Grid-Down Guide

The essentials

First Aid & Health

The skills and supplies that matter most when help is slow to arrive — bleeding, CPR, burns, breaks, and a well-stocked kit.

Photo: Renée Kools, CC BY 4.0

This is not medical training

Read this page now, not during an emergency. Then take a real class — the American Red Cross, the American Heart Association, or a free Stop the Bleed course. Always call 911 first if you can. Even in a disaster, dispatchers can coach you.

The order of priorities

  1. Is the scene safe? Don't become a second victim (downed lines, fire, traffic, CO).
  2. Call 911, or have someone else call, and get the first aid kit and AED.
  3. Life-threatening bleeding: stop it.
  4. Not breathing normally / no response: start CPR.
  5. Everything else: burns, breaks, sprains, shock.

Stop serious bleeding

Severe bleeding can kill in minutes, faster than an ambulance can arrive.

  1. Find the source. Open or cut away clothing.
  2. Press hard directly on the wound with gauze, a clean cloth or your hands. Keep pressing. Don't peek.
  3. Pack deep wounds (thigh, groin, armpit, neck) by stuffing gauze or cloth into the wound, then pressing hard for at least 3 minutes.
  4. Tourniquet for arm or leg bleeding that pressure won't control: place it 2–3 inches above the wound (not on a joint), tighten until bleeding stops, and note the time. It will hurt — that's normal. Don't loosen it; leave that to medical staff.

A commercial tourniquet (CAT or SOF-T style) belongs in every home, car and go-bag. Improvised ones rarely work well.

CPR

If an adult collapses and is not responding and not breathing normally (or only gasping):

  1. Call 911 and send someone for an AED.
  2. Push hard and fast in the center of the chest: at least 2 inches deep, 100–120 pushes a minute — the beat of "Stayin' Alive."
  3. Don't stop until help arrives, an AED is ready, or the person starts breathing.
  4. Use an AED as soon as you have one. Turn it on and follow its voice prompts.

Hands-only CPR is recommended for adults and teens. For children and babies, training that includes rescue breaths is best.

Common injuries

Problem What to do
Burns Cool with cool (not ice-cold) running water for 10–20 minutes. Remove rings and tight items. Cover loosely with clean plastic wrap or a non-stick dressing. No butter, ice or ointments on serious burns. Get care for burns larger than your palm, or on face, hands, feet, groin or joints.
Cuts Clean with lots of clean water, apply pressure until bleeding stops, cover. Watch for infection: spreading redness, warmth, swelling, pus, fever.
Sprains Rest, ice (wrapped, 20 minutes on/off), compression wrap, raise above the heart.
Possible broken bone Don't straighten it. Splint it in the position found (padded board, rolled magazine, pillow) to the joints above and below. Check fingers/toes for warmth and feeling.
Shock (pale, clammy, fast breathing, confused) Lay them flat, keep warm, raise legs if no spine/leg injury, treat the cause, get help.
Choking Ask "are you choking?" If they can't speak or cough: 5 back blows, then 5 abdominal thrusts (Heimlich), repeat.
Hypothermia / heat stroke See Staying warm — and cool.
Carbon monoxide Get everyone into fresh air, call 911.

Build a real first aid kit

Store-bought kits are mostly small bandages. Add the things that handle serious problems:

Staying healthy in a long outage

  • Wash hands with soap before eating and after the toilet. Diarrhea spreads fast when water and sanitation are down.
  • Rehydrate: if someone has diarrhea or vomiting, give small sips often. Make oral rehydration solution with 1 liter clean water, 6 level teaspoons sugar, and ½ level teaspoon salt.
  • Medications: keep a 2-week supply where possible. See Medications, kids, elders & pets.
  • Mental health: stress, darkness and isolation are hard. Keep routines, get daylight, talk, and check on each other.

Free offline references: FM 4-25.11 First Aid and ATP 3-50.21 Survival (chapter 2: survival medicine). For remote areas, Hesperian's Where There Is No Doctor is a classic.

Sources: American Heart Association — Hands-Only CPR · Stop the Bleed · American Red Cross · WHO — Oral rehydration salts

Watch & learn

Videos stream from YouTube, so they need an internet connection. Everything else on this page works offline.