First aid MUDr. Stanislava Pingorová Department of trauma surgery LF UPJŠ

First aidFirst aid

MUDr.MUDr. Stanislava PingorováStanislava Pingorová

Department of trauma surgeryDepartment of trauma surgery

LF UPJŠLF UPJŠ

FracturesFractures closedclosed openopen

Status assessmentStatus assessment:: DeformDeformationation, , swellingswelling a and hematomasnd hematomas PainPain a andnd difficulty by motion with injured partdifficulty by motion with injured part,,

shortened or bending extremitiesshortened or bending extremities Crepitations of Crepitations of bone fragmentsbone fragments Signs of shockSigns of shock – – fractures of pelvis or femurfractures of pelvis or femur Wounds with protruding bone fragmentsWounds with protruding bone fragments

FracturesFractures

Closed fracturesClosed fractures – – intact skinintact skin

+ + aims aims avoidavoid of motion with injured partof motion with injured part managemanage the transport to hospitalthe transport to hospital firm fixation of brokenfirm fixation of broken part through the part through the

transport transport

FracturesFractures

ImImmobilisationmobilisation Fix to healthy sideFix to healthy side Transport to the hospitalTransport to the hospital Check the circulation arrouCheck the circulation arrounnd the bandaged the bandage Not allowed eatingNot allowed eating, , drinking and smoking drinking and smoking

Extreme state:Extreme state: Broken part is bending that there is no chance to Broken part is bending that there is no chance to

immobilisateimmobilisate Carefull stretching of muscelsCarefull stretching of muscels/tra/tractionction// in axis of extremity in axis of extremity ImImmobilisationmobilisation NNot continue in case of unbearable painot continue in case of unbearable pain

Fractures Fractures

Open fractureOpen fracture+ + aims aims Prevent of blood lossPrevent of blood loss, , motion and infectionmotion and infection Immobilisation and transport to hospitalImmobilisation and transport to hospital

Gently covering of wound with sterile or Gently covering of wound with sterile or clean bandageclean bandage

Not press on protruding bone fragmentNot press on protruding bone fragment immobolisationimmobolisation In case of need treat the shockIn case of need treat the shock

Fractures Fractures

Fractures Fractures

Extreme stateExtreme state:: Protruding of bone fragmentProtruding of bone fragment Place the small pads arround the bone fragmentPlace the small pads arround the bone fragment Fix the pads with wrapping dressingFix the pads with wrapping dressing

Dislocation Dislocation

Complete separation of articular surfacesComplete separation of articular surfaces

Status assessment Status assessment :: PPainain a andnd trouble to move with injured extremitytrouble to move with injured extremity Swelling and bruises arround the jointSwelling and bruises arround the joint Shortening or bendinng of injured partShortening or bendinng of injured part

Dislocation Dislocation

++ aims aims Prevention of movement with injured partPrevention of movement with injured part Transport to the hospital with support Transport to the hospital with support

injured partinjured part

Support injured part in optimal position for Support injured part in optimal position for pacientpacient

Immobilise injured extremityImmobilise injured extremity / /slingsling// Check circulation every Check circulation every 1010 minmin Transport to the hospitalTransport to the hospital

Distorsions/sprainsDistorsions/sprains

Injury of ligamentous aparatInjury of ligamentous aparat

Status assessmentStatus assessment:: Pain and tendernessPain and tenderness Difficulties with movement especially in jointDifficulties with movement especially in joint Swelling and hematoma arround the jointSwelling and hematoma arround the joint

Distorsions/sprainsDistorsions/sprains

RR – – restrest for injured partfor injured part II– – iceice in bag or cold poulticein bag or cold poultice CC – – compressioncompression EE – – elevationelevation of injured partof injured part

++ aimsaims Reduce the swelling and painReduce the swelling and pain In case of needing take to hospitalIn case of needing take to hospital

Head injuryHead injury

Failure of consciousness !!!Failure of consciousness !!!

Unconsciousness !!!Unconsciousness !!!


A B C systemA B C system

A airwayA airway B breathingB breathing C circulationC circulation

D dysfunction/disabilityD dysfunction/disability E exposureE exposure


A: uncontrolled airway head tilt A: uncontrolled airway head tilt unconsciousnessunconsciousness

Head injuryHead injuryA: head tiltA: head tilt chin liftchin lift open the mouthopen the mouth


Clean up the airway


• listen and feel normal breathing

• chest movementB:


B:B: resuscitationresuscitation


C :circulationC :circulation

Pulse:Pulse: A. carotisA. carotis A. femoralisA. femoralis A. radialisA. radialis

Poranenie hlavyPoranenie hlavy

C: resuscitation



Recovery position

• spontaneous breathing !!!

Position for head injury in Position for head injury in consciousnessconsciousness

Head injuryHead injury Head trauma can be associated with injury of Head trauma can be associated with injury of

brain tissue, brain vessel injury and skull fracture brain tissue, brain vessel injury and skull fracture Clear fluid leaking out of nose or ears suggest Clear fluid leaking out of nose or ears suggest

serious injuryserious injury Do not forget on cervical spine injuryDo not forget on cervical spine injuryStatus assessmentStatus assessment::Commotio cerebri /concussion of the brain /Commotio cerebri /concussion of the brain /:: Short unconsciousness after hit the the headShort unconsciousness after hit the the head Dizziness and nauseaDizziness and nausea or vomitingor vomiting AmnAmnesiaesia Gentle diffuse head painGentle diffuse head pain


Contusio cerebriContusio cerebri:: Worsening levels of responses passing to Worsening levels of responses passing to

the unconsciousnessthe unconsciousness Note about recent head traumaNote about recent head trauma IntIntensive head painensive head pain Noisy breathingNoisy breathing Puppilary response, size of pupillasPuppilary response, size of pupillas Unilateral weaknessUnilateral weakness Fever Fever Evident changes of personality and Evident changes of personality and

behavioursbehaviours


Skull fractureSkull fracture:: Wound or hematome on headWound or hematome on head Soft and depression place on skullSoft and depression place on skull Hematomas arround eyesHematomas arround eyes Leaking clear fluid out of nose or earsLeaking clear fluid out of nose or ears DeformDeformation or asymetry of headation or asymetry of head Worsening level of responsesWorsening level of responses


Concussion of the brainConcussion of the brain::

+ + aimsaims:: Keep guietKeep guiet pacient pacient Transport to the hospital if neededTransport to the hospital if needed

If recovery in not complete or if following If recovery in not complete or if following neurologic deterioration is present /transport to neurologic deterioration is present /transport to the hospital/the hospital/

Advise later control in emergency department in Advise later control in emergency department in case of persisting headache and dizznesscase of persisting headache and dizzness


Contusion of the brainContusion of the brain:: Serious injurySerious injury May require operationMay require operation

+ + aimsaims:: Immediate transport to the hospitalImmediate transport to the hospital

If pacient is unconsciousnes: open airway If pacient is unconsciousnes: open airway Check the breathingCheck the breathing CPRCPR


Skull fractureSkull fracture::+ + aimsaims:: Maintain open airwayMaintain open airway Immediate transport to the hospitalImmediate transport to the hospital

Consciousness – think about cervical spine injuryConsciousness – think about cervical spine injury Stop bleeding from wound by pressure dressingStop bleeding from wound by pressure dressing Leaking cleer fliud from nose and ears – cover Leaking cleer fliud from nose and ears – cover

with sterile or clean dressingwith sterile or clean dressing Watch the vital signsWatch the vital signs Unconsciousness – as upperUnconsciousness – as upper



Injury of scalp



Serious facial fractures Serious facial fractures

In most cases hard collisionIn most cases hard collision

Status assessmentStatus assessment:: Pain of injured partPain of injured part, , injury of mandibula – troubles injury of mandibula – troubles

with speaking and chewingwith speaking and chewing Distressed breathingDistressed breathing Swelling and face deformationSwelling and face deformation Bruises arround eyesBruises arround eyes

Serious facial fracturesSerious facial fractures

++ aimsaims Maintain open airwayMaintain open airway MiniMinimize swelling of facemize swelling of face Immediate transport to hospitalImmediate transport to hospital

Call emergency Call emergency 111212 If he responsesIf he responses- - spue bloodspue blood, , teethteeth, , denturedenture Apply cold poulticeApply cold poultice – – reduce swelling and reduce swelling and

painpain Do not wrap chin if paciet is vomiting or he Do not wrap chin if paciet is vomiting or he

has disstressed breathinghas disstressed breathing


Fracture of mandibule


If he is not responsesIf he is not responses Open airway and check breathingOpen airway and check breathing Cardiopulmonary resuscitationCardiopulmonary resuscitation

If he is breathingIf he is breathing – – recovery position to allow recovery position to allow body fluids drain outbody fluids drain out

Remember to CERVICAL SPINE INJURYRemember to CERVICAL SPINE INJURY

Injury of shoulderInjury of shoulder

Falls on arms or outstretched armFalls on arms or outstretched arm VVery painfullery painfullStatus assessmentStatus assessment:: Pain and tendernessPain and tenderness Swelling and deformation of shoulderSwelling and deformation of shoulder Relaxing muscles can decresed painRelaxing muscles can decresed pain+ + aimsaims:: Immobilisation of shoulderImmobilisation of shoulder Transport to hospitalTransport to hospital

Injury of shoulderInjury of shoulder

ImmobilisationImmobilisation Triangulare slingTriangulare sling

Never do reposition of dislocated jointNever do reposition of dislocated joint Do not allow the victim to eat, drink and smokeDo not allow the victim to eat, drink and smoke

Triangle slingTriangle sling

Triangle slingTriangle sling

Injury of elbowInjury of elbow

Fall on elbowFall on elbow Regulary controlling of circulationRegulary controlling of circulation Never do forced stretching of elbowNever do forced stretching of elbow

Status assessmentStatus assessment:: Pain increased by movementPain increased by movement tendernesstenderness Swelling, hematomas and deformationSwelling, hematomas and deformation Movement of elbow joint is not possibleMovement of elbow joint is not possible

Injury of ribs and breastboneInjury of ribs and breastbone

Fracture of one or more ribs /blunt trauma/Fracture of one or more ribs /blunt trauma/ PenePenetrating injurytrating injury Unstable “flail” segments of chest wallUnstable “flail” segments of chest wall Injury of parenchyma organs as liver and spleen Injury of parenchyma organs as liver and spleen

by fractured lower ribsby fractured lower ribs

Injury of elbowInjury of elbow

+ + aimsaims:: Immobilize injured upper extremityImmobilize injured upper extremity Transport to the hospitalTransport to the hospital

Check the pulse on wristCheck the pulse on wrist if you do not find pulse carefuly stretch the elbow if you do not find pulse carefuly stretch the elbow

as long as you will feel it as long as you will feel it Support the arm in that positionSupport the arm in that position


Status assessmentStatus assessment:: Sharp pain in place of broken ribSharp pain in place of broken rib Painfull breathsPainfull breaths Superficial breathingSuperficial breathing Air suction throughout open chest wallAir suction throughout open chest wall Signs of shock and internal bleedingSigns of shock and internal bleeding


+ + aims:aims: Support the chest wallSupport the chest wall Immediate transport to the hospitalImmediate transport to the hospital

Make a sling support on injured sideMake a sling support on injured side In case of penetrating injury close the wound In case of penetrating injury close the wound

from three sidesfrom three sides Tilt the pacient on injured sideTilt the pacient on injured side

PPenetrating chest injuryenetrating chest injury

Cause of pnemothoraxCause of pnemothorax- - air in pleural cavityair in pleural cavity TenTensionsion pneumothorax- pneumothorax- increasing pressure increasing pressure

on injured side compromise heathly side and on injured side compromise heathly side and pacient has depressed breathing, air enters pacient has depressed breathing, air enters a pleural space without a means of exita pleural space without a means of exit

Status assessmentStatus assessment:: depresseddepressed, , painfull, superficial breathingpainfull, superficial breathing Feeling jeopardize lifeFeeling jeopardize life Sign of preterminal hypoxemiaSign of preterminal hypoxemia- /cya- /cyanosisnosis// Crepitation in subcutaneous tissueCrepitation in subcutaneous tissue Chest wall bleedingChest wall bleeding Jugular venous distensionJugular venous distension


+ + aimsaims Cover the wound and reassess the breathingCover the wound and reassess the breathing MinimaMinimaze the shockze the shock Immediate transport to the hospitalImmediate transport to the hospital

Cover the wound with dressingCover the wound with dressing Dressed with occlusive plastic film (bag) on three Dressed with occlusive plastic film (bag) on three

sides to allow gas exit from the pleural space onlysides to allow gas exit from the pleural space only Watch vital signsWatch vital signs Unconsciousness Unconsciousness - - CPRCPR


Spine injurySpine injury

Possibility of spinal cord injuryPossibility of spinal cord injury

Suspecting injury of spineSuspecting injury of spine:: MMechanism of traumaechanism of trauma Disorders of sensitivity and movementDisorders of sensitivity and movement Car crush accident / whiplash injury / Car crush accident / whiplash injury /

/hyperextension and hyperflexion of neck //hyperextension and hyperflexion of neck / The most vulnerable are cervical and lumbar The most vulnerable are cervical and lumbar

spinespine

Spine injurySpine injury

The most often causesThe most often causes:: Fall from highFall from high GymnastGymnastic excercisesic excercises Jump to the swimming pool Jump to the swimming pool Fall from horses or motocyclesFall from horses or motocycles Sudden deceleration of motor vehicleSudden deceleration of motor vehicle Bury of the back with heavy objectBury of the back with heavy object Injury of head and neckInjury of head and neck

Injury of spineInjury of spine

Status assessmentStatus assessment:: Pain of neck and injured part of spinePain of neck and injured part of spine Blocking, irregularities and deformities of normal Blocking, irregularities and deformities of normal

curving of spinecurving of spine Strong tenderness of skin arround injured partStrong tenderness of skin arround injured part

Weakened movement or paralysis of extremitiesWeakened movement or paralysis of extremities Loss of sensitivity or abnormal feelingsLoss of sensitivity or abnormal feelings/ / pin and pin and

needles, tingling needles, tingling // Loss of sfincter controlLoss of sfincter control Depressed breathingDepressed breathing

Injury of spineInjury of spine If pacient is consciousnessIf pacient is consciousness::+ + aimsaims:: PrProtection of further injuryotection of further injury Immediate transport to the hospitalImmediate transport to the hospital

Keep the victim quiet and warn the victim to do Keep the victim quiet and warn the victim to do not move with head not move with head

maintain and support the head in neutral maintain and support the head in neutral position, head, neck and chest and lumbar region position, head, neck and chest and lumbar region in one axisin one axis

Do not move with the victim just in life-threating Do not move with the victim just in life-threating situationsituation

In case of need of movement use the in line In case of need of movement use the in line stabilisation with assistentstabilisation with assistent

Injury of spineInjury of spine If pacient is unconsciousnessIf pacient is unconsciousness+ + aimsaims:: Maintain free airwaysMaintain free airways In case of nees resuscitationIn case of nees resuscitation Excessive head tilt could aggravate the injury and Excessive head tilt could aggravate the injury and

damage the cervical spinal corddamage the cervical spinal cord Transport to the hospitalTransport to the hospital

Maintain head in neutral positionMaintain head in neutral position establish a clear upper airway by using jaw thrust

or chin lift in combination with manual inline stabilisation (MILS) of the head and neck by an assistant


Jaw thrust



If he is breathing spontaneously call emergencyIf he is breathing spontaneously call emergency If he is not breathing start CPRIf he is not breathing start CPR

Log roll maneuverLog roll maneuver:: 5-3 5-3 assisstentsassisstents Maintain head and cervical spineMaintain head and cervical spine, , by alert FLIP by alert FLIP

OVER maintain head, neck, chest and feet fingers OVER maintain head, neck, chest and feet fingers in one axisin one axis


Log roll maneuver


log roll maneveur


www.vdsivrea.it/prod01171.htm


Pelvis fracturesPelvis fractures

Car accident and motorcycle crushesCar accident and motorcycle crushes Complication of injury of other organsComplication of injury of other organs Serious internal bleedingSerious internal bleeding––––––>> shockshockStatus assessmentStatus assessment:: Not ability to walk and standingNot ability to walk and standing Pain and tenderness of lumbar and Pain and tenderness of lumbar and

pelvis regionpelvis region Blood in urine or inability to urinateBlood in urine or inability to urinate Sign of shock or internal bleedingSign of shock or internal bleeding

Pelvis fracturesPelvis fractures

+ + aimsaims:: Minimize theMinimize the shock shock Immediate transport to the hospitalImmediate transport to the hospital

Maintain pacient on his backMaintain pacient on his back Soft small pillow between knees and ankles to Soft small pillow between knees and ankles to

immobilisation of lower extremities with wide immobilisation of lower extremities with wide bandagebandage

If it is very painfull do not bandageIf it is very painfull do not bandage 112, 911112, 911 Treat the shockTreat the shock

Fracture of hip and thighboneFracture of hip and thighbone

Car accident, fall from highCar accident, fall from high RiRisk of big vessel injurysk of big vessel injury Neck of thigboneNeck of thigbone- - very often in old womenvery often in old women

Status assessment:Status assessment: Pain in place of injured partPain in place of injured part Not ability to walkNot ability to walk Signs of shockSigns of shock Shortening and external rotation of lower Shortening and external rotation of lower

extremityextremity


+ + aimsaims:: ImImomilisation of lower extremityomilisation of lower extremity Transport to the hospitalTransport to the hospital

Support the injured partSupport the injured part Careful traction of injured legCareful traction of injured leg callcall 1 11212 immobilisationimmobilisation- - splint splint = = healthy leghealthy leg Prevent the development of shockPrevent the development of shock


Shock Shock ((acute stress reaction) is not a disease in itselfacute stress reaction) is not a disease in itself It is a clinical condition characterized by It is a clinical condition characterized by

symptoms that arise when cardiac output is symptoms that arise when cardiac output is insufficient to fill the arteries with blood under insufficient to fill the arteries with blood under enough pressure to provide an adequate blood enough pressure to provide an adequate blood supply to the organs and tissues.supply to the organs and tissues.

Causes of the shockCauses of the shock:: Serious blood lossSerious blood loss Injury of intraabdominal organsInjury of intraabdominal organs Pelvis fracturePelvis fracture Thighbone fractureThighbone fracture Injury of intrathoracal organsInjury of intrathoracal organs Heart failureHeart failure AnaAnaphphylylaxyaxy

Shock Shock Status assessmentStatus assessment::At the beginningAt the beginning:: Accelerated, fast pulseAccelerated, fast pulse palepale, , coldcold, , moisturemoisture skinskin a andnd sweating /cold/sweating /cold/At the development of the shockAt the development of the shock:: Cyanotic skinCyanotic skin,, depresses capillary refill / depresses capillary refill /first blanch white first blanch white

and then "pink up" in about two secondsand then "pink up" in about two seconds after pressure on after pressure on nail bed or earlobenail bed or earlobe//

weaknessweakness,, dizziness dizziness Nausea and vomitingNausea and vomiting Thirst Thirst Fast and shallow breathingFast and shallow breathing Weak andWeak and "thready""thready" pulse pulse If it is not present on the wrist If it is not present on the wrist = = half of blood volume is losthalf of blood volume is lost

Shock Shock

Deficiency of oxygen in brainDeficiency of oxygen in brain:: anxietyanxiety oror agres agressivitysivity yawningyawning oror whooping, gaspingwhooping, gasping unconsciousnessunconsciousness

Heart failure /the last/Heart failure /the last/

Shock Shock Approx. blood lossApprox. blood loss Clinical manifestationClinical manifestation0,5 l 0,5 l small or any effectsmall or any effect

2l -2l -release hormonsrelease hormons/adrenal/adrenalinin, , ADH, ADH, ccortiortissol, ACTHol, ACTH - centrali- centralisation of the sation of the

circulationcirculation - - sign of the shocksign of the shock

››2l - 2l - loss of consciousnessloss of consciousness - - heart failure and apnoeheart failure and apnoe

Estimation of blood lossesEstimation of blood losses

Fracture Blood loss

Humerus 800 ml

Pelvis 5000 ml

Tighbone 2000 ml

Cruris 1000 ml

Estimation of external bleeding is in 50% not exact!

ShockShock

+ + aimsaims:: Recognize the shockRecognize the shock Treat every cause the shockTreat every cause the shock Improve the blood supply of brain, heart and Improve the blood supply of brain, heart and

lungslungs Immediate transport to the hospitalImmediate transport to the hospital

Control and treat external bleedingControl and treat external bleeding Maintain body heat by insulating the victim from Maintain body heat by insulating the victim from

the surroundings and, in some instances, the surroundings and, in some instances, applying external heatapplying external heat

Antishock positionAntishock position reasses the vital sign reasses the vital sign

Antishock positionAntishock position

!!! !!! never use for: never use for: head injury head injury chest injury chest injury

Bleeding and woundsBleeding and wounds

TypTypes of bleedinges of bleeding::

CapillaryCapillary - - capillaries are the extremely small vessels that capillaries are the extremely small vessels that connect the arteries with the veins. Capillary bleeding most connect the arteries with the veins. Capillary bleeding most commonly occurs in minor cuts and scrapes. This type of commonly occurs in minor cuts and scrapes. This type of bleeding is not difficult to controlbleeding is not difficult to control

VenVenousous - - A steady flow ofA steady flow of dark red,dark red, or bluishor bluish bloodblood

ArterArterialial – – bright redbright red blood from the wound inblood from the wound in distinct spurtsdistinct spurts or pulsesor pulses that correspond to that correspond to the rhythm of the heartbeatthe rhythm of the heartbeat


TypTypes of woundses of wounds:: Incised woundIncised wound Lacerated woundLacerated wound lacero-contused woundlacero-contused wound Stab woundStab wound Gunshot Gunshot Bites Bites Excoriation Excoriation


Incised wounds


Excoriations


Control bleedingControl bleeding: steril: sterile coveringe covering, , pressure pressure dressingdressing, elev, elevation of extremityation of extremity, , direct direct pressurepressure((fingers, handsfingers, hands...), ...), pressure pressure pointspoints, t, touournirniququet (et (note the time note the time ), ), immobilisate the extremityimmobilisate the extremity

TToourniurniququetet efefffeecct t by pressure over by pressure over 75 torr75 torr

ExtraExtraction only free objectsction only free objects





Pressure points


PPenetrating injury of abdomen:enetrating injury of abdomen: cover dressing of cover dressing of the woundthe wound

PrProtruding of abdominal organsotruding of abdominal organs / / bowelbowel//through through the wound: cover the organs with plastic bag or the wound: cover the organs with plastic bag or kitchen foil as a protection against drying kitchen foil as a protection against drying

SteriSterile covering of the woundle covering of the wound Lying down with knees raisedLying down with knees raised Unconsciousness Unconsciousness -- CPR CPR If he responses If he responses – – recovery position with support recovery position with support

abdominal wallabdominal wall


Recovery position

BurnsBurns

The first step is to determine the degree and extent of The first step is to determine the degree and extent of damage to body tissuedamage to body tissue

Causes Causes :: HoHot fluidst fluids Fire Fire EleElectricityctricity ChemiChemical substancescal substances RadiRadiationation

Burns Burns

Classification Classification ::I. I. degreedegree: : injury ofinjury of epidermis epidermis/outer layer//outer layer/: : rednessredness, , minor painminor pain--

lasts onlylasts only 48 h, 48 h, healing without scarhealing without scar, , time of healingtime of healing 3-6 3-6 daysdays

II. II. degreedegree: : injury ofinjury of epidermis + dermis: typic epidermis + dermis: typicall signall sign : : blisterblister typtypee a: a: bottom of blister is redbottom of blister is red, h, healing in 7-14 days ealing in 7-14 days

without scar or changed pigmentationwithout scar or changed pigmentation typtypee b: b: bottom of blister is dark red or whitebottom of blister is dark red or white, h, healing with ealing with

scar in 21 daysscar in 21 daysIII. III. degreedegree: : injury of all layers of the skininjury of all layers of the skin:: skin is white color or charring, produce hard, leather-like skin is white color or charring, produce hard, leather-like

escharseschars tytypicall sign is skin necrosispicall sign is skin necrosis a andnd painlesspainless, diagnos, diagnostictic: :

needle prickneedle prick, , inability to regenerateinability to regenerate, n, necessery surgeryecessery surgery/ / nenecrectomycrectomy + transplant + transplantationation//

BurnsBurns

IV. IV. degreedegree : : injury of musles, fascia and bonesinjury of musles, fascia and bones – / carbonatio / – / carbonatio /

I. aI. andnd IIa – IIa – minor burnsminor burnsII b aII b andnd higherhigher – – major burnsmajor burns

Burns which requires medical assistanceBurns which requires medical assistance:: Children burns Children burns MajorMajor burns burns Burns of hands, face, feet and over groin and buttocksBurns of hands, face, feet and over groin and buttocks Overextending upper and lower extremitiesOverextending upper and lower extremities Minor burnsMinor burns / / more thanmore than 5 % 5 % of body surfaceof body surface//

3 rd degree burns

Burns Burns

Major burnsMajor burns

Status assessmentStatus assessment:: Pain Pain Depressed breathingDepressed breathing Sign of shockSign of shock

+ + aimsaims:: Make sure the victim is no longer in contact with Make sure the victim is no longer in contact with

smoldering materials or not exposed to heatsmoldering materials or not exposed to heat Maintain open airwayMaintain open airway MinimMinimize the risk of infectionize the risk of infection Emergency transport to the hospitalEmergency transport to the hospital

Burns Burns

Dial 911Dial 911 Take off belt, rings, watches, shoes and tight-fitting Take off belt, rings, watches, shoes and tight-fitting

clothes /earlier than swelling of injured tissue will appear /clothes /earlier than swelling of injured tissue will appear / Do not remove burnt adjacent clothingDo not remove burnt adjacent clothing Do not immerse severe large burns in cold water / could Do not immerse severe large burns in cold water / could

cause shock /cause shock / Cover the area of the burn / use a cool, moist, sterile Cover the area of the burn / use a cool, moist, sterile

bandage, clean, moist cloth or moist towel /bandage, clean, moist cloth or moist towel / Do not break blistersDo not break blisters Treat the shockTreat the shock

BurnsBurnsMMinor burnsinor burns::Status assessmentStatus assessment:: Skin rednessSkin redness Pain Pain Blisters Blisters - - laterlater+ + aimsaims:: Prevent the victim to contact with another heat Prevent the victim to contact with another heat reduce the swelling and painreduce the swelling and pain MinimMinimize the risk of infectionize the risk of infection

Hold the burned area under cold running water for at leastHold the burned area under cold running water for at least 10 min 10 min, , cold compressescold compresses

Cooling the burns reduce swelling by conducting heat away from Cooling the burns reduce swelling by conducting heat away from the skinthe skin

removeremove „ „tourniguettourniguet““ Cover the burn with a sterile gauze bandage Cover the burn with a sterile gauze bandage Do not break blistersDo not break blisters

Burns Burns

Burns Burns

Burns of airway/ smoke inhalation /Burns of airway/ smoke inhalation /:: Lifethreating situationLifethreating situation–––– very fast swelling of very fast swelling of

airwayairway Think of it if burns develop in closed areaThink of it if burns develop in closed area!!!!!!

Status assessmentStatus assessment:: Carbon particles arround the nose and mouthCarbon particles arround the nose and mouth Burnt Burnt vibrissavibrissae in the nosee in the nose erythemaerythema, , swelling or burnt tongueswelling or burnt tongue Hoarseness Hoarseness Breathings problemsBreathings problems

Burns Burns

+ + aimsaims: : Maintain open airwayMaintain open airway Transport to the hospitalTransport to the hospital

Call 911, 112Call 911, 112 Release the clothing arround the neckRelease the clothing arround the neck Administer small doses a cold water Administer small doses a cold water – – reduce swelling and reduce swelling and

painpain Check for sign of circulationCheck for sign of circulation

AmputationAmputation Partially or completely torn or cut off the extremityPartially or completely torn or cut off the extremity Possibility of operative reconstructionPossibility of operative reconstruction / replant / replantationation oror

revasrevascularisationcularisation// RiRisk of development of the shocksk of development of the shock !!! !!!

+ + aimsaims:: MinimMinimize the blood losses and development of the shockize the blood losses and development of the shock Pressure dressing and elevationPressure dressing and elevation Put the aPut the ampumputated part in sterile moisted gauze tated part in sterile moisted gauze –––› –––›plastic plastic

bag bag –––›–––›place in an ice chestplace in an ice chest Note the time of injuryNote the time of injury

AmputationAmputation



Car accidentCar accident

ssafety sceneafety scene – watch out for danger – watch out for danger rescuerrescuer ~~ n new victim of the accidentew victim of the accident asses the situation and find out what has happenedasses the situation and find out what has happened reassure the victimreassure the victim Arrange for profesional helpArrange for profesional help Help to the victim where they are lying or sitting Help to the victim where they are lying or sitting

Safety scene:Safety scene: PParking in safety distancearking in safety distance Alarm lightsAlarm lights or warning triangleor warning triangle Hand breakHand break Switch off the engineSwitch off the engine


• extrication of passanger from car

Rautek maneuver

Car accidentCar accident- Rautek man- Rautek maneuvereuver

MotoMotorcycles accidentrcycles accident

• removing a helmet

Removing a helmetRemoving a helmet


victim - stranded (more than 15min):victim - stranded (more than 15min):

callcall 112 112 and for a arrival of fire and for a arrival of fire

brigadesbrigades typictypicallall errors :errors :

stand up the victimstand up the victim

sending the victim to the hospital sending the victim to the hospital

without medical controlwithout medical control

Documents

First aid MUDr. Stanislava Pingorová Department of trauma surgery LF UPJŠ