If you’re working toward the Eagle-required First Aid merit badge, you’re in the right place! In this guide, I’ll be walking you through requirements 5 through 9, covering everything from breathing emergencies and loss of consciousness to heart attacks, bone injuries, and head trauma.
You’ve reached Part 2 of my ultimate guide to the First Aid merit badge! If you haven’t already, check out Part 1 for the answers to requirements 1-4.
If you’ve just come over from Part 1, congratulations! You already know how to assess a scene, call for help, and treat bleeding wounds. Now we’re getting into the heavy-hitting first aid skills that could genuinely save someone’s life. 🙂
These requirements cover situations where every second counts. Whether it’s a choking incident at a troop dinner, a fellow Scout having a seizure at summer camp, or a heart emergency on a family outing, you’ll know exactly what to do.
Scout Tip: Before diving in, grab a notebook. Jotting down the key first aid steps for each condition is one of the best ways to lock them into your memory and prepare for your counselor meeting. Many Scouts who earn this badge say the note-taking habit made all the difference!
Take a minute to closely review requirements 5-9 below. Then, you’ll be ready to learn the answers to each one and continue your journey toward earning this ultra-useful Eagle-required badge!
What Are The First Aid Merit Badge Requirements 5-9?
- Breathing Emergencies. Describe the symptoms and signs of, show first aid for, and explain prevention of these conditions affecting breathing: (a) Choking (b) Asthmatic attack (c) Anaphylaxis from an insect bite or sting or from food or product allergy (d) Inhalation injuries (e) Altitude sickness.
- Loss of Consciousness. Describe the symptoms and signs of, show first aid for, and explain prevention of these conditions causing loss of consciousness: (a) Fainting (b) Hypoglycemia (c) Seizure (d) Drug overdose and alcohol poisoning (e) Underwater hypoxic blackout (f) Cold water shock and drowning (g) Lightning strike and electric shock.
- Heart Attack. Do the following: (a) Explain what a heart attack is. (b) Describe the symptoms and signs of a heart attack and first aid for this condition. (c) Describe the conditions that must exist before performing CPR on a person. (d) Demonstrate proper CPR technique using a training device approved by your counselor. (e) Explain the use of an automated external defibrillator (AED). (f) Demonstrate or simulate the proper use of an AED, using an AED training device if available. (g) Identify the typical location(s) of one or more AED(s) at public facilities in your community.
- Muscle and Bone Injuries. Do the following: (a) Explain the similarities and differences in a strain, a muscle tear, a tendon rupture, a sprain, a dislocation, a simple fracture, and a compound fracture. (b) Describe the symptoms and signs of and first aid for a muscle strain, a muscle tear, and a tendon rupture. (c) Describe the symptoms and signs of, and potential complications of, a sprain, a fracture, and a dislocation. (d) Demonstrate bandages for these injuries. (e) Demonstrate the proper procedures for handling and splinting of suspected closed or open fractures or dislocations.
- Head and Spine Injuries. Do the following: (a) Describe the symptoms and signs of, relationships between, possible complications of, and prevention of head, neck, and back injuries. (b) Describe the symptoms and signs of and first aid for a concussion. (c) Demonstrate first aid for an open head wound with a triangular or other bandage. (d) Demonstrate first aid for someone with a suspected neck or back injury.
Breathing Emergencies (Requirement 5)
5a) Describe the symptoms and signs of, show first aid for, and explain prevention of choking.
Choking happens when food, a small object, or liquid blocks the airway and cuts off airflow to the lungs. It’s one of the most common emergencies you might encounter, whether at a Scout camping trip, a family dinner, or in a school cafeteria. A choking victim typically can’t speak, cough effectively, or breathe, and they may grab their throat with both hands. This gesture is known as the universal choking sign.
The American Red Cross and the American Heart Association now recommend alternating between 5 back blows and 5 abdominal thrusts for a conscious choking adult or child. Here’s how to perform each technique:
| Technique | How to Perform |
|---|---|
| Back Blows | Stand behind and slightly to the side of the victim. Support their chest with one hand and lean them forward. Deliver 5 firm strikes between their shoulder blades using the heel of your other hand. |
| Abdominal Thrusts | Stand behind the victim and wrap your arms around their waist. Make a fist and place the thumb side just above the navel, below the breastbone. Grasp your fist with the other hand and thrust sharply inward and upward. |
Alternate between these two techniques until the object comes out, the person can breathe or cough forcefully, or they become unconscious. If they do become unconscious, lower them to the ground, call 911, and begin CPR with chest compressions.
Pro Tip: If you’re ever choking and alone, you can perform abdominal thrusts on yourself by pressing your fist into your upper abdomen and thrusting upward. You can also lean over the back of a sturdy chair and press your abdomen against it. Knowing this could save your own life someday.
Watch this video from the British Red Cross for a clear walkthrough of choking first aid:
Prevention: Cut food into small pieces, chew thoroughly, and avoid talking or laughing with a full mouth. During Scout campouts, remind younger Scouts to sit down while eating and take their time. The Mayo Clinic’s choking guide is a great reference to bookmark for your merit badge binder.
5b) Describe the symptoms and signs of, show first aid for, and explain prevention of an asthmatic attack.
An asthma attack occurs when the airways become inflamed and narrowed, making it extremely difficult to breathe. According to the CDC, about 1 in 13 Americans has asthma, so there’s a good chance someone in your troop or patrol is affected. Symptoms include wheezing (a whistling sound when breathing), chest tightness, shortness of breath, and persistent coughing. The person may appear anxious or panicked.
Scout Scenario: Imagine you’re on a dusty trail hike and a fellow Scout suddenly stops, hunches over, and starts wheezing. That’s likely an asthma attack, and your calm, quick response can make all the difference. Knowing where they keep their inhaler before the hike starts is half the battle.
First aid for an asthma attack is straightforward but time-sensitive. Help the person sit upright (sitting allows the lungs to expand more fully than lying down). Assist them in using their rescue inhaler, which is usually a blue inhaler containing albuterol. The typical dose is 1-2 puffs with 30-60 seconds between each. Keep them calm and encourage slow, steady breathing, since panic increases the body’s demand for oxygen and makes the attack worse.
Call 911 if the inhaler doesn’t help within 15 minutes, if they can’t speak in full sentences, if their lips or fingernails turn blue (a sign of oxygen deprivation), or if their breathing continues to get worse. Never assume someone is faking an asthma attack. Severe attacks can be fatal, so always take breathing complaints seriously.
Prevention: Scouts with asthma should carry their rescue inhaler at all times, especially on outdoor activities. Common triggers include dust, pollen, smoke, cold air, and intense physical activity. Mayo Clinic’s asthma attack guide has excellent details on recognizing and managing triggers.
5c) Describe the symptoms and signs of, show first aid for, and explain prevention of anaphylaxis from an insect bite or sting or from food or product allergy.
Anaphylaxis is a severe, life-threatening allergic reaction that can develop within seconds or minutes of exposure to an allergen. Common triggers include bee stings, certain foods (peanuts, tree nuts, shellfish, milk), medications, and latex. This is one of the most time-sensitive emergencies you’ll learn about in First Aid, because the throat can swell shut and block breathing entirely if treatment is delayed.
Symptoms of anaphylaxis include swelling of the face, lips, tongue, or throat, difficulty breathing, hives or flushed skin, rapid or weak pulse, nausea, dizziness, and in severe cases, loss of consciousness. According to the Cleveland Clinic, reactions can progress from mild itching to full airway closure in just minutes, which is why speed matters so much.
| Step | Action | Why It Matters |
|---|---|---|
| 1 | Call 911 immediately | Anaphylaxis can worsen rapidly even after initial improvement |
| 2 | Use an EpiPen if available | Epinephrine reverses the reaction, but its effect is temporary (15-20 min) |
| 3 | Have them lie down with legs elevated | Helps maintain blood pressure; let them sit up if they can’t breathe lying down |
| 4 | Be ready to give a second dose | If symptoms don’t improve within 5-15 minutes, a second injection may be needed |
Remember the phrase: “Blue to the sky, orange to the thigh.” That’s the easiest way to remember how to use an EpiPen. Remove the blue safety cap, then press the orange tip firmly into the outer thigh and hold for 10 seconds. It works through clothing, so don’t waste time rolling up a pant leg.
Watch this video (4:36) to see exactly how an EpiPen is used:
After a bee sting, remove the stinger immediately to prevent more venom from being released. Scrape a fingernail or credit card edge across the stinger to pull it out. Avoid using tweezers, which can squeeze more venom into the skin. The Cleveland Clinic’s bee sting guide has more tips on prevention and treatment.
Prevention: If you know you have a severe allergy, always carry two EpiPens (one as a backup). At Scout events, make sure your patrol leader and adult leaders know about your allergy. Avoid wearing brightly colored clothing or strong fragrances when outdoors, and steer clear of open food containers that attract bees.
5d) Describe the symptoms and signs of, show first aid for, and explain prevention of inhalation injuries from smoke, chemicals, and superheated air.
Inhalation injuries occur when a person breathes in harmful substances like smoke, toxic chemical fumes, or superheated air. These injuries are especially dangerous because they can cause swelling and damage deep inside the airway, sometimes getting worse hours after the initial exposure. House fires, chemical spills, and industrial accidents are common causes.
Watch for coughing, hoarseness, or difficulty speaking. Singed nose hairs or eyebrows, soot or burns around the mouth and nose, and wheezing are strong indicators. With chemical fumes or carbon monoxide, the victim may also experience confusion, dizziness, or a severe headache. Carbon monoxide is especially tricky because it’s odorless and colorless.
Safety First: Your own safety always comes before a rescue. If the area isn’t safe (smoke-filled room, chemical spill zone), do NOT go in. Call 911 and let trained professionals handle it. You can’t help anyone if you become a victim too. This is a core principle of the scene assessment you learned in Part 1.
If you can safely reach the victim, move them to fresh air immediately. Call 911 even if they initially seem OK, because inhalation injuries can worsen rapidly. Monitor their breathing closely and be ready to start rescue breathing or CPR. Keep them calm and sitting upright, which usually helps with breathing.
Prevention: At Scout camps, follow all fire safety rules and never burn plastics, treated wood, or chemicals. Make sure your campsite has good ventilation and never use fuel-burning stoves inside a tent. If you’re working with chemicals for a merit badge project, always do so in a well-ventilated area and wear appropriate protection.
5e) Describe the symptoms and signs of, show first aid for, and explain prevention of altitude sickness.
Altitude sickness (also called acute mountain sickness or AMS) occurs when your body can’t get enough oxygen at high elevations, typically above 8,000 feet. This is a big one for Scouts heading to Philmont Scout Ranch in New Mexico, the Summit Bechtel Reserve in West Virginia, or any high-altitude camping trip. If you’re coming from a low-elevation area like the coast, your body needs time to adjust to the thinner air.
Symptoms include headache (the most common early warning sign), nausea, vomiting, dizziness, fatigue, shortness of breath during activity, and difficulty sleeping. Most people experience mild symptoms that pass within a day or two as their body acclimatizes. But in severe cases, altitude sickness can progress to life-threatening conditions.
| Condition | Key Symptoms | Severity |
|---|---|---|
| Mild AMS | Headache, nausea, fatigue, poor sleep | Common, usually resolves with rest |
| HACE (High Altitude Cerebral Edema) | Confusion, loss of coordination, inability to walk straight | Life-threatening emergency |
| HAPE (High Altitude Pulmonary Edema) | Severe breathlessness at rest, persistent cough, pink/frothy fluid | Life-threatening emergency |
First aid: For mild symptoms, stop ascending and rest at your current altitude. Stay hydrated, eat light meals, and avoid alcohol. If symptoms worsen, descend immediately. Even dropping 1,000-2,000 feet can make a significant difference. Call for emergency help if the person shows any signs of HACE or HAPE.
Philmont Tip: The CDC recommends ascending no more than 1,000-1,500 feet of elevation gain per day once you’re above 8,000 feet. Many Philmont crews schedule a rest day early in their trek for exactly this reason. Drink plenty of water, eat well, and listen to your body. Pushing through symptoms is how mild AMS turns dangerous.
Loss of Consciousness (Requirement 6)
Requirement 6 covers seven different conditions that can cause a person to lose consciousness. That might sound like a lot, but the core first aid principles are surprisingly consistent: keep the victim safe, protect their airway, call for help, and monitor their condition. Let’s walk through each one.
6a) Describe the symptoms and signs of, show first aid for, and explain prevention of fainting.
Fainting (syncope) is a sudden, temporary loss of consciousness caused by a drop in blood flow to the brain. It’s very common and usually not dangerous on its own, but the fall that comes with it can cause injuries. Common triggers include standing up too quickly, overheating, dehydration, skipping meals, emotional stress, or standing at attention for long periods (something Scouts at flag ceremonies know well!).
Warning signs include pale or clammy skin, sweating, lightheadedness, tunnel vision, and nausea. If you notice these signs in someone, help them sit or lie down right away before they fall. Once someone has actually fainted, lay them on their back and elevate their legs about 12 inches to help blood flow return to the brain. Loosen tight clothing like belts and collars.
Scout Scenario: Picture a hot summer day at your troop’s outdoor Court of Honor. A Scout who skipped breakfast is standing in the sun during the flag ceremony, and you notice them swaying and turning pale. Gently guide them to sit in the shade and give them water. That quick action could prevent a fall and a trip to the ER.
The person should regain consciousness within about a minute. When they wake up, don’t let them jump right back to their feet. Have them sit up slowly, rest for several minutes, and drink some water before standing. If they don’t wake up within one minute, call 911, because this may indicate something more serious than a simple faint.
Prevention: Stay hydrated, eat regular meals, and avoid standing locked at the knees for long periods. If you feel faint, sit down and put your head between your knees to increase blood flow to your brain.
6b) Describe the symptoms and signs of, show first aid for, and explain prevention of hypoglycemia (low blood sugar).
Hypoglycemia occurs when blood sugar drops dangerously low, starving the brain and body of fuel. It most commonly affects people with diabetes who take insulin, but it can also happen from skipping meals, intense exercise, or illness. On a Scout outing where everyone is burning extra calories, it’s more common than you might think.
Symptoms range from mild to severe: shakiness, trembling, confusion, irritability, sweating, pale skin, rapid heartbeat, and intense hunger. In severe cases, the person may develop slurred speech, have a seizure, or lose consciousness entirely. The progression from “feeling a little off” to a full emergency can happen quickly.
| If the person is… | Do this |
|---|---|
| Conscious and able to swallow | Give them 15 grams of fast-acting sugar: fruit juice, regular soda, glucose tablets, or a few pieces of candy. Wait 15 minutes and re-check. Follow up with a protein snack (like peanut butter crackers) once they feel better. |
| Unconscious or unable to swallow | Call 911 immediately. Do NOT try to give food or liquid to an unconscious person, as it could cause choking. Place them in the recovery position and monitor their breathing until help arrives. |
Scout Tip: If you know a fellow Scout has diabetes, ask them before a campout where they keep their emergency sugar supply. Clip a few glucose tablets to the outside of your first aid kit as a backup. Being prepared can make all the difference if their blood sugar drops during a hike.
Prevention: Eat regular meals and snacks, especially before and during physical activity. Scouts with diabetes should monitor their blood sugar levels closely and adjust their insulin as needed. Make sure your patrol keeps extra snacks accessible on the trail.
6c) Describe the symptoms and signs of, show first aid for, and explain prevention of a seizure.
A seizure occurs when there’s a sudden burst of abnormal electrical activity in the brain. It can cause uncontrolled muscle movements (convulsions), staring, confusion, or complete loss of consciousness. Seizures can be caused by epilepsy, head injuries, high fever, low blood sugar, or other medical conditions. According to the Epilepsy Foundation, about 1 in 26 people will develop epilepsy at some point in their life.
The Epilepsy Foundation teaches a simple three-word framework for seizure first aid: Stay, Safe, Side. These three words will guide you through any seizure situation you encounter.
- STAY with the person. Remain calm and time the seizure from the moment it starts. How long it lasts is critical information for doctors.
- Keep them SAFE. Clear the area of anything that could hurt them, like furniture, sharp objects, or hard surfaces. Place something soft under their head if possible, like a folded jacket.
- Turn them on their SIDE once the seizure ends to keep their airway clear and prevent choking.
Equally important is what NOT to do. Never hold the person down or try to stop their movements. Never put anything in their mouth (they cannot swallow their tongue, this is a common myth). Do not give them food or water until they are fully alert and oriented. After the seizure ends, talk to them calmly and reassuringly, because they will likely be confused and disoriented.
Watch this video from the Epilepsy Foundation to see seizure first aid in action:
Call 911 if: the seizure lasts longer than 5 minutes, the person doesn’t regain consciousness afterward, they have a second seizure shortly after the first, they’re injured, this is their first seizure, they have difficulty breathing, or the seizure happens in water. When in doubt, always call. Learn more from the CDC’s seizure first aid page.
6d) Describe the symptoms and signs of, show first aid for, and explain prevention of drug overdose and alcohol poisoning.
A drug overdose or alcohol poisoning occurs when someone consumes a toxic amount of a substance, enough to cause dangerous changes in breathing, heart rate, and consciousness. These are medical emergencies that require immediate professional help. This can be a tough topic, but as a Scout, you should be prepared to help in any situation without judgment.
Warning signs include confusion or unresponsiveness, inability to wake up, slow or shallow or irregular breathing, vomiting (especially while unconscious), blue-tinged lips or fingertips, seizures, and very slow heartbeat or cold, clammy skin. If you see even a couple of these signs together, assume the worst and act fast.
- Call 911 immediately. Don’t hesitate or wait to see if they “sleep it off.” This saves lives.
- Place them in the recovery position (on their side with their mouth pointing toward the ground) to prevent choking if they vomit.
- Monitor their breathing. If they stop breathing, begin CPR.
- If an opioid overdose is suspected and naloxone (Narcan) is available, administer it. Narcan is a nasal spray that can reverse the effects of opioids and is now available without a prescription in most states.
Important: Never try to make the person vomit, give them coffee, or put them in a cold shower. These “home remedies” don’t work and can make things worse. The only safe response is to call 911, keep their airway clear, and stay with them.
Prevention: Never mix alcohol with medications or other substances. Know the signs of overdose so you can act quickly. The SAMHSA National Helpline (1-800-662-4357) is a free, confidential resource available 24/7 for anyone who needs support.
6e) Describe the symptoms and signs of, show first aid for, and explain prevention of underwater hypoxic blackout.
Underwater hypoxic blackout (also called shallow water blackout) occurs when a swimmer loses consciousness underwater due to dangerously low oxygen levels. It’s the leading cause of drowning among strong, experienced swimmers, which makes it particularly deceptive. The victim doesn’t feel the urge to breathe, so there’s no warning before they black out.
The culprit is almost always hyperventilation before breath-holding. When you take rapid, deep breaths before diving, you blow off carbon dioxide (the gas your body uses as its “signal to breathe”). This tricks your brain into thinking you have more time underwater, but your oxygen is still dropping the whole time. The result: blackout before you ever feel the need to surface.
Scout Scenario: At a summer camp pool, a Scout challenges his buddy to an underwater breath-holding contest. Before his turn, he takes 10 fast, deep breaths to “load up on air.” Halfway across the pool, he loses consciousness and sinks to the bottom. This exact scenario has caused real drownings. Breath-holding contests should never be allowed at any Scout aquatic activity.
If someone blacks out underwater, get them out of the water immediately. Check for breathing and begin rescue breathing or CPR if needed. Call 911 even if they regain consciousness, because secondary drowning (fluid in the lungs causing problems hours later) is a real risk. For a deeper dive into water rescue skills, check out ScoutSmarts guide to the Lifesaving merit badge.
Prevention: Never hyperventilate before swimming underwater. Always swim with a buddy who can watch you. Never practice breath-holding alone, even in shallow water. If you’re working on the Swimming merit badge, keep these rules front and center.
6f) Describe the symptoms and signs of, show first aid for, and explain prevention of cold water shock and drowning.
Cold water shock is the body’s involuntary response to sudden immersion in cold water, generally below about 70 degrees Fahrenheit. Within the first 1-3 minutes, the body reacts with an uncontrollable gasp reflex, rapid breathing, and a spike in heart rate and blood pressure. If the person’s face is underwater during that gasp, they inhale water and can drown almost immediately.
Drowning itself is often silent. Unlike what you see in movies, victims rarely wave their arms or call for help. Instead, they may appear vertical in the water with their mouth bobbing at water level, eyes glassy or closed, and arms pressing down instinctively at their sides. This is called the Instinctive Drowning Response, and it can be very hard to spot unless you know what to look for.
If you see someone drowning, use the “Reach, Throw, Row, Go” method:
- Reach out with a pole, branch, towel, or anything you can extend to them from solid ground.
- Throw a flotation device, life jacket, or even a sealed cooler.
- Row a boat, canoe, or kayak out to them.
- Go into the water only as an absolute last resort, and only if you are a trained lifeguard or rescue swimmer.
Once the victim is out of the water, check for breathing and begin CPR immediately if needed (start with rescue breaths if you’re trained). Call 911. Remove wet clothing if possible and cover them with dry blankets to prevent hypothermia. All drowning victims should be evaluated by medical professionals, even if they seem fine afterward.
Prevention: Always wear a life jacket when boating, kayaking, or participating in any open-water activity. The BSA’s Safe Swim Defense and Safety Afloat rules exist for exactly this reason. Cold water is more dangerous than most people realize, so be extra cautious at early-season campouts near lakes and rivers.
6g) Describe the symptoms and signs of, show first aid for, and explain prevention of lightning strike and electric shock.
Lightning strikes and electrical shock can cause cardiac arrest, severe burns, and nerve damage. According to the National Weather Service, lightning kills about 20 people per year in the US and injures hundreds more. For Scouts who spend a lot of time outdoors, understanding lightning safety is critical.
Here’s a key fact that surprises many people: it IS safe to touch a lightning strike victim. They do not carry a residual electrical charge. You will not be shocked by touching them. So don’t hesitate to begin first aid. Call 911 immediately, check for breathing and pulse, and begin CPR if they are in cardiac arrest. Treat any burns and keep the victim warm and calm until help arrives.
Did You Know? The “30-30 Rule” is the gold standard for lightning safety: if the time between seeing lightning and hearing thunder is 30 seconds or less, go indoors. Stay inside for 30 minutes after the last clap of thunder. On a Scout camping trip, your tent is NOT a safe shelter. Seek a hard-topped vehicle or substantial building instead.
For electrical shock from outlets, appliances, or power lines, the rules are different. Do NOT touch the victim if they are still in contact with the electrical source, because the current could pass through you too. Turn off the power source first, or use a non-conducting object (dry wood, a rubber-handled tool, thick plastic) to separate them from the source. Once it’s safe, call 911, check for breathing, and begin CPR if needed. Look for both entry and exit burns, because electricity travels through the body.
Prevention: Check weather forecasts before any outdoor activity. Have a lightning action plan for your campsite. Avoid high ground, isolated trees, open fields, and bodies of water during storms. If caught in the open with no shelter, crouch low on the balls of your feet with your head tucked and ears covered. Never shelter under a single tall tree.
Heart Attack and CPR (Requirement 7)
7a) Explain what a heart attack is.
7b) Describe the symptoms and signs of a heart attack and first aid for this condition.
A heart attack occurs when blood flow to part of the heart muscle is blocked, usually by a blood clot in one of the coronary arteries. Without blood, the affected part of the heart begins to die. It’s important to understand the difference between a heart attack and cardiac arrest: during a heart attack the heart usually keeps beating (but is damaged), while cardiac arrest means the heart has completely stopped pumping.
Symptoms can vary widely from person to person. The classic signs include chest pain or pressure (often described as squeezing or a heavy weight), pain radiating to the left arm, jaw, neck, or back, shortness of breath, cold sweats, nausea, and unusual fatigue. But not everyone gets the “Hollywood” heart attack with dramatic chest-clutching.
Did You Know? According to the American Heart Association, women are more likely to experience “atypical” heart attack symptoms like jaw pain, nausea, back pain, or extreme fatigue without much chest pain at all. These less obvious signs are one reason heart attacks in women are sometimes missed or dismissed.
First aid for a suspected heart attack is straightforward but time-critical. Call 911 immediately, because every minute matters. Have the person chew one regular aspirin (325 mg) or four baby aspirin, unless they are allergic. Chewing (not swallowing whole) gets the aspirin into the bloodstream faster and can help thin the clot. Have them rest in a comfortable position, usually sitting or semi-reclined, and do not let them walk or exert themselves.
Monitor their condition closely. If they become unresponsive and stop breathing, their heart attack may have caused cardiac arrest. Begin CPR immediately (which you’ll learn in the next section!). Your calm, fast response gives them the best possible chance of survival.
7c) Describe the conditions that must exist before performing CPR on a person.
7d) Demonstrate proper CPR technique using a training device approved by your counselor.
CPR (cardiopulmonary resuscitation) is only performed when two conditions are met: the victim is unresponsive (tap their shoulder and shout “Are you okay?” with no response), AND they are not breathing normally. Look, listen, and feel for breathing. Occasional gasps are NOT normal breathing and should be treated as no breathing.
If both conditions are met, call 911 (or have someone else call) and begin CPR immediately. According to the American Heart Association, every minute without CPR reduces survival by about 10%. That’s why bystander CPR is so incredibly important.
| Step | Action | Key Details |
|---|---|---|
| 1 | Hand placement | Heel of one hand on the center of the chest (lower half of breastbone), other hand on top, fingers interlocked |
| 2 | Compressions | Push hard and fast: at least 2 inches deep, 100-120 compressions per minute. Let the chest fully recoil between pushes. |
| 3 | Rescue breaths (if trained) | After every 30 compressions, tilt head back, lift chin, pinch nose, and give 2 breaths. Watch for chest rise. |
| 4 | Hands-Only CPR (if untrained) | Continuous chest compressions without stopping. This is highly effective and much better than doing nothing. |
Rhythm Tip: Push to the beat of “Stayin’ Alive” by the Bee Gees. It’s almost exactly 100-120 beats per minute. Seriously, this is what they teach in CPR class! 😄 If that song isn’t your style, “Baby Shark” and “Another One Bites the Dust” also work.
Watch this video (1:56) for a clear visual walkthrough of adult CPR:
Because this is such an important topic, I actually asked a good friend of mine in the healthcare field to write a longer complete guide to CPR and AED use! Check it out for an in-depth explanation on how to save lives using these methods.
7e) Explain the use of an automated external defibrillator (AED).
7f) Demonstrate or simulate the proper use of an AED, using an AED training device if available.
7g) Identify the typical location(s) of one or more AED(s) at public facilities in your community.
An automated external defibrillator (AED) is a portable device that detects abnormal heart rhythms and delivers an electrical shock to restore normal heart function. AEDs are designed to be used by anyone, even someone with no medical training. The device gives clear step-by-step voice prompts that guide you through the entire process, so you really can’t mess it up.
Using an AED is a six-step process: First, turn on the AED and follow its voice prompts. Second, expose the victim’s bare chest and wipe it dry (remove any medication patches, and quickly shave excessive chest hair with the razor included in most AED kits). Third, attach the pads to the chest: one on the upper right below the collarbone and one on the lower left below the armpit.
Fourth, say “Stand clear!” and press the Analyze button while making sure nobody is touching the victim. Fifth, if the AED advises a shock, say “Stand clear!” again and press the Shock button. Sixth, immediately begin CPR after the shock (or if no shock is advised). The AED will continue to prompt you and will tell you when to stop for another analysis.
Watch this video (4:13) for a complete AED walkthrough:
Where to Find AEDs: You’ll typically find AEDs in schools, gyms, airports, shopping malls, community centers, places of worship, government buildings, and sports arenas. These locations are chosen because they have high foot traffic and physical activity, both of which increase the likelihood of a cardiac event. For this requirement, walk through your school, meeting place, and place of worship and actually locate the AED in each building. Being able to find one in 30 seconds matters when someone’s life is on the line.
Muscle and Bone Injuries (Requirement 8)
8a) Explain the similarities and differences in a strain, a muscle tear, a tendon rupture, a sprain, a dislocation, a simple fracture, and a compound fracture.
This requirement asks you to understand seven types of muscle and bone injuries. At first glance they can seem confusing because they share many symptoms (pain, swelling, and limited movement are common to all of them). The key to telling them apart is understanding what structure is injured and how severely.
| Injury | What’s Affected | Description |
|---|---|---|
| Strain | Muscle or tendon | Muscle/tendon stretched beyond its normal range. Mild to moderate pain. |
| Muscle Tear | Muscle fibers | Partial or complete tear of muscle fibers. More severe than a strain. Often a “pop” is felt. |
| Tendon Rupture | Tendon | Complete tear of the tendon connecting muscle to bone. Usually requires surgery. |
| Sprain | Ligament (bone to bone) | Ligament stretched or torn. Common at ankles, knees, and wrists. |
| Dislocation | Joint | Bone forced out of its normal position. Visible deformity at the joint. |
| Simple (Closed) Fracture | Bone | Bone is broken but does not pierce the skin. |
| Compound (Open) Fracture | Bone + skin | Bone breaks through the skin. High infection risk. Medical emergency. |
The big picture: Strains, tears, and tendon ruptures affect the soft tissue that moves your body (muscles and tendons). Sprains affect ligaments that hold joints together. Dislocations and fractures affect bones and joints directly. Compound fractures are the most serious because of the risk of infection and blood loss from the open wound.
Scout Tip: A quick way to remember the difference: “Strains and sprains are stretches, fractures are breaks, and dislocations are joints out of place.” Making a simple vocabulary card for each injury type is a great study trick for your counselor meeting.
8b) Describe the symptoms and signs of and first aid for a muscle strain, a muscle tear, and a tendon rupture.
These three injuries form a spectrum of severity, from mild (strain) to very serious (tendon rupture). A muscle strain feels like a pulling or tightness in the muscle, with mild pain, swelling, and stiffness. You might notice it during a hike or after lifting something heavy at camp. Most mild strains heal on their own with rest.
A muscle tear is more intense. There’s often a sudden “pop” or snapping sensation, followed by significant pain, swelling, and bruising. The muscle feels weak and may not be able to bear weight. Think of the difference between gently stretching a rubber band (strain) versus snapping it (tear). Partial tears may heal with rest, but complete tears may need surgery.
Tendon Rupture: This is the most severe of the three. A ruptured tendon (like the Achilles tendon in your heel) causes sudden, severe pain, often described as being kicked from behind. You may hear or feel a “snap,” and there’s an immediate loss of function. For example, a ruptured Achilles makes it impossible to push off with that foot. Tendon ruptures almost always require medical treatment and often surgery.
First aid for all three uses the RICE method, which is one of the most useful acronyms you’ll learn in first aid. Rest the injured area immediately. Apply Ice for 20 minutes on, 20 minutes off (always wrap ice in a cloth, never put it directly on skin). Use Compression with an elastic bandage to reduce swelling. And Elevate the injured area above heart level. The Mayo Clinic’s sprain and strain guide is a great reference for the details.
Seek medical attention if the person heard a “pop,” can’t bear weight, has significant swelling, or suspects a complete tear or rupture. When in doubt, treat it as the more serious injury and let a doctor make the final call.
8c) Describe the symptoms and signs of, and potential complications of, a sprain, a fracture, and a dislocation.
Sprains, fractures, and dislocations affect bones, joints, and ligaments, and they can look very similar on the outside. A sprain involves a stretched or torn ligament at a joint. You’ll see pain, swelling, bruising, and difficulty moving the joint. Ankle sprains are the most common type (and something every Scout who’s hiked a rocky trail is familiar with!).
A fracture (broken bone) causes intense pain, swelling, bruising, and visible deformity. The limb may look bent or misshapen, and the person usually can’t use or put weight on it. You may hear a cracking or grinding sound at the time of injury. A dislocation also causes intense pain and visible deformity, but at the joint itself. The joint looks obviously “out of place,” and the person cannot move it at all.
| Complication | What Happens | Warning Signs |
|---|---|---|
| Nerve damage | Nerves near the injury are compressed or torn | Numbness, tingling, or loss of sensation below the injury |
| Blood vessel damage | Reduced blood flow past the injury site | Skin turns pale, blue, or cold below the injury |
| Compartment syndrome | Pressure builds inside the muscles, cutting off circulation | Severe pain out of proportion to the injury, tight/swollen area |
| Infection | Bacteria enter through an open wound (compound fractures) | Fever, redness, warmth, increasing pain days after injury |
If you break a bone and develop a fever or the affected area feels hot, get to the emergency room right away. This can indicate a serious infection that needs immediate treatment.
8d) Demonstrate bandages for these injuries.
8e) Demonstrate the proper procedures for handling and splinting of suspected closed or open fractures or dislocations.
Bandaging and splinting are hands-on skills you’ll demonstrate for your counselor. The good news is that the core principles stay the same regardless of the specific injury. For bandaging, always cover open wounds with a sterile dressing first. Wrap snugly but not so tight that you cut off circulation (you should be able to slide a finger under the bandage). For joint injuries like ankle sprains, use a figure-eight pattern for stability. Check the person’s fingertips or toes regularly to make sure they stay warm and pink.
Splinting Golden Rule: The goal of a splint is to immobilize the injury so it doesn’t get worse during transport. Always immobilize the joints above AND below the fracture. For example, if the forearm is broken, the splint should immobilize both the wrist and the elbow. Never attempt to straighten, realign, or push bones back into place.
To apply a splint: First, care for any wound (rinse and cover it). Then, splint the limb in the position you found it. Use rigid material for the splint, like boards, sticks, rolled-up magazines, trekking poles, or even a foam sleeping pad. If nothing rigid is available, you can buddy-splint (tape a broken finger to the adjacent finger, or secure a broken leg to the uninjured leg). Pad the splint well with soft material, then secure it with bandages or strips of cloth. Check circulation below the splint every 15-20 minutes.
Watch this video from St John Ambulance on how to make a proper arm sling:
For specific fracture locations, these resources break down the details nicely: Fingers, Forearm, Leg, and Ankle. First aid for dislocations follows the same principles: splint the joint, apply ice, and get to a doctor. Never try to pop a dislocation back into place yourself.
Scout Tip: Practice splinting at a troop meeting using broomsticks, trekking poles, or cardboard as splints and old T-shirts as padding. The more you practice with improvised materials, the more confident you’ll be in a real situation. If you suspect a fracture in the upper leg, hip, pelvis, head, neck, or back, call 911 immediately. These injuries are too serious for field first aid alone.
Head and Spine Injuries (Requirement 9)
9a) Describe the symptoms and signs of, relationships between, possible complications of, and prevention of head, neck, and back injuries.
Head, neck, and back injuries are closely related because they all involve the central nervous system: the brain and spinal cord. An injury to one area can easily affect the others. For example, a blow to the head can cause the brain to shift inside the skull AND damage the vertebrae in the neck. That’s why medical professionals almost always treat head injuries as potential spinal injuries too.
Symptoms to watch for include headache, dizziness, confusion, nausea or vomiting, unequal pupil size, numbness or tingling in arms or legs, weakness or inability to move extremities, loss of bladder or bowel control, clear fluid draining from the ears or nose (which may indicate a skull fracture), and loss of consciousness. Any combination of these after a fall, collision, or blow to the head should be treated as a serious emergency.
Possible complications can be severe and delayed. Bleeding or swelling in the brain increases pressure inside the skull, which can be life-threatening. Spinal cord damage can lead to partial or complete paralysis. Long-term cognitive and behavioral changes are also possible. These complications can develop hours or even days after the initial injury, which is why monitoring and medical evaluation are so important.
Prevention is the best medicine here. Wear a helmet during biking, climbing, skateboarding, skiing, and any activity with fall risk. Always wear a seatbelt in vehicles. Check water depth before diving and never dive into unknown or shallow water. Use proper safety equipment during all Scouting activities and sports. Maintain three points of contact when climbing. Most head and spine injuries are preventable with basic safety habits.
9b) Describe the symptoms and signs of and first aid for a concussion.
A concussion is a type of traumatic brain injury caused by a bump, blow, or jolt to the head (or even a hit to the body that causes the head to move rapidly). The brain bounces or twists inside the skull, causing chemical changes and sometimes damaging brain cells. Concussions are common in sports, but they can happen in any situation involving impact.
Symptoms include headache or “pressure” in the head, confusion or feeling “foggy,” dizziness and balance problems, sensitivity to light or noise, memory problems (especially around the time of injury), nausea, and sluggishness. According to the CDC, some symptoms may not appear until hours or days after the injury, which is why continued monitoring matters.
Scout Scenario: During a flag football game at a troop campout, a Scout takes a hard hit and seems dazed. He says he’s “fine” and wants to keep playing. “When in doubt, sit them out” is the rule every Scout leader and patrol member should follow. A second impact before the brain has healed can cause much more serious damage.
First aid: Remove the person from activity immediately. Monitor them closely for worsening symptoms, and make sure someone stays with them for at least a few hours. Encourage both physical and mental rest (limit screen time, reading, and other cognitive demands). Do NOT give them aspirin or ibuprofen, as these can increase bleeding risk. Acetaminophen (Tylenol) is OK for headache pain.
Call 911 or go to the ER immediately if: the person vomits repeatedly, their headache gets progressively worse, they have a seizure, they become increasingly confused, clear fluid leaks from their ears or nose, or they lose consciousness. These are signs of a more serious brain injury that needs urgent care.
9c) Demonstrate first aid for an open head wound with a triangular or other bandage.
An open head wound is any wound that breaks the skin on the scalp or head. Head wounds tend to bleed heavily because the scalp has an incredibly rich blood supply, so even a small cut can look terrifying. Don’t panic! The amount of blood often looks much worse than the actual injury. Your job is to control the bleeding with proper bandaging.
- Apply a sterile dressing directly to the wound and use gentle, direct pressure to control bleeding.
- Fold a triangular bandage into a cravat (a long, narrow strip) or use another long bandage. Place the center over the dressing on the wound.
- Wrap the ends around the head and tie them securely on the opposite side from the wound. The bandage should be snug but not so tight it increases pain.
Critical Warning: If you suspect a skull fracture (you feel a depression in the bone, see bone fragments, or notice clear fluid from the ears or nose), do NOT apply direct pressure to the wound. Instead, loosely cover it with a sterile dressing and call 911. Pressing on a fractured skull can push bone fragments into the brain.
9d) Demonstrate first aid for someone with a suspected neck or back injury.
A suspected neck or back injury must be treated as a potential spinal cord injury until proven otherwise. Improper handling could cause permanent paralysis. This is one of the most serious first aid situations you may face, and the number one rule is simple: keep the victim absolutely still.
Assume a spinal injury exists if the person fell from a height greater than their own, was in a diving accident or high-speed collision, complains of neck or back pain, has numbness or tingling or inability to move their limbs, or has a visible deformity in the spine area. When in doubt, always assume the worst and act accordingly.
- Call 911 immediately.
- Tell the victim NOT to move. Do not reposition them unless they are in immediate, life-threatening danger (like a fire or rising water).
- Stabilize the head and neck by placing your hands on either side of their head. Keep the head in line with the body and prevent any movement.
- If you need to open their airway, use the jaw-thrust maneuver (push the jaw forward without tilting the head) instead of the standard head-tilt chin-lift, which could worsen a spinal injury.
- Monitor their breathing and consciousness until EMS arrives. If they stop breathing, begin CPR while trying to minimize neck movement.
Watch this video (3:51) for training on how to assess and handle a head, neck, or back injury:
The Golden Rule: When in doubt, assume a spinal injury exists. The cost of over-caution (keeping someone still for a few extra minutes) is nothing compared to the cost of under-caution (potentially causing permanent paralysis). Your calm presence and steady hands can make an enormous difference in this situation.
Congrats on Finishing Part 2 of the First Aid Merit Badge!
From breathing emergencies to spinal injuries, we just covered some of the most critical first aid skills you’ll ever learn. Knowing how to respond to choking, seizures, heart attacks, fractures, and head trauma could genuinely save a life someday, and that’s not an exaggeration. Well done, you’re making incredible progress on this badge! 🙂
If any of these topics felt overwhelming, remember that practice is the key to confidence. Work through the hands-on demonstrations (CPR, AED, splinting, bandaging) with your counselor, and try to practice the steps at troop meetings so they become second nature.
Once you’re ready to continue on to Part 3 of the First Aid merit badge (Requirements 10-15), click here!
Also, if you’re on the path to Eagle and could use a bit of extra support along the way, be sure to check out some of these other useful articles. You won’t regret it!
- First Aid Merit Badge Explained (All Requirements)
- Your Complete Guide to Scout CPR and AED Training
- The Easiest (And Hardest) Eagle-Required Merit Badges
- Advance Fast in Scouting (5 Rank-Up Keys To Earn Eagle Quickly)
- Leadership in Scouting: A Scout’s Ultimate Guide
Definitely check out any of these articles later on if they interest you! Now, on to Part 3 of my ultimate guide to the First Aid merit badge!