HN to HM3 Emergency Medicine

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131 terms · Corpsman Advancement Study Emergency Medicine Chapters 20, 21, 22

Dressing

Sterile pad or compress (usually made of gauze or cotton wrapped in gauze)

Battle Dressing

Combination compress and bandage

Roller Bandage

Long strip of material (gauze, muslin, or elastic)
Initial turn on extremity should be applied securely, and, when possible around the part of the limb that has the smallest circumference.

Wet Bandage

HM must allow for shrinkage

Roller Bandage for Elbow

Spica or Figure-eight type

Roller Bandage for Hand/Wrist

Bandage diagonally upward and around the wrist and back over the palm. 2 or 3 inch bandages

Roller Bandage for Ankle

Figure-eight

Roller Bandage for Hand and Heel

3 inch bandage

Four-Tailed Bandage

Good for bandaging any protruding part of the body. i.e.: Nose, Chin

Barton Bandage

Lower Jaw fractures and retain compresses to the chin

Triangular Bandage

Usually made of muslin. Can be used for Head, Shoulder, Chest, Hip/Buttock, Side of the Chest, and Foot/Hand.

Tringular Bandage for Head

Retain compresses on the forehead or scalp. tie in a SQUARE KNOT.

Cravat Bandage

Triangular bandage can be folded into a strip for easy application during emergency. Can be used for Head, Eye, Temple/Cheek/Ear, Elbow/Knee, Arm/Leg and Axilla.

Modified Barton

Carvat Bandage for Temple, Cheek, Ear.

CAT (trademark)

Combat Application Tourniquet

Asherman Chest Seal

ACS (Trademark) is 5.5" diameter, includes gauze pad (4"x4")

Monitoring Devices

Automated External Defibrillator (AED).

Pulse Oximeter

Measures O2 saturation of patients blood and changes in blood volume in the skin. Acceptable normal ranges are from 95% to 100%. Although values down to 90% are common.

Intravenous Fluids

Two types:
Crystalloids: Aqueous solutions of mineral salts or other water-soluble molecules.
Colloids: Larger insoluble molecules

Normal Saline

(NS) 0.91% w/v of NaCl. Rapid infusion can cause Metabolic Acidosis. 1.5 and 3 liters a day for an adult.

Lactated Ringers Solution

(LR) Often usef for fluid resuscitation after blood loss due to trauma, surgery, and/or burn injury. Rate of administration: 20 to 30 ml/kg

Hetastarch

Synthetic plasma expander. It is used to prevent shock following severe blood loss caused by trauma. Dosage for plasma volume expansion: Adults: 500-1000 mL (up to 1500 mL/day) or 20 mL/kg/day (up to 1500 mL/day)

Infusion Equipment

Intravenous Infusion Set
Intraosseous Device: Pyng Fast-1 (trademark)
Infusion pump

Use of O2

HM in emergency cases will have D or E cylinder of O2 available

O2 Cylinder

Color coded green, silver or chrome

Big-Valve Mask

(BVM) Ventilator: When using external cardiac compressions, cardiac compressions, the cardiac output is cut to 25 to 30% of normal capacity, and artificial ventilation does not supply enough 02 through the circulatory system to maintain. 5 liters per min. 50% concentration. 15 liters per min. 90% concentration.

Pocket Face Mask

Mouth-to-Mouth ventilation

Hypoxia

Characterized by tachycardia, nervousness, irritability, and finally cyanosis.

Artificial Airways

Oropharyngeal
Nasopharyngeal
Keep the tongue from occluding (closing) the airway

Oropharyngeal

Only on unconscious casualties because a conscious person will gag on it. Extend from corner of the patient's mouth to the tip of the earlobe

Nasopharyngeal

May be used on conscious casualties. Extends from the patient's nasal opening to the tip of the earlobe on the same side of the patient's face.

O2 Breathing Apparatus

Oxygen Breathign Apparatus

SCBA

20 to 45 minutes life span of the oxygen canister

Lifeline

Standard Navy lifeline: steel-wire cable 50 feet long. Rescue personnel must wear gloves

Phase of Rescue Operation

4 phases
1. Remove lightly pinned casualties
2. Remove those casualties who are trapped in more difficult circumstances
3. Removes casulaties where extractions is extremely difficult and time consuming
4. Removal of dead bodies

Stages of Extrication

5 stages
1. Gain access
2. Give lifesaving emergency care
3. Disentanglement
4. Preparing casualties for removal
5. Removing casulaties from trapped areas and transporting to an ambulance or sickbay

Providing Care while Receiving Combat Fire

HM may be essential obtaining tactical fire superiority, Return fire!

Stroker Stretcher

Wire basket supported by iron rods, can also be used with flotation devices to rescue injured survivors from the water. Should be padded with 3 blankets: 2 placed lengthwise; under each leg of patient. 1 folded in half and placed in the upper part to protect shoulders/head.

Kendrik Extrication Device

KED. Semi-regid used to immobilize casualties with minor neck and back injuries.

Miller Board

Full Body. Fits within a Stokes (basket) stretcher and will float a 250 lbs person.

Spineboard

2 sizes: Short: (18"x32") and long (18"x72")

One-rescuer techniques

Fireman's Carry
Pack-strap Carry
Arm Carry
Blanket Drag
Tied-Hands Crawl

Two-Rescuer Techniques

Chair Carry: NEVER BE USED TO MOVE A PERSON WHO HAS AN INJURED NECK BACK OR PELVIS
Arm Carry

Aircrafta

UH-1: 2 pilots, 1 chief, 1 medic. 3 litters, 4 ambulatory.
Max: 6 litters, 9 ambulatory. Red Crosses (4) one one the nose belly and each cargo door
UH-60A: Same crew as UH-1. 4litters and 1 ambulatory
Max: 6 litters, 1 ambulatory or 7 ambulatory. 5 crosses nose, belly, each cargo door and on top.
CH-47: 2 pilots, 2 chiefs, 1 medic 6 litters. 12 litters and 16 ambulatory
Max: 31 ambulatory or 1 ambulatory and 24 litters. No red cross markings. (Casualty Evac)

Toxicity Levels

NFPA 704 Labeling System.
Red: Flammability

Hazmat Classification

Yellow: Reactivity
White: Special Hazards
Blue: Health Hazard

Protection Levels

A,B,C, and D.
A: Fully encapsulating
B. Chemical Resistant Clothing
C. Full-Face piece, air-purifying canister-equiped respirator
D: Coveralls, safety boots, glasses, and hard hat.

Hot Zone

Exclusion Zone: Contamination has occured

Contamination-Reduction Zone

Warm Zone: Transition are between the contaminated area and clean area.

Rescue from Hot Zone

Never Enter the Area Unless Properly Trained to Do So.

Decontamination

Dilution
Absorption
Chemical Washes
Disposal and Isolation

Law of Armed Conflict

Emcompasses all international law regulating the conduct of nations and individuals engaged in armed conflict.

Non Tactical Triage for Treatment

Priority I,II,III,IV,V
I. Immediate
II. Delayed
III. Minor
IV. Expectant
V. Dead

S.T.A.R.T

Simple Triage and Rapid Transport

Surgical Cricothyroidotomy

Casualties with total upper away obstruction, inhalation burns, massive maxillofacial trauma and cannot be ventilated by other means

Needle Chest Decompression

Between the second and third rib, large bored 3.25 inch, 14 gauge needle and catheter unit

NRB Mask

10-15 liters/minute up to 90% O2

Nasal Cannula

1-4 LPM to deliver 24-44% O2

Hypovolemic

Shock loss of intravascular volume
Blood lose is 5-6 liters. Normal loss of approx. 1 liter or 25-40% of person's total blood volume
Massive hemorrahage maybe fatal within 60-120 seconds

Distribute

Shock: Vasogenic; blood vessles dilate

Neurogenic

Shock caused by failure of nerveous system

Septic Shock

Caused by the presence of severe infection
5-7 days to develop

Psychogenic

Vasovagol shock mediated through para-sympathetic system (fainting)

Cardiogenic

Shock caused by heart failure

Stages of Shock

Compensated (non-progressive): Blood pressure is maintained; however, there is narrowing of the pulse pressure
Decompensated (progressive): Blood pressure is falling because blood volume has dropped to 15-25%
Irreversible: Shock has progressed to terminal stage

Destributive Shock

Septic, Neurogenic, and Psychogenic

Most common cause of shock

Uncontrolled hemorrhage

Cerebrovascular Accident

Stroke or Apoplexy interruption of blood supply to a portion of the brain. 1st sign includes weakness or paralysis of the side of the body opposite side of the brain that has been injured.

Convulsions

Seizures; uncontrolled muscle spasms or muscle regidity 1 or 2% population

Epilepsy

Seizure/Fits: Controlled often with medictions, during a conscious states. Multifactorial

Grand Mal Seizure

Serious type of epilepsy. Aura

Petit Mal

Short Duration. Altered State of awarness or partial loss of consciousness

Suicide Attemps

Ranges from verbal threats, gestures to a successful suicide.

Ingestion

In case of ingestion of substances do not induce vomiting in a patient who is not awake or alert

TEN (Scalded Skin Syndrome)

Toxic Epidermal Necrolysis

Toxic Epidermal Necrolysis

Condition charaterized by sudden onset, excessive skin irritation, painful erythema, bullae, and exfoliation of the skin in sheets.

AVPU Scale

Alert, Verbal, Pain, Unresponsive

DCAP-BTLS

Deformities, Contusions, Abrasions, Punctunre-Penetration, Burns, Tenderness, Lacerations, Swelling

SAMPLE

Sign-Symptoms
Allergies
Medications
Past Medical History
Last PO intake
Event leading

Angina Pectoris

Angina, caused by insufficient oxygen being circulated to the heart.

Acute Myocardial Infarction

Heart Attack. Coronary artery is occluded/block

Anaphylatic Emergencies

Anaphylaxis or Anaphylatic Shock; Severe allergic reaction to foreign material

Anaphylatic Shock Treatment

EPI-PEN 0.3cc subcutaneous injection.

Diabetic Ketoacidosis

Forgetting insulin treatment, or too little insulin to maintain a balance condition.

Insulin Shock

Too little sugar in the blood (hyperglycemia)

Hyperglycemia

Most common of all diabetic emergencies

Concussion

Caused by a violent jar or shock

Sucking Chest Wound

Most serious injury that requires immediate first aid treatment

Open Pneumothorax

Air entering pleura space through defect in pleura wall

Fail Chest

2 or more ribs fractured in two or more places or a fracture sternum

Condition in which air enters the chest cavity through a hole in the lung, expanding the space with every breath taken in

Tension Pneumothorax

Placenta must be delivered within how many minutes

10-20 minutes

Breech Delivery

Condition where baby's legs and or buttocks emerge first

Prolapsed Cord

Gently move a sterile gloved hand into the vagina to keep its walls and the baby from compressing the cord

Morphine dose

Adult 10 to 20 mg

Casualty Marking

"M" and hour of injection (Morphine)

Hematemesis

Vomiting bright red blood

Hemoptysis

Coughing up bright red blood

Melena

Tarry black stool

Hematochezia

Excretion of bright red blood from rectum

Methods of Anesthesia Administration

Topical, Local infiltration, and Nerve Block

Suture Removal Time

Face:4-5 days
Body/Scalp: 7 days
Soles/Palms, Back, Joins: 10 days

Hydrophobia

Caused by a virus that is present in the saliva of infected animals

Rabies Treatment Outline

BUMEDINST 6220.8 series, Streptococcal Infection Control Program

Classification of Severity Burns (Thermal)

1st Degree: Epidermal layer
2nd Degree: Blisters, mottled appearance, and a red base.
3rd Degree: Full Thickness injury

Electrica Burns

Entrance and exit wounds may be small, burns large area below the surface

Chemical Burns

Acids, Alkalis, or other chemicals come in contact witht he skin or other body membranes

White Phosphorus Burns

Particles ignite upon contact with air.

Most common condition caused by working or exercising in hot environments

Heat Exhaustion

Less common but far more serious condition than heat exhaustion. 20% mortality rate. Lack of Sweat

Heat Stroke

Chilblain

Mild cold injury caused by prolonged and repeated exposure for several hours to air temp. from above freezing 32F to as high as 60F

May occur in hands, results from prolonged exposure to wet cold at temps

Immersion Foot

Deep Frostbite

The Skin will not move over bony ridges and will feel hard and solid

Big Boxes

Caisson Disease; Decompression sickness (DCS)

Barotrauma

Damage to tissue caused by a change in ambient pressure

POIS

Pulmonary Over Inflation Syndrome. Emphysema

Mediastinal Emphysema

Tearing of the lungs with air leaking out and remaining inside the chest cavity

Subcutaneous Emphysema

Tearing of the lungs with air leaking out of the lung the migrating up and out of the chest cavity and stopping at the base of the neck

AGE

Arterial Gas Embolism; capillaries on the alveolar sacs at the location of a tear in the lung draw gas into the blood stream

Poison

Substance that when introduced into the body, produces a harmful effect on normal body structures or functions

Ingested Poison

Poisons that have been consumed, most common route of exposure

Corrosives

Acids and alkalis (bases) produce actual chemical burning and corrosion of the tissue of the lips, mouth, throat, and stomach

Corrosives (Acid or Base) Ingestion

Never administer a neutralizing solution by mouth. Give H20 only, unless otherwise directed by PCP or medical officer

Scorpion Stings

Centruroides exilicauda "bark scorpion" Mexico and US southwest region may cause severe effects

Black Widow

Red hourglass-shaped spot on belly, Bites causes dull, numbing pain, spreads gradually from bite site to the muscles of the torso

Brown Recluse

Violin-shaped marking. Bite may go unnoticed, after several hours, bleb develops over site and rings or erythema surrounding the bleb.

Snakes; venomous families

5
Viperidae
Elapidae
Hydrophidae
Colubridae
Atractaspididae

NORTH AMERICAN CORAL SNAKES ONLY

Red on Yellow Kill a Fellow, Red on Black Venom Lack

Alcohol

Most widely abused drug today

Cannabis Sativa

Marijuana

Amphetamines

Used in treatment of conditions such as mild depression, obesity, narcolepsy

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