challenge.

First, you have to go through the interview process. You should not only build up on your skills but also try to learn about the family – whether you will be comfortable working for them. If you the family does not make you feel comfortable – For whatever reason – do not take the job. Here are some red flags you should look for:

• You will be assigned to care for more than four kids (especially very young children and babies)
• You are not comfortable with the parents
• You observe the children are badly behaved
• You find the house totally messed up
• The parents insist you do tasks or chores that you are not comfortable with

It is very important that you talk with the parents and observe the family before accepting the job. Make sure you are comfortable working with the family; better yet, try out the job and see whether you will like the working arrangements.

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People with medical conditions that restrict them from changing positions are usually more likely to develop bed sores. People who also use a wheelchair or are instructed to bed rest for prolonged periods are also susceptible to bed sores.

Bedsores that develop rapidly are usually difficult to treat. People with bed sores must consider serious self-care in order to prevent bedsores from taking place and allow proper healing. Managing bed sores are not covered in Red Cross training programs (register here), but similar problems including wound management and treating infections are covered in the courses.

Signs and symptoms

Deepening on their severity, bedsores fall under four main stages.

Stage 1

• Skin is intact
• Red on purple skin, light skin color, skin turns light when touched
• Darker skin tones may not show changes in skin color or blanching when touched. Skin may appear to be slightly blue, purple or ash
• The affected region may be firm, painful, soft, cool or warm compared to other regions of the skin

Stage 2: Open wound

• The outer layer of the skin or the epidermis and part of the dermis (underlying layer) may be lost or damaged
• Pressure ulcer may appear like pinkish red, basin-like, shallow wound
• May appear as a ruptures fluid-filled blister that is intact

Stage 3: Deep wound

• Loss of skin – Some fat may be exposed
• Crater-like appearance of the ulcer
• Bottom of the wound may show some yellowish dead tissue or slough
• Damage may extend beyond the initial region of the wound and affect healthy skin

Stage 4: Large scale loss of tissue

• Exposed muscle, bones or tendons from the wound
• Bottom of the wound may contain slough or dark, scaly, crusty dead tissue called eschar
• Damage will most likely extend beyond the boundaries of the initial wound and affect healthy skin

When to seek medical help

Make sure a person who is confined to a wheelchair or bed is properly checked for any wounds that may indicate bedsores. See your doctor promptly if you notice signs and symptoms of pressure ulcers. Immediate medical attention is required if the person show signs of infection including drainage form the sore, foul odor from the sore, fever, increased redness and heat of the surrounding skin area.

Treatment

Treatment for bedsores primarily involves relieving pressure.

Follow these self-care tips to reduce pressure:

• Reposition. Make sure you reposition yourself regularly in proper positions. People on wheelchairs should do this every 15 minutes, while people in bed are required to do so every 2 hour
• Support materials. Use pads, cushions, beds and mattresses to allow the person to lie in a proper position

To remove damaged tissue, the following steps may be required:

• Surgical debridement to cut away dead tissues
• Mechanical debridement using a number of methods that will loosen and remove dead tissues
• Autolytic debridement – the body’s natural mechanism of bring in enzymes to break down dead tissue – this can be enhanced using appropriate dressing
• Enzyme debridement – usage of chemical enzymes

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A woman with vaginitis may experience symptoms such as vaginal discharge, vaginal redness, vaginal itching, groin rash and vaginal odor.

Treatment for vaginitis often depends on the underlying cause. Treatment may include antifungal medication, antibiotics, estrogen cream and antiviral medication.

Risk factors

Common risk factors associated with vaginitis may include:

• Diabetes
• Conditions that suppress the immune system such as HIVA/AIDS, chemotherapy and organ transplant
• Intrauterine device
• Multiple sex partners
• Unprotected sex

Causes

Causes of vaginitis include:

• Bacterial infection
• Allergies
• Birth control pills
• Chemical vaginitis
• Diabetes
• Genital warts
• Herpes genitals
• Menopause
• Pinworms
• Pruritus vulvae
• Psoriases
• Vaginal foreign body
• Yeast vaginitis
• Trichomonas vaginitis

Causes of vaginitis in female children include:

• Exposure to chemicals
• Bacterial infections
• Hormone changes
• Pinworms
• Vaginal injury
• Sexual abuse

Signs and symptoms

Signs and symptoms of vaginitis include:

• Vaginal discomfort
• Vagina itching
• Vaginal redness
• Vaginal discharge – vaginal discharge may be white, grey or yellow
• Vaginal swelling
• Vaginal pain
• Vaginal spotting
• Vaginal pain during intercourse
• Pain while urinating
• Groin rash
• Skin redness
• Foul vaginal odor
• Abdominal pain – lower back pain

Treatment

Your doctor may prescribe the following treatment to resolve symptoms of vaginitis:

• Antibiotics for bacterial infection to the vagina
• Antifungal medication for yeast infection
• Antiviral medication for viral infection or herpes genitalis
• Topical estrogen for atrophic vaginitis
• Oral corticosteroid medication

Home care

Home care treatment for vaginitis includes:

• Nonprescription medication for vaginitis such as Butoconazole, Clotrimazole,  Miconazole  and Nystatin
• Take baths in lukewarm water to reduce vaginal irritation
• Take medication as prescribed and directed by your health care provider. Avoid skipping disease and familiarize yourself with the common side effects of prescription medication

When to seek medical attention

See your health care provider if any of the following problems occur along with vaginitis:

• Vaginal sores
• Vaginal blisters
• Groin rash
• Unusual bleeding of the vagina
• Vaginal foreign body
• Hematuria – blood in the urine
• Pain while urinating
• Abdominal pain
• Fever
• Pubic lice
• Vomiting
• Fever of 101 degrees F or above

Complications

Complications associated with vaginitis include:

• Atrophic vaginitis
• Endometritis
• Candidiasis
• Pelvic inflammatory disease
• Premature labor

Prevention

Follow these preventative techniques to reduce the risk of infection:

• Avoid using soap and irritating detergents in the vagina
• Avoid using products that may irritate the vagina such as shaving cream and bubble baths
• Make sure your genitals are kept clean
• Dry your genitals carefully after showering or bathing
• Use antifungal cream
• Wear cotton clothes and cotton underwear to reduce sweating
• Change tampons regularly – every 4-6 hours
• Avoid staying in wet clothes such as swim suits for too long
• Use condoms
• Wipe the anus—front to back – in order to prevent bacteria from spreading to the vagina
• Remember to urinate before and after intercourse

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Just like texting and driving, talking on the phone while babysitting can potentially put the child at risk. When you are using the telephone, your attention is divided between the child and the phone call. You can easily lose focus on the child and that’s when accidents can happen. So it is recommended that you keep all phone conversations short. If possible, avoid unnecessary phone calls, especially personal calls. You should also avoid using your cellphone to text message or smartphone to surf the net.

Telephone Safety Tips

Here are some important things to remember about telephone and mobile phone use while babysitting:

• Ask the parents if you can pick up phone calls and how they would like the phone answered.
• Keep conversations as short as possible. Be polite at all times.
• Limit phone calls to those related to the job only, avoid making or receiving personal calls. Ask the parent’s permission about your use of the phone for making brief personal calls.
• Make sure you use the phone only for important calls.
• Telephone lines can be tied up when you use the internet; so keep your internet time brief.
• Call the parents, the police or a trusted adult if you receive unsolicited phone call that scares you.
• Place emergency phone number, the office or mobile phone number of the parents, the address of the home, paper and pen near telephone lines.
• Never leave the child unattended while using the phone. Keep the child near you while talking over the phone.
• Never give the caller information about the child or the whereabouts of the parents, unless you have been instructed to do so.
• Never inform the caller that you are the babysitter and that the parents are out. Tell them the parents are busy at the moment and ask them if they want to leave a note.
• Never call, text message or chat with your friends while you are babysitting, even if you are using your personal mobile phone. You can get distracted and miss important phone calls or you may not be able to attend to the child well.

Safety First

The safety of the child is your top concern. Although phone calls do not pose any immediate harm, children could be put in an unsafe situation or get harmed if you lose focus on them. Babysitting courses offered by the Canadian Red Cross include these safety tips and many more. To learn more about how you can be the best babysitter, visit your local Red Cross Chapter and enrol in a babysitting or first aid and CPR course today!

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Causes

• Injuries resulting from contact sports such as football
• Physical assault
• Fist fights
• Motor vehicle accidents
• Falls
• Walking into a hard surface
• Boxing or wrestling type games

Symptoms

Signs and symptoms may appear promptly after the physical trauma or may take a few days to kick in. Some of the common ones include:

• Swelling of and/or around the nose
• Nose bleeding
• Tenderness and pain while touching the nose
• Deformed or crooked nose
• Bruising on and/or around the nose and around the eyes
• Breathing difficulties through the nose
• Rhinorrhea–discharge of mucus
• Feeling as if one or both nostrils are blocked

When to seek medical help

Seek immediate medical attention if the injury involves the following symptoms:

• Breathing difficulties
• Head or neck injury is suspected due to severe headache, vomiting, neck pain and unconsciousness
• Uncontrolled bleeding
• An unusual shape of your nose–not due to swelling–the nose may seem twisted
• Clear drainage from the nose

Treatment

1. Seek medical help if the following problems result from the injury:

• Bleeding cannot be stopped
• The nostril seems to be out of place or twisted
• Clear, gel like drainage comes out of the nose

2. Treat symptoms of the condition

• Allow the casualty to rest with his head elevated to discourage bleeding, also while sleeping
• For pain and swelling, apply an ice pack over the affected region
• Do not allow the casualty to blow his nose to discharge fluids
• For pain, over the counter pain medication can be taken. Avoid giving NSAIDs such as aspirin or ibuprofen.

If the nose does not seem deformed or unusual, plenty of rest at home will suffice. If you suspect that the nose is severely broken due to it being twisted or crooked, see your doctor immediately. Quick treatment will bring about speedy recovery.

For bleeding, the doctor will apply gauze on the nostrils.

For a fracture, the nose will be straightened out by the doctor.

Surgery is only required for complicated fractures in order to move the bone back in its place.

Courses that include training in managing and recognizing broken and fractured bones:

• Emergency First Aid and CPR – more info.
• Standard First Aid and CPR – more info.
• Standard Childcare First Aid and CPR – more info. 

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How can you reduce dangers or hazards in your home?

First of all, you need to perform a complete home hazard assessment. Hazard mitigation and is critical for reducing injuries due to accidents. Identify obvious hazards such as inclined walls, landslide prone areas, tree branches near electric lines or faulty electrical lines. Inclined walls can fall in case of strong winds or wind-storm while anything that has to do with electricity increases the risk of having a fire.

Be aware of potential hazards in your immediate surrounding or neighbourhood such as a rail line for transporting chemicals or petroleum, chemical plants, dams and electrical outlets. Rivers and lakes may also pose the risk of flooding during extreme weather conditions. Ask your local authorities about the dangers or risks in your place.

How do I develop home emergency plan?

Identifying home hazards can help you develop a response plan as well as an escape and evacuation plan in case it becomes necessary.

After you have completed a hazard assessment, you should address all hazards that are within your control. Preventing dangers should be your top priority. Familiarize yourself with the floor area of your residence. Create an escape plan and inform all household members about it.

Fire is one of the most common household emergencies. If your residence is on fire, make sure to get everyone out. Every room in the house should have at least two fire exits. Household members must have a designated place away from the house where they shall meet in case of fire. This makes it easier for you to account everyone, eliminate the need to get back inside the burning house to rescue someone.

Take note, however, that not all emergencies require that you go out of the house. In some emergencies, it may be best to stay put and shelter in place until safety is guaranteed. It is recommended in case of thunderstorm, flooding, nuclear accident or hazardous chemical spill. In these situations, it is important that you stay tuned with your local officials for necessary instructions. Make sure you follow their instructions. Do not go out unless there is instruction to do so.

Keep your first aid kit fully stocked and store in accessible part of the house. As much as possible, at least one member of the household should know basic first aid.

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