1. First Aid and Emergency Care
Medical Surgical Nursing Unit 8
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2. Introduction Know your terms! Facts Home Safety Highway Safety
Water Safety
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3. Triage Categories Emergent - immediate intervention is needed
Urgent - care is needed in 1-2 hours to prevent deterioration
Non-urgent – care can be delayed without risk of permanent dysfunction or disability
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4. General Principles of First Aid
Think before acting. Stay calm.
Survey the scene.
Check each victim quickly. Treat most serious injuries first.
Evaluate injuries and summon help.
Do not move victim, unless necessary.
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5. General Principles of First Aid
Do not remove impaled objects.
If unconscious, NPO!
Explain everything you are doing.
Good Samaritan Law
Protects medical personnel
The nurse is expected to demonstrate the same skill, knowledge, and care as would be given by other nurses in the area with same credentials.
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6. Initial Assessment Assess ABC’s and LOC
Initiate rescue breathing or CPR if needed
Control bleeding and identify its source
If needed immobilize the C-spine
Head to toe assessment
Look for fractures
Look for medic alert tags.
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7. Initial Interventions
Splint fractures in the position they are found
Prevent chilling
Do not remove penetrating objects
Keep them NPO!
Stay with the patient until the ambulance arrives.
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8. The Nursing Assessment
Physical Exam
Primary Survey
Scene safety! BSI!
LOC and overall general appearance
ABC’s
Neuro deficits
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9. The Nursing Assessment
Physical Exam
Secondary Survey
Vital Signs
Expose for head to toe assessment
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10. The Nursing Assessment
Health History
Chief Complaint
Treatment
Past Medical History
Medications
Allergies
Last Meal
Private Physician
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11. CPR Points to Remember Reestablishment of heart and lung function
Indicated when there are no pulses, no respirations
Prompt action is ESSENTIAL!
Use AHA or ARC standards
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12. CPR Points To Remember Indications for CPR Absence of carotid pulse
Absence of response to stimuli
Absent respirations
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13. CPR Points To Remember
Artificial breathing is done by mouth to mask, or barrier device
Open airway
Breathe for victim about 12 times per minute, or once every 5 seconds
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14. CPR Points to Remember Cardiac compressions
Done on the lower ½ of the sternum, between the nipples, to squeeze the heart between the sternum and spinal column
Press hard and fast, 100 times/minute
Compression ventilation ratio is 30:2 (30 every 23 seconds)
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15. Choking Emergencies
Obstructed airway is the sixth leading cause of accidental death
Victim may give the universal sign for choking, be unable to speak or cough, and be cyanotic
If victim is able to cough, allow
to expel the object
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16. Control of Hemorrhage Internal -Signs and symptoms
External -Signs and symptoms are obvious
Place clean or sterile dressing
Apply firm, steady pressure
When bleeding slows, apply bandage
Elevate and immobilize
Pressure points
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17. Shock 5 basic types: neurogenic, septic, hypovolemic, cardiogenic, and
anaphylactic
Shock is the inadequate perfusion of body tissues
Symptoms are due to inadequate blood volume, loss of vascular tone, and shift of body fluids
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18. Shock Symptoms Pallor Weak or absent pulses Clammy skin Thirst
Air hunger
Hypotension
Low UO
Restlessness
Confusion
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19. Shock Shock Management Reassure and comfort the patient
Maintain body heat
Place patient flat
Restore circulating blood volume
Relieve symptoms
Control pain
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20. Burns First stop the burning process! 1st degree or superficial burns
Minor burns can be immersed in cold water and covered with cool, moist dressings
2nd degree or partial thickness burns
3rd degree or full thickness burns
Shock and infection
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21. Burns Major burns Assess airway and respirations
Cover with a clean, dry dressing
No ointments!
Do not disturb blisters!
Do not allow two burned skin surfaces to touch
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22. Burns Chemical burns FLUSH! Cover with dry dressing
If ingested, call poison control
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23. Poisoning
Illness or harm caused by ingestion,inhalation,injection, or contact of a toxic substance
Education
When should poisoning be suspected?
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24. Poisoning
Swallowed
Inhaled
Food poisoning
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25. Bites
Complications include infection, tissue destruction, and anaphylaxis
Treat wound immediately
Vaccinations r/t rabies
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26. Bites Snakebite Assess for puncture marks
Assess for neurotoxic signs and symptoms
Nonpoisonous treatment
Poisonous treatment
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27. Insect Bites or Stings Usually a local reaction
Serious stings need immediate care
Less serious stings
Tick bites
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28. Injuries Due to Heat and Cold
Heat Exhaustion-caused by excessive salt and H2O loss with perspiration
Heat Stroke-caused by a problem with the body’s heat regulation
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29. Injuries Due to Heat and Cold
Hypothermia-drastic lowering of body temperature
Frostbite-a local condition with constriction of blood vessels, damage to tissue, and vessel walls

30. Traumatic Injuries Fractures Head Injuries Neck and Spinal Trauma
Eye Injury
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31. Traumatic Injuries Chest Injuries Abdominal Injury
Pneumothorax-air in the pleural cavity
Flail Chest-segment of fractured ribs
Hemothorax-blood in the pleural cavity
Cardiac Tamponade-blood in the pericardial sac
Abdominal Injury
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32. Legal Implications
Outside the hospital you are expected to demonstrate the same skill, knowledge, and care as a like trained nurse at the same licensure level.
Good Samaritan Laws
Patient privacy and confidentiality still pertains.
End of Unit!
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