Unit G Emergency Care Unit G Emergency Care SkillsSkills
A.A. Bleeding and WoundsBleeding and Wounds
Abrasion: skin scraped off, bleeding limited
PuncturePuncture
Caused by sharp object (pin, nail, etc.) External bleeding minimal, may lead to infection or tetanus
LacerationLaceration
A tearing of tissues from excessive force, jagged edges, bleeding may be heavy. Deep lacerations may become infected
IncisionIncision
A cut with sharp object such as a knife, scissors, razor blade, etc., if cut is deep, bleeding can be heavy, also can have damage to muscles and nerves
Bleeding and Wounds Bleeding and Wounds continued..continued..
- avulsion: tissue torn or separated from the body, bleeding is heavy, important to preserve the body part because a surgeon may be able to reattach it
- amputation: body part cut off or separated from the body, bleeding can be extensive, important to preserve separated part for reattachment. Wrap part in cool, moist dressing (sterile water or saline preferred) and place in plastic bag. Keep bag cool or in ice water and transport with the victim. (Don’t place the body part in direct contact with the ice.)
A. Bleeding and WoundsA. Bleeding and Wounds
~Arterial bleeding is bright red in color and life threatening.
~Venous bleeding is slower and dark red.
Control BleedingControl Bleeding
1. Direct Pressure2. Elevation3. Pressure Bandage4. Pressure points
Use protective barrier to control bleeding (gloves)
or thick layers of dressings. Avoid direct contact
with blood. Wash hands after providing first aid.
InfectionInfection
Signs and symptoms of wound infection:
SwellingHeatRednessPainFeverPusRed Streaks
InfectionInfection
Tetanus- bacterial infection, most common in puncture wounds, be sure to find out when victim last had tetanus shot, advise to consult medical professional about tetanus booster.
Close WoundsIf a bruise, apply coldSigns of internal bleeding-pain,
tenderness, swelling, deformity, cold and clammy skin, rapid and weak pulse, uncontrolled restlessness, excessive thirst, vomiting blood, blood or urine in feces.
ShockShockWhen caring for bleeding/wounds, or any
other injury or illness, be alert for signs of shock.
Clinical set of signs and symptoms associated with inadequate supply of blood to body organs, especially the brain and heart.
[ If not treated shock can lead to death, even when the victim’s injuries are not life threatening.]
ShockShock
Caused by:
HemorrhageExcessive painInfectionHeart attackPoisoning by chemicals, drugs or gasesLack of oxygenPsychological traumaDehydration from burns, vomiting, or
diarrhea
ShockShock
Symptoms:
Skin pale or cyanotic Skin cool to touch Diaphoresis Pulse rapid and weak Respirations rapid and shallow Hypotension Victim weak, listless, confused and eventually
unconscious Victim anxious and extremely restless Victim may complain of excessive thirst Victim may experience nausea and vomiting Victim may complain of blurred vision – as
shock progresses, eyes may appear sunken and have vacant, confused expression, pupils dilate
ShockShock
Get medical help right away. If possible:
1. Eliminate the cause of shock 2. Improve circulation to the brain and
heart3. Provide oxygen4. Maintain body temperature
ShockShock
Positioning patient depends on injuries:IF NECK OR SPINAL INJURY SUSPECTED-do not move the victimHow would you position the following victims? Victim has a broken arm, no other apparent
injuries. Victim is vomiting and bleeding profusely
from a lacerated tongue.Victim has broken rips and is dyspneic.
ShockShock
Cover the patient with blankets or additional clothing. Blankets may also be placed between the ground and the victim.
Avoid giving the patient anything to eat or drink. A wet cloth may be used to moisten the lips and mouth.
If help wont arrive for more than an hour and dehydration is evident, provide fluids.
PoisoningPoisoning
If poison is ingested, call a poison control center (PCC) or physician immediately. If not available call EMS.
Save the label or container of the substance taken.
If it is helpful to know-estimate how much was taken and the time the poisoning occurred.
If the victim vomits, save a sample.If the victim is unconscious check for
breathing. Provide rescue breathing is the victim is not breathing. If victim is breathing, turn victim on his-her side.
PoisoningPoisoning
If the poison control center tells you to induce vomiting:
- Give syrup of ipecac- Tickle the back of the victims throat- Administer warm salt waterDO NOT induce vomiting if:- The victim is unconscious- The victim swallowed acid of alkali- The victim swallowed petroleum- The victim is convulsing- The victim has burns on the lips or mouths
PoisoningPoisoning
Vomiting only removes half of the poison, so you may need to administer activated charcoal to counteract the remaining poison.
If poisoning is due to gas inhalation…remove victim from area
Carbon Monoxide PoisoningCarbon Monoxide Poisoning
Odorless and colorless gasBefore entering the area, take a deep
breath and don’t breathe the gas while removing the victim from the area
After the rescue, check for breathing and administer CPR if needed
Obtain medical help immediately
Chemicals or Poisons that Chemicals or Poisons that come in Contact with Skincome in Contact with Skin
Wash with large amounts of waterRemove clothing or jewelry that contains
the substanceIf poisonous plant, wash with soap and
water- use Calamine or Caladryl (or paste made from baking soda and water.)
Obtain medical help
For insect bite, sting or For insect bite, sting or snakebite…snakebite…If possible, hold part below level of the
heartRemove the stinger and wash the area
with soap and waterApply sterile dressing and cold packMonitor the victim and give CPR if neededWatch for allergic reactionTreat for shock
BURNSBURNS
First Degree BurnsFirst Degree Burns
Involves only the epidermisHeals in 5-6 daysNo scarringSkin red, mild swellingVictims feels painUsually cause by the sun, hot objects or
steam, or exposure to weak acid-alkali
Second Degree BurnsSecond Degree Burns
Epidermis and dermisBlister or vesicle formsSkin red an mottle with swelling Surface appears wetVery painfulUsually cause by the sun, sunlamp,
contact with hot or boiling liquids, contact with fire
Third Degree BurnsThird Degree Burns
Injury to all layers and underlying tissueArea has white or charred appearanceCan be extremely painful or painless (if
nerve endings destroys)Usually caused by flames, prolonged
contact with hot objects, contacts with electricity, immersion in hot or boiling liquids
TreatmentTreatment
Remove source of heatCool affected skin areaCover the burnRelieve painObserve painObserve and treat for shockMedical care should be obtained in more
than 15% of adult body burned (10% of a child)
TreatmentTreatment
DO NOT apply cotton, tissues, ointment, powders, oils, grease, butter, or other substances to the burned area unless you are instructed to do so by a physician
DO NOT break open blisterCall for help immediately if 3rd degree burnsDehydration can occur quickly with burnsBe alert for signs of shockRemain calm and reassure burn victim
BONE AND JOINT INJURIESBONE AND JOINT INJURIES
FracturesFractures
A break in a boneClosed or simple- does not break the skinCompound or open-accompanied by open
woundCommon signs and symptoms include
deformity, limited (loss of) motion, pain and tenderness at fracture site, swelling and discoloration, protrusion of bone ends
Victim may have heard a snap or feel a grating sensation
Treatment includes immobilizing above and below fracture, treat for shock
DislocationDislocation
When the end of bone moves out of the joint
Usually accompanied by tearing-stretching of ligaments
Signs and symptoms include deformity, limited of abnormal movement, swelling, discoloration, pain, tenderness, shortening or lengthening of affected arm or leg
Treatment similar to fractures- immobilize affected area, do not attempt to reduce the dislocation
SprainSprain
Injury to tissues surrounding a joint when the part is forced beyond its normal ROM
Ligaments, tendons and other tissues stretched or torn
Usually ankle or wristSymptoms similar to fracture and
dislocationTreatment includes application of cold,
elevation of affected part, and rest
StrainStrain
Overstretching of muscle- frequently the back
Signs-symptoms include sudden pain, swelling and-or bruising
Treatment aimed at resting affected muscle
SUDDEN ILLNESSSUDDEN ILLNESS
Heart AttackHeart Attack
Blood supply to heart is blockedIf heart stops beating CPR must be performedSigns/symptoms- chest pain or pressure, pain
radiating to shoulders, arms, neck or jawShortness of breathCyanosisVictim weak and apprehensiveNausea, vomiting, loss of consciousnessEncourage victim to relax, place in
comfortable position, and obtain medial help
Cerebrovascular Accident Cerebrovascular Accident (Stroke)(Stroke)
Either a clot in a cerebral artery or hemorrhage of a blood vessel in the brain
Signs/symptoms- numbness, paralysis, pupils unequal size, mental confusion, slurred speech, nausea, vomiting, difficulty breathing and swallowing, and loss of consciousness
Remember that although the patient/victim may be unable to speak or may be unconscious, he/she may be able to hear and understand what is going on
FaintingFainting
Temporary reduction of blood supply to the brain
Victim regains consciousness after being in a supine position
Signs- dizziness, extreme pallor, diaphoresis, coldness of the skin, nausea, numbness and tingling of hands and feet
When signs occur, help the victim sit with the head at the level of the knees
If victim loses consciousness, try to prevent injury, loosen clothing, maintain open airway
ConvulsionConvulsion
SeizureOccurs in conjunction with high body
temperature, head injuries, brain disease, and brain disorders such as epilepsy
Body muscles become rigid followed by jerking movements
During seizure, victim may stop breathing, bite their tongue, lose bladder and bowel control, and injure body parts
Face and lips develop a bluish colorVictim loses consciousness
Diabetic ComaDiabetic Coma
Caused by an increase in the level of glucose in the bloodstream
A result of an excess intake of sugar, failure to take insulin, or insufficient production of insulin
Signs: Confusion, weakness or dizziness, nausea or vomiting, rapid, deep respirations, flushed skin, and fruity smelling breath
Victim will lose consciousness and die if not treated
Obtain medical treatment as quickly as possible
Insulin ShockInsulin Shock
Caused by an excess amount of insulin (low level of glucose in bloodstream)
A result of failure to eat or too much insulinSigns: Muscle weakness, mental confusion,
restlessness or anxiety, diaphoresis, pale, moist skin, hunger pains, palpitations
If victim conscious, give sweetened drink or sugar
Avoid giving victim hard candy if confusedIf victim loses consciousness, get medical help
Dressing and BandagesDressing and Bandages
Dressing= sterile covering over wound or injured part
Bandages= materials to hold dressing in place, secure splints, and support body parts
Roller gauze bandagesTriangular bandageElastic (Ace) bandages
After bandage applied, check to be sure it is not too tight
(Check circulation by pressing lightly on nail beds lightly on nail beds to make them turn white. Color should return to nail beds immediately.)