SPECIFIC INJURIES

1
1. EYE INJURIES

Foreign bodies in the eye

Signs &symptoms
 Headache.
 Redness of the eye.
 Over production of tears.
 Burning sensation.
 Swelling.
 Pain.
 Presence of foreign body.

2
PRECAUTIONS
 Wash your hands thoroughly before examining the
victim’s eye
 Keep the victim from rubbing his/her eye.
 Do not attempt to remove a foreign object by inserting a
match stick, tooth pick, or any other instrument.
 Don't try to remove an object that's embedded in the
eyeball.
3
Removal of A FB from the surface of the eye ball

 Pull down the lower lid to determine whether or not the

object lies on the inner surface.
 If the object lies on the inner surface, lift it gently with
the corner of clean handkerchief/clean cotton.

 If the object has not been located, it may be lodged

beneath the upper lid.
 While the victim looks down, grasp the lashes of the
upper lid gently.
 Pull the upper lid foreword and down over the lower lid
then tears may dislodge the foreign object.
4
CONT..

 If foreign object has not been dislodged, depress the

victim’s upper lid with a match stick or similar object
placed horizontally on the top of the cartilage and
Evert the lid.
 Flash the eye with water.
 If the object is not removed, apply a dry dressing
and refer to hospital.
5
6
 INJURY OF THE EYE
 Stop hemorrhage by gently applying direct pressure.
 Clean the wound and apply a sterile or clean dressing.
Penetrating injuries of the eye
 Can result from injury with sharp, and pointed objects, bullet
injury.
 Are extremely serious and can result in blindness.
Blunt Injury of the eye
 A contusion occurs from direct blow, such as fist, a vehicle
accident or explosions and results in black eye.
 In serious case, the structure of the eye may be torn or
ruptured & may result in vision loss.

7
FIRST AID MEASURES

Do not try to remove the object or to wash the eye.

Cover both eyes loosely with a sterile or clean dressing.
Keep and transport the victim by stretcher.
Take the victim to emergency room of hospital to get quick
medical attention

8
HEAD INJURIES
Scalp injuries
 It is mild or serious injury on the skin covering skull
 Wounds of the scalp even if small tend to profusely bleed

First aid measures

 Do not try to clean scalp wounds.
 Control bleeding by raising the victim’s head and shoulder, do
not bend the neck .
 Place a sterile dressing on the wound.
 Apply a bandage to hold the dressing in place.

9
BRAIN INJURY
 May occur from either injury of the scalp or illness like stroke
or tumor.
 Can occur from open or closed fracture of the skull

S/S
 Clear or blood stained CSF draining from the nose or ears
following skull fracture.
 Temporary loss of consciousness.
 Partial or complete paralysis of muscle of extremities

of the opposite side and facial paralysis on the same side of

brain injury.
 Disturbance of speech.
 Loss of bowel and bladder control.

10
SIGN OF BASAL SKULL FRACTURE
 CSF leakage from nose or ear
 Racoon eyes
 Battle sign

Racoon eyes
Battle sign
11
FIRST AID FOR BRAIN INJURY

 Give particular attention to insuring an open air way.

 Control hemorrhage.
 Do not give fluid by mouth to the victim.
 Apply dressing and bandage over the skull if wound is present.
 Record the level of consciousness.
 Do not remove or disturb any foreign matter that may be in the
wound.
 Keep victim warm
 Call for ambulance, and seek medical aid immediately.

12
3. Ear injuries

Perforation of the eardrum

 Result from direct blow to the head
 Sudden change in atmospheric pressure and disease of the
middle ear. Etc.

First aid measures

 Put a small gauze or cotton loosely in the outer ear canal for
protection.

 Do not insert instrument or any kind of liquid into the ear canal.

13
…CONT.
N.B Perforation of ear drum associated with skull fracture requires
special attention.
 Don't clean the ear.
 Don't stop the flow of CSF from the ear.
 Turn the victim on to his injured side to allow fluid to drain
away.
 Get immediate medical care

14
4. NOSE INJURIES AND BLEEDS

 One of the most frequent causes of bleeding.

 It is estimated to occur in 60% of persons world wide
during their lifetime

 Most of the time, bleeding is self-limited, but can often

be serious and life-threatening.

 Approximately 6% of those seek medical treatment

 Epistaxis should never be treated as a harmless event.

15
Nose bleeding,,,,,,,

16
Local Causes of Epistaxis
 Nasal trauma (nose picking,
foreign bodies, forceful
nose blowing)
 Allergic, chronic or
infectious rhinitis
 Chemical irritants
 Medications (topical)
 Drying of the nasal mucosa
from low humidity
 Deviation of nasal septum
or septal perforation
 Bleeding polyp of the
septum or lateral nasal
wall (inverted papilloma)
 Neoplasms of the nose or
sinuses
 Tumors of the
nasopharynx especially
Nasopharyngeal
Angiofibroma
 Vascular malformation
17
Systemic Causes of Epistaxis
 Systemic arterial
hypertension
 Endocrine Causes: pregnancy,
pheochromocytoma
 Hereditary hemorrhagic
disorder
 Anticoagulants
 Hepatic disease
 Blood diseases and
coagulopathies such as
Thrombocytopenia, ITP,
Leukemia, Hemophilia
 Platelet dysfunction
18
Most Common Causes of Epistaxis
 Disruption of the nasal mucosa - local trauma, dry
environment, forceful blowing, etc.
 Facial trauma
 Scars and damage from previous nose bleeds that reopen
and bleed
 Intranasal medications or recreational drugs
 Hypertension and/or arteriosclerosis
 Anticoagulant medications

19
Nasal Blood Supply

 Internal and external carotid arteries

 Kiesselbach’s plexus (Little’s area) in anterior septum
 Woodruff’s plexus in posterior septum

20
Vascular anatomy of the medial and lateral nasal walls

21
22
Patient History

 Previous bleeding episodes

 Nasal trauma
 Family history of bleeding
 Hypertension - current medications and how tightly controlled
 Hepatic diseases
 Use of anticoagulants
 Other medical conditions - DM, CAD, etc.

23
Types of Nose bleeds

ANTERIOR (90%)
 Kiesselbach’s plexus vessels (small vessels).
 Most common in younger population

 Usually due to nasal mucosal dryness

 May be alarming because can see the blood readily, but generally

less severe
 Easy to locate and treatment
 Usually controlled with conservative measures

24
Types of Nosebleeds
POSTERIOR(10%)
 Usually occurs in older population
 Larger vessels.
 HTN common contributing factor
 May also have deviation of nasal septum
 Significant bleeding in posterior pharynx
 More challenging to control
 Harder to locate and treatment

25
Cont . . .
Signs and symptoms
 Blood coming from the nose or the rhino pharynx
Investigations
 Full blood count
 Clotting profile
 Nasal endoscopy
 Other investigations requested based on general examination
findings

26
FA Measures Nasal Bleeds

 Keep the victim quiet since it is common for patients to be anxious in

response to a nosebleed.

 Assuring the patient in a calm, efficient manner that bleeding can be

controlled can help reduce anxiety.

 Keep the victim in sitting position (upright) & slightly head tilted forward.

 Inform the victim to breathe through the mouth.

 Apply direct pressure to the bleeding nostril by pinching.
 Apply cold compress to nose and face of the victim.

27
…CONT.

 If bleeding does not stop, insert a small clean pad of gauze

into one or both nostrils and apply pressure externally
 Discourage swallowing blood.
 If it does not stop, obtain medical assistance.

28
 4. FACE AND JAW INJURY

 It often occurs as a result of automobile accidents or other

type of violent injuries.
 The immediate problems are obstruction of the air passage
by blood, saliva, and other secretions; swelling and severe
hemorrhage.

29
 FIRST AID MEASURES
A. Call for ambulance and seek immediate medical care
B. maintain an open air way.
C. Provide continuous support to the head to prevent air way
obstruction.
D. If the victim is conscious help to lean foreword to drain secretion
from mouth and cough up.
E. Give artificial respiration or CPR if necessary.
F. Treat for shock.
G. Apply protective dressing as necessary.

30
 5. NECK INJURIES

 Air way blockage may result due to hard blow on the

front of the neck especially if the laryngeal area is
affected and throat tissue are bruised.
Fist aid measures
A. Apply mouth- to -mouth or mouth- to- nose respiration.
B. Obtain immediate medical assistance in case emergency
tracheostomy is needed.
C. Place the victim at supine position to relax the
abdominal muscles.
D. Control bleeding.
E. Give first aid for shock. 31
 6. CHEST INJURY

Injury to the chest might result either

from penetrating or blunt injury
First aid measures
A. Ensure patent air way

B. Cover sucking chest wound

C. Stabilize impaled objects with bulky dressing.

D. Do not move or remove if they are deep in the tissue.

E. Stabilize flail rib segment with hand followed by
application of large pieces of tape horizontal across the
flail segment. 32
 …CONT.
semi fowler position
F. Place pt. in a semi-Fowler’s
position or position victim
on the injured side.
G. Monitor vital signs, LOC,
RR, and urinary output.
H. Release dressing if tension
pneumothorax develops.

33
 7. OPEN WOUNDS OF THE ABDOMEN
 Are particularly dangerous because of the risk of
damage of the internal organs.

First aid measures

A. Don't try to replace protruding intestines or abdominal
organs but cover with sterile dressings.
B. Hold the dressing in place with a firm bandage, but
don't tighten the bandage.
C. Don't give food or fluid.
D. Keep the victim’s head and shoulders elevated
E. Seek medical attention rapidly
34
Burn

35
 DEFINITION

 Burn is an injury that results from heat, chemical agents,

radiation or electric accident.
 It may vary in depth, size, and severity causing injury to
the cells in the affected area.
 Skin exposed to temperatures of 120°F (48.8 ° C) will be
burned after about 5 minutes.

36
CAUSES BURN INJURY

 Carelessness with matches and cigarette

 Scalds from hot liquids.
 Defective heating, cooking and electrical equipment.
 Use of open fires
 Unsafe use of flammable liquids for starting fires, for
cleaning and for rubbing wax off floors.
 Immersion in over heated bath water.
 Use of chemicals such as dyes, strong acids and strong
detergents.
37
EFFECTS OF BURN

 Asphyxia

 Joint contracture
 scarring

 Inhaling of fumes .
 Falls and injuries from collapsing walls in burning
buildings.
Classification of burn injury
 Based on degree of skin or other tissue damage. 38
 SUPERFICIAL BURN
 Superficial burn which affects only
epidermis!
 Over exposure to the sunlight,
contact with hot objects, or scalding
by hot water or steam.
signs are
 Redness or discoloration
 Mild swelling and pain
 Rapid healing 39
 CONT’D,,,,,,,,,,,,,,,

First aid objective

 to relieve pain, prevent complications and treat for shock;
usually medical treatment is not required.
 Apply cold water or submerge the burned area in cold
water.
 Apply a dry dressing if it is necessary
 severe sun burn should receive medical care as soon as
possible. 40
PARTIAL THICKNESS BURN

 Epidermis and dermis layers

of skin burned .

Causes
 Deep sunburn,
 Contact with hot liquids
 Flash burns from gasoline,
kerosene and other products.
41
USUAL SIGN

 It has greater depth than superficial burns.

 Red or mottled appearance.
 Development of blisters.
 Considerable swelling over a period of several days.
 Wet appearance of the surface of the skin due to the
loss of plasma
 Very Painful, edema, pale
42
FIRST AID MEASURE

A. Immerse the burned part in cold water.

B. Apply freshly ironed cloths that have been wrung out
in ice water.
C. Apply dry sterile gauze or clean cloth as a protective
bandage
D. Do not break blisters or remove tissue.

43
CONT.

E. Do not use an antiseptic preparation, ointments, spray,

or home remedy on a severe burn.
F. If the arms or legs are affected keep them elevated.

44
FULL THICKNESS BURN

 All skin layers and tendon, ligament

muscles and bone can be burned

Causes :
 Flame
 Immersion in hot water,
 Contact with hot objects, or
electricity.
 Strong alkali and acids
45
 USUAL SIGNS

 Deep tissue destruction.

 White or charred appearance (leathery appearance )
 Complete loss of all layers of the skin.
 Little or no pain
 No blister

46
FA MEASURE

A. Do not remove adhered particles of charred clothing.

B. Cover burns with thick, sterile dressings or a freshly ironed or

laundered sheet or other household linen.
C. Keep burned hand, feet or legs elevated

D. Give weak solution of salt & soda(two table spoon of sugar & one
table spoon of salt in one liter of water.)
E. Do not apply ointment, commercial preparations, grease or other
home remedies
F. Refer to burn center
47
 Specific fire or burn preventive measures

 Fire extinguishers in danger spots.

 Keep a garden hose ready a for use in case of fire.

 Install adequate insulation at all heating surfaces.

 Repair or replace defective or in adequate electrical
wiring.

 Perform the required maintenance on heating systems.

48
 CONT.…

 Dispose of trash immediately.

 Use only non flammable cleaning fluids.

 Hang clothes well away from stoves or fire places.

 Place curtains so that they will not blow in to flames from
any stove, candle etc.

49
CONT..

 Store flammable materials in a safe place.

 Supervise children playing near an open fire.
 Store flammable materials out of reach of children.
 Do not smoke in bed.
 Install home fire detectors. If available

50
Shock

51
DEFINITION

 Inadequate delivery of oxygen & nutrients to tissues to

meet metabolic demand

 a condition resulting from a depressed state of many vital

body functions due to hypo perfusion of tissue.

 Often characterized by inadequate perfusion

 Goal: prevent end-organ injury & halt progression to

cardiopulmonary failure & cardiac arrest
52
TYPES OF SHOCK

1. Hypovolemic (Hemorrhagic)
2. Distributive /Vasogenic/
3. Cardiogenic (Insufficient cardiac output due to poor
myocardial function)
4. Obstructive (Obstructed blood flow either into or out
of heart)

53
HYPOVOLUMIC

 Inadequate Fluid Volume

causes
 Vomiting, diarrhea
 Hemorrhage
 Acute severe burn
 Nephrotic syndrome
 Malnutrition

54
CARDIOGENIC SHOCK

 life-threatening condition in which your heart

suddenly can't pump enough blood to meet your
body's needs
 Pump Malfunction(decreased contractility)
 Rare
 Cardiomyopathy
 Congenital heart diseases
 Dysrythmias
 Post operative complications

55
OBSTRUCTIVE SHOCK

 Obstructed blood flow into or out of heart

causes
 Tension pneumothorax,
 Cardiac tamponade,
 Massive pulmonary embolism.
 Coarctation of the aorta
 narrowing, or constriction, in a portion of the aorta

56
DISTRIBUTIVE SHOCK:

 Results from excessive vasodilation and the impaired

distribution of blood flow
 Abnormal Vessel Tone(decreased afterload)
causes
 Sepsis
 Anaphylaxis
 Neurogenesis (spinal cord injury)
 Drug intoxication

57
S/S OF SHOCK

 Pale skin & mucus membrane, cold extremities to touch.

 Weakness/ fatigue
 Rapid and weak pulse,
 Rapid shallow breathing and Low BP.
 Restlessness, anxiety severe thirst, vomiting.
 sunken eyes
 Unconsciousness and hypothermia, finally death.

58
TREATMENT OBJECTIVES

 To identify and treat the cause.

 To improve circulation.
 To ensure an adequate supply of oxygen
 To maintain normal body temperature.
 To transfer the patient to health facility immediately.

59
 FIRST AID MEASURES
A. Body Position
 It must be based on the cause.
 The most satisfactory position is lying down .
 If injury is suspected on the neck or spine, don’t move
the victim until he/she is prepared for transportation.
 A victim with severe wounds of the lower part of the
face and jaw or who is unconscious should be placed on
his/her side
60
 CON’T,,,,,,,,,,,,,,,

 A person with a head injury may be kept flat or propped up

but his/her head must not be lower than the rest the body.
 Raise foot of the stretcher or bed from 20-30 inches for
other types of injuries. Trendelenburg position

61
 B. Regulating Body Temperature
 Keep the victim warm enough to avoid or over
come chilling.
 Use blanket or other available materials

62
 C. Administering Fluids
 Don't give fluid by mouth if:
 Victim is unconscious
 Victim is vomiting and having a convulsion.
 a victim likely to have surgery or anesthetic or have
brain or abdominal injury.

63
HEART ATTACK OR (MI)
 A heart attack occurs when an artery supplying
your heart with blood and oxygen becomes blocked
 Heart attack usually involves a clot in one of the blood vessels that
supply the heart.
 A heart attack may or may not be accompanied by loss of
consciousness.
 If the attack is severe, the victim may die suddenly.

64
 SIGNS AND SYMPTOMS
 Persistent chest pain usually under the sternum.
 Gasping and shortness of breath.
 Extreme pallor or bluish discoloration of the lips, skin and finger
nails.
 Extreme prostration or distress
 Swelling of the ankles which may be an indication of heart
disease.
N.B. The two principal symptoms are shortness of breath &chest
pain.

65
FIRST AID MEASURES

A. Place the victim in a comfortable position (sitting position).

B. Provide ventilation and guard against cold.
C. If the victim is not breathing begin artificial respiration.
D. If there is no pulse, begin CPR
E. Do not give liquids to an unconscious victim
F. Call for ambulance.
G. Immediately refer

66
 STROKE
 It is a sudden loss of brain function resulting from
disruption of the blood supply to the part of the brain.
 It usually involves a spontaneous rupture of a blood
vessel in the brain or formation of a clot that interferes
with circulation.
 A stroke is the acute neurological impairment/injury
caused by one of these pathologic processes.
 Brain ischemia(85%) and Brain hemorrhage(15%)
67
 MAJOR STROKE

 Involves damage to large vessels in the brain

Signs and Symptoms
Unconsciousness.
Paralysis or weakness on one side of the body.
Difficulty in breathing and swallowing.
Loss of bladder and bowel control.
Unequal size of pupils of the eye.
Lack of ability to talk or slurring of speech.
68
FIRST AID MEASURES

1. Maintain an open air way.

2. Give CPR if indicated.

3. Position the victim on his side to drain secretion.

4. Do not give fluids unless the victim is fully conscious.

5. Transport the patient to hospital immediately

69
 MINOR STROKE
 In a minor stroke small blood vessels in the brain are
involved.
 These usually do not produce unconsciousness.

Symptoms
 Minor stroke may occur during sleep & may be

accompanied by:
 Headache.

 Confusion.

 Slight dizziness and ringing in the ears.

 Other mild complaints.

70
LATER THERE MAY BE

 Minor difficulties in speech.

 Memory changes.
 Weakness in arm or leg.
 Some disturbances in the normal pattern of the
personality

71
FA MEASURES FOR STROKE

A. keep them at a comfortable temperature;

B. loosen any tight clothing;

C. wipe away any secretions from the mouth;

D. make sure the airway is clear and open;
E. do not give anything to eat or drink.

F. Protect the victim against accident or physical

exertion
G. Suggest immediate medical attention
72
FAINTING

 Fainting is a partial or complete loss of consciousness due to a

reduced supply of blood to the brain for a short time.

 Occasionally a person collapsed suddenly without warning.

 To prevent fainting, a person who feels weak and dizzy should lie

down or bend over with his/her head at the level of his/her knees .

73
MANIFESTATIONS

S/S are:-
 Extreme paleness
 Sweating

 Coldness of the skin

 Dizziness

 Numbness and tingling of the hands and feet

 Nausea
 Possible disturbance of vision
74
FA MEASURES

 Leave the victim lying down.

 Loosen any tight clothing and keep crowds away.

 Turn the head to the side.

 Maintain an open air way.
 Do not pour water over the victim’s face instead bath his face
gently with cool water.

 Do not give any liquid unless the victim has revived.

 Unless recovery is prompt, seek medical assistance

75
 CONVULSION

 A convulsion is a medical event in which nerve cell activity in the

brain is disrupted, causing muscles to involuntarily contract and
spasm, resulting in sudden, violent, and irregular movements of
the body
 Convulsions associated with head injury or brain diseases such as
a tumor, an abscess or hemorrhage often tend to be localized with
rigidity and jerking of groups of muscles instead of the whole
body.

76
COMMON CAUSES OF CONVULSION

Severe dehydration
Febrile illnesses such as
Meningitis
Malaria
Tetanus and other illnesses
Epilepsy
Preeclampsia (Toxemia of pregnancy)
hypoglycemia

77
 S/S

 Rigidity of body muscles from a few seconds to perhaps half a

minute followed by jerking movement.
 Bluish discoloration of the face and lips
 Foaming in the mouth or drooling.
 Gradual subsidence (improvement ).

78
FA MEASURES

A. Prevent victim from hurting himself.

B. Do not place a blunt object between the victims
teeth.
C. Do not restrain.
D. Do not pour any liquid in to his/her mouth.
E. Do not place a child in a tub of water.
F. Avoid overcrowding.
G. Reassure and advise to seek medical attention.

79
EPILEPSY
 Is chronic disease usually of unknown cause
characterized by recurrent seizure.
 can be due to inherited or acquired diseases, metabolic
derangement, drug or alcohol withdrawal , stroke or
encephalitis.
First Aid Measures
 FA is the same as for other convulsions, which includes
the following:
A. Keep air way open.

B. Give artificial respiration, if breathing stop.

80
 … CONT.

C. Push away near by objects.

D. Do not force a blunt object between the victim’s teeth.
E. If the victim’s mouth is open you might place a soft
object such as rolled hand kerchiefs between his side
teeth.
F. When jerking is over, loosen the clothing around his
neck.
G. Keep the in lying down position.
H. After the seizure, allow the victim to sleep and rest

81
THANKS!!!!

82