Your Safety First — Check Before You Act
Before administering first aid, ensure your own safety. Check for aftershocks, gas leaks, unstable structures, and downed power lines. A rescuer who becomes a victim creates two problems. Assess the scene quickly and identify hazards before approaching any injured person.
Triage — Sorting by Severity
When multiple people are injured, triage prioritizes care: immediately life-threatening injuries first, followed by serious but stable injuries, minor injuries, and finally those who cannot survive. Simple triage: unconscious but breathing (position and monitor), unconscious not breathing (rescue breathing if trained), bleeding wounds (direct pressure), broken bones (stabilize and wait for professional help).
Controlling Bleeding
Apply firm, direct pressure to bleeding wounds using a clean cloth or bandage. Maintain pressure for at least 10 minutes without lifting the cloth — if it soaks through, apply additional layers on top. Tourniquets should be used for life-threatening limb bleeding only when direct pressure fails. Mark the time of tourniquet application.
Crush Injuries and Crush Syndrome
People trapped under debris can develop crush syndrome — a potentially fatal condition where muscle breakdown releases toxins into the bloodstream when pressure is released. For someone trapped for more than 15-20 minutes, do not rapidly remove heavy debris without medical personnel present. Provide water if the person is conscious and you can safely do so.
Suspected Spinal Injuries
If a person fell or was struck by debris, suspect a spinal injury. Do not move the person unless they are in immediate danger (fire, flooding). Keep the head and neck still if you must move them. Gently support the head in its current position if the person is conscious. Improper movement of spinal injuries can cause permanent paralysis.
Treating for Shock
Earthquake victims can go into shock from blood loss, crush injuries, or severe psychological trauma. Signs: pale, cold, clammy skin; rapid weak pulse; confusion or loss of consciousness. Keep the person lying down and warm. Elevate the legs if no spinal or leg injury is suspected. Do not give fluids to an unconscious person.
Finding and Helping Trapped Survivors
Listen for sounds from under debris — tapping is more audible than calling. Speak calmly to trapped people to assess their condition and provide reassurance. Unless a person is in immediate danger, it is generally safer to wait for trained search and rescue personnel rather than attempting extraction of people pinned under heavy debris.
When Professional Medical Help Cannot Arrive
During major earthquakes, professional medical help may be hours or days away. Community Emergency Response Team (CERT) training provides practical skills for responding in this gap. Consider taking a certified first aid and CPR course before an earthquake, and keep your first aid knowledge current.
