This is the main menu of this presentation return here by clicking on the home button looks like a house HeadNeck Injuries BleedingShock Wounds amp First Aid Room Burns ChestAbdomen Injuries ID: 508329
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Slide1
Traumatic Emergencies
This is the main menu of this presentation, return here by clicking on the home button (looks like a house).
Head/Neck Injuries
Bleeding/Shock
Wounds &
First Aid Room
Burns
Chest/Abdomen Injuries
Click this button on any page to return to the main menu
Fractures, Sprains
Childbirth/
Peds
Rescue/Extrication/MCISlide2
Bleeding and Shock
http://www.dailymotion.com/video/x7tnc9_the-french-chef_fun#.UTjPnXp3HEYSlide3
Bleeding and Shock
Why is blood important?
Transport oxygen and nutrients,
Take away wastes
Immune system
chemical messagesSlide4
Bleeding and ShockSlide5
Bleeding and ShockSlide6
Bleeding and Shock
Shock = lack of perfusion (perfusion = blood flow + oxygen)Slide7
Bleeding and Shock
Equipment for bleeding:
Gauze (first one must be sterile) dressing
Bandage
Note: dressing goes on wound, bandage holds in place
Do not removed soaked through dressings, add more insteadSlide8
Bleeding and Shock
Treatments for bleeding:
Pressure (direct) and position (elevate wound, lay patient down)
Pressure point
Tourniquet (last resort…tourniquet or death)Slide9
Bleeding and Shock
Pressure points: squeeze artery against bone, cut off blood flow, release every 5 minutes for 1 minute or less.Slide10
Bleeding and Shock
Tourniquet: use broad material to twist and cut off blood flow on upper arm or thigh, can also use BP cuff (but they may leak),
- release for 1 minute every 45 minutes, write time of application of patient’s foreheadSlide11
Minor Wounds &
First Aid Room
Do not need to do full
pt
assessment if they just have minor wound.
Must meet the following criteria:Walked in under own powerNo airway/breathing distress apparent
Skin colour is fineNo other signs of a significant injuryIf patient meets all these criteria, follow Modified patient assessment on study guide 97-100***must memorize wounds that require medical aid, study guide page 98***Slide12
Wounds &
First Aid Room
Cleaning a wound:
- use PPE
Use mild detergent/
anitbacterial soap to clean AROUND wound
Use ONLY sterile saline in the wound Send to medical aid as neededSlide13
Wounds &
First Aid RoomSlide14
Wounds &
First Aid Room
You are responsible for reading and knowing about the following conditions of page 100-111 of study guide:
Occupation dermatitis
Tendonitis/tenosynovitis/bursitis
Nerve entrapment syndrome
Hand-arm syndromeSlide15
Wounds &
First Aid Room
Occupational dermatitisSlide16
Wounds &
First Aid Room
TendonitisSlide17
Wounds &
First Aid Room
BursitisSlide18
Wounds &
First Aid Room
Nerve entrapment (ex. carpal tunnel)Slide19
Wounds &
First Aid Room
Sprained Ankle:
Simple sprain – can bear weight, not much swelling
Severe sprain – cannot bear weight, widespread swelling
Treatment: – assess severity and range of motion (ROM), if not sure if it’s a severe sprain/fracture, send to medical aid
- elevate, apply cold, use crepe bandage or tensor (“figure 8”)- re-assess in 24 hours, if no improvement, refer to medical aidSlide20
Wounds &
First Aid Room
Start near toes
Pull up on “weak” or painful side
Not too tight, check CMS after
Wrapping a sprained ankle.Slide21
Wounds &
First Aid Room
Application of cold:
Must check distal pulse first, if pulse is impaired CANNOT apply ice
Have thin layer between cold and skin
10 on, 5 off
Cool burns max 10 minutes, use sterile water if availableSlide22
Wounds &
First Aid RoomSlide23
Wounds &
First Aid Room
Avulsion (flapping of skin)
Ex -
deglovingSlide24
Wounds &
First Aid Room
Notes:
May have to use tourniquet
Use sterile water, gauze if available Slide25
Wounds &
First Aid Room
Evisceration (internal organs protruding)
Do NOT stuff them back in!
Cover with thick, moist sterile dressings
Use occlusive material on top to keep moisture in
Occlusive – air tight – use what you have!Slide26
Head/Neck Injuries
Spinal
DuratomesSlide27
Head/Neck Injuries
Vertebrae detailSlide28
Head/Neck Injuries
Sequencing of spinal immobilizationSlide29
Head/Neck Injuries
Eye injuries:
For severe injuries, send to medical aid
In general for severe injuries, cover both eyes.
Do not replace extruded (falling out) eyes, secure in place
Do not remove impaled objects, secure in place
Flush chemical burns for 20 minutesFor foreign objects in the eye, refer to techniques in your study guide pages 113Slide30
Head/Neck Injuries
Spinal Videos
(grips, rolls)
Rolls, full sequence
.Slide31
Head/Neck Injuries
Spinal Immobilization: key points
Must temporarily immobilize in Primary, this could be using a head grip, sandbags or other objects
A hard collar/immobilizing is a TREATMENT and is done at the end of primary if RTC, end of secondary if non-RTC
NOTE: any gunshot wound to core (chest/abdomen/neck) suspect spinal due to forces and possible path
of bullet.Slide32
Head/Neck InjuriesSlide33
Head/Neck Injuries
Battle’s sign
Racoon
eyesSlide34
Head/Neck InjuriesSlide35
Head/Neck Injuries
Vital Signs—Possible Abnormal Findings in the
Presence of a Head Injury*
Vital Sign
Abnormality
Pulse Slow and strongBreathing—rhythms Central neurogenic hyperventilation: rapid deep pattern
Cheyne-Strokes pattern: increasing and decreasing rate and depth/volume Biot’s respiration: irregular pattern of apnea and hyperventilationBlood pressure Increasing systolic with same or decreasing diastolicPupil
reaction Dilated and fixed Anisocoria: unequal pupil reactions Doll’s eye response: eyes move with head during rotation (not to be tested if suspected cervical spine injury)Presence of nystagmus
(involuntary rapid movement of the eyeballs)Slide36
Head/Neck Injuries
Some Signs and Symptoms of a Head
Injury
Intracranial
Hemmorhage
• Increasing headache• Nausea or vomiting• Pupil irregularity• Localizing neurological deficits• Confusion• Progressive impairment of consciousness
• Sudden unconsciousness• Rising blood pressure• Falling pulse rate• Abnormal breathing rhythmAbnormal Posturing• Decerebrate: extension of all four extremities (midbrain or brainstem injury)• Decorticate: extension of lower extremities; adduction, flexion of the elbow, wrist, and fingers(diencephalon injury)Possible Skull Fracture• Abnormalities, crepitation, and/or step-off with palpation
• Otorrhea: discharge from the ears (blood or cerebrospinal fluid)• Rhinorrhea: discharge from the nose (blood or cerebrospinal fluid)• Raccoon sign: discoloration of the eyelids and periorbital region (orbital or basilar skull fracture)• Battle’s sign: discoloration over the mastoid process (temporal or basilar skull fracture)Slide37
Head/Neck Injuries
Note that the brain has “redundant” circulation, meaning the L and R carotid arteries supply the same areas.Slide38
Head/Neck Injuries
Major neck wounds:
PPPT
Use occlusive dressing to prevent air entering carotid/jugular and going to brain.
Never apply pressure to both sides of neck at same time (cuts off blood flow to brain)
Teeth: put in milk (helps preserve tooth for dentist)Slide39
Chest/Abdominal Injuries
General treatments for Chest/Abdomen injuries:
Position for shock (if no spinal), oxygen
Consider possibility of internal bleeding (signs of shock, decreased BP, rigid or distended abdomen
Secure all impaled objects
inplace
Use three sided dressing occlusive dressing for sucking chest woundsSlide40
Chest/Abdominal InjuriesSlide41
Chest/Abdominal Injuries
If air cannot escape from the chest in a pneumothorax, a tension
pneumo
can resultSlide42
Chest/Abdominal Injuries
Tracheal deviation
(mediastinum shift)Slide43
Chest/Abdominal Injuries
Support flail segment with bulky dressing, tape in placeSlide44
Chest/Abdominal Injuries
Your abdomen contains many vital organs, knowing where they are can help you in determining possible injuries.Slide45
Chest/Abdominal Injuries
Abdominal evisceration:
Do not try to put organs back
Cover with sterile, moist, bulky dressings to keep in place
Cover with occlusive dressing (to prevent drying out)
Elevate feet, flex knees.Slide46
BurnsSlide47
BurnsSlide48
Burns
General treatment:
Stop the burning with cool water (sterile saline if possible)
Protect burned area with sterile, dry dressing…NO creams, lotions, butter
etc
!!!! Do not pop blisters.Consider use of entonox
for pain if NOT an inhalation injuryKnow your RTC criteria for burns from study guide (there is a bunch!)Slide49
Fractures
General Treatment:
Temporary immobilization in primary (sandbags, holding), apply splint in secondary
Check and compare CMS to uninjured limb in primary
Apply cold in primary if no circulation issues
Immobilize above and below fracture site
Use traction to realign limbs where appropriateApply entonox for pain if appropriateRefer to study guide p. 119-121Slide50
FracturesSlide51
Fractures
Sager splint videosSlide52
Childbirth/Pediatrics
While there are lots of possible complication in childbirth, remember women have been giving birth for many thousands of years without doctors, paramedics or hospitals….usually it goes fine.
Refer to study guide checklist for emergency childbirthSlide53
Childbirth/PediatricsSlide54
Rescue/Extrication/MCI
Generally done by fire department or separate rescue crew….they are in charge of extricating. Think SAFETY!Slide55
Rescue/Extrication/MCISlide56
Rescue/Extrication/MCISlide57
Rescue/Extrication/MCI
MCI treatment area general setup.Slide58
Bleeding and Shock
Socrative
Review
Which had the correct order of interventions for bleeding?
Pressure, position, pressure point, tourniquet
Pressure, pressure point, position, tourniquetPosition, pressure point, pressure, tourniquet
Tourniquet right off the batSlide59
Bleeding and Shock
Socrative
Review
What % is the MINIMUM blood loss that would likely result in decompensated shock?
10%
60%30%80%Slide60
Bleeding and Shock
Socrative
Review
Which of these is NOT an example of a dressing?
Triangular
Sterile gauzeBulk gauzeTrauma gauzeSlide61
Burns
Socrative
Review
An adult has burned both legs, front and back. What is the BSA?
9%
18%36%72%Slide62
Burns
Socrative
Review
Which of these burns WOULD be RTC?
Superficial, 60%
Full thickness, 4%Partial thickness, 8%Partial thickness 4%Slide63
Burns
Socrative
Review
Put these priorities in order for a burn: pain management, cooling, sterile treatment, EMR safety, oxygen
EMR safety, cooling, sterile treatment, pain management, oxygen
EMR safety, cooling, sterile treatment, oxygen, pain management
cooling, sterile treatment, EMR safety, cooling, pain managementsterile treatment, EMR safety, cooling pain management, oxygen