1. First Aid Chapter 15 DHO

2. What is a wound??? Injury to soft tissue. Injury to soft tissue. –2 classifications:  Open- break in the skin  Closed – no break in the skin, but injury in the underlying tissue –First aid important to prevent 2 primary situations  Excessive bleeding  Infection

3. Open Wounds Classified according to injury. Classified according to injury. –Abrasion –Incision –Laceration –Puncture –Avulsion –Amputation

4. Abrasion Skin is scraped off. Skin is scraped off. Limited bleeding Limited bleeding Needs to be cleaned and bandaged to prevent infection Needs to be cleaned and bandaged to prevent infection

5. Incision Cut or injury caused by a sharp object (knife, scissors, or razor blade) Cut or injury caused by a sharp object (knife, scissors, or razor blade) Wound has smooth edges Wound has smooth edges Can be deep or superficial Can be deep or superficial If deep can cause muscle or nerve damage If deep can cause muscle or nerve damage

6. Laceration Tearing of tissues due to excessive force Tearing of tissues due to excessive force Jagged, irregular edges Jagged, irregular edges Heavy bleeding possible Heavy bleeding possible

7. Puncture Caused by a sharp object (i.e. nail) Caused by a sharp object (i.e. nail) External bleeding limited, internal bleeding and infection are possible External bleeding limited, internal bleeding and infection are possible

8. Avulsion Occurs when tissue is torn away from the victim’s body Occurs when tissue is torn away from the victim’s body Heavy bleeding Heavy bleeding Tissue hanging from ear, hand, nose, etc. Tissue hanging from ear, hand, nose, etc. Preserve tissue reattachment can be attempted Preserve tissue reattachment can be attempted

9. Amputation When a body part is cut off and separated from the body. When a body part is cut off and separated from the body. Heavy bleeding possible Heavy bleeding possible Part should be preserved if at all possible Part should be preserved if at all possible –Wrap in cool, moist dressing –Place in plastic bag & put in ice water –NEVER PUT DIRECTLY ON ICE

10. Your first priority when someone is bleeding should be… CONTROL BLEEDING!!! CONTROL BLEEDING!!! –Victim could bleed to death Bleeding occurs from Arteries, Veins, & Capillaries Bleeding occurs from Arteries, Veins, & Capillaries

11. Arterial Blood Spurts from the wound Spurts from the wound Heavy blood loss Heavy blood loss Bright red in color Bright red in color **Life threatening & must be controlled quickly**

12. Venous bleeding Slower & steadier Slower & steadier Dark Red in color Dark Red in color Easier to control the bleeding Easier to control the bleeding

13. Capillary Blood “oozes” from the wound “oozes” from the wound Less red than arterial blood Less red than arterial blood Clots easily Clots easily

14. 4 methods for controlling bleeding Direct Pressure Direct Pressure Elevation Elevation Pressure bandage Pressure bandage Pressure points Pressure points Locate gloves or some sort of protective barrier before handling blood and always wash hands immediately after assisting.

15. Direct Pressure Use one hand to apply pressure Use one hand to apply pressure Use sterile dressing or gauze Use sterile dressing or gauze –Clean cloth if nothing available Continue applying pressure for 5-10 minutes or until bleeding stops Continue applying pressure for 5-10 minutes or until bleeding stops –Add gauze if it soaks through Leave all blood clots “scabs” alone Leave all blood clots “scabs” alone

16. Elevation & Pressure Bandage Raise bleeding extremity above to a position above the heart Raise bleeding extremity above to a position above the heart –Slows blood flow Continue applying pressure while wrapping pressure bandage around the wound. Continue applying pressure while wrapping pressure bandage around the wound.

17. Pressure Points If bleeding is not slowing after the elevation and direct pressure, then… If bleeding is not slowing after the elevation and direct pressure, then… –Apply pressure to a pressure point. –Press against the bone that is behind the artery.  This pressure to the artery will discontinue blood flow  Only do if absolutely necessary Pressure Points: Arm = brachial artery Leg = femoral artery When bleeding discontinues, slowly remove pressure from pressure point, but continue elevation and direct pressure to wound. When bleeding discontinues, slowly remove pressure from pressure point, but continue elevation and direct pressure to wound.

18. What’s next…?? Once bleeding is controlled: Once bleeding is controlled: –Obtain medical help –Do NOT remove any bandages –Do NOT attempt to clean

19. Treating minor wounds Wash hands thoroughly Wash hands thoroughly Gloves Gloves Clean, if possible, with sterile gauze, soap, and water Clean, if possible, with sterile gauze, soap, and water Wipe wound in an outward direction Wipe wound in an outward direction –Discard wipe after each use Rinse with cool water and blot dry Rinse with cool water and blot dry Apply bandage or sterile dressing Apply bandage or sterile dressing Avoid Infection!!! Avoid Infection!!!

20. Infection Bacteria in the wound Bacteria in the wound Signs & Symptoms: Signs & Symptoms: –Swelling –Heat –Redness –Pain –Fever pus –Red streaks from the wound Medical is necessary immediately with any of these symptoms Medical is necessary immediately with any of these symptoms

21. Infection Tetanus: can enter a wound and lead to serious illness or death. Tetanus: can enter a wound and lead to serious illness or death. –Common in puncture wounds –Find out when last tetanus shot was –Seek medical advice about booster shot

22. Embedded objects If object is superficial: If object is superficial: –Remove splinters, small rocks, etc with sterile tweezers and gauze. –Clean tweezers with rubbing alcohol Deeply embedded objects: Deeply embedded objects: –Leave in place and seek medical care immediately –Physician should remove

23. Closed Wounds Bruise = apply cold pack to reduce/prevent swelling Bruise = apply cold pack to reduce/prevent swelling Severe internal wounds – involve internal bleeding that can result in death Severe internal wounds – involve internal bleeding that can result in death –Sign & symptoms:  Pain  Tenderness  Swelling  Deformity  Cold clammy skin  Rapid weak pulse  Decreased BP  Restlessness  Excessive thirst  Blood in vomit, urine, &/or feces

24. What should you do?? If you suspect a severe internal wound… If you suspect a severe internal wound… –Get medical help ASAP –Check breathing –Treat for shock –Avoid movement –Avoid giving food or water to the victim

25. Providing First Aid for Shock Shock = “hypoperfusion;” a clinical set of signs and symptoms associated with an inadequate supply of blood to body organs, especially the brain & heart. Shock = “hypoperfusion;” a clinical set of signs and symptoms associated with an inadequate supply of blood to body organs, especially the brain & heart. –Can appear with any injury or illness –Untreated it can lead to death regardless of injury severity.

26. What causes shock? Hemorrhage: excessive bleeding Hemorrhage: excessive bleeding Excessive pain Excessive pain Infection Infection Heart attack Heart attack Stroke Stroke Poisoning by chemicals, drugs, or gases Poisoning by chemicals, drugs, or gases Lack of oxygen Lack of oxygen Psychological trauma Psychological trauma Dehydration from burns, vomiting, or diarrhea Dehydration from burns, vomiting, or diarrhea

27. Shock… Shock… –Impairs circulation –Decreases oxygen supply to body cells, tissues, and organs

28. 8 Types of Shock ( See pg. 404) Anaphylactic – allergic reaction to food, medications, insect bites Anaphylactic – allergic reaction to food, medications, insect bites Cardiogenic – Damage to the heart Cardiogenic – Damage to the heart Hemorrhagic – severe bleeding Hemorrhagic – severe bleeding Metabolic – Loss of body fluid (vomiting, diarrhea, diabetes) Metabolic – Loss of body fluid (vomiting, diarrhea, diabetes) Neurogenic – Injury/Trauma to brain or spinal cord Neurogenic – Injury/Trauma to brain or spinal cord Psychogenic – emotional distress (anger, fear) Psychogenic – emotional distress (anger, fear) Respiratory – trauma to respiratory tract (resp distress or arrest) Respiratory – trauma to respiratory tract (resp distress or arrest) Septic – Acute infection (Toxic Shock Syndrome) Septic – Acute infection (Toxic Shock Syndrome)

29. What happens when shock sets in? Body attempts to increase blood flow brain, heart, and vital organs by reducing flow elsewhere. Body attempts to increase blood flow brain, heart, and vital organs by reducing flow elsewhere. Resulting signs & symptoms Resulting signs & symptoms –Skin (pale/bluish-gray) –Skin is cool to touch –Excessive perspiration = diaphoresis –Rapid, weak pulse –Rapid, shallow breathing –BP very low –General weakness, becomes unconscious –Anxiety/extreme restlessness –Extreme thirst, nausea, vomiting –Blurred vision, pupils dilate

30. Caring for Shock Victims Get medical help ASAP Get medical help ASAP Treatment: Treatment: 1.Eliminate cause of shock 2.Improve circulation (brain & heart especially) 3.Provide adequate oxygen supply 4.Maintain body temperature

31. Determining recovery position for shock treatment Analyze injury location Analyze injury location If neck injury…DO NOT MOVE If neck injury…DO NOT MOVE No neck injury…elevate feet No neck injury…elevate feet –w/ breathing difficulty…elevate head –w/ excessive facial/oral bleeding…roll on side Site of injury will determine safe treatment position

32. Treating Shock (continued) Cover with blankets to prevent exposure to the cold. Cover with blankets to prevent exposure to the cold. –Do not overheat. Remove blankets if skin becomes warm to the touch or patient is perspiring Avoid giving the patient anything to eat or drink. Avoid giving the patient anything to eat or drink. –Wet cloth can be used if necessary to moisten lips & mouth.

33. References http://mcfralick.tripod.com/sitebuildercontent/sitebuilderpictures/abbrasion.jpg http://mcfralick.tripod.com/sitebuildercontent/sitebuilderpictures/abbrasion.jpg http://mcfralick.tripod.com/sitebuildercontent/sitebuilderpictures/abbrasion.jpg http://www.personal.usyd.edu.au/~zielinsk/DW/Surgical%20Topics/Pics/incision.jpg http://www.personal.usyd.edu.au/~zielinsk/DW/Surgical%20Topics/Pics/incision.jpg http://www.personal.usyd.edu.au/~zielinsk/DW/Surgical%20Topics/Pics/incision.jpg http://www.manukahoneyusa.com/images/stomach%20incision%20wound.jpg http://www.manukahoneyusa.com/images/stomach%20incision%20wound.jpg http://www.manukahoneyusa.com/images/stomach%20incision%20wound.jpg http://www.sarpy.com/ema/drill/laceration.jpg http://www.sarpy.com/ema/drill/laceration.jpg http://www.sarpy.com/ema/drill/laceration.jpg http://www.fighttimes.com/magazine/images/7/mc-incised-foot.jpg http://www.fighttimes.com/magazine/images/7/mc-incised-foot.jpg http://www.fighttimes.com/magazine/images/7/mc-incised-foot.jpg http://health.yahoo.com/media/healthwise/n5551173.jpg http://health.yahoo.com/media/healthwise/n5551173.jpg http://health.yahoo.com/media/healthwise/n5551173.jpg http://www.utahmountainbiking.com/firstaid/pics/nailavu1.jpg http://www.utahmountainbiking.com/firstaid/pics/nailavu1.jpg http://www.utahmountainbiking.com/firstaid/pics/nailavu1.jpg http://www.emsresponder.com/article/photos/1151430722779_907.jpg http://www.emsresponder.com/article/photos/1151430722779_907.jpg http://www.emsresponder.com/article/photos/1151430722779_907.jpg http://www.wits.ac.za/trauma/images/Photos/Amputation.jpg http://www.wits.ac.za/trauma/images/Photos/Amputation.jpg http://www.wits.ac.za/trauma/images/Photos/Amputation.jpg http://health.howstuffworks.com/blood1.htm http://health.howstuffworks.com/blood1.htm http://health.howstuffworks.com/blood1.htm http://www.vaccineinformation.org/photos/tetaiac001.jpg http://www.vaccineinformation.org/photos/tetaiac001.jpg http://www.vaccineinformation.org/photos/tetaiac001.jpg http://health.allrefer.com/health/wounds-laceration-versus-puncture-wound.html http://health.allrefer.com/health/wounds-laceration-versus-puncture-wound.html http://health.allrefer.com/health/wounds-laceration-versus-puncture-wound.html http://health.allrefer.com/health/shock-shock.html http://health.allrefer.com/health/shock-shock.html http://health.allrefer.com/health/shock-shock.html