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.)