Introduction of First Aid

Emergency treatment administered to an injured or sick person before professional medical care is available.

First Aid is the temporary or the immediate care to a burn, wound, injury, etc that a victim has obtained from an accident. First Aid is used to ease the pain of an injury, to prevent the worsening of the injury, to stop the loss of blood from bleeding and to prepare the victim for bringing to the hospital. Sometimes, without First Aid the victim may die before even reaching the hospital, which is why each one of us should learn the basics of First Aid.

When you see someone in an accident and you know how to give First Aid, you should not be afraid to help the person for it is the right thing to do. When you see someone hurt, don't just let the person stand up but let him/her stay down for awhile and examine the injury. If it's a fracture, let him/her stay down for awhile and maybe you could get a wheel chair or stretcher to bring the person to a nearby clinic/hospital. If he/she is bleeding, get a clean cloth such as your handkerchief or your clothes and tie it around to prevent further bleeding.

These are just some examples of accidents but there are still more that can happen so always take notice of things that happen and don't be afraid to help a person who is injured or hurt.

We don’t know what will happen later, tomorrow, and in the future. We should be ready for what is to happen and what the world has to give to us whether good or bad. Do not be afraid to help another when they are in need. What if you were the one in need and no one would help you? How would you feel? We need to apply the things we learn especially those in school, which are much disregarded

BASIC FIRST AID HELP

ANIMAL BITE

If an animal bites you or your child, follow these guidelines:

For minor wounds. If the bite barely breaks the skin and there's no danger of rabies, treat it as a minor wound. Wash the wound thoroughly with soap and water. Apply an antibiotic cream to prevent infection and cover the bite with a clean bandage.

For deep wounds. If the animal bite creates a deep puncture of the skin or the skin is badly torn and bleeding, apply pressure with a clean, dry cloth to stop the bleeding and see your doctor.

For infection. If you notice signs of infection, such as swelling, redness, increased pain or oozing, see your doctor immediately.

For suspected rabies. If you suspect the bite was caused by an animal that might carry rabies — including any wild or domestic animal of unknown immunization status, particularly bats — see your doctor immediately.

Doctors recommend getting a tetanus shot every 10 years. If your last one was more than five years ago and your wound are deep or dirty, your doctor may recommend a booster. Get the booster as soon as possible after the injury.

Domestic pets cause most animal bites. Dogs are more likely to bite than cats. Cat bites, however, are more likely to cause infection because they are usually puncture wounds and can't be thoroughly cleaned. Bites from no immunized domestic animals and wild animals carry the risk of rabies. Rabies is more common in bats, raccoons, skunks and foxes than in cats and dogs. Rabbits, squirrels and other rodents rarely carry rabies.

The Centers for Disease Control and Prevention recommends that children or adults exposed to bats, or who are sleeping and discover bats present, seek medical advice, even if they don't think they've been bitten. This is because bat bite marks can be hard to see.


ALLERGIC

Allergic reactions may include mild nausea and intestinal cramps, diarrhea, or swelling larger than 4 inches (about 10 centimeters) in diameter at the site, bigger than the size of a baseball. See your doctor promptly if you experience any of these signs and symptoms.

For severe reactions

severe reactions affect more than just the site of the insect bite and may progress rapidly. Call 911 or emergency medical assistance if the following signs or symptoms occur:

1. Difficulty breathing 
2. Swelling of the lips or throat 
3. Faintness 
4. Dizziness 
5. Confusion 
6. Rapid heartbeat 
7. Hives 
8. Nausea, cramps and vomiting

Take these actions immediately while waiting with an affected person for medical help: 

1. Check for medications that the person might be carrying to treat an allergic attack, such as an auto injector of epinephrine (EpiPen, Twinject). Administer the drug as directed — usually by pressing the auto injector against the person's thigh and holding it in place for several seconds. Massage the injection site for 10 seconds to enhance absorption.
2. Loosen tight clothing and cover the person with a blanket. Don't give anything to drink. 
3. Turn the person on his or her side to prevent choking if there's vomiting or bleeding from the mouth. 
4. Begin CPR if there are no signs of circulation, such as breathing, coughing or movement.

If your doctor has prescribed an auto injector of epinephrine, read the instructions before a problem develops and also have your household members read them.

BURN

To distinguish a minor burn from a serious burn, the first step is to determine the extent of damage to body tissues. The three burn classifications of first-degree burn, second-degree burn and third-degree burn will help you determine emergency care.

• 1st-degreeburn
• The least serious burns are those in which only the outer layer of skin is burned, but not all the way through. 
• The skin is usually red 
• Often there is swelling 
• Pain sometimes is present 
• Treat a first-degree burn as a minor burn unless it involves substantial portions of the hands, feet, face, groin or buttocks, or a major joint, which requires emergency medical attention.

• 2nd-degree burn
• when the first layer of skin has been burned through and the second layer of skin (dermis) also is burned, the injury is called a second-degree burn. 
• Blisters develop 
• Skin takes on an intensely reddened, splotchy appearance 
• There is severe pain and swelling.

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 if the burn is on the hands, feet, face, groin or buttocks, or over a major joint, treat it as a major burn and get medical help immediately.

For minor burns, including first-degree burns and second-degree burns limited to an area no larger than 3 inches (7.6 centimeters) in diameter, take the following action:

1. Cool the burn. Hold the burned area under cool (not cold) running water for 10 or 15 minutes or until the pain subsides. If this is impractical, immerse the burn in cool water or cool it with cold compresses. Cooling the burn reduces swelling by conducting heat away from the skin. Don't put ice on the burn. 
2. Cover the burn with a sterile gauze bandage. Don't use fluffy cotton, or other material that may get lint in the wound. Wrap the gauze loosely to avoid putting pressure on burned skin. Bandaging keeps air off the burn reduces pain and protects blistered skin. 
3. Take an over-the-counter pain reliever. These include aspirin, ibuprofen (Advil, Motrin, others), naproxen (Aleve) or acetaminophen (Tylenol, others). Use caution when giving aspirin to children or teenagers. Though aspirin is approved for use in children older than age 2, children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. Talk to your doctor if you have concerns.

Minor burns usually heal without further treatment. They may heal with pigment changes, meaning the healed area may be a different color from the surrounding skin. Watch for signs of infection, such as increased pain, redness, fever, swelling or oozing. If infection develops, seek medical help. Avoid re-injuring or tanning if the burns are less than a year old — doing so may cause more extensive pigmentation changes. Use sunscreen on the area for at least a year.

Caution

1. Don't use ice. Putting ice directly on a burn can cause a person's body to become too cold and cause further damage to the wound. 
2. Don't apply egg whites, butter or ointments to the burn. This could cause infection. 
3. Don't break blisters. Broken blisters are more vulnerable to infection.

3rd-degree burn
the most serious burns involve all layers of the skin and cause permanent tissue damage. Fat, muscle and even bone may be affected. Areas may be charred black or appear dry and white. Difficulty  inhaling and exhaling, carbon monoxide poisoning, or other toxic effects may occur if smoke inhalation accompanies the burn.

For major burns, call 911 or emergency medical help. Until an emergency unit arrives, follow these steps:

1. Don't remove burned clothing. However, do make sure the victim is no longer in contact with smoldering materials or exposed to smoke or heat. 
2. Don't immerse large severe burns in cold water. Doing so could cause a drop in body temperature (hypothermia) and deterioration of blood pressure and circulation (shock). 
3. Check for signs of circulation (breathing, coughing or movement). If there is no breathing or other sign of circulation, begin CPR. 
4. Elevate the burned body part or parts. Rise above heart level, when possible. 
5. Cover the area of the burn. Use a cool, moist, sterile bandage; clean, moist cloth; or moist cloth towels. 
6. Get a tetanus shot. Burns are susceptible to tetanus. Doctors recommend you get a tetanus shot every 10 years. If your last shot was more than five years ago, your doctor may recommend a tetanus shot booster

Cardiopulmonary resuscitation (CPR)

Cardiopulmonary resuscitation (CPR) is a lifesaving technique useful in many emergencies, including heart attack or near drowning, in which someone's breathing or heartbeat has stopped. The American Heart Association recommends that everyone — untrained bystanders and medical personnel alike — begin CPR with chest compressions. 

It's far better to do something than to do nothing at all if you're fearful that your knowledge or abilities aren't 100 percent complete. Remember, the difference between your doing something and doing nothing could be someone's life.

Here's advice:

1. Untrained. If you're not trained in CPR, then provide hands-only CPR. That means uninterrupted chest compressions of about 100 a minute until paramedics arrive (described in more detail below). You don't need to try rescue breathing. 
2. Trained, and ready to go. If you're well trained and confident in your ability, begin with chest compressions instead of first checking the airway and doing rescue breathing. Start CPR with 30 chest compressions before checking the airway and giving rescue breaths. 
3. Trained, but rusty. If you've previously received CPR training but you're not confident in your abilities, then just do chest compressions at a rate of about 100 a minute. (Details described below.)

The above advice applies to adults, children and infants needing CPR, but not newborns. CPR can keep oxygenated blood flowing to the brain and other vital organs until more definitive medical treatment can restore a normal heart rhythm. When the heart stops, the lack of oxygenated blood can cause brain damage in only a few minutes. A person may die within eight to 10 minutes. To learn CPR properly, take an accredited first-aid training course, including CPR and how to use an automatic external defibrillator (AED).

Before you begin

before starting CPR, check:

1. Is the person conscious or unconscious? 
2. If the person appears unconscious, tap or shake his or her shoulder and ask loudly, "Are you OK?" 
3. If the person doesn't respond and two people are available, one should call 911 or the local emergency number and one should begin CPR. If you are alone and have immediate access to a telephone, call 911 before beginning CPR — unless you think the person has become unresponsive because of suffocation (such as from drowning). In this special case, begin CPR for one minute and then call 911 or the local emergency number. 
4. If an AED is immediately available, deliver one shock if instructed by the device, then begin CPR.

Remember to spell C-A-B

The uses the acronym of CAB — circulation, airway, breathing — to help people remember the order to perform the steps of CPR.
Circulation: Restore blood circulation with chest compressions

1. Put the person on his or her back on a firm surface. 
2. Kneel next to the person's neck and shoulders. 
3. Place the heel of one hand over the center of the person's chest, between the nipples. Place your other hand on top of the first hand. Keep your elbows straight and position your shoulders directly above your hands. 
4. Use your upper body weight (not just your arms) as you push straight down on (compress) the chest at least 2 inches (approximately 5 centimeters). Push hard at a rate of about 100 compressions a minute. 
5. If you haven't been trained in CPR, continue chest compressions until there are signs of movement or until emergency medical personnel take over. If you have been trained in CPR, go on to checking the airway and rescue breathing.

Airway: Clear the airway

If you're trained in CPR and you've performed 30 chest compressions, open the person's airway using the head-tilt, chin-lift maneuver. Put your palm on the person's forehead and gently tilt the head back. Then with the other hand, gently lift the chin forward to open the airway.

Check for normal breathing, taking no more than five or 10 seconds. Look for chest motion, listen for normal breath sounds, and feel for the person's breath on your cheek and ear. Gasping is not considered to be normal breathing. If the person isn't breathing normally and you are trained in CPR, begin mouth-to-mouth breathing. If you believe the person is unconscious from a heart attack and you haven't been trained in emergency procedures, skip mouth-to-mouth rescue breathing and continue chest compressions.

Breathing: Breathe for the person

Rescue breathing can be mouth-to-mouth breathing or mouth-to-nose breathing if the mouth is seriously injured or can't be opened. With the airway open (using the head-tilt, chin-lift maneuver), pinch the nostrils shut for mouth-to-mouth breathing and cover the person's mouth with yours, making a seal. Prepare to give two rescue breaths. Give the first rescue breath — lasting one second — and watch to see if the chest rises. If it does rise, give the second breath. If the chest doesn't rise, repeat the head-tilt, chin-lift maneuver and then give the second breath. Thirty chest compressions followed by two rescue breaths is considered one cycle.

Resume chest compressions to restore circulation.

If the person has not begun moving after five cycles (about two minutes) and an automatic external defibrillator (AED) is available, apply it and follow the prompts. Administer one shock, and then resume CPR — starting with chest compressions — for two more minutes before administering a second shock. If you're not trained to use an AED, a 911 or other emergency medical operator may be able to guide you in its use. Use pediatric pads, if available, for children ages 1 through 8. Do not use an AED for babies younger than age 1. If an AED isn't available, go to step 5 below.

Continue CPR until there are signs of movement or emergency medical personnel take over.

To perform CPR on a child

The procedure for giving CPR to a child age 1 through 8 is essentially the same as that for an adult. The differences are as follows:

1. If you're alone, perform five cycles of compressions and breaths on the child — this should take about two minutes — before calling 911 or your local emergency number or using an AED. 
2. Use only one hand to perform heart compressions. 
3. Breathe more gently. 
4. Use the same compression-breath rate as is used for adults: 30 compressions followed by two breaths. This is one cycle. Following the two breaths, immediately begin the next cycle of compressions and breaths. 
5. After five cycles (about two minutes) of CPR, if there is no response and an AED is available, apply it and follow the prompts. Use pediatric pads if available. If pediatric pads aren't available, use adult pads. 
6. Continue until the child moves or help arrives.

To perform CPR on a baby

Most cardiac arrests in babies occur from lack of oxygen, such as from drowning or choking. If you know the baby has an airway obstruction, perform first aid for choking. If you don't know why the baby isn't breathing, perform CPR.

To begin, examine the situation. Stroke the baby and watch for a response, such as movement, but don't shake the baby.

If there's no response, follow the CAB procedures below and time the call for help as follows:

1. If you're the only rescuer and CPR is needed, do CPR for two minutes — about five cycles — before calling 911 or your local emergency number. 
2. If another person is available, have that person call for help immediately while you attend to the baby.

Circulation: Restore blood circulation

Place the baby on his or her back on a firm, flat surface, such as a table. The floor or ground also will do.

Imagine a horizontal line drawn between the baby's nipples. Place two fingers of one hand just below this line, in the center of the chest.

Gently compress the chest about 1.5 inches (about 4 cm).

Count aloud as you pump in a fairly rapid rhythm. You should pump at a rate of 100 compressions a minute.

Airway: Clear the airway

After 30 compressions, gently tip the head back by lifting the chin with one hand and pushing down on the forehead with the other hand.

In no more than 10 seconds, put your ear near the baby's mouth and check for breathing: Look for chest motion, listen for breath sounds, and feel for breath on your cheek and ear.

Breathing: Breathe for the infant

Cover the baby's mouth and nose with your mouth. Prepare to give two rescue breaths. Use the strength of your cheeks to deliver gentle puffs of air (instead of deep breaths from your lungs) to slowly breathe into the baby's mouth one time, taking one second for the breath. Watch to see if the baby's chest rises. If it does, give a second rescue breath. If the chest does not rise, repeat the head-tilt, chin-lift maneuver and then give the second breath. If the baby's chest still doesn't rise, examine the mouth to make sure no foreign material is inside. If the object is seen, sweep it out with your finger. If the airway seems blocked, perform first aid for a choking baby. Give two breaths after every 30 chest compressions.

Perform CPR for about two minutes before calling for help unless someone else can make the call while you attend to the baby. Continue CPR until you see signs of life or until medical personnel arrive.

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:

1. Inability to talk 
2. Difficulty breathing or noisy breathing 
3. Inability to cough forcefully 
4. Skin, lips and nails turning blue or dusky 
5. Loss of consciousness 
6. 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 hospital 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 you:
First, if you're alone and choking and you have a landline phone; 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.

• Clearing 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.

• Clearing the airway of an unconscious person:

• Lower the person on his or her back onto the floor.

• Clear the airway. If there's a visible blockage 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.

Clearing 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 face up 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. 

To prepare yourself for these situations, learn the Heimlich maneuver and CPR in a certified first-aid training course.

FEVER

Fever is a sign of a variety of medical conditions, including infection. Your normal temperature may differ slightly from the average body temperature of 98.6 F (37 C).

For young children and infants — especially newborns — even slightly elevated temperatures may indicate a serious illness. For adults, a fever usually isn't dangerous until it reaches 103 F (39.4 C) or higher.

For adults, don't treat fevers below 102 F (38.9 C) with any medications unless your doctor tells you to. If you have a fever of 102 F (38.9 C) or higher, your doctor may suggest taking an over-the-counter medication, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others).

Adults also may use aspirin, but don't give aspirin to children or teenagers under the age of 19. It may trigger a rare, but potentially fatal, disorder known as Reye's syndrome. Also, don't give ibuprofen to infants younger than 6 months of age.

Fahrenheit-Celsius conversion table
Fahrenheit	Celsius
105	40.5
104	40.0
103	39.4
102	38.9
101	38.3
100	37.7
99	37.2
98	36.6
97	36.1
96	35.5

How to take a temperature

Most thermometers have digital readouts. Some take the temperature quickly from the ear canal and can be especially useful for young children and older adults. Other thermometers can be used rectally, orally or under the arm (auxiliary).

If you use a digital thermometer, be sure to read the instructions so that you know what the beeps mean and when to read the thermometer. Under normal circumstances, temperatures tend to be highest around 4 to 6 p.m. and lowest around 6 a.m.

Because of the potential for mercury exposure or ingestion, glass mercury thermometers have been phased out and are no longer recommended.

Rectally (for infants)

to take your child's temperature rectally:

1. Place a dab of petroleum jelly or other lubricant on the thermometer bulb. 
2. Lay your child on his or her stomach. 
3. Carefully insert the bulb one-half inch to one inch into the rectum. 
4. Hold the thermometer and child still for about one minute, until you hear a beep. To avoid injury, don't let go of the thermometer while it's inside your child. 
5. Remove the thermometer and read the temperature as recommended by the manufacturer. 
6. Taking a rectal temperature is also an option for older adults when taking an oral temperature is not possible. 
7. A rectal temperature reading is generally 1 degree Fahrenheit (about 0.5 degree Celsius) higher than an oral reading.

Orally

To take your temperature orally:

1. Place the thermometer bulb under your tongue 
2. Close your mouth for the recommended amount of time or until you hear a beep, usually one minute 

Under the arm (auxiliary)

1. although it's not the most accurate way to take a temperature, you can also use an oral thermometer for an armpit readin 
2. lace the thermometer under your arm with your arm down. 
3. Hold your arms across your chest. 
4. Wait about one minute or until you hear a beep. 
5. Remove the thermometer and read the temperature. 
6. To take your child's auxiliary temperature, have the child sit in your lap, facing to the side. Place the thermometer under your child's near arm, which should be against your chest. 
7. An auxiliary reading is generally 1 degree Fahrenheit (about 0.5 degree Celsius) lower than an oral reading. 

When to seek medical help

Get medical help for a fever if:

1. A baby younger than 3 months has a rectal temperature of 100.4 F (38 C) or higher, even if your baby doesn't have other signs or symptoms 
2. A baby older than 3 months has a temperature of 102 F (38.9 C) or higher 
3. A child younger than age 2 has a fever longer than one day, or a child age 2 or older has a fever longer than three days 
4. An adult has a temperature of more than 103 F (39.4 C) or has had a fever for more than three days

When to seek emergency help

Call your doctor immediately if your child has a fever after being left in a hot car or if a child or adult has any of these signs or symptoms with a fever:

1. A severe headache
2. Sore throat
3. Unusual skin rash 
4. Unusual eye sensitivity to bright light 
5. A stiff neck and pain when the head is bent forward
6. Mental confusion 
7. Persistent vomiting 
8. Difficulty breathing or chest pain 
9. Extreme listlessness or irritability 
10. Abdominal pain or pain when urinating 
11. Other unexplained symptoms

SPRAIN

Your ligaments are tough, elastic-like bands that connect bone to bone and hold your joints in place. A sprain is an injury to a ligament caused by tearing of the fibers of the ligament. The ligament can have a partial tear, or it can be completely torn apart.

Of all sprains, ankle and knee sprains occur most often. Sprained ligaments swell rapidly and are painful. Generally, the greater the pain and swelling, the more severe the injury is. For most minor sprains, you probably can treat the injury yourself. 

Follow the instructions for R.I.C.E.

• Rest the injured limb. Your doctor may recommend not putting any weight on the injured area for 48 hours. But don't avoid all activity. Even with an ankle sprain, you can usually still exercise other muscles to minimize reconditioning. For example, you can use an exercise bicycle with arm exercise handles, working both your arms and the uninjured leg while resting the injured ankle on another part of the bike. That way you still get three-limb exercise to keep up your cardiovascular conditioning.

• Ice the area. Use a cold pack, a slush bath or a compression sleeve filled with cold water to help limit swelling after an injury. Try to ice the area as soon as possible after the injury and continue to ice it for 15 to 20 minutes, four to eight times a day, for the first 48 hours or until swelling improves. If you use ice, be careful not to use it too long, as this could cause tissue damage.

• Compress the area with an elastic wrap or bandage. Compressive wraps or sleeves made from elastic or neoprene are best.

• Elevate the injured limb above your heart whenever possible to help prevent or limit swelling. 

After two days, gently begin using the injured area. You should feel a gradual, progressive improvement. Over-the-counter pain relievers, such as ibuprofen (Advil, Motrin, others) and acetaminophen (Tylenol, others), may be helpful to manage pain during the healing process. 

See your doctor if your sprain isn't improving after two or three days.

Get emergency medical assistance if:

1. You're unable to bear weight on the injured leg, the joint feels unstable or numb, or you can't use the joint. This may mean the ligament was completely torn. On the way to the doctor, apply a cold pack. 
2. You develop redness or red streaks that spread out from the injured area. This means you may have an infection. 
3. You have re-injured an area that has been injured a number of times in the past. 
4. You have a severe sprain. Inadequate or delayed treatment may contribute to long-term joint instability or chronic pain.