chapter 56 first aid for accidents and injuries copyright ©2012 delmar, cengage learning. all...

Chapter 56

First Aid for Accidents and Injuries

Accidents and Injuries

• Knowing basic first aid is critical• Seek medical assistance if unsure or untrained

to render aid

Foreign Bodies• In the eye

– Remove with fold of tissue or moistened cotton– Turn upper lid over swab and

remove >>– Flush with water– Embedded material requires

medical intervention– Cover both eyes with compress– Advise not to rub

Foreign Bodies

• In the ear– Instill warm water; then drain– Avoid oil with smooth objects– Irrigate out objects that will not swell with water

• In the nose– Irrigate or reach with forceps

Foreign Bodies

• Swallowed items– Will move through the body and be eliminated

• Splinters– Use needle or thumb forceps– Area washed and covered with adhesive bandage

Foreign Bodies

• Fish hook– Removal techniques– Clean and dress wounds– Tetanus and antibiotic

Strains and Sprains

• Strains– Rest in comfortable

position– Ice then heat– Analgesic or muscle

relaxers

• Sprains– Elevate– Apply ice first 48-72

hours– Elastic bandage for

support

Dislocations

• Usually severe pain and deformity at joint• Immobilize and get medical attention

Fractures

• Closed or simple• Open or compound

– Control bleeding– Splint as is

Fractures

• Treat for shock• Check pulse, motor and sensory reflexes• Medical attention as soon as possible

Bites and Stings

• Can come from humans, animals, or insects• Can be superficial or break the skin

• Animal bites– Cleanse thoroughly– Provider examination– Report bite to authorities– Observe animal– Anti-rabies serum if rabid or animal status not

available– Snake bites

• Human bites– Skin surface breaks and biter has bleeding gums– Give hepatitis B immunization– Tetanus injection

Stings

• Number of stings is a factor• Allergic response

– Restlessness– Shortness of breath with cyanotic skin– Nausea, vomiting, diarrhea– Need for emergency kit

• Remove stinger by scraping

• Types– Thermal – Chemical– Electrical

• Degree of skin involvement– First-degree– Second-degree– Third- and fourth-degree

Classification of Burns

• Based on percentage of body surface area and degree of skin involvement

Treatment of Burns

• Minor burn– Treat with cold water– No butter or ointment– No ice (due to frostbite possibility)– Photosensitive drugs increase sunburn risk

Treatment of Burns

• Second-degree– Can involve prevention of shock– Remove jewelry, due to edema– Force fluids– Cover area with sterile dressing– Provider breaks blisters

Treatment of Burns

• Third- and fourth-degree– Immediate medical treatment– Surgical intervention possible– Replacement fluids by IV– Pain medication and tetanus– No cleaning, cover with sterile dressing– Treatment for shock

Treatment of Burns

• Electrical– Remove victim from electrical source

• Electrical shut-off• Water conduction danger

– Administer CPR if in arrest– Treat burn as non-electrical– Damage along conduction path

Treatment of Burns

• Chemical– Remove clothing from area– Brush off dry chemical first– Flood with water– Cover with sterile dressing– If in eye, flush for 20 minutes and have provider

examine

Use of Heat and Cold

• Disposable packs, activate and reuse– May place in covering or towel

• Use on 20 minutes, off 10

Cold Applications

• Decreases local circulation

• Provides local anesthetic

• Relieves inflammation• Controls bleeding and

swelling

Heat Applications

• Increases tissue temperature

• Increases circulation• Increases healing• Decreases pain• Relieves congestion in

deep tissues

Wounds

• Abrasions, scrapes of epidermis– Treat by cleaning and applying dressing

• Avulsion– Clean and replace flap of torn skin

• Incision, clean cut by sharp object– May require Steri-strips or sutures to close

Wounds

• Laceration, tearing of the tissue– Hard to clean and close

• Puncture– From pointed object or bite– Clean thoroughly

Cleaning Wounds

• Clean and assess• Wash (Betadine) or other antibacterial agent• Apply disinfectant• Pressure bandage is applied• Prepare suture setup

With severe bleeding, initial cleaning is delayed until medical care is received

Dressing and Bandaging Wounds

• Apply nonstick dressing• Bandage with appropriate material

– Tubular gauze and cylinder– Open or closed spiral– Figure-eight– Cravat from triangular bandage

Bandaging

Figure Eight Cravat

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