1. Visual 4.1 Unit 3 Review The “Killers”:  Airway obstruction  Excessive bleeding  Shock All “immediates” receive airway control, bleeding control, and treatment for shock.

2. Visual 4.2 Unit 3 Review Triage involves:  Rapid assessment.  Rapid treatment.

3. Visual 4.3 Unit Introduction Topics:  Public health concerns  Organization of disaster medical operations  Establishing treatment areas  Conducting head-to-toe assessments  Treating injuries

4. Visual 4.4 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. Visual 4.5 Public Health Considerations  Maintain proper hygiene.  Maintain proper sanitation.  Purify water (if necessary).

6. Visual 4.6 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. Visual 4.7 Maintaining Sanitation  Control disposal of bacterial sources.  Put waste products in plastic bags, tie off, and mark as medical waste.  Bury human waste.

8. Visual 4.8 Functions of Disaster Medical Operations  Triage  Treatment  Transport  Morgue

9. Visual 4.9 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. Visual 4.10 Establishing Treatment Areas

11. Visual 4.11 Indicators of Injury  Bruising  Swelling  Severe pain  Disfigurement Provide immediate treatment for life-threatening injuries!

12. Visual 4.12 Conducting Victim Assessment A head-to-toe assessment:  Determines the extent of injuries and treatment.  Determines the type of treatment needed.  Documents injuries.

13. Visual 4.13 Head-to-Toe Assessment 1.Head 2.Neck 3.Shoulders 4.Chest 5.Arms 6.Abdomen 7.Pelvis 8.Legs 9.Back

14. Visual 4.14 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. Visual 4.15 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. 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!

17. Visual 4.17 In-Line Stabilization Stabilize Head & NeckStabilize Neck and Torso

18. Visual 4.18 Hands-on Exercise Conduct a head-to-toe assessment on your partner Use verbal & hands-on method!

19. Visual 4.19 Treating Burns  Cool the burned area.  Cover to reduce infection.

20. Visual 4.20 Layers of Skin  Epidermis  Dermis  Subcutaneous layer

21. Visual 4.21 Classification of Burns  First degree  Second degree  Third degree

22. Visual 4.22 Wound Care  Control bleeding  Prevent secondary infection  Clean wound—don’t scrub  Apply dressing and bandage

23. 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.

24. 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

25. Visual 4.25 Impaled Object

26. Visual 4.26 Treating Impaled Objects Impaled Objects:  Immobilize.  Don’t move or remove.  Control bleeding.  Clean and dress wound.  Wrap.

27. Visual 4.27 Immobilize and Dress Cut Dressing to fitWrap Dressing and Immobilize

28. Visual 4.28 Treating Fractures, Dislocations, Sprains, and Strains  Objective: Immobilize the injury and joints about and below the injury.  If questionable, treat as a fracture.

29. Visual 4.29 ClosedOpen Fracture Types

30. Visual 4.30 Treating an Open Fracture  Do not draw exposed bones back into tissue.  Do not irrigate wound.

31. 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.

32. Visual 4.32 Signs of Sprain  Tenderness at injury site  Swelling and/or bruising  Restricted use or loss of use Immobilize and elevate.

33. Visual 4.33 Guidelines for Splinting 1.Support the injured area. 2.Splint injury in the position that you find it. 3.Don’t try to realign bones. 4.Check for color, warmth, and sensation. 5.Immobilize above and below the injury.

34. Visual 4.34 Arm and Ankle Splint or SlingAnkle using Cardboard

35. Visual 4.35 Leg Splint and Anatomical Splint Anatomical

36. Visual 4.36 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. Visual 4.37 Heat Injuries  Heat Cramps  Heat Exhaustion  Heat Stroke (Sun Stroke)

38. Visual 4.38 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. Visual 4.39 Treating Heat Cramps Treatment of heat cramps include: Good hydration before exertion Rehydrate with sport drinks Get to a cool location

40. Visual 4.40 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. Visual 4.41 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. rehydration drink

42. Visual 4.42 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 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

43. Visual 4.43 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. Visual 4.44 Symptoms of Hypothermia Primary signs and symptoms:  A body temperature of 95 o Fahrenheit (37 o Celsius) or less  Redness or blueness of the skin  Numbness accompanied by shivering

45. Visual 4.45 Symptoms of Hypothermia At later stages, hypothermia will be accompanied by:  Slurred speech.  Unpredictable behavior.  Listlessness.