unit 4: disaster medical operations

Visual 4.1

Unit 4: Disaster Medical Operations

Visual 4.2

Unit 4 Introduction

Topics: Public health concerns Organization of disaster

medical operations Establishing treatment

areas Conducting head-to-toe

assessments Treating injuries

Visual 4.3

Public Health Considerations

Maintain proper hygiene. Maintain proper sanitation. Maintain pure water.

Visual 4.4

Isolation Precautions

If there is any reason that some victims may be contagious, isolate them immediately.

DO NOT forget about them. Delegate someone to “stand guard” to lesson the chance of accidental exposures.

Visual 4.5

Steps to Maintain Hygiene

Wash hands frequently using soap and water. Sing The Pledge of Allegiance

Wear latex gloves; change or disinfect after each patient. 1:10 ratio of bleach to water

Wear a mask and goggles. Keep dressings sterile. Avoid contact with body fluids.

Visual 4.6

Maintaining Sanitation

Control disposal of bacterial sources. Put waste products in plastic bags, tie off, and

mark as medical waste. Bury human waste.

Visual 4.7

Water Purification

Mix 8 drops of bleach per gallon of water (16 drops if water is cloudy).

Let the solution stand for 30 minutes.

If the solution does not smell or taste of bleach, add an additional 6 drops.

Visual 4.8

Functions of Disaster Medical Operations

Triage Treatment Transport Morgue

Visual 4.9

Establish Treatment Areas

The site selected should be: In a safe area. Close to (but upwind and uphill from) the hazard. Accessible by transportation vehicles. Expandable.

Visual 4.10

The Alley

Visual 4.11

Treatment Area Organization

CERT Leaders MUST assign Supervisors to maintain control in the functional areas. These Supervisors will: Ensure orderly placement.

• Head-Toe configuration

• 2-3ft between victims Direct assistants head-to-toe

assessments.

Visual 4.12

Treatment Area Documentation

Supervisors need to oversee and make sure thorough documentation is being performed on all victims. Use a Treatment Documentation Form

Visual 4.13

Consent To Treat

CERT members need to ask the victim for permission to conduct the assessment. The victim has a right to refuse treatment (make sure you document it!).

If the victim is unconscious treat the injuries under implied consent and assume they have a spinal injury.

Visual 4.14

Conducting Head-to-Toe Assessments

Head-to-Toe assessments are performed to go beyond “the killers” to gain more information to determine the nature of the victims injury.

Visual 4.15

Head-to-Toe Assessment

1. Head2. Neck3. Shoulders4. Chest5. Arms6. Abdomen7. Pelvis8. Legs9. Back

Visual 4.16

Multiple Assessments

If medical teams run out of or low on latex gloves, use rubber gloves and clean between treatment of victims in a bucket of bleach-water solution (1:10 ratio) to reduce the risk of cross contamination.

Visual 4.17

Indicators of Injury

Bruising Swelling Severe pain Disfigurement

CERT members need to pay careful attention to how the victim has been hurt (mechanism

of injury) because it provides insight to probable injuries suffered.

Visual 4.18

Head, Neck and Spinal Injuries

CERT members main objective with a suspected head or spinal injury patient is to do no harm.

Minimize movement of the head and spine while treating any of “the killers”.

Visual 4.19

Closed-Head Injury Signs

ALOC Inability to move a body part Severe head, neck or back pain(s) Tingling or numbness Difficulty seeing or breathing Facial trauma Bruising behind ears (late sign)

Bruising under the eyes Equal pupils Unexplained seizures Nausea or vomiting Mechanism of injury

Visual 4.20

Spinal Immobilization

Visual 4.21

Burn Severity

May be from heat, chemical, electrical or radiation.

Severity depends on: Temperature of the burning agent Period of exposure Area effected Depth of burn

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Layers of Skin

Epidermis Dermis Subcutaneous layer

Visual 4.23

Classification of Burns

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Rule of 9’s: Burn Surface Area (BSA)

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Treatment of Burns

Remove or cut away the burning source. Cool skin or clothing (if still hot) by immersing in water for

no more then 1 minute or cover with a clean compress. Cover with a dry sterile dressing. Elevate the extremity, if possible. Remove rings, bracelets, watches! Do not use ice Do not apply butter or antiseptics Do not remove skin or break blisters

TREAT FOR SHOCK!

Visual 4.26

Wound Care

Control bleeding (discussed in Unit 3) Prevent secondary infection

Wear gloves Clean wound—don’t scrub

Use a turkey baster or bulb syringe to irrigate Mild soap and water

Apply dressing and bandage

Visual 4.27

Rules of Dressing

1. In the absence of active bleeding, remove dressing and flush, check wound at least every 4-6 hours.

2. If there is active bleeding, redress over existing dressing and maintain pressure and elevation.

Visual 4.28

Treating Amputations

Control bleeding Treat for shock Save tissue parts, wrapped in clean cloth Keep tissue cool (do not place directly on ice) Keep tissue with the victim

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Treating Impaled Objects

Impaled Objects: Immobilize the body part. Don’t move or remove. Control bleeding. Clean and dress wound. Wrap with bulky dressings. Treat for shock.

Visual 4.30

Treating an Open Fracture

DO: Cover wound. Splint fracture without disturbing wound. Place a moist 4" x 4" dressing over bone end to

prevent drying.DO NOT: Irrigate the wound. Draw the exposed bones back under the skin.

Visual 4.31

Dislocation

Displaced or misaligned joint. Ligaments always become damaged.

Do not try to reduce the injury.

Immobilize the joints.

Visual 4.32

Strain

Muscle fibers tear as a result of overstretching.

Pain Stiffness Inflammation Bruising

R-Rest

I- Ice

C- Compression

E-Elevation

Visual 4.33

Sprain

Overstretching or tearing of a ligament at a joint. Tenderness at injury site Swelling and/or bruising Restricted use or loss of use

R-RestI-IceC- CompressionE-Elevate

Visual 4.34

Guidelines for Splinting

1. Support the injured area.

2. Splint injury in the position that you find it.

3. Don’t try to realign bones.

4. Check for color, warmth, and sensation.

5. Immobilize above and below the injury.

Visual 4.35

Creative Splinting

Visual 4.36

Nasal Bleeding

Causes: Blunt force Skull fracture Nontrauma-related conditions

Blood loss can lead to shock. Victims may become nauseated and vomit if they swallow

blood. Treatment:

Lean forward Apply ice to bridge of nose Allow drainage

Visual 4.37

Symptoms of Hypothermia

Primary signs and symptoms: A body temperature of 95o Fahrenheit (37o

Celsius) or less Redness or blueness of the skin Numbness accompanied by shivering

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Symptoms of Hypothermia

At later stages, hypothermia will be accompanied by: Slurred speech. Unpredictable behavior. Listlessness.

Visual 4.39

Treatment for Hypothermia

Remove from wind and rain

Remove all wet clothing Give warm drinks by

mouth (if conscious) Bundle in warm blankets,

cover the head

Visual 4.40

“Break” Time