This chapter is broken off into several sections, depending on the medical emergency which you may encounter. The sections are described below:
Burns
Trauma
Bites and Stings
Burns
Definition
The burning of skin due to a chemical, thermal, or radiation
Prevention
Safely Handle Fire
Avoid Fire if Possible
Be aware of surroundings especially when in hazardous conditions
Be very careful when dealing with chemicals
Practice safe handling with all hazards
Causes
Thermal burns- Exposure to heat or fire
Chemical burns- From either strong acids or strong bases (both can be used in cleaning supplies!)
Radiation burns- Burns resulting from exposure to radiation (ie. Medical imaging machines). The sun can also give radiation burns!
Signs & Symptoms
There are three major types of burns, and they are classified based on the severity of the burn. The skin is composed of different layers. The outer portion of skin is called the epidermis. Below this is the dermis, and below the dermis is layers of muscle, fat and nerves. This is important information to know since burns are fairly common injuries, and if you call 9-1-1, you can be an integral part of the EMS system by notifying the dispatchers about the severity of the burns.
1st Degree Burns
Reddened skin at the burn site
1st degree burns only affect the Superficial (outer layer) portion of skin
Mild Pain
A sunburn is classified as a 1st degree burn
2nd Degree Burns
Deeper Involvement of skin layers
May cause blisters
Greater Surface Area
Moderate-Severe Pain
3rd Degree Burn
Deepest Tissue Involvement
Blisters and charring of the skin, muscle (and sometimes bone) occurs.
Usually covers a large portion of the body.
Excruciating Pain Around Burn site.
Dead Tissue (Including Skin & Muscle). The burned tissue may be black in color.
What To Do
Stop the Burning Process if it is safe to do so. If the patient is on fire, try to put the fire out if it does not put you in danger.
If it is a chemical injury, apply cool running water for at Least 20 Minutes.
Don't Touch a Victim of Electrocution
Shut Off Power if Possible
BE AWARE OF YOUR SURROUNDINGS
You do not want to get injured trying to help!
When To Call 9-1-1
3rd Degree & Bad 2nd Degree Burns
Breathing Difficulty
Blackened Skin
Severe Pain of Injured Person
Burns to face or head
When in doubt, Call 911!
Trauma
Definition
A A serious injury or shock to the body that may result in life threatening injury.
Injury from trauma can range from minor to severe and are often life threatening. Traumatic injuries are the leading cause of death for young adults and children in the United States.
Prevention
Accidents happen but there are some preventative measures that can be taken
Avoid dangerous activity
Be aware of your surroundings and environment around you
Causes
There are so many causes for a traumatic injury that it is impossible to list each and every factor contributing to trauma. Some common traumatic injuries result from playing sports, motor vehicle accidents, violent crimes and falls.
Signs & Symptoms
Laceration
A laceration is a break in the skin integrity that presents as a slice or a cut to the layers of skin. A laceration can be shallow (as seen in a paper-cut) or deeper (as seen as a large cut from a piece of glass).
Abrasion
Shaving Off one or more layers of Skin (scraping your knee on the sidewalk or road rash from a motorcycle accident)
Avulsion
An avulsion occurs when injury to skin and/or muscle causes a deep cut and a flap of skin is removed either partially or fully. It can be remembered as a "chunk of skin" that has become detached either fully or partially.
Bruising
Bruising is caused by a blunt force that results in bleeding of small vessels under the skin. The skin remains intact so blood accumulates under the skin causing discoloration and pain.
Bluish, Yellowish Discoloration of Skin
A hematoma occurs when a force causes significant, continued bleeding under the skin. A hematoma presents as a large swollen area of skin that is filled with blood. It looks like a red/purple sac at the injury site.
Mass Under Skin as a Result of Trauma (Hematoma)
Broken Bones
Open Fracture: Occurs when the fractured bone protrudes through the skin.
Closed Fracture: A loss in bone integrity (broken bone) without bone fragments protruding through the skin.
Dislocation
A dislocation occurs when two bones of a joint become detached or separated. These are incredibly painful injuries, and range from minor to severe dislocation.
Shock
What is Shock?
Shock is a complex series of events that the body encounters when a significant injury or illness overpowers the body's ability to compensate. When a person is inured, the body has it's own mechanisms to make up for the insult and keep you alive. When the injury is too severe for the body to handle, it starts to shut down. These series of events is called shock and it can be an ominous sign.
An example of shock would be significant blood loss from a gun shot wound. If the person continues to bleed without interventions, the body tries to pump blood faster and harder to the body. As blood loss continues, the heart has less and less blood to pump to the organs. Eventually, the heart will slow, the organs will starve for oxygen (in the blood) and the patient will die. This entire process of compensating for blood loss (increased heart rate), then slowing down because of lack of blood and oxygen, is called shock.
Signs of Shock (Severe Cases)
Pale and Sweaty
Fast Heartbeat ('Palpitations')
Thirst
Excessive Blood Loss
Unconsciousness
What To Do
Always Consider ABCs First
For Bleeding: Stop Bleeding With Direct Pressure. THIS IS CRITICAL! If direct pressure alone does not stop the bleeding, elevate the inured body part (if it is an extremity.)
If the Above Does Not Work, Use a Pressure Point to slow blood flow to the injured part.
Tourniquets are NOT Recommended - May Cause Further Damage. If the patient will die without a tourniquet and it is a last resort, you may use this approach. For example, if a patient has a partially amputated leg and direct pressure and elevation does not stop the bleeding, try pressure on the femoral pressure point. If you still see heavy bleeding from the leg and the patient is in shock, you may apply the tourniquet.
Bleeding & Bleeding Control Video Resource
Trauma Continued
For Bruising
Apply Cold Compress or Ice Wrapped in Towel
If Severe, Call 9-1-1
For Broken Bones/Dislocations
Do Not Attempt to Reset the broken bone.
Place the broken bone in the Position of Function and Splint / Bandage to reduce movement.
If the above is not Possible, keep the injured body part in a Position of Comfort
Call 9-1-1 for Open Fractures
When to Call 9-1-1
Severe Bleeding
Open Fractures
Car Accidents
When the Person is Acting Strange
Unconsciousness
Slow Breathing
Very Rapid Breathing
Severe pain
When in doubt, Call 911
Bites & Stings
Definition
A bite or sting from an insect, reptile, or other animal that may cause an undesired reaction
Examples include but are not limited to:
Bees
Spiders
Snakes
Ants
Wasps
Other Insects
Signs & Symptoms
Redness & Irritation
Bumps
Hives
Numbness/Tingling Sensation
Burning Sensation
Skin Discoloration
Fever
Chills
Dizziness/Lightheadedness
Nausea & Vomiting
Difficulty Breathing
Anaphylaxis (Severe)
How It Happens
There are many routes by which a person can suffer a sting or a bite.
What To Do
Remove the person From Danger if it does not put your safety at risk.
Don't Become a Victim!
For Bee Stings: Remove Stinger with Fingernail or Credit Card. Using a credit card, slowly use a sweeping Motion over the stinger and away from the stinger to pull the stinger out.
For Other Insects: Call 9-1-1 for Severe Reactions
