UNIT 4: DISASTER MEDICAL OPERATIONS PART 2

In this unit you will lea n a!out: Public Health Considerations: "ow to #aintain hy$iene an% sanitation& Functions of Disaster Medical Operations: 'hat the (i)e #a*o (un+tions o( %isaste #e%i+al o,e ations a e an% how they a e set u,& Disaster Medical Treatment Areas: "ow to esta!lish the# an% what thei (un+tions a e& Patient Evaluation: "ow to ,e (o # a hea%-to-toe assess#ent to i%enti(y an% t eat in*u ies& Basic Treatment Ho! to: T eat !u ns D ess an% !an%a$e woun%s T eat ( a+tu es. %islo+ations. s, ains. an% st ains T eat hy,othe #ia T eat heat- elate% in*u ies Cont ol nasal !lee%in$ T eat !ites an% stin$s

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$#T&OD"CT$O# A#D "#$T O,E&,$E"#$T OB.ECT$,E( At the en% o( this unit. you shoul% !e a!le to: Ta0e a,, o, iate sanitation #easu es to , ote+t ,u!li+ health& Pe (o # hea%-to-toe ,atient assess#ents& Esta!lish a t eat#ent a ea& A,,ly s,lints to sus,e+te% ( a+tu es an% s, ains E#,loy !asi+ t eat#ents (o othe in*u ies

"#$T TOP$C( The unit to,i+s a e: Pu!li+ "ealth Consi%e ations 2un+tions o( Disaste Me%i+al O,e ations Esta!lishin$ Me%i+al T eat#ent A eas Con%u+tin$ "ea%-to-Toe Assess#ents T eatin$ 3u ns 'oun% Ca e T eatin$ 2 a+tu es. Dislo+ations. S, ains. an% St ains Nasal In*u ies T eatin$ Col%-Relate% In*u ies T eatin$ "eat-Relate% In*u ies 3ites an% Stin$s

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P"B*$C HEA*TH CO#($DE&AT$O#(

'hen %isaste )i+ti#s a e shelte e% to$ethe (o t eat#ent. ,u!li+ health !e+o#es a +on+e n& Measu es #ust !e ta0en. !oth !y in%i)i%ual CERT #e#!e s an% CERT o,e ations. to a)oi% the s, ea% o( %isease& The , i#a y ,u!li+ health #easu es in+lu%e: Maintainin$ , o,e hy$iene Maintainin$ , o,e sanitation Pu i(yin$ wate 4i( ne+essa y5 P e)entin$ the s, ea% o( %isease

MA$#TA$#$#' H%'$E#E Maintenan+e o( , o,e ,e sonal hy$iene is + iti+al e)en un%e #a0eshi(t +on%itions& So#e ste,s that in%i)i%uals shoul% ta0e to #aintain hy$iene a e to: 'ash han%s ( e6uently usin$ soa, an% wate & "an% washin$ shoul% !e tho ou$h 4at least 78 to 29 se+on%s o( )i$o ous u!!in$ on all su (a+es o( the han%5& Al+ohol-!ase% han% saniti:e s whi+h %on;t e6ui e wate a e a $oo% alte nati)e to han% washin$& The Cente s (o Disease Cont ol 4CDC5 e+o##en%s , o%u+ts that a e at least <9= al+ohol& To use an al+ohol-!ase% han% saniti:e . a,,ly a!out > teas,oon o( the , o%u+t to the ,al# o( you han%& Ru! you han%s to$ethe . +o)e in$ all su (a+es. until han%s a e % y& 'ea non-late? e?a# $lo)es at all ti#es& Chan$e o %isin(e+t $lo)es a(te e?a#inin$ an%@o t eatin$ ea+h ,atient& As e?,laine% ea lie . un%e (iel% +on%itions. in%i)i%uals +an use u!!e $lo)es that a e ste ili:e% !etween t eatin$ )i+ti#s usin$ !lea+h an% wate 47 ,a t !lea+h to 79 ,a ts wate 5& 'ea an NA8 #as0 an% $o$$les& Bee, % essin$s ste ile& Do not e#o)e the o)e w a, ( o# % essin$s until use& A(te o,enin$. use the enti e ,a+0a$e o( % essin$. i( ,ossi!le& Tho ou$hly wash a eas that +o#e in +onta+t with !o%y (lui%s with soa, an% wate o %ilute% !lea+h as soon as ,ossi!le&

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P"B*$C HEA*TH CO#($DE&AT$O#( 2CO#T$#"ED3

MA$#TA$#$#' (A#$TAT$O# Poo sanitation is also a #a*o +ause o( in(e+tion& CERT #e%i+al o,e ations ,e sonnel +an #aintain sanita y +on%itions !y: Cont ollin$ the %is,osal o( !a+te ial sou +es 4e&$&. soile% e?a# $lo)es. % essin$s. et+&5 Puttin$ waste , o%u+ts in ,lasti+ !a$s. tyin$ o(( the !a$s. an% #a 0in$ the# as #e%i+al waste& Bee, #e%i+al waste se,a ate ( o# othe t ash. an% %is,ose o( it as ha:a %ous waste& 3u yin$ hu#an waste& Sele+t a !u ial site away ( o# the o,e ations a ea an% #a 0 the !u ial site (o late +leanu,&

-ATE& P"&$F$CAT$O# Pota!le wate su,,lies a e o(ten in sho t su,,ly o a e not a)aila!le in a %isaste & 'ate +an !e ,u i(ie% (o % in0in$. +oo0in$. an% #e%i+al use !y heatin$ it to a ollin$ !oil (o 7 #inute o !y usin$ wate ,u i(i+ation ta!lets o non-,e (u#e% li6ui% !lea+h& The !lea+h to wate atios a e: C % o,s o( !lea+h ,e $allon o( wate 7< % o,s ,e $allon o( wate . i( the wate is +lou%y o %i ty

Let the !lea+h an% wate solution stan% (o D9 #inutes& Note that i( the solution %oes not s#ell o taste o( !lea+h. a%% anothe si? % o,s o( !lea+h. an% let the solution stan% (o 78 #inutes !e(o e usin$& Res+ue s shoul% not ,ut anythin$ on woun%s othe than ,u i(ie% wate & The use o( othe solutions 4e&$&. hy% o$en ,e o?i%e5 on woun%s #ust !e the %e+ision o( t aine% #e%i+al ,e sonnel& P&E,E#T$#' THE (P&EAD OF D$(EA(E CERT #e#!e s #ust use non-late? e?a# $lo)es. $o$$les. an% an NA8 #as0 %u in$ all #e%i+al o,e ations& Co)e all o,en woun%s as a way o( , e)entin$ the s, ea% o( in(e+tion&

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The e a e (i)e #a*o (un+tions o( %isaste #e%i+al o,e ations: T ia$e: The initial assess#ent an% so tin$ o( )i+ti#s (o t eat#ent !ase% on the se)e ity o( thei in*u ies T eat#ent: The %isaste #e%i+al se )i+es , o)i%e% to )i+ti#s T ans,o t: The #o)e#ent o( )i+ti#s ( o# in+i%ent lo+ation to the t eat#ent a ea Mo $ue: The te#,o a y hol%in$ a ea (o )i+ti#s who ha)e %ie% at the t eat#ent a ea& Those who a e ta$$e% as EDea%F %u in$ t ia$e a e not e#o)e% ( o# the in+i%ent site& Su,,ly: The hu! (o + u+ial su,,ly , o+u e#ent an% %ist i!ution

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E(TAB*$(H$#' MED$CA* T&EATME#T A&EA(

3e+ause ti#e is + iti+al when CERTs a+ti)ate. CERT #e%i+al o,e ations ,e sonnel will nee% to sele+t a site an% set u, a t eat#ent a ea as soon as in*u e% )i+ti#s a e +on(i #e%& Dete #inin$ the !est lo+ation4s5 (o the CERT t eat#ent a ea shoul% in+lu%e the (ollowin$ o)e all +onsi%e ations: Sa(ety (o es+ue s an% )i+ti#s Most e((e+ti)e use o( esou +es. e&$&. CERT #e#!e s the#sel)es. ti#e. #e%i+al su,,lies

(AFET% FO& &E(C"E&( A#D ,$CT$M( As )i+ti#s a e lo+ate%. es+ue%. an% t ia$e%. they a e #o)e% to a lo+ation whe e they +an !e t eate%& The se)e ity o( the %a#a$e an% the sa(ety o( the i##e%iate en)i on#ent %ete #ine whe e the initial CERT t eat#ent a ea shoul% !e lo+ate%& In all +ases. e#e#!e that you sa(ety is the nu#!e one , io ity& In st u+tu es with li$ht %a#a$e. CERT #e#!e s t ia$e the )i+ti#s as they a e lo+ate%& 2u the #e%i+al t eat#ent is ,e (o #e% in a sa(e lo+ation insi%e the st u+tu e whe e )i+ti#s a e o $ani:e% a++o %in$ to the e?tent o( thei in*u ies& In st u+tu es with #o%e ate %a#a$e. CERT #e#!e s also t ia$e the )i+ti#s as they a e lo+ate%G howe)e . )i+ti#s a e sent to a #e%i+al t eat#ent lo+ation that is a sa(e %istan+e ( o# the in+i%ent lo+ation& Hi+ti#s a e o $ani:e% a++o %in$ to the e?tent o( thei in*u ies&

'hethe the t eat#ent a ea is set u, insi%e o a sa(e %istan+e ( o# the st u+tu e. a #o $ue #ay nee% to !e set u, as a te#,o a y hol%in$ a ea (o )i+ti#s who %ie at the t eat#ent a ea&

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In a%%ition to the se)e ity o( the %a#a$e to the st u+tu e whe e )i+ti#s a e (oun%. the e a e two othe i#,o tant sa(ety +onsi%e ations: The t eat#ent a ea itsel( #ust !e ( ee o( ha:a %s an% %e! is& The site shoul% !e +lose to !ut u,hill an% u,win% ( o# the ha:a % :one&

MO(T EFFECT$,E "(E OF CE&T &E(O"&CE( In a%%ition to the sa(ety o( es+ue s an% )i+ti#s. a se+on% o)e all +onsi%e ation (o settin$ u, t eat#ent a eas is how to #a0e the !est use o( CERT esou +es. e&$&. CERT #e#!e s the#sel)es. ti#e. #e%i+al su,,lies. an% e6ui,#ent& To hel, #eet the +hallen$e o( li#ite% esou +es. ,a ti+ula ly i( initial t eat#ent o,e ations will +ontinue (o so#e ti#e. CERT #ay nee% %e+ent ali:e% t eat#ent lo+ations an%@o #ay esta!lish one +ent al #e%i+al t eat#ent lo+ation. %e,en%in$ on the +i +u#stan+es& The CERT #ay nee% to in+lu%e one o !oth in thei #e%i+al o,e ations ,lan: De+ent ali:e% T eat#ent Sites: In a wi%es, ea% e)ent with #any in*u e%. it is so#eti#es ne+essa y to set u, an% #aintain #o e than one #e%i+al t eat#ent lo+ation. es,e+ially when a +ent al t eat#ent lo+ation woul% !e a +onsi%e a!le %istan+e ( o# the initial t eat#ent site& A #e%i+al t eat#ent lo+ation woul% !e set u, +lose to. !ut a sa(e %istan+e ( o#. ea+h o( the %a#a$e sites& Ea+h o( the t eat#ent lo+ations woul% in+lu%e a eas (o I##e%iate. Delaye%. an% Mino )i+ti#s an% a #o $ue& Hi+ti#s e#ain un%e t eat#ent at the lo+ation until they +an !e t ans,o te% to a lo+ation (o , o(essional #e%i+al +a e o to the CERT;s #ain t eat#ent a ea&

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Cent ali:e% T eat#ent Site: In an e)ent with one o a (ew in*u e% )i+ti#s at ea+h o( a nu#!e o( sites. the CERT #ay nee% to esta!lish one +ent al #e%i+al t eat#ent lo+ation& A +ent ali:e% lo+ation #ay nee% to !e set u, e)en when the e a e %e+ent ali:e% sites esta!lishe%& The lo+ation woul% in+lu%e t eat#ent a eas (o I##e%iate. Delaye%. an% Mino )i+ti#s. an% a #o $ue& Hi+ti#s a e #o)e% ( o# whe e they we e es+ue%. t ia$e%. an% initially t eate% to the +ent al lo+ation. an% e#ain un%e t eat#ent the e until they +an !e t ans,o te% to a lo+ation (o , o(essional #e%i+al t eat#ent& A +ent al #e%i+al t eat#ent lo+ation allows (o e((e+ti)e use o( esou +es sin+e a li#ite% nu#!e o( CERT #e%i+al o,e ation ,e sonnel in one lo+ation +an ta0e +a e o( a $ eate nu#!e o( )i+ti#s& EMS o othe #e%i+al , o(essionals will $ene ally !e a!le to t ans,o t the in*u e% #o e e((i+iently ( o# one +ent al lo+ation than ( o# #ulti,le %e+ent ali:e% lo+ations&

'hethe a t eat#ent site is +ent ali:e% o one o( a nu#!e o( %e+ent ali:e% sites. the lo+ation4s5 sele+te% shoul% !e: A++essi!le !y t ans,o tation )ehi+les 4a#!ulan+es. t u+0s. heli+o,te s. et+&5 E?,an%a!le

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T&EATME#T A&EA *A%O"T The t eat#ent a ea #ust !e , ote+te% an% +lea ly %elineate%& Si$ns shoul% !e use% to i%enti(y the su!%i)isions o( the a ea: EIF (o I##e%iate +a e EDF (o Delaye% +a e EMF (o Mino in*u ies@wal0in$ woun%e% EDEADF (o the #o $ue

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The EIF an% EDF a eas shoul% !e elati)ely +lose to ea+h othe to allow: He !al +o##uni+ation !etween wo 0e s in the t eat#ent a eas Sha e% a++ess to #e%i+al su,,lies 4whi+h shoul% !e +a+he% in a +ent al lo+ation5 Easy t ans(e o( ,atients whose status has +han$e%

Hi+ti#s who ha)e !een i%enti(ie% with #ino in*u ies #ay +hoose to stay at the t eat#ent a ea o lea)e& I( they stay. they +an assist CERT ,e sonnel& I( they lea)e. it shoul% !e %o+u#ente%& Patients in the t eat#ent a ea shoul% !e ,ositione% in a hea%-to-toe +on(i$u ation. with 2 to D (eet !etween )i+ti#s& This syste# will , o)i%e: E((e+ti)e use o( s,a+e E((e+ti)e use o( a)aila!le ,e sonnel& As a tea# #e#!e (inishes one hea%-to-toe assess#ent. he o she tu ns a oun% an% is at the hea% o( the ne?t ,atient&

The #o $ue site shoul% !e se+u e. away ( o# an% not )isi!le ( o# the t eat#ent a ea& This will hel, #ini#i:e t a((i+ nea the a ea an% e%u+e the ,otential ,sy+holo$i+al i#,a+t on those in the t eat#ent a ea& P e-,lannin$ (o CERT #e%i+al o,e ations in+lu%es e6ui,#ent nee%e% to set u, the t eat#ent a ea. su+h as $ oun% +o)e s o ta ,s an% si$ns (o i%enti(yin$ %i)isions 4EIF. EDF. EMF.F DEADF5&

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Treatment Area (ite *a:out

The %istan+e shown !etween the In+i%ent Site@T ia$e an% the T eat#ent A ea will %e,en% on whethe o not the t eat#ent lo+ation is site s,e+i(i+ o #o e +ent ali:e% in the CERT;s se )i+e a ea&

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T&EATME#T A&EA O&'A#$;AT$O# The e is an o!)ious nee% (o ,lannin$ !e(o e %isaste st i0es. in+lu%in$ oles o( ,e sonnel assi$ne% to the t eat#ent a ea& The CERT #ust assi$n lea%e s to #aintain +ont ol in ea+h o( the #e%i+al t eat#ent a ea su!%i)isions& These lea%e s will: Ensu e o %e ly )i+ti# ,la+e#ent Di e+t tea# #e#!e s to +on%u+t hea%-to-toe assess#ents

It is )e y i#,o tant to tho ou$hly %o+u#ent the )i+ti#s in the t eat#ent a ea. in+lu%in$: Na#e. a%% ess. an% ,hone nu#!e i( )i+ti# is a!le to tal0 Des+ i,tion 4a$e. se?. !o%y !uil%. esti#ate% hei$ht5 Clothin$ In*u ies T eat#ent T ans(e lo+ation

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CO#D"CT$#' HEAD1TO1TOE A((E((ME#T(

The (i st ste,s that you will ta0e when wo 0in$ with a )i+ti# will !e to +on%u+t t ia$e an% a,i% t eat#ent& A(te all )i+ti#s in an a ea ha)e !een t ia$e% an% #o)e% to a #e%i+al t eat#ent a ea. CERT #e#!e s will !e$in a tho ou$h hea%-to-toe assess#ent o( ea+h )i+ti#;s +on%ition& Du in$ t ia$e. you a e 0ee,in$ an eye out (o Ethe 0ille sF: Ai way o!st u+tion E?+essi)e !lee%in$ Si$ns o( sho+0

A hea%-to-toe assess#ent $oes !eyon% the E0ille sF to t y to $ain #o e in(o #ation to %ete #ine the natu e o( the )i+ti#;s in*u y& The enti e assess#ent #ust !e ,e (o #e% !e(o e initiatin$ t eat#ent& OB.ECT$,E( OF HEAD1TO1TOE A((E((ME#T( The o!*e+ti)es o( a hea%-to-toe assess#ent a e to: Dete #ine. as +lea ly as ,ossi!le. the e?tent o( in*u ies Dete #ine what ty,e o( t eat#ent is nee%e% Do+u#ent in*u ies

Re#e#!e to always wea you sa(ety e6ui,#ent when +on%u+tin$ hea%-to-toe assess#ents&

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CO#D"CT$#' HEAD1TO1TOE A((E((ME#T( 2CO#T$#"ED3

-HAT TO *OO< FO& $# HEAD1TO1TOE A((E((ME#T( The #e%i+al +o##unity uses the a+ ony# DCAP-3TLS to e#e#!e what to loo0 (o when +on%u+tin$ a a,i% assess#ent& DCAP-3TLS stan%s (o the (ollowin$: De(o #ities Contusions 4! uisin$5 A! asions Pun+tu es 3u ns Ten%e ness La+e ations Swellin$

'hen +on%u+tin$ a hea%-to-toe assess#ent. CERT #e#!e s shoul% loo0 (o DCAP3TLS in all ,a ts o( the !o%y& Re#e#!e to , o)i%e IMMEDIATE t eat#ent (o li(e-th eatenin$ in*u ies& Iou shoul% ,ay +a e(ul attention to how ,eo,le ha)e !een hu t 4the #e+hanis# o( in*u y5 !e+ause it , o)i%es insi$ht to , o!a!le in*u ies su((e e%&

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HO- TO CO#D"CT A HEAD1TO1TOE A((E((ME#T 'hene)e ,ossi!le. as0 the ,e son a!out any in*u ies. ,ain. !lee%in$. o othe sy#,to#s& I( the )i+ti# is +ons+ious. CERT #e#!e s shoul% always as0 ,e #ission to +on%u+t the assess#ent& The )i+ti# has the i$ht to e(use t eat#ent& Tal0in$ with the +ons+ious ,atient e%u+es an?iety& "ea%-to-toe assess#ents shoul% !e: Con%u+te% on all )i+ti#s. e)en those who see# all i$ht He !al 4i( the ,atient is a!le to s,ea05 "an%s-on& Do not !e a( ai% to e#o)e +lothin$ to loo0&

It is )e y i#,o tant that you +on%u+t hea%-to-toe assess#ents syste#ati+allyG %oin$ so will #a0e the , o+e%u e 6ui+0e an% #o e a++u ate with ea+h assess#ent& Re#e#!e to: Pay +a e(ul attention Loo0. listen. an% (eel (o anythin$ unusual Sus,e+t a s,inal in*u y in all un+ons+ious )i+ti#s an% t eat a++o %in$ly

Re#e#!e to +he+0 you own han%s (o ,atient !lee%in$ as you ,e (o # the hea%-totoe assess#ent&

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CO#D"CT$#' HEAD1TO1TOE A((E((ME#T( 2CO#T$#"ED3

Che+0 !o%y ,a ts ( o# the to, to the !otto# (o +ontinuity o( !ones an% so(t tissue in*u ies 4DCAP-3TLS5 in the (ollowin$ o %e : 7& "ea% 2& Ne+0 D& Shoul%e s 4& Chest 8& A #s <& A!%o#en J& Pel)is C& Le$s 'hile +on%u+tin$ a hea%-to-toe assess#ent. CERT #e#!e s shoul% always +he+0 (o : PMS 4Pulse. Mo)e#ent. Sensation5 in all e?t e#ities Me%i+al ID e#!le#s on ! a+elet o on ne+0 +hain

C*O(ED1HEAD= #EC<= A#D (P$#A* $#."&$E( 'hen +on%u+tin$ hea%-to-toe assess#ents. es+ue s #ay +o#e a+ oss )i+ti#s who ha)e o #ay ha)e su((e e% +lose%-hea%. ne+0. o s,inal in*u ies& A +lose%-hea% in*u y (o the ,a ti+i,ants is a +on+ussion-ty,e in*u y. as o,,ose% to a la+e ation. althou$h la+e ations +an !e an in%i+ation that the )i+ti# has su((e e% a +lose%-hea% in*u y& The #ain o!*e+ti)e when CERT #e#!e s en+ounte sus,e+te% in*u ies to the hea% o s,ine is to %o no ha #& Mini#i:e #o)e#ent o( the hea% an% s,ine while t eatin$ any othe li(e-th eatenin$ +on%itions&

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(i>ns of a Closed1Head= #ec?= or (pinal $n@ur: The si$ns o( a +lose%-hea%. ne+0. o s,inal in*u y #ost o(ten in+lu%e: Chan$e in +ons+iousness Ina!ility to #o)e one o #o e !o%y ,a ts Se)e e ,ain o , essu e in hea%. ne+0. o !a+0 Tin$lin$ o nu#!ness in e?t e#ities Di((i+ulty ! eathin$ o seein$ "ea)y !lee%in$. ! uisin$. o %e(o #ity o( the hea% o s,ine 3loo% o (lui% in the nose o ea s 3 uisin$ !ehin% the ea ERa++oonF eyes 4! uisin$ a oun% eyes5 EUne)enF ,u,ils Sei:u es Nausea o )o#itin$ Hi+ti# (oun% un%e +olla,se% !uil%in$ #ate ial o hea)y %e! is

I( the )i+ti# is e?hi!itin$ any o( these si$ns. he o she shoul% !e t eate% as ha)in$ a +lose%-hea%. ne+0. o s,inal in*u y&

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COMM"#$T% EME&'E#C% &E(PO#(E TEAM "#$T ): D$(A(TE& MED$CA* OPE&AT$O#( PA&T +

CO#D"CT$#' HEAD1TO1TOE A((E((ME#T( 2CO#T$#"ED3

(TAB$*$;$#' THE HEAD In a %isaste en)i on#ent. i%eal e6ui,#ent is a ely a)aila!le& CERT #e#!e s #ay nee% to !e + eati)e !y: Loo0in$ (o #ate ials that +an !e use% as a !a+0!oa % a %oo . %es0to,. !uil%in$ #ate ials anythin$ that #i$ht !e a)aila!le& Loo0in$ (o ite#s that +an !e use% to sta!ili:e the hea% on the !oa % towels. % a,e ies. o +lothin$ !y tu+0in$ the# snu$ly on eithe si%e o( the hea% to i##o!ili:e it&

&emember: Movin> victims !ith suspected head= nec?= or spinal in@ur: reAuires sufficient victim stabiliBationC $f the rescuer or victim is in immediate dan>er= ho!ever= safet: is more important than an: potential spinal in@ur: and the rescuer should move the victim from the area as Auic?l: as possibleC EDE&C$(E: CO#D"CT$#' HEAD1TO1TOE A((E((ME#T Purpose: This e?e +ise will $i)e you a +han+e to , a+ti+e +on%u+tin$ hea%-to-toe assess#ents& $nstructions: 7& A(te ! ea0in$ into ,ai s. the ,e son on the i$ht will !e the )i+ti#& 2& The es+ue will +on%u+t a hea%-to-toe assess#ent (ollowin$ the , e)iously %e#onst ate% , o+e%u e& Re,eat& D& A(te #a0in$ two o!se )e% hea%-to-toe assess#ents. the )i+ti# an% the es+ue swa, oles&

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T&EAT$#' B"&#(
As always. the (i st ste, in t eatin$ !u ns is to +on%u+t a tho ou$h si:eu,& A (ew e?a#,les o( !u n- elate% si:eu, 6uestions to as0 a e: 'hat +ause% the !u nK Is the %an$e still , esentK 'hen %i% the !u nin$ +easeK

The o!*e+ti)es o( (i st ai% t eat#ent (o !u ns a e to: Cool the !u ne% a ea Co)e with a ste ile +loth to e%u+e the is0 o( in(e+tion 4!y 0ee,in$ (lui%s in an% $e #s out5

3u ns #ay !e +ause% !y heat. +he#i+als. ele+t i+al +u ent. o a%iation& The se)e ity o( a !u n %e,en%s on the: Te#,e atu e o( the !u nin$ a$ent Pe io% o( ti#e that the )i+ti# was e?,ose% A ea o( the !o%y that was a((e+te% Si:e o( the a ea !u ne% De,th o( the !u n

B"&# C*A(($F$CAT$O#( The s0in has th ee laye s: The e,i%e #is. o oute laye o( s0in. +ontains ne )e en%in$s an% is ,enet ate% !y hai s& The %e #is. o #i%%le laye o( s0in. +ontains !loo% )essels. oil $lan%s. hai (olli+les. an% sweat $lan%s& The su!+utaneous laye . o inne #ost laye . +ontains !loo% )essels an% o)e lies the #us+les&

De,en%in$ on the se)e ity. !u ns #ay a((e+t all th ee laye s o( s0in&

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T&EAT$#' B"&#( 2CO#T$#"ED3

B"&# C*A(($F$CAT$O# Classification Su,e (i+ial (?in *a:ers Affected E,i%e #is 2ull Thi+0ness Co#,lete %est u+tion o( e,i%e #is an% %e #is Possi!le su!+utaneous %a#a$e 4%est oys all laye s o( s0in an% so#e o all un%e lyin$ st u+tu es5 (i>ns Re%%ene%. % y s0in Pain Swellin$ 4,ossi!le5 Re%%ene%. !liste e% s0in 'et a,,ea an+e Pain Swellin$ 4,ossi!le5 'hitene%. leathe y. o +ha e% 4! own o !la+05 Pain(ul o elati)ely ,ainless

Pa tial Thi+0ness

E,i%e #is Pa tial %est u+tion o( %e #is

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*$(T OF '"$DE*$#E( FO& T&EAT$#' B"&#(

Re#o)e the )i+ti# ( o# the !u nin$ sou +e& Put out any (la#es an% e#o)e s#ol%e in$ +lothin$ unless it is stu+0 to the s0in& Cool s0in o +lothin$. i( they a e still hot. !y i##e sin$ the# in +ool wate (o not #o e than 7 #inute o +o)e in$ with +lean +o#, esses that ha)e !een soa0e% in +ool wate an% w un$ out& Coolin$ sou +es in+lu%e wate ( o# the !ath oo# o 0it+henG $a %en hoseG an% soa0e% towels. sheets. o othe +loths& T eat all )i+ti#s o( (ull thi+0ness !u ns (o sho+0& In(ants. youn$ +hil% en. an% ol%e ,e sons. an% ,e sons with se)e e !u ns. a e #o e sus+e,ti!le to hy,othe #ia& The e(o e. es+ue s shoul% use +aution when a,,lyin$ +ool % essin$s on su+h ,e sons& A ule o( thu#! is %o not +ool #o e than 78= o( the !o%y su (a+e a ea 4the si:e o( one a #5 at on+e. to e%u+e the +han+es o( hy,othe #ia&

Co)e loosely with % y. ste ile % essin$s to 0ee, ai out. e%u+e ,ain. an% , e)ent in(e+tion& ' a, (in$e s an% toes loosely an% in%i)i%ually when t eatin$ se)e e !u ns to the han%s an% (eet& Loosen +lothin$ nea the a((e+te% a ea& Re#o)e *ewel y i( ne+essa y. ta0in$ +a e to %o+u#ent what was e#o)e%. when. an% to who# it was $i)en& Ele)ate !u ne% e?t e#ities hi$he than the hea t& Do not use i+e& I+e +auses )essel +onst i+tion& Do not a,,ly antise,ti+s. oint#ents. o othe e#e%ies& Do not e#o)e sh e%s o( tissue. ! ea0 !liste s. o e#o)e a%he e% ,a ti+les o( +lothin$& 4Cut !u ne%-in +lothin$ a oun% the !u n&5

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T&EAT$#' B"&#( 2CO#T$#"ED3

DO( A#D DO#ET( OF B"&# T&EATME#T 'hen t eatin$ a !u n )i+ti#. DO: Cool s0in o +lothin$ i( they a e still hot& Co)e loosely with % y. ste ile % essin$s to 0ee, ai out. e%u+e ,ain. an% , e)ent in(e+tion& Ele)ate !u ne% e?t e#ities hi$he than the hea t&

'hen t eatin$ a !u n )i+ti#: Do #OT use i+e& I+e +auses )essel +onst i+tion& Do #OT a,,ly antise,ti+s. oint#ents. o othe e#e%ies& Do #OT e#o)e sh e%s o( tissue. ! ea0 !liste s. o e#o)e a%he e% ,a ti+les o( +lothin$& 4Cut !u ne%-in +lothin$ a oun% the !u n&5

In(ants. youn$ +hil% en. an% ol%e ,e sons. an% ,e sons with se)e e !u ns. a e #o e sus+e,ti!le to hy,othe #ia& The e(o e. es+ue s shoul% use +aution when a,,lyin$ +ool % essin$s on su+h ,e sons& A ule o( thu#! is %o not +ool #o e than 78= o( the !o%y su (a+e a ea 4the si:e o( one a #5 at on+e. to , e)ent hy,othe #ia& 'E#E&A* '"$DE*$#E( FO& T&EAT$#' CHEM$CA* A#D $#HA*AT$O# B"&#( Che#i+al an% inhalation !u ns )a y ( o# t a%itional heat- elate% !u ns in thei o i$in an% t eat#ent& Bee, in #in% that sus,i+ion o( eithe +he#i+al o inhalation !u ns ele)ates the )i+ti#;s status to EI&F

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T&EAT$#' B"&#( 2CO#T$#"ED3

'"$DE*$#E( FO& T&EAT$#' CHEM$CA* B"&#( Unli0e #o e t a%itional !u ns. +he#i+al !u ns %o not esult ( o# e?t e#e heat. an% the e(o e t eat#ent %i((e s $ eatly& Che#i+al !u ns a e not always o!)ious& Iou shoul% +onsi%e +he#i+al !u ns as a ,ossi!ility i( the )i+ti#;s s0in is !u nin$ an% the e is no si$n o( a (i e& I( +he#i+al !u ns a e sus,e+te%: 7& P ote+t you sel( ( o# +onta+t with the su!stan+e& Use you , ote+ti)e $ea es,e+ially $o$$les. #as0. an% $lo)es& 2& Ensu e that any a((e+te% +lothin$ o *ewel y is e#o)e%& D& I( the i itant is % y. $ently ! ush away as #u+h as ,ossi!le& Always ! ush away ( o# the eyes an% away ( o# the )i+ti# an% you& 4& Use lots o( +ool unnin$ wate to (lush the +he#i+al ( o# the s0in (o 78 #inutes& The unnin$ wate will %ilute the +he#i+al (ast enou$h to , e)ent the in*u y ( o# $ettin$ wo se& 8& A,,ly +ool. wet +o#, ess to elie)e ,ain& <& Co)e the woun% )e y loosely with a % y. ste ile o +lean +loth so that the +loth will not sti+0 to the woun%& J& T eat (o sho+0 i( a,, o, iate& '"$DE*$#E( FO& T&EAT$#' $#HA*AT$O# B"&#(

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COMM"#$T% EME&'E#C% &E(PO#(E TEAM "#$T ): D$(A(TE& MED$CA* OPE&AT$O#( PA&T +

Re#e#!e that <9 to C9= o( (i e (atalities a e the esult o( s#o0e inhalation& 'hene)e (i e an%@o s#o0e is , esent. CERT #e#!e s shoul% assess )i+ti#s (o si$ns an% sy#,to#s o( s#o0e inhalation& These a e in%i+ato s that an inhalation !u n is , esent: Su%%en loss o( +ons+iousness E)i%en+e o( es,i ato y %ist ess o u,,e ai way o!st u+tion Soot a oun% the #outh o nose Sin$e% (a+ial hai 3u ns a oun% the (a+e o ne+0

T&EAT$#' B"&#( 2CO#T$#"ED3

'"$DE*$#E( FO& T&EAT$#' $#HA*AT$O# B"&#( 2CO#T$#"ED3 The ,atient #ay not , esent these si$ns an% sy#,to#s until hou s 4so#eti#es u, to a (ull 24 hou s5 a(te the in*u y o++u e%. an% su+h sy#,to#s #ay !e o)e loo0e% when t eatin$ #o e o!)ious si$ns o( t au#a& S#o0e inhalation is the nu#!e one (i e- elate% +ause o( %eath& I( CERT #e#!e s ha)e eason to sus,e+t s#o0e inhalation. !e su e the ai way is #aintaine%. an% ale t a #e%i+al , o(essional as soon as ,ossi!le&

-O"#D CA&E
The #ain t eat#ent (o woun%s in+lu%es: Cont ol !lee%in$ Clean the woun% A,,ly % essin$ an% !an%a$e

T eat#ent (o +ont ollin$ !lee%in$ was +o)e e% in Unit D& The (o+us o( this se+tion is on +leanin$ an% !an%a$in$. whi+h will hel, to , e)ent se+on%a y in(e+tion& C*EA#$#' A#D BA#DA'$#' -O"#D(

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'oun%s shoul% !e +leane% !y i i$atin$ with +lean. oo# te#,e atu e wate & NEHER use hy% o$en ,e o?i%e to i i$ate the woun%& Iou shoul% not s+ u! the woun%& A !ul! sy in$e is use(ul (o i i$atin$ woun%s& In a %isaste . a tu 0ey !aste #ay also !e use(ul& 'hen the woun% is tho ou$hly +leane%. you will nee% to a,,ly a % essin$ an% !an%a$e to hel, 0ee, it +lean an% +ont ol !lee%in$& The e is a %i((e en+e !etween a % essin$ an% a !an%a$e: A % essin$ is a,,lie% %i e+tly to the woun%& 'hene)e ,ossi!le. a % essin$ shoul% !e ste ile& A !an%a$e hol%s the % essin$ in ,la+e&

I( a woun% is still !lee%in$. the !an%a$e shoul% ,la+e enou$h , essu e on the woun% to hel, +ont ol !lee%in$ without inte (e in$ with +i +ulation&

-O"#D CA&E 2CO#T$#"ED3

&"*E( OF D&E(($#' Iou shoul% (ollow these ules: 7& I( the e is a+ti)e !lee%in$ 4i&e&. i( the % essin$ is soa0e% with !loo%5. e% ess o)e the e?istin$ % essin$ an% #aintain , essu e an% ele)ation to +ont ol !lee%in$& 2& In the a!sen+e o( a+ti)e !lee%in$. e#o)e the % essin$s. (lush the woun%. an% then +he+0 (o si$ns o( in(e+tion at least e)e y 4 to < hou s& Si$ns o( ,ossi!le in(e+tion in+lu%e: Swellin$ a oun% the woun% site Dis+olo ation Dis+ha $e ( o# the woun% Re% st iations ( o# the woun% site

I( ne+essa y an% !ase% on eassess#ent an% si$ns o( in(e+tion. +han$e the t eat#ent , io ity 4e&$&. ( o# Delaye% to I##e%iate5& AMP"TAT$O#(
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The #ain t eat#ents (o an a#,utation 4the t au#ati+ se)e in$ o( a li#! o othe !o%y ,a t5 a e to: Cont ol !lee%in$ T eat sho+0 Sa)e tissue ,a ts. w a,,e% in +lean #ate ial an% ,la+e% in a ,lasti+ !a$. i( a)aila!le& La!el the# with the %ate. ti#e. an% )i+ti#;s na#e& Bee, the tissue ,a ts +ool. !ut NOT in %i e+t +onta+t with i+e Bee, the se)e e% ,a t with the )i+ti#

'hen the se)e e% !o%y ,a t +an !e lo+ate%. CERT #e#!e s shoul%:

-O"#D CA&E 2CO#T$#"ED3

$MPA*ED OB.ECT( So#eti#es. you #ay also en+ounte so#e )i+ti#s who ha)e (o ei$n o!*e+ts lo%$e% in thei !o%ies usually as the esult o( (lyin$ %e! is %u in$ the %isaste & 'hen a (o ei$n o!*e+t is i#,ale% in a ,atient;s !o%y. you shoul%: I##o!ili:e the a((e+te% !o%y ,a t Not atte#,t to #o)e o e#o)e the o!*e+t. unless it is o!st u+tin$ the ai way T y to +ont ol !lee%in$ at the ent an+e woun% without ,la+in$ un%ue , essu e on the (o ei$n o!*e+t Clean an% % ess the woun% #a0in$ su e to sta!ili:e the i#,ale% o!*e+t& ' a, !ul0y % essin$s a oun% the o!*e+t to 0ee, it ( o# #o)in$&

T&EAT$#' F&ACT"&E(= D$(*OCAT$O#(= (P&A$#(= A#D (T&A$#(

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The o!*e+ti)e when t eatin$ a sus,e+te% ( a+tu e. s, ain. o st ain is to i##o!ili:e the in*u y an% the *oints i##e%iately a!o)e an% !elow the in*u y site& 3e+ause it is %i((i+ult to %istin$uish a#on$ ( a+tu es. s, ains. o st ains. i( un+e tain o( the ty,e o( in*u y. CERT #e#!e s shoul% t eat the in*u y as a ( a+tu e& F&ACT"&E( A ( a+tu e is a +o#,lete ! ea0. a +hi,. o a + a+0 in a !one& The e a e se)e al ty,es o( ( a+tu es& A +lose% ( a+tu e is a ! o0en !one with no asso+iate% woun%& 2i st ai% t eat#ent (o +lose% ( a+tu es #ay e6ui e only s,lintin$& An o,en ( a+tu e is a ! o0en !one with so#e 0in% o( woun% that allows +onta#inants to ente into o a oun% the ( a+tu e site&

Closed and Open Fractures

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T&EAT$#' A# OPE# F&ACT"&E
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O,en ( a+tu es a e #o e %an$e ous than +lose% ( a+tu es !e+ause they ,ose a si$ni(i+ant is0 o( se)e e !lee%in$ an% in(e+tion& The e(o e. they a e a hi$he , io ity an% nee% to !e +he+0e% #o e ( e6uently& 'hen t eatin$ an o,en ( a+tu e: Do not % aw the e?,ose% !one en%s !a+0 into the tissue& Do not i i$ate the woun%&

Iou shoul%: Co)e the woun% with a ste ile % essin$ S,lint the ( a+tu e without %istu !in$ the woun% Pla+e a #oist 4 !y 4-in+h % essin$ o)e the !one en% to 0ee, it ( o# % yin$ out

I( the li#! is an$le%. then the e is a %is,la+e% ( a+tu e& Dis,la+e% ( a+tu es #ay !e %es+ i!e% !y the %e$ ee o( %is,la+e#ent o( the !one ( a$#ents& Non%is,la+e% ( a+tu es a e %i((i+ult to i%enti(y. with the #ain si$ns !ein$ ,ain an% swellin$& Iou shoul% t eat a sus,e+te% ( a+tu e as a ( a+tu e until , o(essional t eat#ent is a)aila!le&

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Displaced and #ondisplaced Fractures

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D$(*OCAT$O#( Dislo+ations a e anothe +o##on in*u y in e#e $en+ies& A %islo+ation is an in*u y to the li$a#ents a oun% a *oint that is so se)e e that it ,e #its a se,a ation o( the !one ( o# its no #al ,osition in a *oint& The si$ns o( a %islo+ation a e si#ila to those o( a ( a+tu e. an% a sus,e+te% %islo+ation shoul% !e t eate% li0e a ( a+tu e& I( %islo+ation is sus,e+te%. !e su e to assess PMS 4Pulse. Mo)e#ent. Sensation5 in the a((e+te% li#! !e(o e an% a(te s,lintin$@i##o!ili:ation& I( PMS is +o#, o#ise%. the ,atient;s t eat#ent , io ity is ele)ate% to EI&F Iou shoul% not t y to elo+ate a sus,e+te% %islo+ation& Iou shoul% i##o!ili:e the *oint until , o(essional #e%i+al hel, is a)aila!le& (P&A$#( A#D (T&A$#( A s, ain in)ol)es a st et+hin$ o tea in$ o( li$a#ents at a *oint an% is usually +ause% !y st et+hin$ o e?ten%in$ the *oint !eyon% its no #al li#its& A s, ain is +onsi%e e% a ,a tial %islo+ation. althou$h the !one eithe e#ains in ,la+e o is a!le to (all !a+0 into ,la+e a(te the in*u y& The #ost +o##on si$ns o( a s, ain a e: Ten%e ness at the site o( the in*u y Swellin$ an%@o ! uisin$ Rest i+te% use o loss o( use

The si$ns o( a s, ain a e si#ila to those o( a non%is,la+e% ( a+tu e& The e(o e. you shoul% not t y to t eat the in*u y othe than !y i##o!ili:ation an% ele)ation& A st ain in)ol)es a st et+hin$ an%@o tea in$ o( #us+les o ten%ons& St ains #ost o(ten in)ol)e the #us+les in the ne+0. !a+0. thi$h. o +al(& In so#e +ases. st ains #ay !e %i((i+ult to %istin$uish ( o# s, ains o ( a+tu es& 'hethe an in*u y is a st ain. s, ain. o ( a+tu e. t eat the in*u y as i( it is a ( a+tu e&

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(P*$#T$#' S,lintin$ is the #ost +o##on , o+e%u e (o i##o!ili:in$ an in*u y& Ca %!oa % is the #ate ial ty,i+ally use% (o #a0eshi(t s,lints !ut a )a iety o( #ate ials +an !e use%. in+lu%in$: So(t #ate ials& Towels. !lan0ets. o ,illows. tie% with !an%a$in$ #ate ials o so(t +loths Ri$i% #ate ials& A !oa %. #etal st i,. (ol%e% #a$a:ine o news,a,e . o othe i$i% ite#

Anato#i+al s,lints #ay also !e + eate% !y se+u in$ a ( a+tu e% !one to an a%*a+ent un( a+tu e% !one& Anato#i+al s,lints a e usually ese )e% (o (in$e s an% toes. !ut. in an e#e $en+y. le$s #ay also !e s,linte% to$ethe & So(t #ate ials shoul% !e use% to (ill the $a, !etween the s,lintin$ #ate ial an% the !o%y ,a t& 'ith this ty,e o( in*u y. the e will !e swellin$& Re#o)e est i+ti)e +lothin$. shoes. an% *ewel y when ne+essa y to , e)ent these ite#s ( o# a+tin$ as uninten%e% tou ni6uets&

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(P*$#T $**"(T&AT$O#(

Cardboard Splint
Cardboard (plint in !hich the ed>es of the cardboard are turned up to form a FmoldG in !hich the in@ured limb can restC

(plintin> "sin> a To!el

(plintin> usin> a to!el= in !hich the to!el is rolled up and !rapped around the limb= then tied in placeC

Pillo! splint
Pillo! splint= in !hich the pillo! is !rapped around the limb and tiedC

(plint $llustrations
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Anatomical (plint
Anatomical splint in !hich the in@ured le> is tied at intervals to the non1in@ured le>= usin> a blan?et as paddin> bet!een the le>sC

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EDE&C$(E: (P*$#T$#' Purpose: This e?e +ise will , o)i%e you with a +han+e to , a+ti+e you s,lintin$ te+hni6ues& $nstructions: 7& 3 ea0 %own into ,ai s o( two& One ,e son will !e the es+ue . the othe will !e the )i+ti#& 2& The es+ue will ,la+e a s,lint on the )i+ti#;s u,,e a #. an% then one on the )i+ti#;s lowe le$& D& A(te se)e al o!se )e% atte#,ts at s,lintin$. the es+ue an% the )i+ti# will swa, oles&

#A(A* $#."&$E(
3lee%in$ ( o# the nose +an ha)e se)e al +auses& 3lee%in$ ( o# the nose +an !e +ause% !y: 3lunt (o +e to the nose S0ull ( a+tu e Nont au#a- elate% +on%itions su+h as sinus in(e+tions. hi$h !loo% , essu e. an% !lee%in$ %iso %e s

A la $e !loo% loss ( o# a nose!lee% +an lea% to sho+0& A+tual !loo% loss #ay not !e e)i%ent !e+ause the )i+ti# will swallow so#e a#ount o( !loo%& Those who ha)e swallowe% la $e a#ounts o( !loo% #ay !e+o#e nauseate% an% )o#it& These a e #etho%s (o +ont ollin$ nasal !lee%in$: Pin+h the nost ils to$ethe Put , essu e on the u,,e li, *ust un%e the nose

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#A(A* $#."&$E( 2CO#T$#"ED3

'hile t eatin$ (o nose!lee%s. you shoul%: "a)e the )i+ti# sit with the hea% sli$htly (o wa % so that !loo% t i+0lin$ %own the th oat will not !e ! eathe% into the lun$s& Do not ,ut the hea% !a+0& Ensu e that the )i+ti#;s ai way e#ains o,en Bee, the )i+ti# 6uiet& An?iety will in+ ease !loo% (low&

T&EAT$#' CO*D1&E*ATED $#."&$E(

Col%- elate% in*u ies in+lu%e: "y,othe #ia. whi+h is a +on%ition that o++u s when the !o%y;s te#,e atu e % o,s !elow no #al 2 ost!ite. whi+h o++u s when e?t e#e +ol% shuts %own !loo% (low to e?t e#ities. +ausin$ tissue %eath

H%POTHE&M$A "y,othe #ia #ay !e +ause% !y e?,osu e to +ol% ai o wate o !y ina%e6uate (oo% +o#!ine% with ina%e6uate +lothin$ an%@o heat. es,e+ially in ol%e ,eo,le& The , i#a y si$ns an% sy#,to#s o( hy,othe #ia a e: A !o%y te#,e atu e o( A8 2 4DJ C5 o lowe Re%ness o !lueness o( the s0in Nu#!ness a++o#,anie% !y shi)e in$

In late sta$es. hy,othe #ia will !e a++o#,anie% !y: Slu e% s,ee+h Un, e%i+ta!le !eha)io Listlessness

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T&EAT$#' CO*D1&E*ATED $#."&$E( 2CO#T$#"ED3

3e+ause hy,othe #ia +an set in within only a (ew #inutes. you shoul% t eat )i+ti#s who ha)e !een es+ue% ( o# +ol% ai o wate en)i on#ents& Re#o)e wet +lothin$& ' a, the )i+ti# in a !lan0et o slee,in$ !a$ an% +o)e the hea% an% ne+0& P ote+t the )i+ti# a$ainst the weathe & P o)i%e wa #. sweet % in0s an% (oo% to +ons+ious )i+ti#s& Do not o((e al+ohol& Do not atte#,t to use #assa$e to wa # a((e+te% !o%y ,a ts& Pla+e an un+ons+ious )i+ti# in the e+o)e y ,osition: 7& Pla+e the )i+ti#;s a # that is nea est to you at a i$ht an$le a$ainst the $ oun%. with the ,al# (a+in$ u,& 2& Mo)e the )i+ti#;s othe a # a+ oss his o he +hest an% ne+0. with the !a+0 o( the )i+ti#;s han% estin$ a$ainst his o he +hee0& D& L a! a hol% o( the 0nee (u thest ( o# you an% ,ull it u, until the 0nee is !ent an% the (oot is (lat on the (loo & 4& Pull the 0nee towa % you an% o)e the )i+ti#;s !o%y while hol%in$ the )i+ti#;s han% in ,la+e a$ainst his o he +hee0& 8& Position the )i+ti#;s le$ at a i$ht an$le a$ainst the (loo so that the )i+ti# is lyin$ on his o he si%e& I( the )i+ti# is +ons+ious. ,la+e hi# o he in a wa # !ath&

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T&EAT$#' CO*D1&E*ATED $#."&$E( 2CO#T$#"ED3

H%POTHE&M$A 2CO#T$#"ED3 Do not to allow the )i+ti# to wal0 a oun% e)en when he o she a,,ea s to !e (ully e+o)e e%& I( the )i+ti# #ust !e #o)e% out%oo s. +o)e the )i+ti#;s hea% an% (a+e& F&O(TB$TE A ,e son;s !loo% )essels +onst i+t in +ol% weathe in an e((o t to , ese )e !o%y heat& In e?t e#e +ol%. the !o%y will (u the +onst i+t !loo% )essels in the e?t e#ities in an e((o t to shunt !loo% towa % the +o e o $ans 4hea t. lun$s. intestines. et+&5& The +o#!ination o( ina%e6uate +i +ulation an% e?t e#e te#,e atu es will +ause tissue in these e?t e#ities to ( ee:e. an% in so#e +ases. tissue %eath will esult& 2 ost!ite is #ost +o##on in the han%s. nose. ea s. an% (eet& The e a e se)e al 0ey si$ns an% sy#,to#s o( ( ost!ite: S0in %is+olo ation 4 e%. white. ,u ,le. !la+05 3u nin$ o tin$lin$ sensation. at ti#es not lo+ali:e% to the in*u y site Pa tial o +o#,lete nu#!ness

A ,atient su((e in$ ( o# ( ost!ite #ust !e wa #e% slowlyM Thawin$ the ( o:en e?t e#ity too a,i%ly +an +ause +hille% !loo% to (low to the hea t. sho+0in$ an% ,otentially sto,,in$ it& I##e se in*u e% a ea in wa # 4NOT hot5 wate . a,, o?i#ately 79J&< 2& Do NOT allow the !o%y ,a t to e-( ee:e as this will e?a+e !ate the in*u y& Do NOT atte#,t to use #assa$e to wa # !o%y ,a ts&

' a, a((e+te% !o%y ,a ts in % y. ste ile % essin$& A$ain. it is )ital this tas0 !e +o#,lete% +a e(ully& 2 ost!ite esults in the (o #ation o( i+e + ystals in the tissueG u!!in$ +oul% ,otentially +ause a $ eat %eal o( %a#a$eM

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T&EAT$#' HEAT1&E*ATED $#."&$E(

The e a e se)e al ty,es o( heat- elate% in*u ies that you #ay en+ounte in a %isaste s+ena io: "eat + a#,s a e #us+le s,as#s ! ou$ht on !y o)e -e?e tion in e?t e#e heat& "eat e?haustion o++u s when an in%i)i%ual e?e +ises o wo 0s in e?t e#e heat. esultin$ in loss o( !o%y (lui%s th ou$h hea)y sweatin$& 3loo% (low to the s0in in+ eases. +ausin$ !loo% (low to %e+ ease to the )ital o $ans& This esults in a #il% (o # o( sho+0& "eat st o0e is li(e-th eatenin$& The )i+ti#Ns te#,e atu e +ont ol syste# shuts %own. an% !o%y te#,e atu e +an ise so hi$h that ! ain %a#a$e an% %eath #ay esult&

HEAT EDHA"(T$O# The sy#,to#s o( heat e?haustion a e: Cool. #oist. ,ale. o (lushe% s0in "ea)y sweatin$ "ea%a+he Nausea o )o#itin$ Di::iness E?haustion

A ,atient su((e in$ heat e?haustion will ha)e a nea no #al !o%y te#,e atu e& I( le(t unt eate%. heat e?haustion will %e)elo, into heat st o0e&

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T&EAT$#' HEAT1&E*ATED $#."&$E( 2CO#T$#"ED3

HEAT (T&O<E "eat st o0e is +ha a+te i:e% !y so#e o all o( the (ollowin$ sy#,to#s: "ot. e% s0in La+0 o( ,e s,i ation Chan$es in +ons+iousness Ra,i%. wea0 ,ulse an% a,i%. shallow ! eathin$

In a heat st o0e )i+ti#. !o%y te#,e atu e +an !e )e y hi$h as hi$h as 798O 2& I( an in%i)i%ual su((e in$ ( o# heat st o0e is not t eate%. %eath +an esult T&EATME#T T eat#ent is si#ila (o !oth heat e?haustion an% heat st o0e& 7& Ta0e the )i+ti# out o( the heat an% ,la+e in a +ool en)i on#ent& 2& Cool the !o%y slowly with +ool. wet towels o sheets& I( ,ossi!le. ,ut the )i+ti# in a +ool !ath& D& "a)e the )i+ti# % in0 wate . SLO'LI. at the ate o( a,, o?i#ately hal( a $lass o( wate e)e y 78 #inutes& Consu#in$ too #u+h wate too 6ui+0ly will +ause nausea an% )o#itin$ in a )i+ti# o( heat si+0ness& 4& I( the )i+ti# is e?,e ien+in$ )o#itin$. + a#,in$. o is losin$ +ons+iousness. DO NOT a%#iniste (oo% o % in0& Ale t a #e%i+al , o(essional as soon as ,ossi!le. an% 0ee, a +lose wat+h on the in%i)i%ual until , o(essional hel, is a)aila!le&

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B$TE( A#D (T$#'(

In a %isaste en)i on#ent. e)e ythin$ is sha0en ( o# no #al+y. in+lu%in$ inse+ts an% ani#als& In this ti#e o( +haos. inse+t !ites an% stin$s #ay !e #o e +o##on than is ty,i+al as these + eatu es. li0e ,eo,le. a e un%e a%%itional st ess& 'hen +on%u+tin$ a hea%-to-toe assess#ent. you shoul% loo0 (o si$ns o( inse+t !ites an% stin$s& The s,e+i(i+ sy#,to#s )a y %e,en%in$ on the ty,e o( + eatu e. !ut. $ene ally. !ites an% stin$s will !e a++o#,anie% !y e%ness an% it+hin$. tin$lin$ o !u nin$ at the site o( the in*u y. an% o(ten a welt on the s0in at the site& T eat#ent (o inse+t !ites an% stin$s (ollows these ste,s: 7& Re#o)e the stin$e i( still , esent !y s+ a,in$ the e%$e o( a + e%it +a % o othe sti((. st ai$ht-e%$e% o!*e+t a+ oss the stin$e & Do not use twee:e sG these #ay s6uee:e the )eno# sa+ an% in+ ease the a#ount o( )eno# elease%& 2& 'ash the site tho ou$hly with soa, an% wate & D& Pla+e i+e 4w a,,e% in a wash+loth5 on the site o( the stin$ (o 79 #inutes an% then o(( (o 79 #inutes& Re,eat this , o+ess& Iou #ay hel, the )i+ti# ta0e his o he own alle $y #e%i+ine 43ena% yl. et+&5. !ut you #ay NOT %is,ense #e%i+ations& B$TE( A#D (T$#'( A#D A**E&'$C &EACT$O#( The $ eatest +on+e n with any inse+t !ite o stin$ is a se)e e alle $i+ ea+tion. o ana,hyla?is& Ana,hyla?is o++u s when an alle $i+ ea+tion !e+o#es so se)e e that the ai way is +o#, o#ise%& I( you sus,e+t ana,hyla?is: 7& Che+0 ai way an% ! eathin$& 2& Cal# the in%i)i%ual& D& Re#o)e +onst i+ti)e +lothin$ an% *ewel y as the !o%y o(ten swells in es,onse to the alle $en& 4& I( ,ossi!le. (in% an% hel, a%#iniste a )i+ti#;s E,i-,en& Many se)e e alle $y su((e e s +a y one at all ti#es& a& DO NOT a%#iniste #e%i+ine asi%e ( o# the E,i-,en& This in+lu%es ,ain elie)e s. alle $y #e%i+ine. et+& 8& 'at+h (o si$ns o( sho+0 an% t eat a,, o, iately&

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"#$T ("MMA&%
To sa(e$ua % ,u!li+ health. ta0e #easu es to #aintain , o,e hy$iene an% sanitation. an% ,u i(y wate i( ne+essa y& All ,u!li+ health #easu es shoul% !e ,lanne% in a%)an+e an% , a+ti+e% %u in$ e?e +ises& Disaste #e%i+al o,e ations in+lu%e (i)e (un+tions:

T ia$e T eat#ent T ans,o t Mo $ue Su,,ly

T eat#ent a eas #ust !e esta!lishe% as soon as +asualties a e +on(i #e%& T eat#ent a eas shoul% !e:

In a sa(e a ea that is +lose to. !ut u,hill. u,win%. an%. i( ,ossi!le. u,st ea# ( o# the ha:a % a ea A++essi!le !y t ans,o tation )ehi+les E?,an%a!le

De,en%in$ on the +i +u#stan+es. a CERT #ay esta!lish a +ent al #e%i+al t eat#ent lo+ation an%@o t eat#ent lo+ations at in+i%ent sites whe e #any )i+ti#s ha)e !een in*u e%& "ea%-to-toe assess#ents shoul% !e )e !al an% han%s-on& Always +on%u+t hea%-totoe assess#ents in the sa#e way !e$innin$ with the hea% an% #o)in$ towa % the (eet& I( in*u ies to the hea%. ne+0. o s,ine a e sus,e+te%. the #ain o!*e+ti)e is to not +ause a%%itional in*u y& Use in-line sta!ili:ation an% a !a+0!oa % i( the )i+ti# #ust !e #o)e%& 3u ns a e +lassi(ie% as su,e (i+ial. ,a tial thi+0ness. o (ull thi+0ness %e,en%in$ on se)e ity an% the %e,th o( s0in laye s in)ol)e%& T eat#ent (o !u ns in)ol)es e#o)in$ the sou +e o( the !u n. +oolin$ the !u n. an% +o)e in$ it& 2o (ull thi+0ness !u ns. always t eat (o sho+0&

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"#$T ("MMA&% 2CO#T$#"ED3

The #ain (i st ai% t eat#ent (o woun%s +onsists o(:

Cont ollin$ !lee%in$ Cleanin$ D essin$ an% !an%a$in$

In the a!sen+e o( a+ti)e !lee%in$. % essin$s #ust !e e#o)e% an% the woun% +he+0e% (o in(e+tion at least e)e y 4 to < hou s& I( the e is a+ti)e !lee%in$. a new % essin$ shoul% !e ,la+e% o)e the e?istin$ % essin$& 2 a+tu es. %islo+ations. s, ains. an% st ains #ay ha)e si#ila si$ns& T eat all sus,e+te% ( a+tu es. s, ains. an% st ains !y i##o!ili:in$ the a((e+te% a ea usin$ a s,lint& The 0ey to t eat#ent o( +ol%- elate% in*u ies su+h as hy,othe #ia an% ( ost!ite is to wa # the )i+ti# slowly& Ana,hyla?is is the #ost + iti+al +on+e n when an inse+t !ite is sus,e+te%& Bnow how to use an E,i-,en an% #a0e su e to #onito the )i+ti#;s ai way until , o(essional hel, a i)es&

HOME-O&< A(($'#ME#T Rea% an% !e+o#e (a#ilia with the unit that will !e +o)e e% in the ne?t session& T y , a+ti+in$ a a,i% hea%-to-toe assess#ent on a ( ien% o (a#ily #e#!e & Don;t (o $et to %o+u#entM

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