As a 30-year-old engineer living in a Philadelphia suburb, Joe Cammarata's combat experience amounts to playing Street Fighter II on his computer.
Yet his medical history makes it sound like characters leaped from the screen to rough him up: a torn rotator cuff and torn Achilles tendon, both from playing baseball; third-degree burns on both legs after a drunken sprint through a frat-party bonfire; a sprained ankle from playing soccer; and, after a memorable roll in the hay, a missing front tooth.
"My reaction has always been to run around screaming," says Cammarata of his stock response to injury, one mimicked by other men.
And there's no shortage of screamers: The National Center for Health Statistics says injuries sent nearly 18 million American men to the E.R. in 2005. Most of those scrapes, burns, and cuts occurred at home or on the field or court.
But here's the thing: People like Joe would recover more quickly if they knew what to do before a paramedic or doctor took over. And armed with some simple yet effective DIY techniques, your only E.R. experience might come as you're sitting on the sofa.
If you're cut...
First things first: Grab a clean napkin or towel or some sterile gauze, place it over the wound, and apply pressure. If the wound is to a limb, raise it above your heart to slow bloodflow to the site and encourage nature's bandage — clotting. "If the cloth soaks through with blood, keep adding to it," says paramedic Connie Meyer, a board member of the National Association of Emergency Medical Technicians. "If you disturb the clot, it'll start bleeding again."
The "uh-oh" moment: If the blood is bright red and spurting, an artery has been breached. EMTs often focus on pressure points — key places on the body where an artery is next to bone — and apply direct pressure. Done correctly, this tactic at least slows the bleeding. If you cut your hand, for example, find the brachial artery, located on the inside of your arm just above the elbow. Press it hard with your fingers or palm. If you're severely gashed and can see inside the wound, pinch the artery shut. Hold on tight until you make it to an E.R..
Dial 911: If you've lost enough blood to fill a 20-ounce soda bottle or if you start to feel thirsty, cold, or both, you could be going into shock. Phone for help, stat. Then work to control the bleeding — without panicking. Stopping a severe bleed could take as long as 20 minutes, Meyer says.
Rookie mistake: Putting soap into a wound. If you slice your finger, run it under the tap for a few seconds. Then cover it with a bandage and watch it the next day. Increasing pain at the site, redness, warmth, and foul-smelling drainage are all signs of infection.
If you're burned...
First things first: If the affected area is smaller than 3 inches in diameter, run it under cold water for 5 minutes, says Meyer. If the skin isn't blistered or charred — signs of serious burns — pop two ibuprofen or acetaminophen and leave the burn exposed to air. Don't slather on an antiseptic cream right away, says Meyer. "Wait at least an hour, or until the skin has cooled." When the burning sensation stops, prevent infection with an antibiotic ointment. Mild soap and water can work in a pinch.
The "uh-oh" moment: Blistering skin means a second-degree burn. "These are fairly serious, but an area smaller than your palm can be managed at home," says David Ross, D.O., an emergency physician at Penrose Hospital, in Colorado Springs, and a member of the American College of Emergency Physicians. Don't pop the blisters, and skip the cream. Cover unhealed blisters loosely with gauze or an adhesive strip.
Dial 911: If your skin resembles an overcooked rib-eye, you have third-degree burns. While you're waiting for paramedics, don't submerge the burns in cold water, which could lead to shock and hypothermia. Make sure your skin is no longer in contact with smoldering fabric, and let the experts remove any stuck clothing.
Rookie mistake: "Applying ice to any burn interrupts tissue repair," says Charles F. Pattavina, M.D., chief of emergency medicine at St. Joseph Hospital in Bangor, Maine. "Use water that's 40°F or warmer."
If you've been bitten...
First things first: How deep is it? "An abrasion or scratch doesn't usually need a doctor's attention," says Dr. Pattavina. "The risk of infection is much lower than with penetrating wounds." Rinse away germs with cool tap water, cover the site with an adhesive strip, and watch for infection.
The "uh-oh" moment: If teeth do plunge into your skin, it's a different story. "These are dangerous," says Dr. Pattavina. "Long fangs push bacteria deep into the wound, where they can thrive in an inaccessible, low-oxygen environment." You can try flushing the wound with cool water, but your best bet is an E.R.. "Even with irrigation by a doctor, these wounds are prone to infection," says Dr. Pattavina. "They may need a lot of cleansing and antibiotics."
Dial 911: If man's best friend suddenly turns into a creature from a horror movie, and you can't stop the bleeding or a huge chunk of tissue is missing, call for an ambulance immediately.
Rookie mistake: Not keeping up with your tetanus shot. Dr. Ross recommends receiving a booster within 72 hours if you've been bitten and 5 years have elapsed since your last shot.
If you're stung...
First things first: A bee sting produces an odor that can prompt other bees to attack, so cover your face and neck with a shirt or jacket until you can scramble indoors. Then curb the pain with acetaminophen or ibuprofen.
No matter what your mother slathered on a sting, topical home remedies such as baking powder and mud only cool the skin. "They don't actually mediate your body's reaction," says P. Kirk Visscher, Ph.D., an associate entomologist at the University of California at Riverside.
The "uh-oh" moment: The longer the stinger stays stuck in your skin, the more venom your body receives. So yank the stinger out with your fingers, scrape it off with a fingernail or credit card, or brush it off on your jeans — just remove it ASAP. Seconds matter, says Visscher, who notes that the squeeze itself won't affect the amount of poison that leaks into your system.
Dial 911: If you've been stung 20 or more times, develop hives away from the site of the sting, or experience difficulty breathing, you may be having an allergic reaction, which in extreme cases can be fatal if not treated quickly.
Rookie mistake: Sucking on the sting to remove the venom, which does nothing more than cause the venom to infuse the tissue further, resulting in a larger, uglier welt.
If it's sprained or broken...
First things first: Whether it's a sprain or a break, apply ice (alternating 10 minutes on and 10 minutes off) for the first day or so. To make a quick ice pack, place crushed ice in a zip-top bag and then wrap the bag in a thin towel or T-shirt. A bag of frozen peas will work, too.
If you can move the joint or bone without major discomfort and there's no obvious deformity, it's probably not broken, says Dr. Ross. Ice it, elevate it, and grab an ibuprofen or two to dull discomfort.
The "uh-oh" moment: The huge crunch you heard or the disturbing S shape of your arm leaves little doubt — it's broken. Try to keep the bone immobilized on your way to the E.R., and elevate a broken arm or leg above heart level. This counteracts gravity's pull on blood moving into the arm.
Dial 911: Call an ambulance immediately if you can see the bone or if there's a hole in the skin — a broken bone may have pierced the skin. Resist the urge to pop pain meds: They could cause complications if you need immediate surgery.
Rookie mistake: Jury-rigging a splint or sling. "Splints are necessary only if you're far from help," says Dr. Ross. "A sling does nothing but remind you not to move the injury. If you're thinking sling, see a doctor."