Unit G Emergency Care Skills

1. Unit G Emergency Care Skills

2. Bleeding and Wounds Abrasion: skin scraped off, bleeding limited

3. Caused by sharp object (pin, nail, etc.) External bleeding minimal, may lead to infection or tetanus Puncture

4. Atearing of tissues from excessive force, jagged edges, bleeding may be heavy. Deep lacerations may become infected Laceration

5. 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 Incision

6. Bleeding and Wounds 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.)

7. ~Arterial bleeding is bright red in color and life threatening. ~Venous bleeding is slower and dark red. A. Bleeding and Wounds

8. Direct Pressure • Elevation • Pressure Bandage • 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. Control Bleeding

9. Signs and symptoms of wound infection: • Swelling • Heat • Redness • Pain • Fever • Pus • Red Streaks Infection

10. 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 Wounds • If a bruise, apply cold • Signs 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. Infection

11. When 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.] Shock

12. Caused by: • Hemorrhage • Excessive pain • Infection • Heart attack • Poisoning by chemicals, drugs or gases • Lack of oxygen • Psychological trauma • Dehydration from burns, vomiting, or diarrhea Shock

13. 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 Shock

14. Get medical help right away. If possible: • Eliminate the cause of shock • Improve circulation to the brain and heart • Provide oxygen • Maintain body temperature Shock

15. Positioning patient depends on injuries: IF NECK OR SPINAL INJURY SUSPECTED -do not move the victim How 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. Shock

16. 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. Shock

17. 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. Poisoning

18. If the poison control center tells you to induce vomiting: • Give syrup of ipecac • Tickle the back of the victims throat • Administer warm salt water • DO 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 Poisoning

19. 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 Poisoning

20. Odorless and colorless gas • Before 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 Carbon Monoxide Poisoning

21. Wash with large amounts of water • Remove clothing or jewelry that contains the substance • If poisonous plant, wash with soap and water- use Calamine or Caladryl (or paste made from baking soda and water.) • Obtain medical help Chemicals or Poisons that come in Contact with Skin

22. If possible, hold part below level of the heart • Remove the stinger and wash the area with soap and water • Apply sterile dressing and cold pack • Monitor the victim and give CPR if needed • Watch for allergic reaction • Treat for shock For insect bite, sting or snakebite…

23. BURNS

24. Involves only the epidermis • Heals in 5-6 days • No scarring • Skin red, mild swelling • Victims feels pain • Usually cause by the sun, hot objects or steam, or exposure to weak acid-alkali First Degree Burns

25. Epidermis and dermis • Blister or vesicle forms • Skin red an mottle with swelling • Surface appears wet • Very painful • Usually cause by the sun, sunlamp, contact with hot or boiling liquids, contact with fire Second Degree Burns

26. Injury to all layers and underlying tissue • Area has white or charred appearance • Can 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 Third Degree Burns

27. Remove source of heat • Cool affected skin area • Cover the burn • Relieve pain • Observe pain • Observe and treat for shock • Medical care should be obtained in more than 15% of adult body burned (10% of a child) Treatment

28. 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 blister • Call for help immediately if 3rd degree burns • Dehydration can occur quickly with burns • Be alert for signs of shock • Remain calm and reassure burn victim Treatment

29. BONE AND JOINT INJURIES

30. A break in a bone • Closed or simple- does not break the skin • Compound or open-accompanied by open wound • Common 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 Fractures

31. 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 Dislocation

32. 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 wrist • Symptoms similar to fracture and dislocation • Treatment includes application of cold, elevation of affected part, and rest Sprain

33. Overstretching of muscle- frequently the back • Signs-symptoms include sudden pain, swelling and-or bruising • Treatment aimed at resting affected muscle Strain

34. SUDDEN ILLNESS

35. Blood supply to heart is blocked • If heart stops beating CPR must be performed • Signs/symptoms- chest pain or pressure, pain radiating to shoulders, arms, neck or jaw • Shortness of breath • Cyanosis • Victim weak and apprehensive • Nausea, vomiting, loss of consciousness • Encourage victim to relax, place in comfortable position, and obtain medial help Heart Attack

36. 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 Cerebrovascular Accident (Stroke)

37. 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 Fainting

38. Seizure • Occurs 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 color • Victim loses consciousness Convulsion

39. 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 Diabetic Coma

40. Caused by an excess amount of insulin (low level of glucose in bloodstream) • A result of failure to eat or too much insulin • Signs: 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 confused • If victim loses consciousness, get medical help Insulin Shock

41. Dressing= sterile covering over wound or injured part Bandages= materials to hold dressing in place, secure splints, and support body parts • Roller gauze bandages • Triangular bandage • Elastic (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.) Dressing and Bandages