COMMON EMERGENCY MEASURES

Mayer L. Tominez RN, MSN

OBJECTIVES
At the end of the lecture, the students will be able to:
1. identify the different kinds of burns and its characteristics,  2. apply emergency care at the scene of injury following the steps for prompt and effective treatment of common types of burn  3. prevent spread of infection with the use of sterile technique.

BURNS
injury to tissue caused by contact with dry heat (fire), moist heat (steam or liquid), chemicals, electricity or lightning, or radiation.

SKIN

BURN CHART

BURNS CHARACTERISTICS
Classificati Damage on Examples
Sunburn Heat flame

Appearanc Sensation e
Very RED Blisters (Bullae) White leathery inelastic Moderately painful Very painful

1st 2nd

Superficial Partial thickness, epidermal Full thickness, epidermis and dermis Full thickness, incl. Muscle bone

3rd
4th

Heat flame Chemical

No pain at site

Electricity

Exposed No pain at muscle, bone site charred

1ST DEGREE BURNS

SECOND DEGREE BURNS

THIRD DEGREE BURNS

ELECTRICAL BURNS

SMOKE INHALATION INJURY

RULE OF NINE’S
PEDIA Head -18% Lower Extremeties13.5%

BURNS FIRST AID AND TREATMENT
Once safe, remove the patient from the source of burns  Extinguish and remove smoldering clothes  Remove patient from electrical source  Wash off chemicals with water  Remove objects that may continue to cause burns  Brush off solid chemical before applying water  Brush off solid chemical before applying water  Provide oxygen, if in respiratory distress bring to the hospital immediately  Control hemorrhage w/ direct pressure  Cover burns w/ sterile dry dressing, gauze or sheets  Don’t break blisters or apply ice  Cover eyes if involved, if fingers & toes are burned separate them w/ a gauze

Patients to be brought to the hosp.
 


   

All electrical burns, those w/ additional trauma ( GSW, SW, open wounds, Fracture) Elderly, children, babies, those who cannot care for themselves. Burns involving hands, feet, flexor areas, face, inguinal area Those w/ concomitant medical illnesses Massive skin loss Debilitated patients Smoke inhalation Injury patients

EMERGENCY CARE
2. 1.

3.

Give the victims fluids orally ( if can swallow) or intravenously. To prevent dehydration and fluid imbalances.

4.

•cover other unaffected areas with blanket to prevent chilling. Prevent infection

5.

CHEMICAL BURNS AND OTHER BURNS

Acids: Affected area should be bathed immediately using plenty of water and continuing bathing until all the chemical has been washed away. Then cover it with sterile dressing. Medical help should be a priority. Electrical burns: Shock is the main danger. Artificial respiration should begun as soon as the currents has been broken. A person struck by lightning requires also an artificial respiration.

NURSING CONSIDERATIONS:
•Clothing should be removed from the burned area only if it does not traumatize further the skin. •Burned clothing's should be sent to the burnt center as it may help determine the chemicals and other substances that either caused or entered the wound. • Absorbent cotton, oil, ointments and creams should not be applied to moderate to severe burns. •Blistered are not opened or disturbed in any way. •Blanket is use to cover other unaffected areas •If major burns are evident, it is necessary to establish and maintain an airway. Medical attention should be prompt.

FRACTURES

A break in the continuity of bone caused by trauma, by twisting due to muscle spasm, or indirect loss of leverage by disease.

OBJECTIVES
At the end of the lecture, the students will be able to:
1. identify the different kinds of fractures and its characteristics,  2. apply emergency care at the scene of injury following the steps for prompt and effective treatment of common types of fracture  3. prevent further injury with the use of proper technique.

TYPES OF FRACTURE

Femoral

Lower leg

Shoulder

Upper and Lower Extremeties

FACIAL FRACTURE

RIB FRACTURES

MATERIALS:
1. 2. 3. 4. 5. 6. 7. 8. 9. Bandages Splints Casts Elastic bandages Gauze Antiseptic/ disinfectant Collars Spine boards blankets

PROPER CARE FRACTURE
1.Splinting the bone, it should be splinted “as it lies”: i.e. it should be supported in such a way that the injured part will remain steady and will resist jarring if the victim is moved. No attempt should be made to reduce the fracture.
2. Hold the injured part as a unit. And move as a unit.

3. Keep the patient warm.

SPLINTING

IMMOBILIZATION

SURGICAL TREATMENT:
1. Reduction- pulled into alignment and the continuity of the bone is establish so that the healing can take place and bone is made whole again. 2. Closed reduction- manual manipulation of the fractured bone so that the fragments are brought into proper alignment. 3. Open reduction-highly contaminated and must be debrided and copiously irrigated in the OR. Immobilized by casts. 4. Internal fixation with pins, nails, metals plates, or screws to stabilize the alignment.

SHOCK

ANAPHYLACTIC SHOCK
System Respiratory CardioVascular Skin GIT Reaction
Laryngeal edema. Brochospasm Vascular pooling, arrythmias

Symptoms
Dyspnea, wheezing, cough Faintness, apprehension

Signs
Stridor, respiratory distress Hypotension, loss of consciousness

Hives, Facial Swelling

Itching

Raised red rash, edema of soft tissue, lips, tongue, eyelids

Smooth muscle contraction

Nausea, Vomiting, diarrhea abdominal cramps

WOUNDS, INSECT and ANIMAL BITE

Insect bites

Bandaging

KINDS OF WOUNDS

Abrasions

LACERATED AND AVULSED WOUND

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