Ch 63 First Aid, Emergency Care and Disaster Management

Click the card to flip 👆
1 / 52
Terms in this set (52)
1. Assess the ABC's: airway, breathing, and circulation
2. Initiate CPR or rescue breathing as needed.
3. Look for uncontrolled bleeding and apply pressure.
4. Assess level of consciousness.
5. To assess exposure, remove clothes and observe injury.
6. Allow family to be close and look for medical alert tag.
What are the general guidelines for first-aid treatment of emergency patients? (SATA)Splint injured parts in the position they are found. Prevent chilling and do not add excessive heat. Stay with the injured person until help arrives.which are problems for patients in cardiopulmonary arrest? (SATA)Inadequate peripheral circulation. Inadequate oxygenextensive burns (intervention)cover burns with a clean, dry dressing or clothsuperficial, minor burn (intervention)immerse the injured body part in cool water for 2-5 minutes. (Superficial burns are pink or red and painful)Chemical burns (intervention)Remove contaminated clothing and then flush skin with water for 30 minutes. (Chemical burns, remove any remaining chemical. To avoid potential tissue damage)Sunburn (intervention)Apply topical preparations with benzoncaine.Snake bite (intervention)immobilize the body part with the bite and keep it at or below the heart to minimize absorption of venom. Try to keep the patient still.insect bite or sting (intervention)Calamine lotion or a paste of baking soda for mild reactions. The patient with severe allergies may be given epinephrine, Benadryl, aminophylline, or hydrocortisone. Remove the stinger with a scraping motion.Animal bite (intervention)Clean the wound thoroughly and apply a bulky dressing. Advice the patient to have a tetanus booster if immunizations are not current. (Rabies is an infection of the CNS that is fatal).Human bite (intervention)Clean thoroughly and apply a dressing. Seek medical attention for antibiotic therapy.Complete fractureA fracture in which the broken ends are seperatedIncomplete fracturea fracture in which the bone ends are not seperatedSimple fracturea fracture that does not break the skinCompound fracturea fracture in which the ends of the broken bone protrude through the skin.S.A.M.P.L.ESymptoms Allergies Medication Past illness/Pregnancy Last oral intake Event related to injuryCauses for cardiopulmonary arrestdrug overdose, asphyxiation, drowning, myocardial infraction, electrocution, heart failure, anaphylaxisSevere airway obstructionpoor or no air exchange, poor or no cough, high-pitched noise (stridor on inhalation) or no noise on inhalation, respiratory distress, cyanosis, inability to speak, inability to move air, clutching the neck (universal choking signChoking or airway obstruction prevention•Cut food into small pieces, eat slowly and chew food thoroughly before swallowing •Avoid laugh and talk while chewing and swallowing •Perform the abdominal thrusts promptly when a person is in distress because of an obstructed airwayEpistaxis - nosebleed coming from anterior or posterior portion of the nose•Sit down and lean the head forward (prevent aspiration), pinch the nostrils of the patient shut for at least 10 minutes. •Advise patient not to blow or pick at the nose for several hours.Fracture assessment/objective signspain, numbness, tingling, deformity, swelling, discoloration, decreased function, bone fragments protruding through the skinFracture interventionsRest, immobilization, compression, elevation (RICE) application of cool pack, seen by physician for further evaluationhead injury in older adults are higher risksensory deficits, unstable gait, circulatory disordersSigns of increased intracranial pressure•Change in behavior, agitation, confusion •Decreasing LOC •Pupil dilation or constriction, inequality, slow response or no response to light •Impaired sensory or motor function •Increasing blood pressure with widening pulse pressure •Decreasing pulse and respiratory rates •Projectile vomitingDiving injury interventionimmobilized neck and back while removing from water. (Rationale: Primary Goal: Decreased potential for additional injury)Eye injury interventions: Chemical contactImmediately flush the eye for at least 20 minutes using sterile NS or water (tap water can be used), direct the irrigating fluid to flow from the inner canthus to the outer canthus of the eyeEye injury intervention: Perforation of the globePatch the unaffected eye because eye move together. Tell patient why both eyes need to be coveredPneumothorax : open chest wound penetrates the pleural cavity, allowing air to enter which collapses lung on affected sideSigns and symptoms: dyspnea, asymmetric chest wall movement, "sucking" sound as air moves in and out of wound with respirations. Interventions: apply vented dressing: sealed on three sides so air can escape but not enter the woundTraumatic amputation tissue has been partially or completely detached, partial or complete, reattachment is possible1. Clean wound with sterile water or saline, place the tissue in its normal position; if detached, wrap in sterile gauze moistened with sterile saline, placed in a watertight container such as resealable plastic bag and placed in an iced saline bath. 2. Tissue should not be frozen or placed in direct contact with ice. 3. Amputated extremities may be healthy for reattachment for 4 -6 hours whereas digits (fingers and toes) may be viable for as long as 8 hoursBurnsstop the burning process. Protection of the airway primary importance in burn patient. Check oxygenation r/t inhalation or thermal injury and edema of airway tissues.Frostbites signs and symptoms: pain then tingling then numbnessInterventions: Transport. Do not attempt to thaw the tissue unless warmth can be maintained. Frostbitten extremities are best rewarmed by immersion in warm water bath of 37.7 -40.5 C(100 -105 F). Handle affected areas very gently to prevent additional tissue trauma. Do not rub, massage or apply cold to the tissue.Carbon monoxide poisoningInterventions: Move to fresh air, if not breathing, start rescue breathing, oxygen, hyperbaric oxygen chamber (use pressure to force oxygen into the blood and tissues)Drug and chemical poisoningInterventions: Call the poison control center; have the product container with you, limited use of ipecac syrup, activated charcoal (binds with many poisons and preventing their absorption), total bowel lavage, cathartics (rapid transit of the poison through the intestinal tract for elimination) Know the condition, age, weight, exact time poising occurredTick / lyme diseasetreat with doxycycline, amoxicillin.Emergency doctrinein emergencies, person may be unable to consent to care. Treatment can be provided under the assumption that the patient would have consented if able.A high school football player collapses during practice on a hot, humid day. he is breathing with pulse but lethargic and does not follow commands. Skin is hot, red and dry. Nursing actions taken:Move to cool location. Immediately transport to medical care. place icepack on the forehead and in the axilla.A nurse is caring for a client who becomes unresponsive. While administering CPR, which of the following actions should the nurse take?Provide chest compressions at a rate of 100/min.Patient has frostbite on both legs from prolonged exposure outdoor at 12.2°C (10°F). The following nursing action?Elevate the lower extremities. (Rationale: after rewarming, the nurse should plan to elevate the patient's legs to help minimize edema)patient suffered severe concussion when he was robbed. Fluid coming from ear. Physician told patient he has cerebrospinal fluid leakage. Characteristics of cerebrospinal fluid with blood?A yellow halo is produced around the pink center of the fluid on the cloth (page: 1248)Emergency personnel arrive at the scene of two-car accident on the shoulder of a busy interstate highway. One car has a victim who appears trapped inside and unconscious. The first priority for the emergency personnel will be to: a. Start mouth to mouth resuscitation b. Determine whether the injuries are life threatening c. Perform CPR immediately d. Ensure their own safetyEnsure their own safetyA nurse is teaching cardiopulmonary resuscitation to a group of community members. The nurse asks a member of the group to describe the reason why blind finger sweeps are avoided in infant, the nurse determines that the person understands this reason if the person makes which statement: a. The object may be force back further into the throat and into the respiratory tract b. The mouth is too small to see the object c. The mouth is too delicate d. The infant may bite down on the fingerThe object may be force back further into the throat and into the respiratory tract1. Which of the following are common signs and symptoms of heat exhaustion? SATA a. Seizures b. Muscle cramps c. Dizziness d. Pale, damp skin e. Absent perspiration f. Hot, dry skinb. Muscle cramps c. Dizziness d. Pale, damp skin. (Heat exhaustion signs and symptoms: dizziness, headache, muscle cramps, nausea and vomiting, collapse, skin is pale and damp; temperature as high as 41.1°C. Cardiac output and heart rate first increase then fall; loss of fluid cause hypovolemia and electrolyte imbalances)What is the danger of too-rapid rewarming as the treatment for a patient with severe hypothermia?cardiac dysrhythmias