Unit 3 Review

1
Unit 3 Review

• The Killers
• Airway obstruction
• Excessive bleeding
• Shock
• All immediates receive airway control, bleeding
  control, and treatment for shock.

2
Unit 3 Review

• Triage involves
• Rapid assessment.
• Rapid treatment.

3
Unit Introduction

• Topics
• Public health concerns
• Organization of disaster medical operations
• Establishing treatment areas
• Conducting head-to-toe assessments
• Treating injuries

4
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.

5
Public Health Considerations

• Maintain proper hygiene.
• Maintain proper sanitation.
• Purify water (if necessary).

6
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.

7
Maintaining Sanitation

• Control disposal of bacterial sources.
• Put waste products in plastic bags, tie off, and
  mark as medical waste.
• Bury human waste.

8
Functions of Disaster Medical Operations

• Triage
• Treatment
• Transport
• Morgue

9
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.

10
Establishing Treatment Areas
11
Indicators of Injury

• Bruising
• Swelling
• Severe pain
• Disfigurement
• Provide immediate treatment for life-threatening
  injuries!

12
Conducting Victim Assessment

• A head-to-toe assessment
• Determines the extent of injuries and treatment.
• Determines the type of treatment needed.
• Documents injuries.

13
Head-to-Toe Assessment

• Head
• Neck
• Shoulders
• Chest
• Arms
• Abdomen
• Pelvis
• Legs
• Back

14
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

15
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

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 dont manipulate or move unless
  absolutely necessary
• DO NO HARM!

17
In-Line Stabilization
Stabilize Head Neck
Stabilize Neck and Torso
18
Hands-on Exercise

• Conduct a head-to-toe assessment on your partner

Use verbal hands-on method!
19
Treating Burns

• Cool the burned area.
• Cover to reduce infection.

20
Layers of Skin

• Epidermis
• Dermis
• Subcutaneous layer

21
Classification of Burns

• First degree
• Second degree
• Third degree

22
Wound Care

• Control bleeding
• Prevent secondary infection
• Clean wounddont scrub
• Apply dressing and bandage

23
Rules of Dressing

• In the absence of active bleeding, remove
  dressing and flush, check wound at least every
  4-6 hours.
• If there is active bleeding, redress over
  existing dressing and maintain pressure and
  elevation.

24
Treating Amputations

• Control bleeding
• Treat for shock
• Save tissue parts, wrapped in clean cloth
• Keep tissue cool
• Keep tissue with the victim

25
Impaled Object
26
Treating Impaled Objects

• Impaled Objects
• Immobilize.
• Dont move or remove.
• Control bleeding.
• Clean and dress wound.
• Wrap.

27
Immobilize and Dress
Cut Dressing to fit
Wrap Dressing and Immobilize
28
Treating Fractures, Dislocations, Sprains, and
Strains

• Objective Immobilize the injury and joints
  about and below the injury.
• If questionable, treat as a fracture.

29
Fracture Types
Closed
Open
30
Treating an Open Fracture

• Do not draw exposed bones back into tissue.
• Do not irrigate wound.

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.

32
Signs of Sprain

• Tenderness at injury site
• Swelling and/or bruising
• Restricted use or loss of use
• Immobilize and elevate.

33
Guidelines for Splinting

• Support the injured area.
• Splint injury in the position that you find it.
• Dont try to realign bones.
• Check for color, warmth, and sensation.
• Immobilize above and below the injury.

34
Arm and Ankle
Splint or Sling
Ankle using Cardboard
35
Leg Splint and Anatomical
Splint
Anatomical
36
Nasal Bleeding

• Causes
• Blunt force
• Skull fracture
• Nontrauma-related conditions
• Blood loss can lead to shock.
• Victims may become nauseated and vomit if they
  swallow blood.

37
Heat Injuries

• Heat Cramps
• Heat Exhaustion
• Heat Stroke (Sun Stroke)

38
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

39
Treating Heat Cramps

• Treatment of heat cramps include
• Good hydration before exertion
• Rehydrate with sport drinks
• Get to a cool location

40
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.

41
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.

42
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 105F (40.56C) 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

43
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.

44
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

45
Symptoms of Hypothermia

• At later stages, hypothermia will be accompanied
  by
• Slurred speech.
• Unpredictable behavior.
• Listlessness.