Lamorinda Community Emergency Response Team 01/01/2017 Lamorinda Community Emergency Response Team Unit 4a: Bandaging and Splinting Released: 1 January 2017 Lamorinda CERT

Community Emergency Response Team Personal safety is ALWAYS the number one priority Work as a team Wear personal protective equipment…gloves, helmet, goggles, N95 mask and boots The CERT goal is to do the Greatest Good for the Greatest Number Hope for the best but plan for the worst Visual 4a.1 Lamorinda CERT

Wound Care Objectives of wound care: Control bleeding Prevent secondary infection Treatment of wounds: Clean wounds – don’t scrub Apply dressing Apply bandage to hold dressing in place No Hydrogen Peroxide Visual 4a.2 Lamorinda CERT

Tourniquets Tourniquets are an effective means of arresting life- threatening external hemorrhage from limb injury Their use remains a subject of much debate Tourniquets are often discouraged in contemporary pre-hospital civilian trauma care The Combat Application Tourniquet (CAT) has been found to safely and effectively occlude blood flow with a low incidence of adverse events Visual 4a.3 Lamorinda CERT

Tourniquets Tourniquets effectively stop blood flow and all tissue beyond the tourniquet should be considered forfeited due to loss of oxygen to the cells Once applied, write date and time on the tourniquet or skin and leave the tourniquet in place Israeli Bandage SWAT-T Visual 4a.4 Lamorinda CERT

Rules of Dressing Dressings are in direct contact with the wound and should be sterile if at all possible Dressings reduce the risk of infection Dressings stop bleeding and start clotting Dressings absorb any excess blood, plasma or other fluids Bandages hold dressings in place Band-Aid® and like products combine dressing and bandage. The adhesive plastic is perforated to allow airflow. Do not use solid plastic to hold a dressing in place, the wound needs oxygen from air to heal. Visual 4a.5 Lamorinda CERT

Rules of Dressing In the absence of active bleeding, remove dressing, flush and check wound at least every 4-6 hours, redress as necessary If there is active bleeding, redress OVER existing dressing and maintain pressure and elevation Visual 4a.6 Lamorinda CERT

Rules of Dressing After applying a dressing, always check CSM: Circulation Assess COLOR, TEMPERATURE, CAP REFILL Sensory Ask patient about presence or absence of SENSATION, (e.g. numbness, tingling, lack of feeling) Motor Ask patient to MOVE affected fingers and toes Visual 4a.7 Lamorinda CERT

Dressing a wound Irrigate the wound to remove as much contamination as possible. Use tweezers if possible to remove any glass shards, splinters or other solid material from the wound. Dab the wound with cotton or cloth, do not scrub. Visual 4a.8 Lamorinda CERT

Dressing a wound Cover the wound with a dressing. Secure the dressing with a bandage. Visual 4a.9 Lamorinda CERT

Bandaging over a Dressing Place dressing over wound Make a “Tail” on the roller gauze so the bandage can be secured and won’t come undone. Wrap around the “Tail” on the first pass and fold over the “Tail” after the first pass. Visual 4a.10 Lamorinda CERT

Bandaging over a Dressing Periodically put “half twists” in the roller gauze to make the bandage tighter and snug. Always wrap starting distal to proximal to avoid creating a tourniquet. Tie off the roller gauze by opening up the remainder of the roller gauze and making a loop under the forearm. Tie the two ends of the gauze together in a bow tie. Completed bandage maintains pressure on the wound and will not slide on the forearm. Visual 4a.11 Lamorinda CERT

Treating Amputations Control bleeding and elevate part Treat for shock if present Save tissue parts, wrapped in clean cloth Place in baggy with patient’s name, date and time Keep tissue cool, not frozen Keep tissue with the victim Duct tape to body, out of victim’s sight Visual 4a.12 Lamorinda CERT

Treating Impaled Objects Immobilize Don’t move or remove Control bleeding Clean and dress wound Wrap Visual 4a.13 Lamorinda CERT

Guidelines for Splinting Support the injured area Assess CSM Circulation Sensory Motor Splint injury in the position that you found it Don’t try to realign bones Immobilize the joints above and below the injury After splinting, recheck CSM below the injury sight Visual 4a.14 Lamorinda CERT

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 DO NOT: Draw exposed bones back into tissue Irrigate wound Visual 4a.15 Lamorinda CERT

Treating Nasal Bleeding Causes: blunt force, skull fracture, non-trauma related issues Blood loss can lead to shock Victims may become nauseated and vomit if they swallow blood Pinch the nostrils together, lean forward Put pressure on the upper lip just under the nose Use hemorrhagic nasal packing such as Celox Treating Nasal Bleeding Visual 4a.16 Lamorinda CERT

Anyone who is unconscious is “Immediate” Exercise Anyone who is unconscious is “Immediate” Visual 4a.17 Lamorinda CERT