# 13. Emergency situations: what to do first This section covers just one thing: what actions you should take right away when an emergency occurs, what to do next, and what to avoid. The entries on first aid and wilderness survival focus on specific causes of death and survival rates. Those dealing with scams and threats involve financial loss and threats to personal freedom. These two sets of figures cannot be compared with each other. Entries are ordered by how common each situation is and how much difference proper or improper action can make in terms of lives saved. These guidelines are primarily meant for you, your spouse, and close family members. In fact, 79.2% of cardiac arrests happen at home, so the people you’re most likely to help are your household members, followed by friends and coworkers. While helping strangers can also be worthwhile, it ranks last in priority due to risks such as false accusations or getting involved in legal trouble. Therefore, the entries in this category emphasize actions to protect yourself and include clauses that limit your liability. Only actions that must be taken within a few minutes are included here. Identifying scams or dealing with extortion attempts require longer-term measures and are not covered in this section. Detailed anti-fraud rules and descriptions of seven common types of fraud can be found in Section 8, Item 3. Information on handling situations where someone threatens to release private photos or intimate videos is provided in Section 8, Item 32. If money has already been transferred, you should immediately call 110 or 96110 to request a stop payment, as explained in Section 8, Item 2. ### 1. Immediate chest compressions can save lives when someone collapses and stops breathing — call 120 and fetch an AED too - Cost: This costs nothing. A CPR course from the Red Cross or a hospital lasts half a day to a full day, and one training session is enough for years of use. Even without prior training, you can do it: place both hands on top of each other at the midpoint between the nipples, then press down hard at a rate of about 2 times per second without stopping. - In plain terms: Most people you’d need to help are family members — 79.2% of cardiac arrests happen at home. When someone performs CPR, the survival rate jumps from 3.9% to 16.1%. If a person is unresponsive and not breathing, start compressions right away. Position your hands at the midpoint between the nipples, press down hard at 2 times per second, and keep going. Ask a second person to call 120 and bring an AED; you must not stop compressing. - Benefit: Meta-analysis of 79 studies involving 142,740 participants shows that overall, only 7.6% of people suffering from out-of-hospital cardiac arrest survive to leave the hospital. For those receiving CPR from bystanders, the survival rate rises from 3.9% to 16.1%. While 53% of cardiac arrests are witnessed by someone nearby, only 32% actually get CPR. The BASIC-OHCA registry in China recorded 38,227 emergency cases; among them, 30,282 cases (79.2%) occurred at home. In this group, the bystander CPR rate was 20.3%, and the survival rate was just 1.2%. The correct sequence is to start compressions first, then ask someone else to call 120 and fetch an AED; once the AED is powered on, follow its voice prompts. - Evidence grade: A - Sources:Sasson C 等 (2010). Predictors of survival from out-of-hospital cardiac arrest: a systematic review and meta-analysis. Circulation: Cardiovascular Quality and Outcomes. ; Zheng J 等 (2023). Incidence, process of care, and outcomes of out-of-hospital cardiac arrest in China: a prospective study of the BASIC-OHCA registry. The Lancet Public Health. ; 全国人大 (2020). 民法典（第一百八十四条）. - Notes: Do not pinch the philtrum first, do not look for family members, and do not record a video. Also, do not hesitate to press hard for fear of breaking ribs. Article 184 of China’s Civil Code states that anyone who voluntarily provides emergency aid and accidentally causes injury to the victim still bears no civil liability. ### 2. Elderly falls: if someone falls, first kneel down, call out to them, and dial 120 — don’t rush to help them up. It is perfectly legal to walk away from strangers; once you stop, however, you must not touch or move them - Cost: No money is required. Kneeling down to ask a few questions and making a phone call takes only a few minutes. The hard part is resisting the urge to reach out and help. For strangers, there’s an extra cost to consider: calling 120 leaves your phone number on record, which may result in follow-up calls or inquiries. If family members later target you, legal battles can last months, and even if you ultimately win, you’ll still have to pay your own legal fees. - In plain terms: This guidance is primarily aimed at one’s own elderly relatives and people you know well. First, check whether they’re breathing; if not, follow step 1 (perform chest compressions). Even if they are breathing, don’t lift them up — they may have suffered a stroke or fainting spell prior to the fall, and forced movement could worsen injuries. Instead, kneel down, speak to them, and ask if they remember how they fell. If they complain of back pain or seem to have a fracture, do not move them; call 120 right away. - Benefit: The Ministry of Health’s “Technical Guidelines for Intervention in Elderly Falls” states two key points: “Falls are the leading cause of injury-related death among people aged 65 and older in China,” and “When an elderly person falls, do not rush to help them up; instead, respond according to the specific circumstances.” For those who are unconscious, immediately call emergency services. If they’re vomiting, turn their head to one side and clear any vomit from their mouth and nose. If breathing or heartbeat has stopped, start chest compressions at once. The guidelines also note: “If moving the person is necessary, do so gently and keep them as flat as possible.” For conscious individuals, ask whether they recall the fall; if not, it may indicate fainting or a cerebrovascular event. If they suffer severe headaches, facial drooping, slurred speech, or limb weakness, lifting them could worsen bleeding or ischemia in the brain. Likewise, if there are signs of fracture, back pain, or incontinence, avoid moving them unless you have relevant medical training. In all these cases, call 120 immediately. If the elderly person wishes to stand up on their own, assist them slowly, then let them sit or lie down while you monitor them until you’re sure they’re alright. Regarding fears of being held liable, the law is clear: Article 90 of the Supreme People’s Court Interpretation of the Civil Procedure Law states that “any party making a claim must provide evidence to support it; failure to do so results in losing the case.” Article 1198 of the Civil Code obliges operators of public venues — hotels, malls, banks, stations, airports, sports arenas, entertainment venues, etc. — to uphold safety standards; failure to do so makes them legally responsible for any resulting harm. Conversely, Article 184 protects anyone who voluntarily and urgently helps another person: “A rescuer bears no civil liability for any harm caused to the victim during such efforts.” A notable court case involved a pharmacy owner who performed CPR on a cardiac arrest victim, inadvertently breaking several ribs. The victim required 18 days of hospitalization and sought over 9,000 yuan in compensation; the court ruled in favor of the rescuer, absolving him of liability. - Evidence grade: B - Sources:卫生部 (2011). 老年人跌倒干预技术指南（「老年人跌倒后的处理」）. 全文 PDF 见广东省疾病预防控制中心 ，现场处理部分全文见贵南县人民政府转载 ；全国人大 (2020). 民法典（第一百八十三、一百八十四条）. ；最高人民法院 (2023). 人民法院抓实公正与效率践行社会主义核心价值观典型案例（案例十三，齐某某诉孙某某健康权纠纷案，辽宁省康平县人民法院）. ；最高人民法院 (2022 年第二次修正，2022 年 4 月 10 日施行). 关于适用《中华人民共和国民事诉讼法》的解释（第九十条）. ；民法典第一千一百九十八条同上最高检转载全文；全国人大常委会 (2023 年修正，2024 年 1 月 1 日施行). 民事诉讼法（第一百五十二、一百六十四条）. 上海市发展和改革委员会转载全文 ；国务院 (2006). 诉讼费用交纳办法（国务院令第 481 号，第六、二十九条）. ；全国人大常委会 (2025). 治安管理处罚法（2025 年修订，2026 年 1 月 1 日起施行，第二十六条第一项、第五十条第五项）. - Notes: This grade is assigned because the guidelines describe proper procedures but provide no quantitative data on how many lives they actually save. Article 184 shields rescuers only when their actions are voluntary and occur in an emergency; it does not cover situations such as “taking it upon oneself to load a stranger into a private car for transport” — waiting for 120 remains the safer choice. After dialing 120, stay on the line and follow the dispatcher’s instructions. This advice is primarily intended for one’s own elderly relatives and acquaintances. For strangers on the street, walking away is both legal and advisable; the law does not obligate you to intervene. That said, once you stop, you must weigh all associated costs: time spent, leaving your contact details, potential contact from family members, possible legal action, workplace repercussions, and even online backlash. For further details, see [docs/遇到陌生人出事该不该停.md](../../docs/research/遇到陌生人出事该不该停.md). The only unequivocal action required is not to move the person — this is a medical, not a legal, imperative, as forced movement can exacerbate cerebral hemorrhage or spinal injury. One exception applies if you are the proprietor, manager, or organizer of the location; in such cases, walking away no longer qualifies as a “free” option, as Article 1198 of the Civil Code imposes a duty of care on venue operators. For fall prevention, refer to Section 1, Item 13 (balance and leg-strength training); delayed symptoms following head trauma are covered in Section 10; financial recourse after injury sustained while rescuing others is addressed in Section 39; and evidence collection and reporting in cases of online harassment are outlined in Section 8, Item 16. ### 3. Sudden facial drooping, weakness in one arm, and slurred speech — call 120 immediately; don’t wait or drive yourself - Cost: No cost at all. These three steps are easy to remember: ask the person to smile, raise both arms straight out, and say a complete sentence. - In plain terms: If someone’s face suddenly droops, they can’t lift one arm, and their speech becomes slurred, call 120 right away. Administering medication within 3 hours of symptom onset can increase the chance of regaining basic independence by about 1.75 times compared to not receiving treatment. Waiting 3 to 4.5 hours reduces this benefit to only 1.26 times. After 4.5 hours, there is virtually no difference. Be sure to note the exact time symptoms first appeared. Do not give water or medicine, and never drive the person to the hospital yourself. - Benefit: This conclusion comes from a meta-analysis of 16 randomized trials involving 6,756 patients. Intravenous thrombolysis means delivering medication to reopen blocked blood vessels. When alteplase is given within 3 hours of symptom onset, the odds of the patient regaining basic independence — defined as a modified Rankin score of 0–1 — increase by a factor of 1.75. The 95% confidence interval for this effect is 1.35–2.27. In other words, the likelihood of a good recovery is roughly 1.75 times higher with treatment. Waiting 3 to 4.5 hours lowers this advantage to 1.26 (95% CI 1.05–1.51), while after 4.5 hours the difference becomes statistically insignificant at 1.15 (95% CI 0.95–1.40). - Evidence grade: A - Sources:Emberson J, Lees KR, Lyden P, et al. (2014). Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials. Lancet, 384(9958), 1929-1935. - Notes: Thrombolysis involves administering medication to clear blocked blood vessels; the earlier it is given, the greater its effectiveness. After 4.5 hours, it provides little to no benefit. Calling 120 instead of driving is essential because ambulances transport patients directly to stroke centers where staff can be alerted in advance. Recording the exact time symptoms began helps doctors determine whether thrombolysis is still appropriate. Never give water or medicine, and never wait “to see if things get better on their own.” ### 4. Sudden dizziness, double vision, loss of vision in one eye, or inability to touch one’s nose — all warrant calling 120 for stroke suspicion - Cost: No cost involved. Besides the three FAST signs — facial droop, arm weakness, and speech difficulty — two additional checks are recommended. First, ask the person to stand straight with eyes closed and see if they lose balance; then ask whether they see double or have blind spots. Second, have them extend a finger toward their nose, close their eyes, and repeat the motion. - In plain terms: Out of 736 stroke cases, 14.1% showed none of the classic FAST symptoms at onset — no facial droop, no arm weakness, no slurred speech. Relying solely on those three signs would miss many cases. Adding checks for unsteady gait, double vision, or inability to touch the nose reduces that omission rate to just 4.4%. Any sudden dizziness, double vision, or failure to touch one’s nose should prompt an immediate call to emergency services and precise timing documentation. - Benefit: In 2014, researchers at the University of Kentucky Stroke Center reviewed 736 cases of acute ischemic stroke. They found that 14.1% of patients exhibited none of the FAST indicators at the time of onset. When additional screening criteria — including gait instability, limb weakness, and visual disturbances — were incorporated, the proportion of missed diagnoses dropped to 4.4%. - Evidence grade: B - Sources:Aroor S, Singh R, Goldstein LB (2017). BE-FAST (Balance, Eyes, Face, Arm, Speech, Time): Reducing the Proportion of Strokes Missed Using the FAST Mnemonic. Stroke, 48(2), 479-481. - Notes: Infarctions affecting the cerebellum or brainstem — known as posterior circulation strokes — often lack facial droop or limb weakness. Instead, they manifest as vertigo, gait deviation, double vision, or difficulty swallowing, which are frequently mistaken for cervical spine disorders, hypoglycemia, or benign paroxysmal positional vertigo. Inability to touch one’s nose or maintain balance with eyes closed are telltale signs of cerebellar involvement. However, no single test can definitively rule out stroke; any sudden onset of these symptoms demands immediate emergency care and accurate timing recording. This study relied on records from a single medical center, and the authors themselves acknowledge the need for further validation. ### 5. One eye suddenly goes dark, as if a curtain has been pulled shut; even if it clears up within minutes, seek emergency care for stroke on the same day - Cost: No direct cost. However, emergency evaluation and vascular testing will take up half a day to a full day. - In plain terms: When one eye suddenly goes dark, as if a curtain has been pulled shut, it means a blockage has occurred in the blood vessels at the back of the eye. The longer the blockage persists, the less of the retina can be saved. This condition is also a form of cerebral ischemia, and the following days represent a high‑risk window for stroke. For patients in this situation, receiving evaluation and treatment on the same day reduces the likelihood of another stroke within 90 days from 10.3% to 2.1%. Seek emergency care at a hospital with a stroke center on the same day; do not wait until the next day to see an ophthalmologist. - Benefit: The 2021 scientific statement from the American Heart Association on central retinal artery occlusion — blockage of the main vessel at the back of the eye — explicitly states that acute central retinal artery occlusion is a medical emergency. Healthcare systems should recognize it as such and prioritize treatment accordingly. The longer blood flow is cut off, the less retina can be salvaged. The Oxford EXPRESS study examined two groups of patients: those with cerebral ischemia whose symptoms resolved on their own, and those with minor strokes. The former are medically termed transient ischemic attacks. After these patients received same‑day evaluation and treatment, the rate of subsequent strokes within 90 days fell from 10.3% (32 out of 310) to 2.1% (6 out of 281). - Evidence grade: B - Sources:Mac Grory B, Schrag M, Biousse V, et al. (2021). Management of Central Retinal Artery Occlusion: A Scientific Statement From the American Heart Association. Stroke, 52(6), e282-e294. ; Rothwell PM, Giles MF, Chandratheva A, et al. (2007). Effect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke (EXPRESS study): a prospective population-based sequential comparison. Lancet, 370(9596), 1432-1442. - Notes: The grade B rating is due to the fact that EXPRESS was not a randomized trial; it compared outcomes before and after implementing the new protocol within the same patient population, making it difficult to isolate the effect of the intervention from other potential changes. A brief episode of darkness in one eye that resolves on its own is often dismissed as fatigue or low blood sugar. In reality, it is a type of transient ischemic attack, and the ensuing days are a critical window for stroke risk. Sudden, painless, non‑red, non‑teary loss of vision in one eye must be taken seriously. Do not wait until the next day for an ophthalmology appointment; go directly to the emergency department of a hospital equipped to handle strokes. ### 6. One eye is swollen, painful, red; there’s a rainbow halo around lights; plus headache, nausea, and vomiting — so an emergency eye visit is needed that same day - Cost: No cost at all. An emergency eye exam includes measuring intraocular pressure and checking the anterior chamber, which takes up half a day. - In plain terms: This is an acute glaucoma attack. Fluid can’t drain from the eye, so pressure spikes quickly. The longer it goes untreated, the more damage occurs to the optic nerve, and that damage is permanent. During Wuhan’s lockdown, patients waited an average of 241 hours before getting treatment; 21.87% ended up blind. In the same period the year after the lockdown, the average wait time dropped to 121 hours, and only 7.84% became blind. A total of 76 days of lockdown were covered in this study. - Benefit: An eye hospital in Wuhan compared two groups of patients with acute primary angle-closure glaucoma. In 2020, during the lockdown, 54 patients with 64 affected eyes received care; the following year, 46 patients with 51 affected eyes were treated. Both groups had similar demographic profiles. From symptom onset to treatment, the lockdown group waited 241.84±211.95 hours versus 121.53±96.12 hours for the control group (P=0.001). Their intraocular pressure at diagnosis was 52.63±12.45 mmHg versus 45.16±9.79 mmHg (P=0.001). Blindness rates were 21.87% versus 7.84%. Glaucomatous optic nerve damage was found in 20/64 eyes (31.25%) versus 7/51 eyes (13.73%) (P=0.03). A South Korean hospital reviewed 50 eyes that had experienced one acute attack and later had their lenses removed; a year later, 25 of those eyes (50%) showed varying degrees of visual field loss. The longer the time between symptom onset and pressure reduction, the higher the chance of lasting damage (P=0.005). Another prospective study had 43 people with shallow anterior chambers lie face-down in a dark room for one hour; intraocular pressure rose significantly in both eyes (P<0.01). The dominant eye saw a median increase of 3.60 mmHg, while the other eye rose 2.70 mmHg (P<0.05). - Evidence grade: B - Sources:Zhou L, Wu S, Wang Y, Bao X, Peng T, Luo W, Ortega-Usobiaga J (2022). Clinical presentation of acute primary angle closure during the COVID-19 epidemic lockdown. Frontiers in Medicine, 9, 1078237. ; Sung MS, Kim HJ, Park SW (2023). Predictors of long-term visual field outcome after an episode of acute primary angle closure. Clinical & Experimental Ophthalmology, 51(4), 291-299. ; Wang J, Wang J, Ng TK, Huang C (2025). Asymmetric intraocular pressure changes in dominant and contralateral eyes: the dark room prone provocative test. Seminars in Ophthalmology, 40(4), 325-331. - Notes: There are two main reasons this is graded B. First, the Wuhan comparison relied on reviewing old medical records, and the lockdown itself introduced other differences that can’t be separated from the effect of delayed treatment. Second, the South Korean study involved only 50 eyes and was retrospective. This does not mean screen time causes glaucoma; in the dark, pupils dilate, and prolonged head-down posture pushes the lens forward, especially in people with naturally shallow anterior chambers. Those at highest risk are over 50, farsighted, or with a family history of angle-closure glaucoma. Young people who game all night are unlikely to develop this condition. Common misdiagnoses during an attack include gastroenteritis, migraine, or high blood pressure, since headache and vomiting are more noticeable than eye symptoms. Sudden, painless vision loss in one eye is a separate issue — see item 5 (sudden blackout in one eye). Whether blue-light blocking glasses help is discussed in section 6, item 16 (blue-light blocking glasses). ### 7. Chest pressure, tightness, or heaviness lasting more than 15 minutes without relief — call 120; do not drive yourself - Cost: No cost at all. - In plain terms: If you feel chest pressure, tightness, or heaviness that lasts over 15 minutes without easing up, call 120 right away. For patients treated within 55 minutes of arrival at the hospital, the mortality rate within 30 days is 2.8%. For those treated later than 55 minutes, the rate rises to 9.7%. Every minute of delay means more heart muscle tissue dies. Do not drive yourself — losing consciousness while behind the wheel could lead to a second accident. - Benefit: Israel conducted a nationwide study on acute coronary syndrome. The research focused on patients experiencing ST-segment elevation myocardial infarction, a specific type of heart attack. It measured the time interval from hospital admission to the point when a balloon catheter was used to reopen the blocked blood vessel. For patients treated within 55 minutes, 5 out of 178 (2.8%) died within 30 days. For those treated after 55 minutes, 15 out of 155 (9.7%) died within the same timeframe. - Evidence grade: B - Sources:Karkabi B, Meir G, Zafrir B, et al. (2021). Door-to-balloon time and mortality in patients with ST-elevation myocardial infarction. European Heart Journal - Quality of Care and Clinical Outcomes. - Notes: This study compares outcomes based on the time elapsed after hospital admission, not from the onset of symptoms to arrival at the hospital. However, the underlying principle remains the same: any delay results in additional heart muscle damage. The pain may also be felt in the upper abdomen, back, or jaw, and numbness in the left arm can also be a symptom. Diabetic patients and older adults may not experience any pain at all, only shortness of breath. Again, do not drive yourself — losing consciousness while driving can easily cause another accident. ### 8. Sudden tearing pain that spreads from the chest to the back and waist — call 120 and describe it as “pain moving downward” - Cost: No cost at all. - In plain terms: This condition causes a tearing-like pain that starts in the chest and travels down the back and waist. When calling 120, simply describe it as “a tearing pain that’s moving downward.” Without surgery, treatment with medication alone results in a mortality rate of 58%. Its management is the exact opposite of that for heart attacks: doctors only order enhanced CT scans after suspecting this condition, not anticoagulant or thrombolytic therapy. Also mention any significant difference in blood pressure between both arms or absence of a pulse on one side. - Benefit: The International Registry of Acute Aortic Dissection (IRAD) includes data from 464 patients across 12 centers. Acute aortic dissection is precisely this disease marked by sudden, severe tearing pain in the chest and back. Among all symptoms reported by patients, sudden onset of intense sharp pain is the most common. Overall in-hospital mortality stands at 27.4%. For patients with type A dissection receiving only medication, mortality reaches 58%. - Evidence grade: B - Sources:Hagan PG, Nienaber CA, Isselbacher EM, et al. (2000). The International Registry of Acute Aortic Dissection (IRAD): new insights into an old disease. JAMA, 283(7), 897-903. - Notes: Management of aortic dissection is completely opposite to that of heart attacks. Heart attacks require anticoagulant and thrombolytic drugs to prevent blood clotting; applying such drugs to aortic dissection would essentially encourage bleeding at the tear site. Therefore, upon arriving at the hospital, patients must clearly state “a tearing pain that’s moving downward” to prompt doctors to order enhanced CT scans. A notable difference in blood pressure between arms or absence of a pulse on one side are also important warning signs. Individuals with poorly controlled blood pressure, Marfan syndrome, or a family history of aortic aneurysm or dissection are at higher risk. In such cases, driving oneself to the hospital is strongly discouraged; symptoms must be addressed immediately rather than waiting until the next day. ### 9. A sudden “worst headache of one’s life” that peaks within an hour — go to the ER for a head CT right away - Cost: An emergency visit itself costs very little. A head CT in the ER typically runs a few hundred yuan. - In plain terms: The key point isn’t how intense the pain is, but how quickly it reaches its peak. In 2,131 people experiencing severe headaches that peaked within an hour, 6.2% had a ruptured blood vessel on the surface of the brain. Anyone aged 40 or older, with neck pain or stiffness, who was seen collapsing by others, whose headache started during physical activity, came on suddenly like an explosion, or has limited neck flexion when examined should go to the ER for a head CT. The vast majority of people who get tested end up fine, but missing even one case of bleeding can be fatal. - Benefit: Ten Canadian emergency departments conducted a prospective cohort study on 2,131 patients with “severe headaches peaking within an hour.” They defined clear criteria upfront and tracked outcomes accordingly. Of these, 132 patients (6.2%) had subarachnoid hemorrhage, meaning a ruptured surface blood vessel in the brain. The Ottawa SAH rule includes six criteria: age 40 or older, neck pain or stiffness, witnessed loss of consciousness, onset during physical activity, sudden explosive onset of pain, and limited neck flexion on physical exam. Meeting any one of these criteria triggers a CT scan. This rule identified every single patient with bleeding, with 100% sensitivity. The 95% confidence interval for this figure is 97.2%–100.0%. The trade-off is that only 15.3% of people without bleeding were excluded by this rule (specificity of 15.3%). - Evidence grade: A - Sources:Perry JJ, Stiell IG, Sivilotti MLA, et al. (2013). Clinical decision rules to rule out subarachnoid hemorrhage for acute headache. JAMA, 310(12), 1248-1255. - Notes: It’s not “how painful it is” that matters, but “how fast it reaches peak pain.” Headaches that erupt within seconds to a minute are the real warning sign; gradually worsening migraines are not. Additional symptoms like vomiting, neck stiffness, light sensitivity, or brief fainting also warrant immediate attention. With a specificity of just 15.3%, most people who follow this rule end up with normal results. Yet missing even one case of bleeding can be fatal, so getting tested is absolutely worthwhile. Do not take painkillers to mask the pain and then fall asleep. ### 10. After an elderly person suffers a head injury, they may develop unsteady gait, sluggishness, excessive sleepiness, or weakness on one side of the body two to three weeks later — a CT scan is recommended - Cost: A single cranial CT scan costs roughly 200–300 RMB. - In plain terms: After a head injury, blood usually starts accumulating only around the third week. At the time of impact, there may be absolutely no symptoms at all, and the person might not even recall the injury. The recurrence rate after surgery for this condition can reach 33%, while the mortality rate may be as high as 32%. If an elderly individual suddenly appears confused, walks unsteadily, feels unusually sleepy, or shows weakness on one side, it’s important to first ask whether they fell or hit their head in the past two to three months, then proceed with a CT scan. - Benefit: The Neurosurgical Society of the Chinese Medical Association has published a Chinese expert consensus on medical treatment for chronic subdural hematoma. This condition involves slow accumulation of blood between the meninges; technically, it refers to chronic mass formation caused by blood buildup between the arachnoid membrane and dura mater. It “typically develops three weeks after head trauma” and is most common among older adults. Post-surgery recurrence and mortality rates can reach 33% and 32% respectively. Among patients aged 90 or older, only 24% achieve a satisfactory recovery overall. Global data shows that incidence rates range from 3.39 to 39.1 new cases per 100,000 people annually, rising sharply after age 80. The most common causes are trauma and falls, followed by chronic alcohol consumption, use of anticoagulant medications, and violent injury. Geriatric literature notes that typical symptoms include confusion, cognitive decline, gait disturbances, and excessive sleepiness — features that may overlap with other geriatric syndromes. - Evidence grade: B - Sources:Zhang J 等 (2021). Expert consensus on drug treatment of chronic subdural hematoma. Chinese Neurosurgical Journal, 7(1), 47. ; Dziho A 等 (2025). Global prevalence and incidence of chronic subdural hematoma: A systematic review. Brain and Spine, 5, 105893. ; Mathon B, Shotar E (2026). Diagnostic and therapeutic management of chronic subdural hematoma in elderly patients. Gériatrie et Psychologie Neuropsychiatrie du Vieillissement, 24(1), 30-41. - Notes: At the time of injury, there may be absolutely no symptoms, and the elderly person might not even recall the incident. Therefore, when families notice sudden confusion, unsteady walking, excessive sleepiness, or unilateral weakness, they should first check whether a head injury occurred in the past two to three months before ordering a CT scan. It’s crucial not to automatically attribute these symptoms to “senile dementia” or “post-stroke sequelae,” as doing so could lead to delayed diagnosis. Elderly individuals taking aspirin, clopidogrel, warfarin, or newer oral anticoagulants face higher risks, as does long-term heavy alcohol consumption. For fall prevention, refer to Section 1, Item 13 — focusing on balance training and leg strength exercises. ### 11. A leg suddenly swells, feels tight, and is tender to the touch — seek medical care promptly; if shortness of breath or chest pain develops suddenly, call 120 immediately - Cost: An ultrasound of the leg veins (lower extremity venous ultrasound) costs around 100–200 yuan. - In plain terms: If one leg suddenly swells, becomes noticeably thicker than the other, and is painful to press, get a leg vein ultrasound done as soon as possible. Should shortness of breath, chest pain when taking a deep breath, a rapid heartbeat, or dizziness appear, a blood clot may have traveled to the lungs — call 120 right away. Among people diagnosed with pulmonary embolism, 17.4% die within three months. Sitting still for more than four hours roughly doubles the risk, though the actual chance for any one person remains very low. - Benefit: The International Cooperative Registry on Pulmonary Embolism (ICOPER) gathered data from 2,454 patients with confirmed acute pulmonary embolism treated at 52 hospitals across seven countries. Pulmonary embolism occurs when a blood clot blocks a pulmonary artery. Within three months, the overall mortality rate for these patients — regardless of cause — was 17.4% (426 out of 2,454). The WHO WRIGHT project found that travel lasting four or more continuous hours “roughly doubles” the risk of blood clots forming in veins and traveling to the lungs (venous thromboembolism). Even so, the actual probability for any individual remains low; prolonged inactivity exceeding four hours translates to roughly one in 6,000 people facing this risk. - Evidence grade: B - Sources:Goldhaber SZ, Visani L, De Rosa M (1999). Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). Lancet, 353(9162), 1386-1389. ; WHO (2007). Study results released on travel and blood clots. - Notes: Swelling in both legs is usually linked to issues involving the heart, liver, kidneys, or venous function. Sudden swelling of just one leg, noticeably larger than the other, is a classic sign of deep vein thrombosis. High-risk situations include long car or plane trips, bed rest after surgery or a fracture, wearing a cast, pregnancy and the postpartum period, cancer, and oral contraceptive use. When a clot breaks loose and blocks a pulmonary artery, pulmonary embolism results — marked by sudden shortness of breath, worsening chest pain with deep breaths, rapid heartbeat, dizziness, and sometimes coughing up blood. In such cases, call 120 immediately. The 17.4% figure reflects mortality among confirmed pulmonary embolism cases, not the overall risk associated with leg swelling alone; don’t let this number cause undue alarm. ### 12. For severe bleeding, first press firmly on the wound with your hand; if this fails on limbs, apply a tourniquet and call 120 immediately - Cost: A twist-style tourniquet costs anywhere from a few dozen to over a hundred yuan; it can easily be stored in a car or first-aid kit. Learning how to position it above the wound, twist it until bleeding stops, and note the time takes just a few minutes. - In plain terms: Begin by pressing hard on the wound with your hand or a cloth; if bleeding on a limb persists, fasten a tourniquet and call 120 right away. Once applied, never loosen it. Among battlefield casualties, 90% who received a tourniquet before going into shock survived, compared to only 10% who got one after shock set in; all five patients who needed a tourniquet but did not receive one died. Position the tourniquet above the wound, twist it until bleeding ceases, and record the time. Never substitute shoelaces or ordinary rope. For neck or torso injuries, only compression is allowed—no tourniquets may be used. - Benefit: Over six years, 11 Level I trauma centers in Texas treated 1,026 patients with limb vascular injuries; 181 of them (17.6%) had a tourniquet applied prior to arrival. Unadjusted mortality rates were 3.9% for those with a tourniquet and 5.2% for those without. After adjusting for other factors, tourniquet use remained strongly linked to survival; the adjusted odds ratio was 5.86, with a 95% confidence interval ranging from 1.41 to 24.47. At a Baghdad field hospital, 90% of 232 injured patients who received a tourniquet before shock survived, versus just 10% who got one after shock occurred; all five patients needing a tourniquet but not receiving one perished, while 87% of those with a tourniquet survived. The recommended sequence is: direct manual compression using any cloth or towel → if bleeding on a limb persists, apply a tourniquet → call 120 → never loosen it. - Evidence grade: A - Sources:Teixeira PGR 等 (2018). Civilian Prehospital Tourniquet Use Is Associated with Improved Survival in Patients with Peripheral Vascular Injury. Journal of the American College of Surgeons. ; Kragh JF 等 (2009). Survival with emergency tourniquet use to stop bleeding in major limb trauma. Annals of Surgery. ; 中国医师协会急诊医师分会等 (2020). 止血带的急诊应用专家共识. 中华急诊医学杂志 29(6):773-779：「院前急救时，止血带一旦使用则不建议松开，除非得到可以替代的彻底止血的救治」「最长使用时间不应超过2 h。但如果客观情况无法到医院救治或者无替代止血办法，则在得到正规救援前不解除止血带」. ，全文 - Notes: Never use thin materials such as rope or shoelaces as tourniquets; they cannot sufficiently constrict arteries and may cut the skin. Once a tourniquet is applied, do not loosen it periodically to “release blood flow.” Compression only applies to neck and torso injuries—never a tourniquet. No amputations resulted from tourniquet use in the battlefield data; transient nerve paralysis occurred in four cases. Chinese expert consensus among emergency physicians agrees: once applied pre-hospitally, a tourniquet should not be removed unless an alternative method can fully stop bleeding. For arm bleeding, position the tourniquet on the upper third of the arm; for leg bleeding, place it near the groin. Avoid applying it to forearms, calves, elbows, or knees. Experts recommend keeping tourniquet application time under two hours total before reaching medical care; however, if reaching a facility proves impossible and no other method works, leave it on until professional help arrives. Improvised tourniquets made from belts, ties, or sleeves alone rarely suffice; they must be twisted tightly using a stick or similar tool to be effective. ### 13. For dog or cat bites and scratches, rinse the area with soap and running water for 15 minutes, then get vaccinated on the same day - Cost: Rinsing requires no expense. The full course of rabies vaccination costs several hundred yuan. For category III exposures, an additional passive immunization product—essentially ready-made antibodies administered directly—is needed, adding several hundred to over a thousand yuan. The greatest cost, however, comes from delays. - In plain terms: Once rabies symptoms appear, the fatality rate is practically 100%. Rinsing with soap and water followed by vaccination is the sole safeguard. First, rinse the affected area with alternating streams of soap and running water for 15 minutes, then seek medical care on the same day. If the skin is broken and the wound has been licked, this constitutes a category III exposure, requiring the extra passive immunization product. The fact that a pet has been vaccinated does not alter this classification; exposure level is determined solely by the nature of the injury, not by the animal’s background. - Benefit: According to the 2023 guidelines issued by China’s National Disease Control and Prevention Administration and Health Commission, “The fatality rate from rabies is practically 100%.” Recommended first aid is “to thoroughly rinse all bite and scratch sites with alternating streams of soap (or another mildly alkaline cleanser) and running water under adequate pressure for roughly 15 minutes.” For minor bites where skin remains intact or superficial scratches without bleeding—classified as category II exposures—vaccination alone is sufficient. Category III exposures, involving penetrating wounds or licked broken skin, mandate both wound treatment, passive immunization, and full vaccination. The WHO reports that roughly 59,000 people worldwide die from rabies each year, 99% of cases linked to dog bites. - Evidence grade: A - Sources:国家疾控局综合司、国家卫生健康委办公厅 (2023). 关于印发狂犬病暴露预防处置工作规范（2023 年版）的通知. ; WHO. 狂犬病 实况报道. - Notes: Never skip treatment on the assumption that a pet is vaccinated or well‑tended; guidelines base classification strictly on wound severity, not on the animal’s status. Do not attempt to bandage the wound yourself. The ten‑day observation method may inform whether to discontinue vaccination, but it never negates the need to begin it. The same protocol applies to bites inflicted by wild animals or bats. ### 14. Immediately rinse a burn with cool running water for 20 minutes; avoid applying toothpaste or soy sauce - Cost: No cost involved. It requires 20 minutes of time. - In plain terms: Rinsing a burn with cool running water for at least 20 minutes within 3 hours of injury reduces the likelihood of needing skin grafts to roughly 60% of the rate for those who do not perform this step. Use cool water, not ice water, as ice application can worsen the damage. If clothing sticks to the wound, do not pull it off forcefully; after rinsing, cover the area with a clean cloth and head to the hospital. Never apply toothpaste, soy sauce, sesame oil, or flour to the burn. Even if you remember to rinse later, doing so within 3 hours still provides benefit. - Benefit: An Australian study followed 2,495 children with burns. For kids who rinsed the burn with cool running water for 20 minutes within 3 hours of injury, the relative risk of needing a skin graft was 0.6. The 95% confidence interval for this value is 0.4–0.8, meaning the likelihood of needing a graft is roughly 60% lower than for those who did not rinse. Results from 7 combined studies also confirm that 20 minutes of cool running water irrigation within 3 hours of injury significantly lowers the chance of needing skin grafts or surgical wound treatment. - Evidence grade: A - Sources:Griffin BR, Frear CC, Babl F, Oakley E, Kimble RM (2020). Cool Running Water First Aid Decreases Skin Grafting Requirements in Pediatric Burns: A Cohort Study of Two Thousand Four Hundred Ninety-five Children. Annals of Emergency Medicine, 75(1), 75-85. ；Griffin B, Cabilan CJ, Ayoub B, et al. (2022). The effect of 20 minutes of cool running water first aid within three hours of thermal burn injury on patient outcomes: A systematic review and meta-analysis. Australasian Emergency Care, 25(4), 367-376. - Notes: Use cool water, not ice water, as ice application can worsen burn damage. If clothing sticks to the wound, do not pull it off forcefully; after rinsing, cover the area with a clean cloth and seek medical care. Avoid applying toothpaste, soy sauce, sesame oil, or flour to the burn, as these substances can interfere with doctors’ assessment of injury severity and increase infection risk. Rinsing within 3 hours of injury remains beneficial even if done later than initially intended. ### 15. Sudden widespread rash, difficulty breathing, or dizziness — treat as anaphylactic shock; call 120 immediately and explain the situation clearly - Cost: No cost involved. However, people with known severe allergies must purchase epinephrine auto-injectors themselves; these are prescription-only medications. - In plain terms: If someone suddenly develops a full-body rash along with trouble breathing or dizziness, treat it as anaphylactic shock. Call 120 right away and clearly state “suspected anaphylactic shock” so emergency responders can bring epinephrine with them. Epinephrine is the first-line treatment; antihistamines and steroids act too slowly to be effective in such cases. Individuals who have experienced this before should consult a doctor for an epinephrine auto-injector and learn how to administer it to the outer midsection of the thigh — this can be done even through clothing. - Benefit: Epinephrine is the recommended first-line treatment for all grades of anaphylactic shock (Grade 2 and above); clinical guidelines strongly endorse its use. Antihistamines and steroids are much slower-acting and cannot replace epinephrine in emergency situations. - Evidence grade: B (guidelines strongly recommend it, though the underlying evidence base is relatively weak). - Sources:中国医药教育协会等 (2022). 过敏性休克急救临床实践指南（2020）. Frontiers in Pharmacology：「Epinephrine is the first-line medicine in GRADE II to IV anaphylaxis」「Intramuscular epinephrine should be injected in the mid-anterolateral thigh」，成人肌注上限 0.5 mg、14 岁以下 0.3 mg，无反应可每 5–15 分钟重复一次. ；Muraro A, et al. (2022). EAACI guidelines: Anaphylaxis (2021 update). Allergy. - Notes: The EAACI allergy guidelines themselves note that “most evidence in this field remains at a low level.” They still classify epinephrine as a strongly recommended treatment because its benefits far outweigh the risks, rather than because of large-scale clinical trials. In China, epinephrine is a prescription medication and is not readily available to the general public. The best immediate action is to call 120 and clearly describe “suspected anaphylactic shock” so emergency teams can bring epinephrine along. Those with a history of severe allergic reactions should consult a doctor for an epinephrine auto-injector and learn how to inject it into the outer midsection of the thigh — this can be done through clothing as well. ### 16. Someone is having a seizure — clear the area, place them on their side, time the episode, and don’t put anything in their mouth - Cost: No cost at all. - In plain terms: Move any hard objects away from the person. Lay them on their side with their mouth facing down, and start timing the seizure. Don’t hold them down, don’t force their mouth open, and don’t put anything into their mouth — doing so can easily damage teeth and jaws. Call emergency services if the seizure lasts more than 5 minutes, if it stops briefly then starts again, if the person doesn’t respond afterward or has trouble breathing, if it occurs in water, or if this is the person’s first seizure ever. Only give water after they’ve fully regained consciousness. - Benefit: This approach prevents injuries to teeth and jaws caused by forcing the mouth open or inserting foreign objects. It also avoids fractures that can result from restraining a convulsing person. A seizure lasting over 5 minutes is a clear medical emergency requiring immediate ambulance help. - Evidence grade: B - Sources:美国疾病控制与预防中心. 癫痫发作急救：「Don't hold the person down or stop their movements」「Don't put anything in their mouth. This can hurt their teeth or jaw」「Don't offer water or food until they are fully alert」「Time the seizure to track if it lasts more than 5 minutes. If it does, seek immediate medical attention or call 911」. - Notes: The same page lists several other situations that also demand immediate ambulance call: a seizure that ends only to recur quickly, post‑seizure unresponsiveness or breathing difficulty, any injury sustained during the episode, a seizure occurring in water, or a first‑time seizure. After the seizure stops, the person should be placed on their side with the mouth down, and only then given water once fully awake. This guidance is primarily intended for family members caring for someone with epilepsy; applying these steps to a stranger offers fewer personal benefits but still protects you from legal liability (Civil Code Article 184, see item 2 in this section — don’t rush to lift the person up). ### 17. Diabetic patients suddenly start shaking, break out in cold sweats, and have slurred speech — first give 15 grams of sugar, then retest after 15 minutes - Cost: No cost involved. Just keep a few sugar cubes or a small carton of juice on hand. - In plain terms: First, give 15 grams of sugar — sugar cubes or a small carton of juice both work fine. Retest blood sugar levels after 15 minutes; if they’re still low, repeat the process. A blood sugar level below 3.0 mmol/L is medically significant hypoglycemia. If a person reaches a stage where they need outside help to manage it, it can be fatal. Never feed anything to someone who is unconscious — they could choke, so call emergency services right away. - Benefit: A blood sugar level below 3.0 mmol/L qualifies as clinically meaningful hypoglycemia. If a person shows changes in consciousness or behavior that require outside assistance to manage, this is severe hypoglycemia that can be deadly. - Evidence grade: A - Sources:美国糖尿病学会 (2025). 糖尿病诊疗标准 2025·第 6 章 血糖目标与低血糖. Diabetes Care：分级「Level 1: Glucose <70 mg/dL (<3.9 mmol/L) and ≥54 mg/dL (≥3.0 mmol/L)」「Level 2: Glucose <54 mg/dL (<3.0 mmol/L)」「Level 3: A severe event characterized by altered mental and/or physical status requiring assistance for treatment of hypoglycemia, irrespective of glucose level」；处理「For most individuals, 15 g carbohydrates should be ingested」「Fifteen minutes after initial treatment, repeat the treatment if hypoglycemia persists」. - Notes: Never feed anything to an unconscious person — they could choke, so call emergency services immediately. The same guidelines also recommend that people on insulin or at high risk of hypoglycemia should always carry glucagon. The original text reads: “All individuals treated with insulin or who are at high risk of hypoglycemia...should be prescribed glucagon.” Nasal glucagon sprays and pre-filled injection kits are easier to use than glucagon that needs to be mixed on the spot. This advice is aimed at you or any diabetic family members you care for — keeping sugar on hand is meant to help them in emergencies. ### 18. If someone is electrocuted, cut the power first, then use a dry wooden stick to pry the source of electricity away; never pull the victim by hand directly - Cost: No cost involved. - In plain terms: First, turn off the power, or use a dry wooden stick to move the electrical source away before touching the victim. Pulling them by hand directly can turn one victim into two. If the victim isn’t breathing after being freed from the current, immediately perform chest compressions as described in step 1 of this section — don’t hesitate to act just because it’s an electrical injury. Never attempt to handle situations involving downed high-voltage lines or nearby electrical equipment on your own; instead, move to a safe distance and wait for utility workers to cut the power. - Benefit: This approach prevents rescuers from getting electrocuted as well, avoiding a situation where one victim becomes two. For victims who stop breathing after being freed from the electrical current, performing CPR as outlined in step 1 of this section is effective. The emergency response guidelines from the US Centers for Disease Control and Prevention advise: first observe the scene and avoid touching the victim, as they may still be connected to the power source. If possible, cut the power first. If that’s not feasible, use non-conductive materials like cardboard, plastic or wood to move the power source away. For victims with no breathing or pulse after being freed from the current, immediate CPR is required. A review of relevant studies found that patients who suffer cardiac arrest due to electrocution and are successfully revived generally have a good prognosis. - Evidence grade: B - Sources:US CDC. What to Do to Protect Yourself From Electrical Hazards（First aid 一节）. ；Spies C, Trohman RG (2006). Narrative review: Electrocution and life-threatening electrical injuries. Annals of Internal Medicine 145(7):531-537. - Notes: The rule “cut power first, then touch the victim” is purely self-protective: pulling the victim by hand directly means you’ll be the next victim. Never attempt to handle downed high-voltage lines or nearby electrical equipment on your own; move to a safe distance and wait for utility workers to cut the power. For cardiac arrest caused by electrocution, standard CPR and defibrillation procedures apply — don’t hesitate to perform these just because it’s an “electrical injury”. ### 19. If a carbon monoxide alarm goes off, or if several people in a room suddenly get headaches, nausea, or dizziness, get everyone outside before calling for help - Cost: No cost at all. - In plain terms: When the alarm sounds, or when multiple people in one room start experiencing headaches, nausea, and dizziness, move everyone outdoors first and then call for help. Do not stay inside trying to figure out what’s happening, and do not go back inside to turn off any valves. The fact that symptoms improve once outside is a very strong indicator of carbon monoxide exposure. In 2018 alone, China reported 11,523 deaths caused by carbon monoxide poisoning; most of these occurred in winter, and the majority of victims were at home. - Benefit: According to China’s disease surveillance system, 11,523 people died from carbon monoxide poisoning in 2018. The highest numbers were recorded in January (2,845 cases), February (2,321 cases), and December (2,010 cases). During those three winter months, 66% to 73% of all deaths happened at home. These figures come directly from official reports, not from population-based estimates. In the United States, over 400 people die each year from accidental carbon monoxide poisoning unrelated to fires; more than 100,000 people seek emergency treatment, and over 14,000 are hospitalized. - Evidence grade: B - Sources:You J, Liu J, Zhou M (2020). Number of Deaths due to Carbon Monoxide Poisoning by Month and by Place of Death — China, 2018. China CDC Weekly 2(2):32：「In 2018, there were 11,523 deaths caused by carbon monoxide poisoning reported in China」. ；美国疾病控制与预防中心. 一氧化碳中毒：「More than 400 Americans die from unintentional CO poisoning not linked to fires」「More than 100,000 visit an emergency department」「More than 14,000 are hospitalized」，常见症状「headache, dizziness, weakness, upset stomach, vomiting, chest pain, and confusion」. ；美国消费品安全委员会. 一氧化碳信息中心：「If you suspect CO poisoning, get outside to fresh air immediately, and then call 911」. - Notes: Symptoms of carbon monoxide poisoning often resemble those of a cold or mild intoxication. When several people in the same space experience these symptoms and feel better immediately after leaving the area, it’s a strong sign of exposure. Make sure everyone exits the building before calling for help, and do not attempt to turn off any valves while still inside. Instructions on how to install a carbon monoxide alarm can be found in Section 1, Item 3. ### 20. If someone accidentally ingests detergent, pesticides, or medicine, do not induce vomiting — take the container and seek medical help right away; if it splashes into the eyes or onto the skin, rinse thoroughly with water for at least 15 minutes - Cost: No cost involved. Simply keep detergents, disinfectants, pesticides, and medicines out of children’s reach, preferably in a locked cabinet. Never transfer them into beverage bottles. - In plain terms: If someone swallows detergent, pesticides, or medicine, do not make them vomit — spitting out corrosive liquids would burn the esophagus all over again. Instead, have them drink some milk or egg whites, then head to the hospital right away while bringing the product container and its instructions. If the substance gets into the eyes or onto the skin, rinse with copious amounts of water for a full 15 minutes; for eyes, gently hold the eyelids open while rinsing and avoid rubbing. Mixing disinfectants with toilet cleaners can produce chlorine gas. - Benefit: The Chinese CDC provides four distinct response protocols. For ingestion: drink milk or egg whites promptly and, crucially, do not induce vomiting. Seek medical care at once while carrying the packaging or label so doctors can quickly identify the ingredients and plan treatment. For inhalation: move the person to fresh air, loosen tight clothing to ease breathing; if coughing, shortness of breath, or difficulty breathing occurs, get help immediately. For skin contact: wash the area with water for at least 15 minutes, being careful not to let runoff reach the eyes or intact skin. For eye exposure: flush the eyes with water or saline for a minimum of 15 minutes; keep the eyelids open throughout to ensure full coverage and never rub them. After rinsing, visit an ophthalmologist without delay. Products are categorized by pH: those with pH < 3 include toilet cleaners, descalers, floor cleaners, and stainless‑steel polishes; some heavy‑duty drain cleaners even contain dilute sulfuric acid. Products with pH > 11 comprise drain uncloggers, strong kitchen degreasers, dishwasher powders, oxygen‑based stain removers, and abrasive cleaners. A particularly dangerous combination is mixing disinfectants with hydrochloric‑acid‑based toilet cleaners — this generates chlorine gas that irritates the respiratory tract, provokes severe coughing and breathlessness, and can be life‑threatening. - Evidence grade: B - Sources:中国疾病预防控制中心职业卫生与中毒控制所 (2025). 暑假安全提示：警惕强酸强碱清洁剂. - Notes: This rating of B reflects that official guidance outlines how to respond and how to identify hazardous products, yet it lacks quantitative data on exactly how much risk reduction results from following those steps. The reason not to induce vomiting is that corrosive substances would re‑damage the esophagus upon expulsion. If you’re unsure what was ingested, bring the container, its label, and any vomit to the hospital. Prevention is far cheaper than emergency treatment: store chemicals separately from food and drinks, seal containers tightly, discard empty bottles, and never repurpose them for other liquids. When handling these substances, wear rubber gloves and protective goggles, ensure good ventilation, and never mix different types. For carbon monoxide exposure, see item 19; for burns, refer to item 14. ### 21. In case of splashes of acids, alkalis or other chemicals on the body, immediately remove contaminated clothing and rinse with copious amounts of running water; for eyes, gently pull the eyelids apart and rinse thoroughly before leaving the scene - Cost: No cost involved. On your first day at work, locate the eyewash stations and safety showers so you won’t have to search for them in an emergency. - In plain terms: Follow three simple steps. First, strip off any clothing, shoes and socks that have been exposed — the areas covered by fabric sustain the worst injuries. Second, rinse both skin and eyes with plenty of running water for at least 15 minutes; the Hunan Provincial Emergency Management Department recommends 20–30 minutes, so err on the side of caution. Third, pull the eyelids apart to rinse the eyes thoroughly, then head straight to an ophthalmologist. Use lukewarm water, never hot. - Benefit: These three on‑site actions are vital. First, promptly removing contaminated clothing prevents further absorption of toxins through the skin; areas shielded by fabric are especially vulnerable. Second, copious flushing with water meets the minimum recommendations from the Chinese CDC — at least 15 minutes for skin and eyes — while the Hunan guidelines suggest 20–30 minutes for severe chemical burns, so the longer duration should be followed. Third, gently separating the eyelids ensures water reaches the entire eye surface; rubbing the eyes must be avoided, and immediate medical care is essential. Lukewarm water is ideal; hot water should never be used. Avoid applying ointments, antiseptic solutions or any substances to fresh wounds, and do not cover them with dirty cloth — such actions can obscure the extent of injury and hinder diagnosis. Legally, both chemical skin burns and chemical eye injuries are recognized as occupational diseases; workplace incidents are treated as work‑related injuries. In any acute chemical exposure emergency, employers must promptly provide medical treatment, health monitoring and medical observation at their own expense. - Evidence grade: B - Sources:中国疾病预防控制中心职业卫生与中毒控制所 (2025). 暑假安全提示：警惕强酸强碱清洁剂. ；湖南省应急管理厅 (2015). 常见化学品中毒事故的应急处理与治疗. ；国家卫生健康委等四部门 (2024). 职业病分类和目录（2025 年 8 月 1 日起实施）. ；全国人大常委会 (2018). 职业病防治法（第三十七条）. （北京市人民政府转载） - Notes: This item is graded B because no single national standard specifies the exact flushing duration; one official source cites 15 minutes while another recommends 20–30 minutes. When seeking medical care, bring the chemical’s name, packaging or its Safety Data Sheet so doctors can tailor treatment. Never attempt to neutralize a chemical by mixing it with another acid or base — such reactions release heat and are impossible to control. The “neutralizing solution” mentioned in the Hunan document refers to pre‑prepared rinse fluids kept on site, not improvised mixtures. Dry powders such as lime or cement should be brushed off before rinsing; some emergency guides suggest drying concentrated sulfuric acid first, but this practice is not uniformly endorsed and is not covered here. For household cleaners and accidental ingestion, refer to Item 20. Pre‑employment protective measures and health checks are detailed in Item 19, sections 10 and 11 — employers must provide hazard information and appropriate PPE before workers start their duties. ### 22. Dizziness, nausea, lack of sweating or confusion in high heat — move to shade immediately, remove clothing and apply cool water to cool down; do not give water to anyone who is unconscious, call 120 right away - Cost: No cost at all. - In plain terms: Red, hot skin, slurred speech and confusion are signs of heatstroke. It can take just minutes for someone to go from feeling dizzy to losing consciousness, and the mortality rate is very high. Immediately move the person to a cool, well‑ventilated area, strip off their clothes and use cool water or wet towels to bring their temperature down while calling 120. Never give water to someone who is unconscious — it can cause choking. - Benefit: The U.S. National Weather Service describes heatstroke as a “serious medical emergency.” Its symptoms include a body temperature above 103°F (39.4°C), confusion, slurred speech and hot, red skin. The recommended response is to call emergency services, move the person to a cool place and apply cool water or wet cloths — “do not give any fluids.” Heat exhaustion shows up as heavy sweating, weakness, cool and moist skin, and a rapid but weak pulse; treatment involves moving to shade, loosening clothing and sipping water; seek medical help if vomiting occurs, condition worsens or symptoms persist beyond an hour. The Yunnan Provincial Center for Disease Control warns to relocate to a cool, breezy spot, use cold wet towels, give salt‑containing drinks to conscious victims and call emergency services for severe cases — heatstroke carries an extremely high fatality rate. The Chinese CDC advises cooling first, then transporting; the “golden half‑hour” after loss of consciousness is critical for effective cooling. Healthy young adults without underlying conditions may safely be immersed in cold water for rapid cooling, while the elderly and those with chronic illnesses should have cool water sprayed on their skin to promote evaporation. The Wilderness Medical Society’s 2024 heat‑related illness guidelines list cold water immersion as the fastest and most effective method for severe heatstroke; if ice water isn’t available, any cool water will do, and if immersion isn’t possible, spraying water while fanning can achieve roughly half that cooling rate. - Evidence grade: B - Sources:US National Weather Service. Heat Related Illnesses. ; 云南省疾控局 (2026). 出现这些症状，你可能是中暑了. ; 中国疾病预防控制中心. 高温天气，中国疾控中心提醒您谨防中暑：「如有条件可用冷水浸泡的方法对无基础疾病的青壮年快速降温。老人和有基础疾病的患者可向皮肤喷水通过蒸发降温。降温应遵循"先降温，后转运" 的原则」. ; 国家卫生健康委 (2010). 高温中暑预防知识要点. ; Eifling KP 等 (2024). Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Heat Illness: 2024 Update. Wilderness & Environmental Medicine 35(1_suppl):112S-127S. （正文站点拒绝自动抓取，具体推荐按荒野医学会官网的更新摘要核对：「cold water immersion … is the most important method of treating severe heat illness」「If CWI is unavailable, evaporative cooling is the recommended second-line treatment. … generally half as fast as CWI」）；Lipman GS 等 (2019). 同指南 2019 版. - Notes: Do not wait for symptoms to “settle down” — heatstroke can progress from dizziness to unconsciousness in just minutes. Never force water into someone who is unconscious; it can cause choking. Opinions differ on where to place ice packs: the Chinese CDC recommends the neck, armpits and groin, whereas the Wilderness Medical Society notes that research shows no distinct cooling benefit from these sites. Their advice is to cover the entire body with ice packs if they’re plentiful, and otherwise apply them to the cheeks, palms and soles. Both sources agree that cold water immersion is the best option when available. ### 23. For people suffering from heatstroke, as long as they remain conscious, they should drink small amounts of cool, lightly salted water or sports drinks at frequent intervals — never gulp down large quantities. Alcohol and sugary drinks must be avoided - Cost: No cost involved. A bottle of sports drink costs just a few yuan. - In plain terms: Only conscious individuals should drink. Consume cool, lightly salted water or sports drinks in small portions, about 500–1000 ml per hour. Do not drink too much at once; vomiting can cause liquid to enter the airways, which is far more dangerous than heatstroke itself. Alcohol and sugary drinks must be avoided, as they cause further fluid loss. Applying cool water to the skin or using ice packs on the neck, armpits, and inner thighs is recommended — cooling should always come before rehydration. Never give anything to drink to someone who is unconscious or speaking incoherently. - Benefit: The Chinese CDC published the “Guidelines on Prevention and Emergency Treatment of Heatstroke (2014),” which states: “Consume at least 2–4 cups of cool water per hour (500–1000 ml), ensuring the temperature is not excessively high; drinking should be done in small amounts at frequent intervals.” It also advises: “Avoid beverages containing alcohol or large amounts of sugar, as these lead to further fluid loss. Do not consume overly cold drinks.” For heatstroke specifically, the guidelines explicitly warn: “Do not give the patient any water to drink.” NIOSH in the U.S. recommends encouraging “small, frequent sips of cool water” for heat exhaustion, and for heat cramps, suggests sports drinks with sugar and electrolytes every 15–20 minutes — “do not use salt tablets.” - Evidence grade: B - Sources:中国疾病预防控制中心职业卫生与中毒控制所 (2014). 公众高温中暑预防与紧急处理指南（2014 版）. ; US CDC/NIOSH. Heat-Related Illnesses. - Notes: After heavy sweating, drinking plain water alone dilutes blood sodium levels, so a bit of salt must be added to the water. Gulping down large amounts at once often leads to vomiting, which can be fatal if liquid enters the airways. The 2014 Chinese CDC guideline advises against “very cold drinks” to prevent stomach cramps, though no quantitative evidence supports this restriction; it should not be interpreted as “no cold drinks at all.” In item 22, several cooling methods are described: wiping the body with cool water, immersing in cold water, and applying ice packs to the neck, armpits, and inner thighs — all of which are officially recommended first-line measures. These are meant for external application, not ingestion, and cooling must always precede rehydration. Never give anything to drink to anyone who is unconscious or speaking unclearly. ### 24. Stay low to the ground during a fire, test doors before opening them, and never use elevators — once outside, don’t look back - Cost: Installing one or two standalone smoke detectors at home costs only a few dozen yuan. It’s also worth checking in advance which two exits are available on your hallway. - In plain terms: Drop to the ground and crawl toward the nearest exit, staying under any smoke layer. Before opening a door, touch the handle and door surface first; if either feels hot or smoke is seeping through the crack, don’t open it — instead, head toward the other exit. Open the door slowly, and shut it immediately if thick smoke rushes in. Always use stairs instead of elevators, since power outages can trap you inside them. Once outside, never turn back to retrieve belongings. If your clothes catch fire, stop where you are, lie down, roll on the ground, and shield your face with your hands. - Benefit: FEMA’s official fire escape guidance matches these steps exactly: “Drop to the ground and crawl under smoke toward an exit.” It also advises testing door handles and surfaces first — “If they’re hot, or smoke is coming through the crack, don’t open the door; use the other exit instead.” Open doors slowly, and close them at once if heavy smoke appears. For clothing fires, the same advice applies: “Stop, lie down, roll, and shield your face.” If escape proves impossible, close the door and seal any gaps or vents with cloth or tape, then call for help and state your location. China’s emergency management department shares these same recommendations: never use elevators, head downward if the fire is small, cover your nose and mouth with a wet towel or mask, and evacuate while staying low to the ground. - Evidence grade: B - Sources:US FEMA Ready.gov. Home Fires. ；应急管理部 (2019). 公共场所火灾自救方法：「逃生时不要乘坐电梯，当火势不大时，要尽量往楼层下面跑」「可用湿毛巾或口罩蒙鼻，匍匐或弯腰撤离」. ；贵州省消防救援总队 (2020). 消防常识丨逃生三要点：「湿毛巾对折3次（叠成8层），除烟率比较高，但烟和毒气浓度过高时，过滤效果就无法保证了。另外，毛巾过湿会导致呼吸困难」. - Notes: Elevators are a major risk during power outages — never use them. Never return inside to grab possessions. Only head upward if you’re certain the roof exit is open; jumping from heights is strictly prohibited. Fold a wet towel three times to create eight layers — too much water makes it heavy and hard to breathe through. Even a wet towel offers little protection against thick smoke or toxic gases. ### 25. Upon seeing someone drowning, shout for help and call 110/120, then reach out a pole or floating objects — never enter the water yourself - Cost: No cost involved. The hard part is resisting the urge to jump in. - In plain terms: A drowning person instinctively pulls their rescuer underwater, so anyone who enters the water risks drowning too. The proper sequence is: shout for help → call emergency services → extend a long pole or rope → throw life rings, empty buckets, or plastic bottles → if the victim is on shore and not breathing, start CPR immediately. Never form a human chain by holding hands and entering the water. Globally, roughly 300,000 people drown each year; this ranks as the fourth leading cause of death among children aged 1–4. - Benefit: WHO reports that about 300,000 drownings occur worldwide each year, with 92% occurring in low- and middle-income countries. Drowning is the fourth leading cause of death for kids aged 1–4 and the third leading cause for those aged 5–14. WHO recommends “safe rescue and resuscitation training” — essentially learning how to help without entering the water. The recommended steps are identical: shout for help → call emergency services → reach out poles or ropes, toss life rings, empty buckets, or bottles → if the victim is out of water and not breathing, perform CPR right away. - Evidence grade: C - Sources:WHO. 溺水 实况报道. - Notes: Grade C is assigned because no official source explicitly states the “do not enter the water” rule; we only have WHO’s global death statistics and the broader principle of “safe rescue.” Never form a human chain by holding hands and jumping in. Untrained individuals should not attempt to pull a drowning person out, as the victim will instinctively pull them underwater. This “stay out of water” rule also serves self-preservation — anyone who enters the water risks drowning, regardless of who the victim is. Most cases involve a child, so prevention is covered in Section 1, Item 12: keep children under constant supervision near water. ### 26. If someone is choking and can’t speak, stand behind them and perform 5 back blows followed by 5 abdominal thrusts; if they collapse, start CPR immediately - Cost: No cost involved. To perform the technique: make a fist with one hand and place it just above the navel, then wrap the other hand around it and deliver quick inward and upward thrusts. - In plain terms: First ask, “Are you choking? Can you speak?” If the person can still cough forcefully or make sounds, let them keep coughing — coughing often dislodges the object on its own. If they can’t speak, stand behind them and give 5 back blows followed by 5 abdominal thrusts, repeating this sequence until the object comes out or the person loses consciousness. Once they collapse, begin CPR right away and call emergency services. For pregnant women or very overweight individuals, perform chest thrusts instead. Never reach into someone’s mouth to try to remove an unseen object. - Benefit: According to the original text from the U.S. National Library of Medicine: First ask, “Are you choking? Can you speak?” It also states that “if the person can still cough forcefully or speak, do not intervene” since coughing often removes the obstruction on its own. If they can’t speak, “repeatedly perform 5 back blows followed by 5 abdominal thrusts until the object is dislodged or the person loses consciousness.” At that point, “begin CPR immediately” while calling emergency services. Chest thrusts are recommended for pregnant women and those with obesity. - Evidence grade: B - Sources:US National Library of Medicine, MedlinePlus. Choking – adult or child over 1 year. ；福州市卫生健康委员会 (2026). 海姆立克急救法更新了：「1岁以上幼儿、儿童及成人：从旧版单一腹部冲击改为"5次背部拍击+5次腹部冲击"的循环」「中国红十字系统急救培训一直都是按"5次背部拍击+5次腹部冲击"循环进行的方式进行教学」. - Notes: Never reach into someone’s mouth to remove an unseen object — this can push it deeper. Do not perform this technique on anyone who is still able to cough. Choking incidents most often occur at home, so these steps are especially useful for family members. This same method is taught in China: The Fujian Red Cross Emergency Rescue Training Center notes that for children over 1 year old and adults alike, the Red Cross system has long taught a cycle of 5 back blows followed by 5 abdominal thrusts. Many older online tutorials only cover abdominal thrusts; those are outdated versions of this procedure. ### 27. If lost or stranded in the Gobi Desert, a desert, or any remote area, stay put next to your vehicle. First, transmit your location, then shield yourself from the sun and retain body heat, conserve water, and avoid wandering off - Cost: Before venturing into such areas, inform someone of your planned route, destination, return date, vehicle type, and license plate number. You’ll need at least 4 liters of water per person per day. Satellite communicators or BeiDou short-message devices cost thousands of yuan; rental fees range from several hundred yuan per use. The real challenge is simply remembering to stay put and not wander away. - In plain terms: Stay right where you are, preferably next to your vehicle — it serves as the best shelter from the sun. The proper sequence is: if you have a signal, send your location first and then make a call; next, shield yourself from the sun and retain body heat; then conserve water by staying motionless during the day and only moving after nightfall when it cools down; avoid wandering off; finally, use reflective surfaces, smoke, or three fire piles to signal for help. Be sure to share your route, destination, return date, vehicle type, and license plate details with someone before you depart. - Benefit: The National Park Service’s Mojave Desert page lists three key statements: “Each person needs at least 1 gallon (roughly 3.8 liters) of water daily; hikers and cyclists require 2 gallons per day.” “Tell someone about your planned route, destination, return date, vehicle type, and license plate number.” “Cell service is intermittent.” Death Valley’s guidance advises: “Avoid hiking in the valley floor or at low elevations during peak heat,” while other wilderness areas note “virtually no cell coverage” and recommend bringing a satellite phone. The Mojave driving guide explicitly states: “In an emergency, staying next to your vehicle is the single most important action you can take.” It also notes that such incidents are rare, yet some people still perish from heat exposure or cold after attempting to walk back to a road. These recommendations are organized into five priority steps: first, transmit a status update and coordinates; second, shield yourself from the sun and retain body heat; third, conserve water by staying still during daylight and moving only after nightfall; fourth, avoid wandering off; fifth, attempt to signal for help. The Chongqing Emergency Management Bureau adds that three fire piles arranged in a triangle constitute an internationally recognized distress signal; if rescuers are nearby, shout “three short bursts, three long bursts, then three short bursts” and repeat every minute. On sunny days, reflective objects such as mirrors or tin cans can also be used to attract attention. Meanwhile, China’s Ministry of Culture and Tourism cautions independent drivers against venturing into remote zones; it advises traveling in groups and renting a satellite phone if necessary. - Evidence grade: C - Sources:US National Park Service. Mojave National Preserve Safety. ; US National Park Service. Death Valley Safety. ; US National Park Service. Desert Driving Safety. ; 重庆市应急管理局 (2024). 应急科普>>在野外你需要了解的求救信号（长图）：「燃放三堆火焰是国际通行的求救信号，将火堆摆成三角形」「三声短三声长，再三声短；间隔1分钟之后再重复」. ; 文化和旅游部 (2018). 文化和旅游部提醒游客谨慎选择户外探险旅游：「谨慎前往无人区和人烟稀少区」「尽量多车同行，提前准备对讲机，必要时租用卫星电话」. - Notes: This C rating reflects that these recommendations stem from official guidelines rather than empirical research data. The recommended water intake levels, mandatory reporting procedures, known signal coverage patterns, the directive to remain near one’s vehicle, and the prescribed distress signals all originate directly from official sources. The commonly cited “three short bursts, three long bursts, then three short bursts” phrase could not be verified in any official documentation; consequently, it has been replaced with the officially endorsed method of deploying three fire piles and repeating the three-short-three-long-three-short pattern. Additionally, it is vital to avoid hiking in search of help during midday heat, never drink urine, and under no circumstances withhold water intake merely to conserve supplies. ### 28. Shivering, slurred speech, and unsteady walking are signs of hypothermia; change into dry clothes, wrap up, warm the torso first, and give sweet hot drinks instead of alcohol - Cost: An emergency thermal blanket costs just a few dollars, plus a spare dry set of clothes. Learning to recognize the warning signs costs nothing. - In plain terms: When body temperature drops below 35°C, hypothermia sets in. Victims start to shiver, speak unclearly, walk unsteadily, and have trouble thinking. Remove any wet clothing and wrap the person in a thermal blanket or dry clothes, making sure to warm the torso before the limbs. Offer sweet hot drinks, but avoid alcohol — it suppresses shivering. The absence of shivering does not mean improvement; it actually signals worsening condition. If the person loses consciousness, begin CPR immediately. - Benefit: According to the U.S. National Weather Service, any body temperature below 95°F (35°C) indicates hypothermia, and symptoms such as feeling cold, sluggishness, and confusion warrant immediate medical attention. Recommended actions include moving the victim to a warm indoor environment, focusing on warming the core first, and providing hot drinks. Alcohol is discouraged because it reduces shivering. CPR is required if the person becomes unconscious. Warm water or body heat can be used to treat frostbite, but avoid hot water or direct radiant heat sources like fireplaces. The Wilderness Medical Society’s 2019 hypothermia guidelines serve as the authoritative clinical reference on this topic. - Evidence grade: B - Sources:US National Weather Service. During Extreme Cold. ; Dow J 等 (2019). Wilderness Medical Society Clinical Practice Guidelines for the Out-of-Hospital Evaluation and Treatment of Accidental Hypothermia: 2019 Update. Wilderness & Environmental Medicine. - Notes: Do not rub or massage the limbs to warm them. Avoid hot baths at all costs. Do not drag or force‑move a severely hypothermic person — their heart may stop unexpectedly. Remember, the absence of shivering is not a sign of recovery; it often means the condition is worsening. Full access to the Wilderness Medical Society’s guideline requires a subscription; this translation is based solely on its summary. ### 29. After a snake bite, stay still, remove rings and watches, and rush to a hospital offering antivenom — no cutting, no suction, no tight binding - Cost: No cost involved. The key is knowing in advance which nearby hospitals stock antivenom; the real challenge is resisting the urge to treat the wound yourself. - In plain terms: Sit down and stay motionless; immobilize the bitten limb. Remove any rings or watches right away, as swelling will set in quickly. Get to a hospital with antivenom as fast as possible — this is the only treatment capable of reversing most toxic effects. Do not cut the wound, do not suck out venom with your mouth, do not apply ice, and do not tie anything so tightly that the skin turns purple. Avoid alcohol and physical exertion. If possible, take a photo of the snake from a safe distance — do not try to catch it. - Benefit: The WHO lists three key recommendations: “Immediately immobilize the affected body part and transport the victim to the nearest medical facility,” “Avoid using tourniquets and do not cut the wound,” and “Administer appropriate antivenom specific to local snake species.” High‑quality antivenom is the most effective treatment for preventing or reversing most toxic effects of snake bites. Globally, 81,000–138,000 people die from snake bites each year, and the number of amputations and permanent disabilities is roughly three times that figure. China’s 2024 guidelines estimate 250,000–280,000 venomous snake bites annually, with victims most often aged 50 or older. Between 2017 and 2021, hospitals in 11 southern provinces along the Yangtze River treated 40,817 snake‑bite patients; 23 of them (0.06%) died during hospitalization. - Evidence grade: B - Sources:WHO. 动物咬伤 实况报道. ; WHO (2023). 蛇咬伤中毒 实况报道. ; Lai R 等 (2024). The Chinese guideline for management of snakebites. World Journal of Emergency Medicine 15(5):333-355：「An estimated 250,000–280,000 cases of venomous snakebites occur in China each year, affecting mainly patients aged ≥50 years」. ; Yan S 等 (2026). Clinical epidemiology of snakebite envenoming in hospitals 11 provinces of Yangtze River Basin and southern regions of China. PLoS Neglected Tropical Diseases：「withdrawal (4346, 10.65%), and death (23, 0.06%)」. - Notes: Take a photo of the snake if you can — do not attempt to capture it. Avoid alcohol, running, suction of venom, ice packs, and overly tight bindings. China does not publish official nationwide statistics on snake‑bite mortality. Although the reported hospitalization mortality rate in those 11 provinces appears low, over 10% of patients leave the hospital before completing treatment; their subsequent outcomes are not reflected in these figures. ### 30. First, figure out what kind of building you’re in during an earthquake: if it meets seismic safety standards, stay right where you are; if it’s an old structure prone to collapse, head outside right away - Cost: No cost at all. Just take a moment beforehand to see how many steps it takes to reach the exit, which route to take, and which tables are sturdy enough to hide under. - In plain terms: First, determine what kind of building you’re in. For structures built after 2001 that meet seismic codes, you’ll need to go down stairs or through a hallway to exit — so stay put: protect your head and neck, crawl under a solid table, and hold onto its legs tightly. In single-story homes, older brick buildings, or makeshift houses without seismic protection, the exit is just a few steps away — so leave immediately. Under no circumstances should you jump from heights, use elevators, or try to run down stairs while the ground is shaking. - Benefit: The China Earthquake Administration’s educational video “Earthquake: Hide or Run?” promotes the rule “Take shelter nearby during the quake, then evacuate quickly afterward,” but explicitly limits this advice to “buildings that meet seismic safety standards.” The reasoning is that such structures “are far less likely to collapse entirely.” The video also notes that “falling building components and decorative items” pose the greatest threat to life safety, while “running around without any protection during a quake” increases the risk of being struck by falling ceilings, chandeliers, or other objects. Recommended actions include “using hands or soft objects to shield the head and neck” and “gripping table legs tightly”; if no table is available, “crouch close to load-bearing walls and stay away from exterior walls, windows, and balconies.” For those outdoors, the advice is “immediately move to an open area away from hazards.” Conversely, during the 1988 Armenian earthquake, Soviet-era prefabricated panel buildings collapsed en masse. A case-control study conducted after that disaster concluded that “leaving a building right after the first tremor is a protective behavior.” People who remained indoors were 4.40 times more likely to sustain injuries than those who evacuated (95% CI 2.24–8.71). The odds of injury indoors were 12.20 times higher than outdoors (3.62–63.79), and in buildings five stories or taller, this risk rose to 3.65 times that of lower structures (2.12–6.33). - Evidence grade: B - Sources:中国地震局（安徽省地震局制作）. 地震来了，是躲还是跑？（科普视频，字幕转录）. ；Armenian HK, Noji EK, Oganesian AP (1992). A case-control study of injuries arising from the earthquake in Armenia, 1988. Bulletin of the World Health Organization, 70(2), 251-257. ；US FEMA Ready.gov. Earthquakes. ；Mahue-Giangreco M, Mack W, Seligson H, Bourque LB (2001). Risk factors associated with moderate and serious injuries attributable to the 1994 Northridge Earthquake. Annals of Epidemiology, 11(5), 347-357. - Notes: This topic remains debated, as the two main conclusions apply to distinctly different types of buildings. The China Earthquake Administration itself stipulates that “taking shelter” is only advisable “in buildings that meet seismic safety standards,” and also emphasizes that decisions must be “tailored to local conditions and individual circumstances” — meaning you must consider both the building’s structural integrity and your own physical ability to move. In Armenia, entire buildings collapsed, leaving no safe spot to hide, so evacuation was the only viable option. The U.S. Federal Emergency Management Agency advises residents to “drop to the ground, protect the head and neck, hold on tight, and avoid running outside” — where injuries are primarily caused by falling debris and falls during tremors. Research from the Northridge earthquake further shows that reaching for objects or gripping seemingly stable items can actually increase injury risk. Ultimately, the key question isn’t “should I run or stay?” but rather “is this building likely to collapse, and can I reach open ground within seconds?” For buildings constructed after 2001 that require navigating stairs or hallways to exit, staying put is the safest choice. For single-story homes, older brick buildings, and makeshift houses without seismic protection, the exit is just a few steps away — so leave immediately. It’s worth noting that the Armenian study only compared injured and uninjured survivors, excluded fatalities, and didn’t account for differences in building height; since those able to escape were more likely to live on lower floors, these figures should be interpreted with some caution. Under no circumstances should you jump from heights, use elevators, or attempt to run down stairs during tremors. Once outside, stay far away from tall structures, overpasses, utility poles, glass facades, and billboards. ### 31. When encountering bears, wild boars, or packs of wild dogs, don’t run, don’t scream, don’t make eye contact — instead, turn sideways and back away slowly - Cost: No cost involved. When heading into the mountains, bring a hiking pole, hike in a group, and make noise so animals know you’re coming. The hardest part is staying put instead of running. - In plain terms: Never run — bears can sprint uphill or downhill just as fast as racehorses. Also, don’t climb trees; both black bears and brown bears are excellent climbers. Stand your ground and keep speaking to the bear in a low, calm voice. Once it stops moving, turn sideways and back away slowly. If a brown bear attacks, lie down and play dead: place your hands behind your neck and spread your legs apart. For black bear attacks, do not play dead — run toward a vehicle or building; if escape is impossible, fight back using whatever is at hand. In case of dog bites, follow the steps outlined in item 13. - Benefit: The original guidelines issued by the U.S. National Park Service on bear encounters contain six key points: “Do not run — bears can sprint uphill or downhill just as fast as racehorses.” “Stay calm; most bears have no interest in attacking and simply want to be left alone.” “Keep speaking to the bear in a low, steady voice.” “When the bear stops moving, turn sideways and back away slowly so you can keep watching it without tripping.” “Make yourself appear as large as possible.” “Do not climb trees — both grizzly bears and black bears are capable climbers.” In the event of a brown bear attack, “lie down and play dead, placing hands behind the neck and legs apart.” For black bear attacks, “do not play dead; run toward a vehicle or building, and if escape is impossible, fight back using any available object.” Dog bites should be treated according to item 13. - Evidence grade: B - Sources:US National Park Service. Staying Safe Around Bears. ；国家疾控局综合司、国家卫生健康委办公厅 (2023). 狂犬病暴露预防处置工作规范（2023 年版）. - Notes: The Grade B rating applies solely to bear encounters. The advice regarding wild boars and packs of wild dogs — namely, “don’t run, back away slowly, and seek higher ground or obstacles for protection” — is based on anecdotal experience and is rated Grade C; no official recommendations from China’s forestry authorities or local agencies were identified for these scenarios. Never try to lure animals with food, approach them for photos, or bring dogs into mountainous areas inhabited by wild boars. In China, the primary bear species are black bears and brown bears; the decision to play dead or not depends on which species is involved. ### 32. If caught in a thunderstorm outdoors, get into a hard-topped vehicle or building; avoid ridges, lone trees, water surfaces, and metal objects - Cost: No monetary cost. The downside is that your trip gets interrupted for at least half an hour. The real challenge is actually turning back when the thunder is still far away. - In plain terms: There is no safe spot outdoors during a thunderstorm. You must get into a hard-topped vehicle or building; convertibles and motorcycles do not qualify. Tents, gazebos, areas under trees, or rocky outcrops also do not count as shelter. Stay away from open areas, mountain ridges and peaks, isolated tall trees, water surfaces, and metal railings or poles. If a group cannot all fit together, spread out rather than huddling close. Begin retreating the moment you hear thunder; it is only safe to leave 30 minutes after the final clap of thunder. - Benefit: There is no safe spot outdoors during a thunderstorm. It is only safe to leave 30 minutes after the final clap of thunder. - Evidence grade: B - Sources:美国国家气象局. 户外雷电安全：「There is no safe place outside when thunderstorms are in the area」「Avoid open fields, the top of a hill or a ridge top. Stay away from tall, isolated trees or other tall objects」「Stay away from water, wet items, such as ropes, and metal objects, such as fences and poles」；实在走不了时「If you are in a group, spread out to avoid the current traveling between group members」；恢复活动「Wait 30 minutes until after the last rumble of thunder」. - Notes: Tents, gazebos, areas under trees, and rocky outcrops do not qualify as shelters. Hard-topped cars do count, but convertibles and motorcycles do not. Start retreating the instant you hear thunder; do not wait until rain begins to fall. ### 33. Gradually increase your sleeping altitude when heading to high elevations; if symptoms worsen, descend immediately — don’t tough it out - Cost: It requires an extra day or two for acclimatization. Preventive medications are prescription-only, so you must consult a doctor before traveling. The main challenge is fitting these days into an otherwise tight itinerary. - In plain terms: This guideline focuses on sleeping altitude, not daytime elevation. Sleeping above 2,450 meters already poses a risk of altitude sickness. Once above 3,000 meters, you should only raise your nighttime altitude by 500 meters per night, allowing an additional day of acclimatization for every 1,000-meter increase. Symptoms such as headache, nausea, unsteady gait, altered mental state, or shortness of breath even at rest indicate the need to descend. Descending takes priority over oxygen therapy or medication. - Benefit: Sleeping above 2,450 meters increases the risk of altitude sickness. Without prompt descent, high-altitude cerebral edema and pulmonary edema — fluid buildup in the brain and lungs — can be fatal. - Evidence grade: A - Sources:美国疾病控制与预防中心. 黄皮书·高海拔旅行与高原病：「Any unacclimatized traveler proceeding to a sleeping altitude of ≥2,450 m (≥8,000 ft)—and sometimes lower—is at risk for altitude illness」；上升速度「500 m (1,650 ft) per night in sleeping altitude once above 3,000 m (9,800 ft)」，每上升 1000 米加一天适应日；乙酰唑胺预防「125 mg twice a day; 250 mg twice a day if >100 kg body weight」；「If symptoms become worse despite rest or treatment at the same elevation」必须下撤. ；荒野医学会 (2024). 急性高原病预防、诊断与治疗临床实践指南（2024 更新）. Wilderness & Environmental Medicine. - Notes: The rule specifically refers to sleeping altitude, not daytime elevation. Headache, nausea, unsteadiness, confusion, or breathlessness at rest are clear signs to descend. Descending should always come before oxygen use or medication; continuing upward while on oxygen is unsafe. ### 34. To remove a tick, use fine-point tweezers to pull it straight out along the skin — don’t apply oil, don’t use heat - Cost: A pair of fine-point tweezers. - In plain terms: Use fine-point tweezers to grasp the tick’s head right against the skin, then pull steadily outward. Never apply oil, use heat, or yank sideways — doing so can force infectious fluids into the skin and often leaves the tick’s mouthparts embedded. After removal, write down the date. If you develop fever, rash, or fatigue in the following weeks, be sure to mention the tick bite to your doctor. - Benefit: Applying oil, using heat, or pulling sideways can provoke the tick to release infectious fluids into the skin. Those actions also raise the risk of leaving its mouthparts stuck inside. In China, tick-borne severe fever with thrombocytopenia syndrome led to 6,602 reported cases and 306 deaths in 2024 — the highest totals on record. From 2010 through 2024, the average fatality rate stood at 4.79%, rising with age; for those over 85 it reached 9.15%. - Evidence grade: B - Sources:美国疾病控制与预防中心. 被蜱叮咬之后：「Grasp the tick as close to the skin's surface as possible using clean fine-tipped tweezers」「Pull tick away from the skin with steady, even pressure」「Do not use petroleum jelly, heat, nail polish, or other substances to try and make the tick detach from the skin. This may agitate the tick and force infected fluid from the tick into the skin」. ；Ren Q 等 (2026). Epidemiological characteristics of severe fever with thrombocytopenia syndrome (SFTS) in China, 2010–2024: a fifteen-year national surveillance analysis. BMC Infectious Diseases 26:1497：「The number of reported cases (6,602 cases) and deaths (306 cases) in 2024 were both the highest levels since the discovery of this disease」「The average CFR was 4.79%, and the CFR increased with age, reaching 9.15% among those aged 85 years and above」. - Notes: Be sure to note the date of removal. Should fever, rash, or fatigue appear in the weeks that follow, inform your doctor about the tick bite — otherwise it may be misdiagnosed as a common cold. ### 35. Always boil any water taken from the wild before drinking it; one minute of boiling is sufficient — there’s no need to extend the time just because you’re at high altitude - Cost: You’ll need to carry extra weight in the form of a stove and fuel. - In plain terms: Any microbes capable of causing illness through water are killed within seconds at boiling temperature. Boiling for an additional minute simply provides a safety margin for any possible oversight; it isn’t necessary to prolong the process at higher elevations. If boiling isn’t feasible, use a filter or chemical purification tablets instead — each method has its own limitations regarding which pathogens they can eliminate. Even crystal-clear streams and meltwater can harbor parasites. - Benefit: All microbes that can cause disease via water are inactivated within seconds at boiling temperature. The belief that water fails to reach a safe temperature at high altitudes is a common misconception. - Evidence grade: B - Sources:美国疾病控制与预防中心. 黄皮书·旅行者的水消毒：「All organisms that may cause illness from drinking water are killed within seconds at boiling temperature」「CDC recommends that travelers boil water for a full minute to account for user variability in identifying boiling points and to add a margin of safety」「Although the boiling point for water decreases with increasing elevation, at common travel elevations the temperature needed to achieve boiling is still well above the temperature required to inactivate enteric pathogens」. - Notes: The same page also notes that boiling isn’t strictly mandatory: maintaining water at 60°C for 30 minutes achieves the same effect, and boiling simply offers a visible endpoint without needing a thermometer. Filters and chemical tablets each have their own gaps in pathogen coverage, so boiling remains preferable when possible. Just because water appears clear doesn’t mean it’s free of parasites — appearance alone is no reliable indicator. ### 36. If a stranger demands money in a remote area, hand over cash, avoid any confrontation, note their features, and call police after escaping - Cost: The cash you have on you. The real challenge is keeping your temper in check. - In plain terms: Give him the money, do not fight back, and do not argue. By demanding a few hundred yuan, he is committing robbery — a crime punishable by at least three years up to ten years in prison. If he enters a residence, uses a weapon, or causes serious injury or death, the sentence rises to ten years or more, even life imprisonment or death. If you chase after him and strike him after he has taken the money, that is no longer considered self‑defence. Immediately after escaping, write down his appearance, accent, vehicle license plate, and the direction he fled, then call 110. - Benefit: Your life is far more valuable than a few hundred yuan. The offender is committing a serious crime for such a small amount. Article 263 of the Criminal Law states that anyone who robs public or private property by violence, coercion, or other means faces three to ten years in prison plus a fine; aggravating circumstances raise the penalty to ten years or more, even death. Article 20 limits self‑defence to stopping an ongoing unlawful attack; once the robber has taken the money and walked away, any retaliation is no longer justified. After escaping, record his description, speech patterns, vehicle details, and escape route, then call 110. - Evidence grade: C - Sources:全国人大 (2020 年修正). 刑法（第二十条、第二百六十三条）. （北京市公安交管局转载整合文本） - Notes: The “C” rating reflects the lack of direct literature supporting the principle that “handing over money avoids danger”; the legal text merely outlines the offender’s risks and your boundaries. Never follow an attacker to a secluded spot to “get money,” never reveal your phone password, and never get into his vehicle. This advice is not an invitation to fight or to refrain from calling police; it applies only when you are physically threatened in a remote setting and must first pay to ensure your safety. In contrast, if someone online threatens to release private photos or videos, you must never pay — see Section 8, Item 32 for those cases. ### 37. If you stumble upon a group fight, walk away immediately — don’t try to break it up, don’t stand around watching, and don’t pick up any weapons on the ground. If you want to call the police, retreat to a safe distance and dial 110 - Cost: No money is required. The hard part is resisting the urge to step in and the temptation to watch from the sidelines. After calling, you might be asked to give a statement later; at most, this takes half a day. - In plain terms: If you intervene, your actions shift from “trying to calm things down” to “taking part in a fight.” Participating in a group brawl can land you in prison for up to three years; if many people are involved, it happens on a road, or weapons are used, the sentence rises to three to ten years. Watching isn’t worth it either — the more onlookers there are, the messier the scene gets, and you’re more likely to get hurt. The right move is to walk away. If you do want to call the police, step back to a safe spot and dial 110, clearly stating the location, how many people are involved, whether anyone is carrying knives or sticks, and if anyone has collapsed. - Benefit: Article 292 of the Criminal Law states: “Those who lead or actively take part in group brawls shall be sentenced to up to three years in prison, criminal detention, or surveillance.” If the brawls happen repeatedly, involve many people, have a big social impact, occur in public spaces or on busy roads, or involve weapons, the punishment rises to three to ten years. If such fights cause serious injury or death, perpetrators are charged under laws on intentional injury or homicide. The Public Security Administration Punishment Law also sets penalties: assaulting others brings a detention of five to ten days plus fines of 500 to 1,000 yuan. Group fights handled as hooliganism can lead to up to fifteen days in jail and fines up to 2,000 yuan. Guideline 5 of the “Opinions on Properly Applying Self‑Defence” says unlawful attacks include those aimed at you, at the public, or at others. Guideline 9 adds that if one side starts the fight with excessive force, or continues attacking even after the other side tries to avoid conflict, the responding party is usually considered acting in self‑defence. - Evidence grade: B - Sources:全国人大 (1997). 刑法（第二百三十二、二百三十四、二百九十二、三百零五、三百一十条）. ；全国人大常委会 (2025). 治安管理处罚法（2025 年修订，第三十、五十一条）. ；最高人民法院、最高人民检察院、公安部 (2020). 关于依法适用正当防卫制度的指导意见（法发〔2020〕31 号，第 5、9 条）. ；全国人大 (2018). 刑事诉讼法（2018 年修订，第六十二、一百一十、一百一十一、一百九十三条）. 宁夏回族自治区人民检察院转载全文 - Notes: This grade is B because part of the consequences are backed by clear legal text, but the advice “walk away and call the police instead of intervening” isn’t directly stated in any official rule — it’s inferred from those statutes and from how group fights are judged. Saying “I was just trying to mediate” isn’t a shield; what matters is whether you actually took part and whom you hit. If an attacker is already down or has fled, chasing them to hit them no longer counts as self‑defence. Legally, you may intervene if you see someone being unilaterally beaten; self‑defence protects not only you but also others. Yet stepping in bare‑handed usually just adds another casualty. Calling for help, recording from afar, and calling police are far more effective. The safest choice here is “don’t intervene, don’t watch.” The benefit of calling 110 mainly helps the victim on the ground; overall, this entry offers one of the lowest net benefits in the book, so you must weigh whether the time investment is worth it. You should know a few key facts first. There is already a legal duty to testify: Article 62 of the Criminal Procedure Law says anyone aware of a case must testify; not calling police doesn’t erase that duty. In cases involving serious injury or death, police can still identify witnesses from surveillance footage, so standing around watching actually makes you more likely to be recorded. Authorities “must keep the identity of anonymous callers confidential” (Article 111). Simply stating the location, number of people, and whether weapons are present is enough — you needn’t stay on the scene. Only if a court summons you to testify without a valid reason and you refuse can you face up to ten days in detention (Article 193); ordinary bystanders rarely reach that point. Not calling police isn’t illegal: Article 110 of the Criminal Procedure Law mentions a “right and duty” without any penalty, and no criminal law punishes ordinary citizens for not reporting what they see, so walking away is perfectly legal. Two actions after walking away would cross the line: helping hide someone or giving false testimony to protect them (Article 310 of the Criminal Law, up to three years; serious cases bring three to ten years); and deliberately giving false testimony when called as a witness (Article 305, up to three years; serious cases up to seven years). Staying silent or telling the truth is fine; fabricating stories is not. If you yourself get caught in a fight, see Section 8, Item 10; if a stranger demands money, see Item 36 of this section; for costs after helping an injured person, see Item 39. ### 38. If you may have been exposed to HIV, get PEP within 72 hours — the sooner, the better - Cost: A full 28‑day course of PEP can cost thousands of yuan; in most regions it must be paid out‑of‑pocket. You’ll need to rush to a hospital that same night. The hardest part is admitting you might be infected and leaving right away. - In plain terms: If you suspect you’ve been exposed to HIV, 72 hours is the hard deadline — ideally you should start PEP within 2 hours. The medication must be taken for 28 consecutive days. After 72 hours this option is no longer available, so don’t wait until the next day to decide. - Benefit: The Beijing Municipal Government’s HIV‑prevention outreach defines this as “post‑exposure prophylaxis,” abbreviated PEP. It recommends starting preventive medication “as soon as possible, ideally within 2 hours and no later than 24 hours, but not after 72 hours,” and continuing for 28 days. Beyond 72 hours PEP is not advised. This strict timeline means that acting immediately versus waiting a night can produce completely different outcomes. - Evidence grade: B - Sources:北京市人民政府. 事前、事后分不清？六问六答全面了解艾滋病病毒暴露前/暴露后预防. ；中国疾病预防控制中心性病艾滋病预防控制中心 (2020). 艾滋病病毒暴露后预防技术指南（试用）. - Notes: Where to obtain PEP: any designated HIV‑treatment clinic affiliated with the local Chinese CDC, usually under the Infectious Diseases or STD/HIV department. Many cities now offer 24‑hour clinics; in Chongqing, for example, 29 such clinics operate across 26 districts, 14 of which are open around the clock. Call the local CDC beforehand to find a clinic with PEP on hand — don’t waste time in the emergency room. Situations considered “exposures” include unprotected sex, a broken condom, needle sticks, or blood contact with mucous membranes; only a doctor can decide whether PEP is appropriate. The full 28‑day regimen must be completed; missing doses markedly reduces its effectiveness. Follow‑up testing is required at 4–6 weeks and at 3 months as directed by your physician. This is a remedial measure, not a substitute for regular prevention; for everyday safeguards and testing, see items 30 and 31 in Chapter 1 (consistent condom use and testing after high‑risk encounters). ### 39. After saving someone and getting injured or incurring expenses, first seek compensation from the perpetrator and yibao; then apply for recognition as a person acting in the public interest - Cost: There is no direct expense. However, submitting the application requires paperwork, waiting for approval, and multiple visits — this can take weeks or even months. - In plain terms: If you get hurt while saving someone, you’re not simply out of luck. Those injured while acting in the public interest should receive treatment first, with costs covered afterward. Medical bills are the responsibility of the perpetrator; if the perpetrator flees or cannot pay, basic medical insurance steps in. Even without a perpetrator, the person you saved is legally obligated to provide reasonable compensation — this is a legal requirement, not a matter of personal generosity. At the same time, you should apply for official recognition as a person acting in the public interest so that any injuries can be treated under workers’ compensation rules. - Benefit: Article 183 of the Civil Code states: “Anyone who suffers harm while protecting another person’s civil rights is entitled to compensation from the perpetrator; if no perpetrator exists, has fled, or cannot pay, the beneficiary must provide reasonable compensation.” State Council Document No. 39 of 2012 further clarifies how to handle medical care for such individuals. Healthcare facilities must establish a fast-track system based on the principle “treat first, bill later.” Specifically, medical expenses incurred during emergency treatment are the responsibility of the perpetrator or liable party; otherwise, they are covered by basic medical insurance. In cases of death, individuals meeting criteria for martyr status are recognized as such by law; those qualifying as work-related injuries receive a one-time death benefit plus an additional special allowance equal to 40 months of their salary. Injured individuals meeting workers’ compensation criteria receive benefits under the relevant regulations; others have their disability level assessed by civil affairs bureaus to determine appropriate support. Employment-wise, such individuals are prioritized for job assistance programs and placed in public-sector roles when possible. Housing-wise, they are given priority access to subsidized housing or rental assistance. - Evidence grade: B - Sources:全国人大 (2020). 民法典（第一百八十三条）. ；国务院办公厅转发民政部等部门 (2012). 关于加强见义勇为人员权益保护的意见（国办发〔2012〕39 号）. - Notes: This grade is assigned because national documents clearly define which benefits apply; however, exact amounts of bonuses and detailed application procedures vary by province under local regulations, and these specifics were not verified across all regions in this round. Applications are typically submitted to local police departments or dedicated civil affairs bureaus responsible for recognizing acts of public service. Successful recognition depends on solid evidence: police reports, surveillance footage, witness contact details, and medical records gathered promptly at the scene. Legal aid for such cases is also available free of charge. National standards for death benefits and disability compensation calculations are explained in Sections 15 and 16 of Chapter 19; instructions for obtaining legal aid can be found in Section 3 of Chapter 7. ### 40. Knives, rebar, glass piercing the body – apply pressure around the foreign object to stop bleeding; do not pull it out - Cost: No cost involved. The hard part is resisting the instinct to “pull it out” and instead staying with the injured person until help arrives. - In plain terms: Pulling out the object can cause severe bleeding and makes it harder for doctors to assess the extent of the injury. The correct approach is to call 120, then use your hand or a dressing to apply firm pressure around the object to control bleeding and keep it stable so it doesn’t move. If internal organs are visible through an abdominal wound, do not push them back in; simply cover them with a clean, moist dressing. For chest wounds where air bubbles are escaping, do not seal them with plastic wrap – doing so can cause the lung to collapse. - Benefit: The 2025 International First Aid Guidelines from the International Federation of Red Cross and Red Crescent Societies state: “First aiders should apply pressure around any foreign object (such as a knife) that has penetrated the body and keep it stable; do not remove it.” “Never pull any object out of abdominal or chest wounds – doing so can cause severe bleeding and makes it harder to assess the injury.” “Foreign objects embedded in the body should be kept stable; if they move with the pulse, simply hold them gently in place.” “First aiders must not push protruding organs back into the body.” For open chest wounds with active bleeding, “it is acceptable to leave them uncovered, as sealing them may trap air in the chest cavity and cause partial or total lung collapse (pneumothorax).” All penetrating abdominal or chest injuries require immediate emergency care. - Evidence grade: B - Sources:International Federation of Red Cross and Red Crescent Societies (2025). International First Aid, Resuscitation and Education Guidelines 2025，第 256–257、267–268 页. - Notes: This grade is assigned because these actions are widely accepted in official guidelines; however, no randomized trials exist, and it would be unethical to randomly assign patients to “remove” versus “not remove” such objects. The sole exception is when a foreign object blocks the airway and prevents breathing. In such cases, go directly to the emergency triage desk at the hospital and state “penetrating injury.” This falls under the highest priority category – do not wait in line at the registration desk (see Section 24, Item 8). If a penetrating injury occurs, call 120; the ambulance will alert the hospital in advance. For techniques on controlling severe bleeding and applying tourniquets, see Section 12. ### 41. If a fracture is suspected, don’t move the injured area — keep it supported and apply cold for up to 20 minutes; never try to realign it yourself - Cost: No cost involved. Use a stiff board, rolled‑up magazines, or clothing as a splint. Wrap cold items in a cloth before applying them. - In plain terms: Any injury to a limb should be treated as a possible fracture at first — being able to stand or move does not rule it out; only an X‑ray can confirm it. Keep the injured part still, supporting it with your hand or using a triangular bandage or rigid splint to hold it in its original position. Apply cold as soon as possible, but never for more than 20 minutes at a time. Do not attempt to realign the bone yourself. For open fractures where bone pierces the skin, first stop any bleeding and cover the wound with a clean dressing; do not push the bone back into place. - Benefit: The International Federation of Red Cross and Red Crescent Societies released its 2025 International First Aid Guidelines, which state that “any injury to a limb should be treated as a possible fracture” and “the only reliable way to confirm a fracture is an X‑ray; when in doubt, treat it as a fracture.” The purpose of immobilisation is “to minimise movement and pain.” Cold application “should be limited to 20 minutes at a time to reduce pain; longer exposure can damage the skin.” “For long bones such as the femur, bleeding from the bone itself can be life‑threatening.” Call emergency services if there is significant pain or swelling, signs of shock, a suspected femoral fracture, or obvious deformity of the limb. Only under two specific conditions may a fractured bone be manually realigned on site: first, when help is far away (or resources are limited) and the part of the limb below the angle appears cold and pale, or when the rescuer cannot safely immobilise it for transport; second, only if the rescuer is properly trained. For open fractures, the priority is stopping bleeding and preventing infection. - Evidence grade: B - Sources:International Federation of Red Cross and Red Crescent Societies (2025). International First Aid, Resuscitation and Education Guidelines 2025，第 301–302 页. - Notes: This grade B rating reflects that these practices are widely accepted. There is only one older study supporting the use of traction immobilisation for femoral fractures before hospital care; its reliability is low, yet it shows modest benefits such as reduced blood loss within 24 hours, shorter hospital stays, and no meaningful difference in mortality or complications. No evidence exists regarding whether early realignment yields any advantage over simple immobilisation. Three common misconceptions should be corrected: being able to walk does not rule out a fracture; cold alone — not alternating hot and cold — is appropriate; and sprains do not “work themselves out” with movement; rest is essential. For elderly patients with suspected fractures after a fall, refer to item 2 for handling precautions. Swelling of one leg after casting or bed rest may indicate a clot; see item 11 for details. Information on disability assessment and eligibility for a disability certificate after treatment can be found in section 24, items 10 and 11. ### 42. After sexual assault, go to a safe place and call 110; do not shower, wash clothes, or tidy the room before a medical exam, and visit a hospital within 72 hours - Cost: Calling the police costs nothing. Emergency contraceptives are over-the-counter medicines available at any pharmacy. Post-exposure prophylaxis treatment costs over a thousand yuan per course; whether it is needed must be decided by a doctor — see item 38 in this section regarding obtaining PEP within 72 hours. The real challenge is that it is extremely hard to speak up at the moment, and many victims simply want to take a shower right away. - In plain terms: Physical traces on the body, on clothing, and in the room are the most crucial evidence for identifying the perpetrator. Therefore, avoid showering, washing clothes, or cleaning the area before a medical exam, and call 110 as soon as possible. Emergency contraceptives are readily available at pharmacies and work best when taken early. Within 72 hours, visit a hospital so a doctor can determine if PEP is necessary. - Benefit: Prosecutors from the Beijing People’s Procuratorate state: “Whether minors or adults, anyone who experiences sexual assault should call 110 immediately.” Prompt reporting and medical care “allow investigators to examine the scene, collect physical evidence, and preserve proof in a timely manner.” A sexual assault prevention guide published by the Guizhou Provincial Civil Affairs Bureau and reprinted by People’s Daily advises: “If sexual assault occurs, preserving evidence is the top priority.” It recommends keeping “body fluids, hair, skin cells, and communication records” and warns that “after an assault, one must not shower, wash clothes, tidy the room, or throw anything away.” In cases involving acquaintances, preserving call logs and messages is essential; any threats or attempts at bribery by the perpetrator must also be documented. The Xicheng District Procuratorate in Beijing adds: “Try not to shower before undergoing a physical examination.” WHO notes that emergency contraception may be used “when a woman has been sexually assaulted without effective contraceptive protection,” recommending its use within five days for maximum effectiveness. Emergency contraceptive pills containing levonorgestrel have a pregnancy rate of 1.2% to 2.1% among users; in China, such pills are sold over the counter. According to the Wuhan Health Commission, “the sooner these pills are taken after unprotected intercourse — ideally within 72 hours — the better they prevent pregnancy.” PEP for HIV should be taken within two hours if possible, and no later than 72 hours. - Evidence grade: B - Sources:北京市人民检察院 (2024). 法眼看剧丨看《九部的检察官》 未成年人面对不法侵害该如何保护自己？（转载中央广播电视总台中国之声）. ；贵州省民政厅 (2024). 未成年人防性侵手册，请家长孩子查收！（转载人民日报）. ；北京市西城区人民检察院 (2018). 她们为什么不再沉默……. ；世界卫生组织 (2021). 紧急避孕（实况报道）. ；武汉市卫生健康委员会 (2020). 安全合理使用紧急避孕药. ；北京市人民政府. 事前、事后分不清？六问六答全面了解艾滋病病毒暴露前/暴露后预防. - Notes: This grade is assigned because these recommendations stem from official law‑enforcement experience and medical guidance; there are no statistics showing exactly how much they raise conviction rates. The main beneficiaries are the victim herself and her family. The 72‑hour window for emergency contraception reflects China’s product labeling; WHO states that it remains effective up to five days, though earlier use is preferable. These pills have no effect if pregnancy has already occurred. When reporting to police, provide a truthful account without exaggeration or concealment. Any attempts by the perpetrator to settle privately, pay compensation, or threaten you must be documented and never deleted. You may decide to wait before calling police, but be aware that evidence deteriorates over time. Regardless of whether you call police, seek medical care within the stipulated timeframe. Recordings related to this topic are discussed in item 41 of section 8. If the perpetrator later uses photos or police reports to blackmail you, this also constitutes a crime — see item 32 of section 8. If a friend experiences sexual assault, accompany her to report it and to the hospital; do not suggest she shower or rest first. ### 43. When a baby under 1 year is choking and cannot cry out, alternate 5 back blows (face-down) and 5 chest thrusts — never press the belly - Cost: No cost. Watch a demonstration once or take a short infant first-aid class — a few minutes to half a day. The hard part is staying calm enough to turn the baby face-down on your forearm. - In plain terms: If the child can still cough or cry audibly, let them cough while you watch closely. If they cannot cry, their face turns blue, call 120, lay the baby face-down on your forearm, and give 5 back blows with the heel of your hand between the shoulder blades. If that fails, roll them over and give 5 quick thrusts on the center of the chest. Keep alternating — never push on the belly. If the baby becomes unresponsive, switch to CPR. - Benefit: The American Heart Association and American Academy of Pediatrics issued 2025 pediatric basic life support guidance. It states that choking (for example, an object blocking the airway) “is a leading cause of death in infants and children.” Liquids are what infants most often aspirate. Mild obstruction: still coughing or making sounds — let the child cough while you monitor for worsening. Severe obstruction: weak cough or none, cannot cry, cyanosis — call emergency services first, then “repeat cycles of 5 back blows and 5 chest thrusts until the object is expelled or the infant becomes unresponsive.” Abdominal thrusts are not recommended for infants because they can injure internal organs. Chest thrusts are now taught with the heel of one hand because it achieves greater depth than the old two-finger method. When the infant is unresponsive, start CPR with compressions first; do not check a pulse. Remove only visible objects before giving breaths. The guideline explicitly says “do not perform blind finger sweeps.” The International Federation of Red Cross and Red Crescent Societies 2025 international first-aid guidance uses the same sequence: up to 5 firm back blows between the shoulder blades, then turn the infant and give up to 5 chest thrusts, then call emergency services if needed. Its chest-thrust technique uses a two-thumb encircling grip. The Fujian Provincial Red Cross emergency-care training center describes “5 back blows + 5 chest thrusts” for infants under 1 year: hold the infant prone on the forearm with the head lower than the trunk for back blows. - Evidence grade: B - Sources:Joyner BL 等 (2025). Part 6: Pediatric Basic Life Support: 2025 American Heart Association and American Academy of Pediatrics Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 152(suppl 2):S424–S447. ，全文见 ；International Federation of Red Cross and Red Crescent Societies (2025). International First Aid, Resuscitation and Education Guidelines 2025，第 238–240 页. ；福州市卫生健康委员会 (2026). 海姆立克急救法更新了. - Notes: Rated B because support comes mainly from case reports, with no “how many fewer deaths if you follow this” figure. Benefit is rated large by judgment: a fully blocked airway can stop an infant’s heart within minutes. The main beneficiaries are your own children. For children 1 year and older and adults, use abdominal thrusts; see item 26 in this section (choking: back blows plus abdominal thrusts). Chest-thrust hand position differs across sources: the U.S. guideline and newer Chinese Red Cross training use one-hand heel; IFRC uses two thumbs; older courses used two fingers. The 2025 U.S. guideline dropped two-finger compressions because depth was inadequate. Any of these beats doing nothing. Even after the object is expelled, seek medical care — fragments may remain in the lungs. Keep coins and small toys out of reach. If the baby is unresponsive, see item 44 in this section (infant CPR). ### 44. If a baby under 1 is unresponsive and not breathing normally, call 120 on speakerphone and perform infant CPR: 30 compressions, then 2 breaths - Cost: No cost. Infant CPR takes one hands-on class, half a day to a full day. The hard parts are sealing your mouth over the infant’s mouth and nose for breaths and pressing firmly enough. - In plain terms: No response to foot stimulation and no normal breathing — call 120 on speakerphone and do not stop. Encircle the chest with both hands and compress with two thumbs; if you cannot encircle, use the heel of one hand, about 4 cm (1.5 inches) deep, about 2 compressions per second. After every 30 compressions, give 2 breaths covering mouth and nose. Most infant cardiac arrests start with breathing failure; CPR that includes breaths improves survival. - Benefit: The American Heart Association and American Academy of Pediatrics 2025 pediatric basic life support guideline states that respiratory problems remain the main cause of cardiac arrest in infants and children. Among infants with out-of-hospital cardiac arrest, only 6.6% survive to hospital discharge. For an unresponsive infant or child with abnormal breathing and no signs of life, “CPR should be started immediately” without checking a pulse. Compression depth is at least one-third of the anteroposterior chest diameter; for infants, “about 1.5 inches (4 cm).” Rate 100 to 120 per minute. One rescuer: 30 compressions then 2 breaths. Two rescuers: 15 compressions then 2 breaths. Use one-hand heel or two-thumb encircling compressions; if encircling is not possible, use heel of one hand. Two-finger compression has been removed because depth was inadequate. The guideline also states that for out-of-hospital pediatric cardiac arrest, adding ventilations to compressions improves survival. A U.S. registry of 3,900 children under 18 with out-of-hospital cardiac arrest found 59.4% were infants. Bystander CPR was associated with an adjusted hospital discharge survival of 13.2% versus 9.5% without CPR; adjusted OR 1.57 (about 57% higher odds of survival), 95% CI 1.25–1.96. Among infants, CPR with breaths was linked to higher survival and better neurological recovery; compression-only outcomes were similar to no CPR. IFRC 2025 guidance: check responsiveness by picking up the infant or flicking the foot. If alone, call emergency services on speakerphone. If no phone allows simultaneous calling, perform 1 minute of CPR before calling. A popular-science article from the Capital Institute of Pediatrics, republished by the Beijing Municipal Health Commission, states: “If only 1 person is present, perform 2 minutes of CPR before calling 120.” Compression depth “4 cm for infants.” Mouth-to-mouth-nose for breaths under 1 year. - Evidence grade: B - Sources:Joyner BL 等 (2025). Part 6: Pediatric Basic Life Support: 2025 American Heart Association and American Academy of Pediatrics Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 152(suppl 2):S424–S447. ，全文见 ；Naim MY 等 (2017). Association of Bystander Cardiopulmonary Resuscitation With Overall and Neurologically Favorable Survival After Pediatric Out-of-Hospital Cardiac Arrest in the United States: A Report From the Cardiac Arrest Registry to Enhance Survival Surveillance Registry. JAMA Pediatrics 171(2):133–141. ；International Federation of Red Cross and Red Crescent Societies (2025). International First Aid, Resuscitation and Education Guidelines 2025，第 186–188 页. ；首都儿科研究所 (2022). 【儿研所儿医说】心肺复苏：爸妈必备的急救知识（北京市卫生健康委员会转载）. ；European Resuscitation Council (2025). ERC Guidelines 2025 for the lay public（Paediatric Basic Life Support 一章）. - Notes: Rated B because survival figures come from registry studies with recording bias, pooled across all children; infant-only discharge numbers were not given in the summary. Benefit is rated large from the pooled figures: discharge survival 9.5% to 13.2%, a relative increase of about 40%. Main beneficiaries are your own children. Three differences from item 1 in this section (hard chest compressions for adults): infants need breaths — compression-only works poorly; use two thumbs or one heel at about 4 cm, not stacked adult hands; if you cannot call while compressing, start CPR before calling. How long to compress before calling varies: Capital Institute of Pediatrics and the U.S. single-rescuer flow say 2 minutes; IFRC says 1 minute. Speakerphone removes the trade-off. The European Resuscitation Council teaches 5 breaths first then compressions; the U.S. guideline compressions first — both beat doing nothing. Older Chinese courses taught two-finger compression; the 2025 U.S. guideline removed it. For choking, look in the mouth before breaths and remove only visible objects; see item 43 (infant choking).