Transcript Chapter 9
Chapter 9 First Aid Secondary Assessment Secondary Assessment • After completing the initial assessment and determining that there are no lifethreatening conditions, perform a secondary assessment. • During a secondary assessment , perform a quick head-to-toe examination for an adult • Toe-to-head exam for an child/infant Using SAMPLE to take a brief history • • • • • • S- signs & symptoms A - allergies M- medications P- pertinent past medical history L- last oral intake E- events leading up to incident SUDDEN ILLNESS • Diabetic emergency • Fainting • A seizure • A stroke • Allergic reaction • Poisoning Diabetic Emergency • Too much or too little sugar in their blood • Often, diabetics know what is wrong and will have something to take • Give sugar, preferably in liquid form Stroke • Signs: weakness/numbness of the face, arm or leg (usually on one side) • To care think FAST Face- weakness on one side of face Arm-weakness/numbness in one arm Speech- slurred or troubled Time- time to summon EMS Bites & Stings • Spider/scorpion • Snakebites • Marine Life – Jellyfish – Crabs – Stingray WOUNDS Cuts, Scrapes, & Bruises • • • • • Blood- 60,000 miles of blood vessels Heart Arteries Veins Capillaries Stitches • Uncontrollable bleeding • Wounds that show muscle, bones, joints • Large and deep puncture wounds • Embedded objects • Human / animal bites Types of Wounds • Contusion (bruise) • Abrasion (scrape) • Incision (cut / laceration) • Avulsion • Puncture Contusion (Bruise) • Damage to soft tissues & blood vessels causes bleeding under the skin • At first it may appear red • Turn purple Scrape (abrasion) • Most common type of wound caused by skin that has been rubbed or scrapped away • Usually painful because scraping away of outer skin exposes nerve endings Incision (cut / laceration) • May be jagged or smooth edges • Commonly caused by sharp objects • Can also be caused by a blow from a blunt object Avulsion • A cut in which a portion of the skin or other soft tissue is partially / completely torn away • May hang like a flap • Severed (finger) Puncture • Caused when a pointed object pieces the skin (nail, tack, bullet) • An object that remains embedded in the wound is called an impaled object Signs of Infection • • • • • Swollen / redness Warm / throb / pain Pus discharge Fever, feel ill Red streaks Care for Infection • • • • • Antibiotic ointment (Neosporin) Soak in warm water Elevate Change coverings If persists or worsens- seek a physician Caring for Soft Tissue Injuries • Closed Wound (internal injuries) • Apply something cold to control swelling • Signals of Internal Bleeding – – – – – – Tender, swollen, bruised Rapid / weak pulse Skin (cool, moist, pale, bluish) Vomiting / coughing up blood Excessive thirst Confused, faint, drowsy or unconscious Caring for an Open Wound • Control bleeding (sterile dressing-direct pressure) • Raise / elevate above heart (if no broken bone is suspected) • Apply bandage snugly over dressing (if bleeding does not stop apply additional dressing) • If bleeding cannot be controlled, put pressure to supplying artery Continued • Call EMS • Care for shock • Wash hands after care Shock Signals of Shock • • • • • • Restlessness / irritability Altered consciousness Nausea Pale, cool, moist skin Rapid breathing Rapid pulse Caring for Shock • Have victim lie down, elevate legs about 12” (unless you suspect head, neck, back injuries) • Call 9-1-1 • Control any external bleeding • Help victim maintain body temperature • Do not give food or drink • Reassure victim Special Situations Severed Body Part • Wrap the part completely in gauze or a clean towel. • Wet the towel with cool water. • Place the wrapped body part in a plastic bag & seal it shut. • Place the sealed bag in to another bag or bucket filled with ice. • Take the bag with the amputated body part to the hospital with the victim. Embedded Objects • Do not remove it • Place several objects around object to support it • Eye-cover both eyes Organs that Break Through the Abdomen • Carefully remove clothing from around the move • Cover organs with a moist, sterile / clean dressing • Cover dressing with plastic wrap • Place a folded towel / cloth to keep warm Burns • Burns • Are a specific type of soft tissue injury • You can describe burns by their cause or by their depth (the deeper the burn, the more severe it is) • A critical burn can be life-threatening Burns are caused by: • • • • Heat Chemicals Electrical current Radiation What are Critical Burns? • Burns involving trouble breathing • Burns covering more than one body part • Burns to the head, neck, hands, feet or genitals • Burns (other than very minor) to child/elderly • Burns resulting from chemicals, explosions or electricity Critical Burns • Life-threatening • Seek immediate medical attention • Often hard to tell how severe a burn is after it has happened • Problem breathing Types of Burns Superficial (First Degree) • • • • • Involve the first layer of skin Skin is red & dry & usually painful May be swollen Most sunburns are superficial Heals in 5-6 days without permanent scarring Partial Thickness (Second Degree) • Involves top layers of skin • Skin is red & blistered that may open & seep clear fluid • Usually painful & often swells • Usually heals in 3-4 weeks • Scarring may occur Full Thickness (Third Degree) • Destroys all layers of skin & any/all underlying structures (fat, muscle/bones,nerves) • Burns look brown/black (charred) with tissue underneath appearing white • Can be either extremely painful or relatively painless (nerve endings destroyed) Care for Burns • Stop the burning – Put out flames or remove victim from source of burn • Call fast-serious burns • Cool the burn – Use large amounts of water to cool – Do not use ice Care for Burns Continued • Cover the burn – Use dry, sterile dressings – Loosely bandage them in place (don’t put pressure on burn) – Do not break blisters (unbroken skin helps prevent infection) Minor Burns • • • • Wash area with soap & water Keep clean Apply antibiotic ointment (Neosporin) Watch for infection Severe Burns • Lay victim down-unless trouble breathing • Raise areas above heart • Chill easily- cover Special Kinds of Burns Chemical Burns • Chemicals (cleansers, lawn & garden sprays, paint removers, bleach) come in contact with skin or eyes • May cause severe burns (longer contact) • Flush with large amounts of cool running water • Remove clothing Electrical Burns • Never go near a victim of an electrical burn until you are sure the power source is turned off • Caused by: – Power lines – Lightning – Defective electrical equipment – Electrical outlets Electrical Burns continued • Severity depends on how long the victim was in contact with power source & strength & type of current & path it takes • Often deep • Two wounds-enter/exit Radiation • • • • Sun-may blister Cool the burn Stay out of the sun Protective lotion (SPF-15) • Antibiotic lotionprevent infection Don’ts of Burn Care • Apply ice directly to any burn, unless it’s very minor • Touch a burn w/ anything except clean covering • Remove pieces of cloth that stick to burned area • Try to clean a severe burn • Break blisters • Use any kind of ointment Injury to Muscles, Bones & Joints Skeletal System • Over 200 bones • Various sizes & shapes • Protect the body & help the body move • Hard & dense & have a rich supply of blood/nerves Joints • Consist of 2 or more bones held together by ligaments • All joints have a normal range of motion • When joints are forced beyond this range, ligaments stretch/tear Muscular System • 600 muscles-most attached by strong tissue called tendons • The shortening & lengthening of muscle make the body move • Brain directs muscles to move through the spinal cord • Injuries/diseases to the brain, spinal cord, or nerves can affect muscle control (stroke, parapalegic, Parkinsons) Injuries • Injuries to muscles, bones & joints happen often • Happen to people of all ages • Happen at home, at work, and at play Four Basic Types of Injuries • • • • Fractures Dislocations Strains Sprains Fractures • Complete break, chip or crack • Closed • Fractures can be life-threatening if they involve breaks in large bones, sever an artery, affects breathing Fractures • Open (compound)bone breaks through the skin Dislocations • Is the movement of a bone at a joint from its normal position • Usually more obvious than a fracture • Usually tears ligament away from bone • Forms a bump, ridge or hallow Strains • Stretching and tearing of muscles & tendons • Usually caused by lifting something heavy or working muscle too hard • Usually involve neck, back, thigh, calf Sprain • Tearing ligaments at a joint • Mild sprains may swell, but usually heal quickly • Severe sprain can involve a fracture/dislocation • Joints easily injured(ankle, knee, wrist, finger) How can you tell how bad the injury is? • Pain (most common signal) • Swollen, red or bruised • Significant deformity-twisted or strangely bent • Abnormal lumps or ridges • Inability to use affected part normally • Bone fragments sticking out of wound Continued • Feel bones grating, felt/heard a snap,pop at the time of injury • Injured area is cold/numb • Compare to uninjured leg or arm • X-ray, MRI, CAT scan Splinting • Splint only when victim must be moved • Only if you can do it without causing more pain • Splint the injury in the position you find it • Check circulation Types of Splints • • • • Soft splints Anatomic splints Slings Rigid splints Sprains & Strains • General care (R.I.C.E.) • • • • Rest Immobilize Cold Elevate • Cold then heat-reduces swelling and pain Special Situations Head & Spine Injuries • 2 million each year • Mostly males 15-30 years old • Causes: – Motor vehicle accidents (44%) – Falls (22%) – Acts of violence (24% – Sports (8%) 2/3 from diving When to Suspect Head, Neck, & Back Injuries • A fall from a height greater than that of the victim (elderly person) • Any diving mishap • Unconscious person (unknown reason) • Motor vehicle accidents where severe blunt force to the head, chest, abdomen, or pelvic area (gun shot wound) • Victim’s helmet is broken (motorcycle, bike, football, industrial helmet) • Lightning strike or when a victim is thrown Signals of Head, Neck & Back Injuries • Change in consciousness • Severe pain/pressure in the head, neck or back • Tingling or loss of sensation (hands, fingers, feet & toes) • Partial / complete loss of movement • Unusual bumps/depressions on head/spine • Blood / fluids (ears / nose) Signals continued • Heavy external bleeding (head, neck, back) • Seizures • Impaired breathing / vision • Nausea / vomiting • Persistent headache • Loss of balance • Bruising (head, eyes, behind the ears)