MS 1 QUIZ 5: First Aid, Emergency Care, & Disaster Management
Interventions of head injury
-must be assessed by a physician ASAP -immobilize neck and keep victim flat w/ proper alignment of the neck/head -backboard used for transportation
Assessment of chest injury
-note rate/character of respirations, skin color, pulse rate/rhythm, symmetry of the chest wall movement, presence of any apparent injuries to the chest -note for any dyspnea, tachycardia, restlessness, cyanosis, asymmetric or other abnormal chest wall movement, abnormal sounds of breathing -note mental state and LOC
s/s of hemorrhage
-obvious bleeding -cool sweaty, pale skin -thready pulse -rapid respirations -decreasing altertness
Pneumothorax intervention
-open chest wound -apply vented dressing (sealed on 3 sides so are can escape but not enter)
Severe airway obstruction include
-poor/no air exchange -poor/no cough -high pitched/no noise -no inhalation -respiratory distress -cyanosis -inability to speak -inability to move air -clutching the neck
Abdominal interventions
-require medical evaluation -give nothing NPO in preparing for transport -do not attempt to replace eviscerated organs in the abdomen; may cause additional harm
s/s of heat stroke
-similar to heat exhaustion at first as it worsen skin becomes red, hot, dry -perspiration is noticeably absent
Most anterior nosebleeds respond to pressure, instruct pt to
-sit down lean forward -pinch the nostrils shut for at least 10 min -advise pt not to blow/pick at nose fo several hours
Interventions of choking/airway obstruction if victim is conscious and is standing or sitting
-stand or kneel behind the victim -wrap your arms around the victims waist -make fist/place thumb slightly above the umbilicus -place other hand over your fist and press against the abdomen w/ a quick upward movement -repeat until obstruction is removed or victim loses consciousness
To obtain the most current recommendations for CPR
-verify that the scene is safe -check for responsiveness -if victim is responsive, call for help -activate emergency response system -if u are alone, get AED, if someone else is available send that person to get it
Heat stroke body core temp
106 F or greater
For strains nad sprains
apply elastic bandage starting at the most distal point and moving proximally
Electrical burns include
are difficult to assess; full extent of tissue damage may not be apparent for several days
Interventions of choking/airway obstruction if victim is conscious
ask whether the victim is choking, if victim nods and cannot speak, activate the emergency response system
Epistaxis
blood from anterior/posterior portion of the nose (nose bleed)
incomplete fracture
bone ends are not separated
compound (open) fracture
broken bone protrudes through the skin
complete fracture
broken ends are seperated
CABs
circulation, airway, breathing
Traumatic amputation
clean the wound surfaces w/ sterile water or saline and place the tissue in its normal position
To assist in identifying poisons
collect samples of stool or vomited materials for possible lab analysis
A body part that is completely detached should ideally be wrapped
in sterile gauze moistened w/ sterile saline, placed in a watertight container such as a reusable plastic bag, and placed in an iced saline bath
Sprains
injuries to ligament
Strains
injuries to muscles or tendons or both
Assessment of eye injury include
inspect eye for trauma and the eye for redness, foreign bodies, or penetrating objects
Most sensitive and reliable indicator of neurologic function
level of consciousness (LOC)
Good samaritan laws include
limit liability and provide protection abasing malpractice claims when health care providers render first aid at the scene of an emergency
Interventions for eye injury if perforation of the globe
limit the movement of the object and the eye and transport victim for immediate medical care
Head injury special considerations for older adults
may complicate the assessment of suspected head injury and may be overlooked
Treatment of poisoning in an emergency facility include
maybe be w/ activated charcoal, total bowel lavage, and/or cathartics
Causes of absence of a heartbeat and respirations
myocardial infarction, heart failure, electrocution, drowning, drug overdose, anaphylaxis, and asphyxiation
s/s of food poisoning
n/v, abdominal cramps, and diarrhea
Carbon Monoxide
odorless, invisible gas emitted by internal combustion engines, gas stoves, and furnaces
Ask about symptoms that developed after the bite
pain, edema, numbness, tingling, nausea, fever, dizziness, and dyspnea
Emergency doctrine treatment can be provided under the assumption that the
patient would have consented if able
Chest injury include
pneumothorax, hemothorax
Hypothermia is caused by
prolonged exposure to cold, extremest cold temperates or immersion in cold water
Hemothorax intervention
prompt treatment in a medical facility
Evisceration
protrusion of internal organs through a wound
Cardinal rule
remain calm
RICE
rest, ice, compression, elevation
S.A.M.P.L.E.
symptoms, allergies, medications, easy illness/pregnancy, last oral intake, events related to injury
Hemorrhage
the lose of a large amount of blood
Superficial burns include
typically pink or red and painful
As carbon monoxide in bloodstream arises
victim loses consciousness and develops cardiac and respiratory irregularities
Botulism caused by
Clostridium botulinum
Lyme disease
fever, flu-like manifestations, and erythema migraines, an expanding circular rash that often develops at the bite site
Eye injury includes presence of
foreign bodies, chemical contact, perforation, trauma
Loss of more than 1L of block in an adult may lead to
hypovelmic shock
Interventions for eye injury if foreign body is expected
if not embedded, remove by irrigating or gently remove
Interventions for eye injury if chemical contact is expected
immediately flush the eye for at least 20 mins
Chemical burns
immediately remove any remaining chemicl
heat exhaustion can be treated by
-moving individual into cool place such as shaded or an air-conditioned area -providing fluids w/electrolytes
Interventions of food poisoning
-medical care necessary if symptoms are severe or persistent -physician may order antiemetics and antidiarrheals -IV fluids may be prescribed w/ severe vomiting/diarrhea
Assessment of bites/stings include
-monitor respiratory depression -if allergic to insect bites bring emergency kit w/ them -if bit by a dog assess tetanus vaccine status of pt
Adult chest compression
-30:2 -compress at a rate of 100 to 120/min -compress the chest at least 2 inches -allow the chest to recoil completely after each compression -minimize interruptions in compression
If victim becomes unconscious/loses consciousness from choking/airway obstruction
-activate emergency response system -open airway and inspect -remove any visible object -begin CPR
Assessment of drug/chemical poisoning
-amount consumed -length of time since substance was taken -last food consumed -s/s that may be caused by poisons -victims age/weight -other medications, drugs, or alcohol ingested
The primary survey looks for life-threatening injuries and intervenes immediately in the following sequence
-assess ABCs -initiate CPR/rescue breathing as needed -look for uncontrolled bleeding identify the source, apply pressure -assess for injuries from head to foot, immobilize spine, limbs, or both as indicated -look for medical alert necklace/bracelet
Assessment of Abdominal injury include
-assess for injury -ask pt about abdominal symptoms -inspect abdomen for abnormalities -suspect internal abdominal injuries if victim complains of abdominal pain or shows evidence of trauma/distention
Clear indicator of carbon monoxide
-cherry red skin but skin color often found to be pale or bluish w/ reddish mucous membranes
Nursing assessment in emergencies include
-chief complaint -medical history -check or a medical alert tag -identify current medications/allergies -note any evidence of alcohol or other drugs
s/s of absence of a heartbeat and respirations
-collapse and quickly lose consciousness -no pulse/respiration
Hyperthermia interventions
-cooling quickly is critical -apply wet, cool towels to the trunk and extremities -ice pack on forehead and axilla -immediate transport for medical care
Do not attempt to replace eviscerated organs in the abdomen; this may cause additional harm
-cover organs w/ material, such as plastic wrap or foil, to conserve moisture/warmth -a saline soaked sterile dressing is ideal but is not likely to be available on the scene of an accident -cover wound w/ clean cloth
Chief complaint includes
-determine problem, signs and symptoms, how the injury/illness occurred -if victim is/has been unconscious, note the length of time -if victim is able to speak/witness, obtain health history -determine any known health problems
Assessment of burns include
-determine the type if burn -if pt has a false burn or was in closed, small-filled areas assess respirations first -determine the extent/depth of burns -inspect skin of color, blisters, tissue destruction
Interventions of burns includes
-ensure a patent airway/respirations -immediately apply oxygen and anticipate an order for arterial blood gas analysis -rescue breathing if needed
Early s/s of carbon monoxide poisoning
-headache, shortness of breath w/ mild exertion -then dizziness, n/v, and mental changes
Mild airway obstruction include
-if victim has good air exchange, is responsive, and can cough forcefully, do not interfere -encourage the victims efforts to breathe and cough -if symptoms persist, activate the emergency response system
Interventions of hemorrhage
-immediate treatment for external bleeding is direct, continuous pressure -elevate and immobilize the injured part -after bleeding stops, secure a large dressing if available over the wound
Interventions for drug/chemical poisoning
-immediately call your poison center -can be treated at home or requires physician/hospital
Interventions of carbon monoxide poisoning
-immediately move the victim to fresh air -if person not breathing, start rescue breathing -seek emergency medical assistance immediately -give oxygen as soon as it is available -at the hospital, the pt may be place is a hyperbaric oxygen chamber
Interventions of a fracture
-immobilize the injured part -do not attempt to straighten a broken bone -apply direct pressure to artery above the injury if there is severe bleeding
Head injury assessment include
-inspection/palpation of the head injury -evaluate for s/s of increased intracranial pressure
Results from acute circulatory failure caused by inadequate blood volume, heart failure, overwhelming infection, every allergic reactions or extreme pain/firght
Shock
Deeper burns include
dark, white, or black; may destroy not only the skin but also the underlying tissues
signs of a fracture include
deformity, swelling, discoloration, decreased function, and bone fragments, protruding through the skin
Hypothermia can cause
depression of vital functions, and if not corrected, death results from cardiac dysrhythmias
Clostridium botulinum has neurotoxic effects which include
difficulty breathing, seeing, and swallowing
What characteristics of heat exhaustion can lead to collapse?
dizziness, headache muscle cramps, skin is damped
Simple (close) fracture
does not break skin
Heat exhaustion caused by
excessive fluid loss
