Injury Emergencies

Bleeding  Bleeding can sometimes look worse than it is  When a large blood vessel is cut or torn, the person can lose a lot of blood within minutes HOWEVER you can stop most bleeding with pressure  If the injured person can help you, ask him to put direct pressure on the wound while you put on gloves

Control of External Bleeding Dressing= applied directly to the wound, prevents contamination Bandage= hold the dressing in place, can provide pressure  Apply direct pressure to the wound using flat part of finger or hand.  If no injury to the muscle or bone, elevate a bleeding extremity above the level of the victim’s heart.  If dressing becomes soaked with blood, apply additional dressing WITHOUT REMOVING INITIAL DRESSING.

Internal Bleeding Injured or damaged internal organs often lead to concealed bleeding. Painful, swollen deformed extremities also often lead to serious internal bleeding.

Signs & Symptoms Discolored, tender, swollen, or hard tissue Rapid, shallow breaths Rapid, weak pulse Pale, cool, sweaty skin Nausea and vomiting Extreme thirst Altered mental status Symptoms of shock

Management  Comfort, calm, and reassure the patient while awaiting EMS  Manage any external bleeding  Keep the patient warm, treat for shock if indicated  Position of comfort

Small Wounds  Small wounds heal better and with less infection if an antibiotic ointment or cream is used.  Apply antibiotic ointment or cream and then a clean dressing, but only if wound is a small scrape or surface cut  If the cut or scrape is minor, wash the area with lots of clean water to get the wound clean before applying dressing.

Abrasion Scrape/ “road Rash” Tearing away of outermost layer of skin Very little or no oozing of blood

Laceration Break in skin of varying depth bleeding may be severe caused by sharp object

Penetration/ Puncture Caused by sharp pointed object may be little or no external damage internal damage may be severe may be entrance or exit wound

Management Complete patient assessment expose the wound control bleeding prevent further contamination apply sterile dressing and bandage in place *If a person is injured and a sharp object such as a nail or knife remains stuck in the body, leave it in the body.

Steps to take with Nosebleed 1. Make sure scene is safe. Get the first aid kit. Wear gloves 2. Press both sides of the nostrils while the person sits and leans forward 3. Place constant pressure on both sides of the nostrils for a few minutes until the bleeding stops 4. If bleeding continues press harder 5. Call 911 if: 1. You cant stop the bleeding in about 15 minutes 2. The bleeding is heavy (gushing) 3. The person has trouble breathing

Action for tooth injuries  A person with a mouth injury may have broken, loose, or knocked out teeth. 1. Make sure scene is safe. Get first aid kit, wear gloves. 2. Check the mouth for any missing teeth, loose teeth or parts of teeth. 3. Clean the wound with saline or clean water 4. If a tooth is loose, have the person bite down on a piece of gauze to keep the tooth in place and call the dentist. 5. If a tooth is chipped, gently clean the injured area and call the dentist. 6. Apply pressure with gauze to stop any bleeding at the empty tooth socket 7. If a tooth has come out, put the tooth in a cup of milk or clean water and immediately take the injured person and tooth to a dentist or emergency department. 8. Tell the person to talk with a dentist if a tooth changes color after injury

First aid steps for Eye Injuries 1. Make sure scene is safe, get first aid kit and wear gloves. 2. Phone or ask someone to phone 911 if he was hit hard or punctured. 3. Tell the person to keep both eyes closed. 4. If there is an irritant, use water to rinse the eye 5. If the irritant does not come out or the person is in extreme pain, call 911 or have someone call 911

Types of Injuries  Contusions- bruising of the tissue  Strains – Muscles are stretched or torn  Sprains - the tearing or stretching of the joints, causing mild to severe damage of the ligament and joint capsules  Tendonitis - inflammation of a tendon due to overuse (cord that attaches muscle to bone)  Dislocations - bones are displaced from their normal joint alignment, out of their sockets, or out their normal positions  Fractures - breaks on bones that may or may not be accompanied by open wounds

Basic Care Guidelines for Extremity Injuries  Use the RICE procedure  Apply a splint to stabilize fractures and dislocations

RICE  R est, I ce, C ompression and E levation  Rest - the victim does not move or use the injured body part  Ice -an ice pack is applied to the injured area as soon as possible for minutes and repeated every 2-3 hours for the first hours after in jury.  There are four stages of cold when icing: Cold, Burning, Aching and Numbness (when numbness is achieved, it is time to remove the ice pack)  Cold constricts the blood vessels to and in the injured area, which decreases swelling and inflammation, which dulls pain and reduces muscle spasms.  When icing, place ice into a double plastic bag or wet towel, or use a chemical “snap pack”

 Compression -squeezes out the fluid from the injured site. It limits the ability of the skin underlying tissues to expand and reduces internal bleeding. -Probably the most important step in preventing swelling; the injured victim should wear a compression bandage for at least the first hours after injury.  Elevation - gravity slows the return of blood to heart from the lower parts of the body. -Elevating the injured area, in combination with ice and compression, limits circulation to that area, which in turn helps limit internal bleeding and swelling. -Elevate the injured area above the heart (when possible) for at least the first 24 hours following injury.

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Signs of Head Injury  Does not respond or only moans or moves  Acts sleepy or confused  Vomits  Complains of a headache  Has trouble seeing  Has trouble walking or moving any part of the body  Has a seizure

Actions for Head, Neck and Spine Injuries 1. Make sure that the scene is safe 2. Phone or ask someone to call 911 and get the first aid kit. 3. Minimize movement of the head and neck.

Burns and Electrical Injuries  Burns are injuries that can be caused by contact with heat, electricity, or chemicals.  Heat burns can be caused by contact with fire, a hot surface, a hot liquid or steam  Use cool water on burns, ice can damage burned areas.

THERMAL BURNS  First Degree-  Affect skin’s outer layer. Characteristics include: redness, mild swelling, tenderness and pain.  Healing occurs without scarring usually within a week  Second-Degree Burns -  Extend through entire outer layer and into inner layer of skin  Characteristics: blisters, swelling, weeping/oozing of fluids,  Severe pain  Capillary blood vessels in dermis are damaged  Intact blisters provide a sterile, waterproof covering

 Third- Degree Burns-  Severe burns that penetrate all skin layers into the underlying fat and muscle  Skin looks leathery, waxy or pearly gray and sometimes charred.  Victim feels no pain because nerve endings have been damaged or destroyed.  Any pain felt is from surrounding burns of lesser degrees.  Requires medical care and removal of dead tissue- often skin graft to heal properly

1 st Degree

2 nd Degree

3 rd Degree

Actions to take 1. Make sure the scene is safe, get the first aid kit and wear gloves 2. If the burn area is small, cool it immediately with cold, but not ice cold water. Run cold water on the burn until it doesn’t hurt. 3. You may cover the burn with a dry, nonstick sterile or clean dressing 4. Call 911 if: 1. There is a fire 2. The person has a large burn 3. You are not sure what to do

Electrical Injuries  Electricity can burn the body on the inside and outside.  Electricity can stop breathing or cause a deadly abnormal heart rhythm  Electricity may leave only small marks on the body, you can not tell how much damage there is inside the body based on marks outside.

Actions 1. Make sure the scene is safe, get the first aid kid and AED. Wear gloves. 2. Phone or send someone to phone When it is safe to touch the injured person, see if he needs CPR 4. A healthcare provider should check everyone who has an electrical injury