Transcript September 11, 2001 Lessons Learned

Unit 3 Review
The “Killers”:
 Airway obstruction
 Excessive bleeding
 Shock
All “immediates” receive airway control, bleeding
control, and treatment for shock.
Visual 4.1
Unit 3 Review
Triage involves:
 Rapid assessment.
 Rapid treatment.
Visual 4.2
Unit Introduction
Topics:
 Public health concerns
 Organization of disaster medical operations
 Establishing treatment areas
 Conducting head-to-toe assessments
 Treating injuries
Visual 4.3
Unit Objectives
 Take appropriate measures to protect public
health.
 Perform head-to-toe patient assessments.
 Establish a treatment area.
 Apply splints to suspected fractures and sprains,
and employ basic treatments for other wounds.
Visual 4.4
Public Health Considerations
 Maintain proper hygiene.
 Maintain proper sanitation.
 Purify water (if necessary).
Visual 4.5
Steps to Maintain Hygiene
 Wash hands frequently using soap and water.
 Wear latex gloves; change or disinfect after each
patient.
 Wear a mask and goggles.
 Keep dressings sterile.
 Avoid contact with body fluids.
Visual 4.6
Maintaining Sanitation
 Control disposal of bacterial sources.
 Put waste products in plastic bags, tie off, and
mark as medical waste.
 Bury human waste.
Visual 4.7
Functions of Disaster Medical Operations
 Triage
 Treatment
 Transport
 Morgue
Visual 4.8
Establish Treatment Areas
The site selected should be:
 In a safe area.
 Close to (but upwind and uphill from) the hazard.
 Accessible by transportation vehicles.
 Expandable.
Visual 4.9
Establishing Treatment Areas
Supply & Hygiene
Treatment Areas
Command Post
Immediate
Delayed
Incident Site
Triage
Communications
Morgue
Danger
area
Safer area
Terrain, Drainage, weather, roads, access
Visual 4.10
Transportation
Wheeled, Air,
Boat
Indicators of Injury
 Bruising
 Swelling
 Severe pain
 Disfigurement
Provide immediate treatment for life-threatening
injuries!
Visual 4.11
Conducting Victim Assessment
A head-to-toe assessment:
 Determines the extent of injuries and treatment.
 Determines the type of treatment needed.
 Documents injuries.
Visual 4.12
Head-to-Toe Assessment
1.
2.
3.
4.
5.
6.
7.
8.
9.
Head
Neck
Shoulders
Chest
Arms
Abdomen
Pelvis
Legs
Back
Visual 4.13
Closed Head Injuries
 Change in Consciousness
 Inability to move on or more body parts
 Severe pain or pressure in head, neck or back
 Tingling or numbness in extremities
 Difficulty breathing or seeing
Visual 4.14
Closed Head Injuries Cont.
 Bleeding, bruising or deformity of head or spine
 Blood or fluid in nose or ears
 Bruising behind the ear
 “Raccoon eyes” (bruising around eyes)
 Seizures
 Nausea or vomiting
 Victim is found in collapse or heavy debris
Visual 4.15
Closed Head Injuries Cont.
Visual 4.16
In-line Stabilization
 Normally a C-collar is used, but…
 In disasters you must be creative
Backboards – doors, tables, building materials
 Stabilize the head – towels, draperies, filled
bags
• CAUTION – don’t manipulate or move unless
absolutely necessary
• DO NO HARM!

Visual 4.17
In-Line Stabilization
Stabilize Head & Neck
Visual 4.18
Stabilize Neck and Torso
Hands-on Exercise
Conduct a head-to-toe
assessment on your partner
Use verbal & hands-on method!
Visual 4.19
Treating Burns
 Cool the burned area.
 Cover to reduce infection.
Visual 4.20
Layers of Skin
 Epidermis
 Dermis
 Subcutaneous layer
Visual 4.21
Classification of Burns
 First degree
 Second degree
 Third degree
Visual 4.22
Wound Care
 Control bleeding
 Prevent secondary infection
 Clean wound—don’t scrub
 Apply dressing and bandage
Visual 4.23
Rules of Dressing
1. In the absence of active bleeding, remove
dressing and flush, check wound at least every
4-6 hours.
2. If there is active bleeding, redress over existing
dressing and maintain pressure and elevation.
Visual 4.24
Treating Amputations
 Control bleeding
 Treat for shock
 Save tissue parts, wrapped in clean cloth
 Keep tissue cool
 Keep tissue with the victim
Visual 4.25
Impaled Object
Visual 4.26
Treating Impaled Objects
Impaled Objects:
 Immobilize.
 Don’t move or remove.
 Control bleeding.
 Clean and dress wound.
 Wrap.
Visual 4.27
Immobilize and Dress
Cut Dressing to fit
Visual 4.28
Wrap Dressing and Immobilize
Treating Fractures, Dislocations,
Sprains, and Strains
 Objective: Immobilize the injury and joints about
and below the injury.
 If questionable, treat as a fracture.
Visual 4.29
Fracture Types
Closed
Visual 4.30
Open
Treating an Open Fracture
 Do not draw exposed bones back into tissue.
 Do not irrigate wound.
Visual 4.31
Treating an Open Fracture
DO:
 Cover wound.
 Splint fracture without disturbing wound.
 Place a moist 4" x 4" dressing over bone end to
prevent drying.
Visual 4.32
Open Fracture
Visual 4.33
Signs of Sprain
 Tenderness at injury site
 Swelling and/or bruising
 Restricted use or loss of use
Immobilize and elevate.
Visual 4.34
Guidelines for Splinting
1.
2.
3.
4.
5.
Support the injured area.
Splint injury in the position that you find it.
Don’t try to realign bones.
Check for color, warmth, and sensation.
Immobilize above and below the injury.
Visual 4.35
Arm and Ankle
Splint or Sling
Visual 4.36
Ankle using Cardboard
Leg Splint and Anatomical
Splint
Types of Materials:
Wood, Rolls of
Newspaper, Magazines,
Cardboard, Foam Pads
Pillows, Towel Rolls,
Other body parts – the
other leg.
Visual 4.37
Anatomical
Hands-on Exercise
Bandaging and Splinting
15- 20 minutes
Visual 4.38
Nasal Bleeding
 Causes:





Blunt force
 Skull fracture
 Nontrauma-related conditions
Blood loss can lead to shock.
 Greater than 15 minutes
Victims may become nauseated and vomit if they swallow
blood. So head forward and between the knees if possible
Do not lie down on their back.
Gently pinch nostrils, Do not pack nose with tissue or
gauze
Visual 4.39
Heat Injuries
 Heat Cramps
 Heat Exhaustion
 Heat Stroke (Sun Stroke)
Visual 4.40
Heat Cramps
Signs of heat cramps include:
•Muscle twitching or spasms
•Muscles that feel hard and lumpy
•Tender muscles
•Nausea and vomiting
•Weakness and fatigue
Visual 4.41
Treating Heat Cramps
Treatment of heat cramps include:
• Good hydration before exertion
• Rehydrate with sport drinks
• Get to a cool location
Visual 4.42
Heat Exhaustion
The symptoms include:










Sweating a lot.
Feeling faint, lightheaded, dizzy, or weak.
Nausea and vomiting.
Pale, cool, and moist skin.
Fatigue.
Headache, Blurred vision.
Fast heart rate.
Fast breathing (hyperventilation).
Heat cramps or muscle aches.
Occasionally, fainting.
Visual 4.43
Heat Exhaustion Treatment
Stop your activity and rest.
 Get out of direct sunlight and lie down in a cooler environment,
such as shade or an air-conditioned area. Elevate your feet.
Remove all unnecessary clothing.
 Cool down by applying cool compresses or having a fan blow on
you. Place ice bags under your arms and in your groin area,
where large blood vessels lie close to the skin surface, to cool
down quickly.
 Drink water, juices, or sports drinks to replace fluids and minerals.
Drink 2 qt (1.89 L) of cool liquids over 2 to 4 hours. You are
drinking enough fluids if your urine is normal in color and amount,
and you are urinating every 2 to 4 hours.
 Rest for 24 hours and continue fluid replacement with a
rehydration drink. Rest from any strenuous physical activity. Total
rehydration with oral fluids usually takes about 36 hours, but most
people began to feel better within a few hours.
Visual 4.44
Heat Stroke
Heat exhaustion can sometimes lead to heatstroke, which
requires emergency treatment. Heatstroke occurs when the
body fails to regulate its own temperature and body
temperature continues to rise, often to 105°F (40.56°C) or
higher. A person with heatstroke may stop sweating.
Symptoms of heatstroke include:
 Confusion
 Delirium or unconsciousness
 Skin that is red, hot, and dry, even under the armpits.
Heatstroke is a life-threatening medical
emergency
Visual 4.45
Heat Stroke Treatment
Call 911
 Move the person into a cool place, out of direct sunlight.
 Remove unnecessary clothing and place the person on his or her
side to expose as much skin surface to the air as possible.
 Cool the person's entire body by sponging or spraying cool (not cold)
water and fan the person to lower the person's body temperature.
 Apply ice packs to the groin, neck, and armpits. Do not immerse the
person in an ice bath.
 Do not give aspirin or acetaminophen to reduce a high body
temperature that can occur with heatstroke. These medications may
cause problems because of the body's response to heatstroke.
 If the person is awake and alert enough to swallow, give the person
fluids [32 fl oz (1 L) to 64 fl oz (1.9 L) over 1 to 2 hours] for hydration.
Most people with heatstroke have an altered mental status and
cannot safely be given fluids to drink.
Visual 4.46
Symptoms of Hypothermia
Primary signs and symptoms:
 A body temperature of 95o Fahrenheit (37o
Celsius) or less
 Redness or blueness of the skin
 Numbness accompanied by shivering
Visual 4.47
Symptoms of Hypothermia
At later stages, hypothermia will be accompanied by:
 Slurred speech.
 Unpredictable behavior.
 Listlessness.
Visual 4.48