First aid for self-injury and self-harm

Call NHS Choices on 111 and consider the ideas below

Cutting

When you need to SI please find a safe place where you will not be disturbed and that you feel calm in, always use new blades where you can and have your first aid kit ready to hand. LifeSIGNS does not encourage the use of self injury, we simply accept that self injury is a coping method for some people at this time, and we do encourage people who are determined to self injure to do it in as safe and controlled way as possible to minimise harm.

The main points when considering first aid after cutting is that you must control the bleeding and prevent any possible infection.

If you lose a great deal of blood, you can go into shock. This can get pretty serious as the brain and heart can be deprived of much needed blood.

Once the urge to cut yourself has passed and you can concentrate on treating your injuries you need to be sure to:

• Assess the damage. If blood is pumping out from the injured area, in time to your heartbeat then this means you have cut through an artery as blood is under high pressure when pumped from the heart- therefore immediate direct-pressure is needed, and you must not remove pressure at all for at least 3-5 minutes – consider calling an ambulance;
• When the area of the wound is particularly large then try and press the edges together to prevent further damage;
• The bleeding needs to be controlled to make sure blood loss is minimal. Cover the wound with a clean dressing and apply direct pressure to prevent bleeding;
• When blood trickles or oozes out of a wound then it is a less immediately serious injury, but veins, tendons and nerves may still have suffered damage;
• If the area of injury is on a limb then raise the limb to reduce blood flow to the area, reducing blood loss and allowing time for a blood clot to form.

When direct pressure is not appropriate, such as when something is stuck in the would, then you may use indirect pressure by pressing the would together – do not remove the object, but call for an ambulance. Some people suggest using a tourniquet to give indirect pressure and reduce blood loss, but using a tourniquet requires a lot of skill and so you should call for medical assistance.

• First Aid from NHS Choices (111)
• First-aid manuals from the Dept of Transport
• Need to talk now? See the available Helplines

Burning

If your method of SI is burning by scalding or using a heated object then the most important thing you can do is lower the temperature of the affected area. The tissue damage that has been caused can progress very rapidly so you must rinse the area under cold running water for at least 10 minutes.

Do not apply any creams, balms, oils, moisturisers or anything except cold running water.

If there is any clothing surrounding the burn please remove this by either taking it off or cutting it away; this also applies to removing constricting objects such as rings, watches, bracelets; just take it off. This is done because once tissue has been burned or damaged swelling of the area will follow; also the tissue can become sticky and attach to clothes or other things. IMPORTANT If there is anything that is already stuck to the burn, DO NOT remove it, this could make the situation worse.

The skin can also be burned when it is exposed to certain chemicals. If the chemical you have used is liquid, wash this off with lukewarm water for at least 30 minutes. If the chemical is dry, then brush the chemical off before rinsing the area in water. Please do not try and neutralise the chemical; if you have used an acid DO NOT try and reverse it by adding an alkali.

All chemical burns should be referred to a Doctor, either by attending your local Walk-in-Centre or the nearest A&E Department.

• First Aid from NHS Choices (111)
• Need to talk now? See the available Helplines

Overdosing / Ingesting toxic substances

If you have taken an overdose or have ingested toxic substances, then medical attention must be sought immediately.  Sometimes the effects can be delayed, so even if you feel fine at the moment you might not be.   Never induce vomiting.  When you go to A&E take along with you the packaging from the medication or substance which you have taken.  Not seeking help can result in long-term irreversible damage or death, even if this was not what you intended to occur, so it is very important.

• First Aid from NHS Choices
• Need to talk now? See the available Helplines

When To Seek Medical Attention

It is very important that you tell someone if you have hurt yourself severely or if you have taken an overdose / swallowed chemical substances.  It is normal to be scared, but it is essential to get proper medical attention as quickly as possible.  The following bullet points give some situations where medical attention should be sought, however it is not exhaustive.

If you are ever in doubt,  phone NHS Direct on 0845 4647 or contact your GP, and they will give advice. NHS Direct will provide you with a trained nurse to talk to almost immediately.

• If the wound continues to bleed heavily once you have carried out the above steps, including bandaging;
• If the cut is deep and has exposed underlying muscle, this is dark red in colour and may look like a slab of meat;
• If you have lost sensation in the area of injury, or more widespread; you may have damaged a nerve;
• If a burn is on a sensitive area of the body (e.g. face), over a joint or on the palm – the healing process creates scar tissue that can shrink the skin, causing potential movement difficulties for life;
• If a burn is severe, or large in area;
• If a burn is caused by chemicals;
• If after a few hours or several days you can see the wound is infected; it could be red, sore, swollen or weeping.

Talk to NHS Choices now on (111)

• First Aid from NHS Choices (111)
• First-aid manuals from the Dept of Transport
• Need to talk now? See the available Helplines