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Shock and Torso injuries Extremities and spine injuries

Shock
 Shock is a life-threatening condition  Lack of sufficient blood or oxygen flow to the tissues.  In trauma BLEEDING is the cause of SHOCK  Shock is one of the primary consequences that you

are trying to avoid during first aid.

Signals
 Pale skin, lips, and fingernails;  Moist, clammy skin;  Weak, rapid pulse (more than 100 beats per minute)

 Increased breathing rate;
 Irregular breathing;  Restlessness, anxiety, weakness;

 Thirst, dilated pupils;
 Unresponsiveness in severe conditions

Shock- First Aid
 Shock cannot be managed effectively by first aid alone.  A victim of shock requires emergency medical care as

soon as possible.

 Call 999 or the local emergency number immediately.  Have the victim lie down.  Helping the victim rest comfortably is important because pain can intensify the body's stress and accelerate the progression of shock.  Loosen any tight clothing (collar, sleeves, belt)  Control any external bleeding.

Shock- First Aid
 Elevate the legs about 12 inches unless you suspect

head, neck or back injuries or possible broken bones involving the hips or legs. If you are unsure of the victim's condition, leave him or her lying flat.  If the victim is cool, try to cover him or her to avoid chilling.

Shock- First Aid
 Do not give the victim anything to eat or drink, even

though he or she is likely to be thirsty Moisten

casualty's lips if they seem dry
 Reassure the victim

Summary
 Life-threatening condition call 999 early  Give first aid to the injury that caused the shock in order to eliminate or 


 

minimize shock Be gentle with the casualty to minimize pain which minimizes chances of getting shock Make sure casualty is at a comfortable temperature Place casualty in the best position based on their condition Continue to give care, reassure, be calm until handing the situation over to the paramedics.

Life-threatening injuries
     

Airway obstruction
Tension pneumothorax Open pneumothorax Flail chest Massive hemothorax

Cardiac tamponade

Tension Pneumothorax
 

Rapid breathing Distended neck veins


Unilateral  in chest rise
Bluish lips, fingers(late)

Open torso injury

Need emergency care- call 999 cover wound


Chest tube
Definitive operation

Flail Chest / Pulmonary Contusion

Flail Chest / Pulmonary Contusion
   

Reexpand lung Oxygen Judicious fluids Intubate as indicated Analgesia

Massive Hemothorax

Systemic / pulmonary vessel disruption  1500 mL BL Flat vs distended neck veins Shock with no breath sounds and / or percussion dullness

 

Massive Hemothorax

Rapid volume restoration Chest decompression and x-ray Autotransfusion Operative intervention

 

Cardiac Tamponade
  

Weak pulse Distended neck veins shock

Radio antenna

Cardiac Tamponade

Cardiac Tamponade
A B
C Patent airway / intubate Ventilate, oxygenate FAST / Pericardiocentesis Operation (if delayed, leave catheter in place)

Injuries to the Extremities
 Signals of a serious extremity injury include: Pain or tenderness.
 Swelling.  Discoloration.  Deformity of the limb.  Inability to move or use the limb.  Severe external bleeding.  Loss of sensation, feeling or tingling.  A limb that is cold to the touch.

Upper Extremity Injuries
• The upper extremities are the parts of the body from the shoulder to the fingers.
• The bones of the upper extremity include the: Collarbone (Clavicle).  Shoulder blade (Scapula).  Upper arm (Humerus).  Forearm (Radius and ulna).

 Wrist (Carpals).
 Hand (Metacarpals).  Fingers (Phalanges).

Care for Upper Extremity Injuries
 Take steps to minimize shock.

 Call 999 or the local emergency number

immediately.

Care for Upper Extremity Injuries
 Cover the wound with a clean dressing.
 Apply direct pressure until bleeding stops.  Cover the dressing with a bandage

Care for Upper Extremity Injuries
 Check for pulses, warmth and color before and

after applying a splint.

Care for Upper Extremity Injuries
 Minimize any movement of the injured part.
 Splint above and below the injury.

Care for Upper Extremity Injuries
 Check for pulses, warmth and color before and

after applying a splint.

Lower Extremity Injuries
• From the hip (pelvis) to the toes. • The bones of the lower extremity include the:      

Pelvic bones. Thigh bone (Femur). Kneecap (Patella). Lower leg (Tibia and Fibula). Ankle (Tarsals). Feet (Metatarsals). Toes (Phalanges).

Care for Lower Extremity Injuries
• Call 999 or the local emergency number

immediately. • While waiting for paramedic/EMS to arrive
 Immobilize the injured area.  Help the victim rest in the most comfortable

position.  Control external bleeding with direct pressure.

Care for Lower Extremity Injuries
• If the victim’s extremity is supported by the

ground, do not move it.
 Use rolled towels or blankets to support the leg in

the position you found it.

• Take steps to minimize shock.
• Keep him or her calm. • Keep the person from becoming chilled or

overheated. • Monitor breathing and level of consciousness.

General Care to Splint
• Splint only if you have to move the injured
• • • • • •

person. Cover any open wounds with a dressing and bandage. Check the area below the injury site for pulse, warmth and color. Apply the splint to immobilize the joints or bones above and below the injured area. Secure the splint in place. Recheck below the injury site for pulse, warmth and color. Elevate the splinted part.

Immobilizing Injuries
• The purposes of immobilizing an injury  Reduced pain.  Prevent further damage to soft tissues.  Reduce the risk of serious bleeding.  Reduce the possibility of loss of circulation to the injured part.

Summary
• Care for any life-threatening conditions • Call 999 or the local emergency number if

necessary. • Control any external bleeding. • Reassure the victim. • Immobilize the injured area

Questions?

 Protection of the spinal cord

Function of spine

 Providing support for the limbs and head  Attachment for the pectoral and pelvic girdle and many

other muscles.  Providing motion for the human skeleton  Transmitting body weight in walking and standing.

 There's evidence of a head injury with an ongoing change   

Spinal Injury Signals

in the person's level of consciousness The person complains of severe pain over neck or back The person won't move his or her neck An injury has exerted significant force on the back or head The person complains of weakness, numbness or paralysis or lacks control of limbs, bladder or bowels

Spinal Injury Signals

If you suspect someone has a spinal injury:
 Call 999 or emergency medical help.
 Keep the person/victim still.  Place towels on both sides of the neck or hold the head and

neck to prevent movement.

If you suspect someone has a spinal injury:
 Provide as much first aid as possible

without moving the person's head or neck.

If you suspect someone has a spinal injury:
 If you absolutely must roll the person because he or she is vomiting, choking on

blood or in danger of further injury, you

need at least one other

person.
 With one of you at the head and another along the side of the injured

person, work together to keep the person's head,

neck and back aligned while rolling the person onto one side

If you suspect someone has a spinal injury:
 Log-roll

If you suspect someone has a spinal injury:
 If the person is wearing a helmet, don't remove it- wait

for help

Summary
 Suspect spine injury in trauma patient
 Call for help early  Minimize spine movement during first aid care

Question?