Return Demonstration: Medical Emergencies

Patient Assessment
COMMON MEDICAL EMERGENCIES 🚑
● Scene-safety How to Treat Fracture and Fracture Types
● Primary Assessment Fracture - break in the bone:
● History Taking ● Closed - does not penetrate the skin
● Secondary Assessment ● Open - penetrates the skin
● Reassessment What to look for:
- swelling and bruising
- difficulty moving
Building Rapport
- limb looks shorter; twisted; bend
● Introduce yourself - grating noise or feeling in the limb
● If the px is responsive get actual consent. - loss of strength
● Assess for LOC or responsiveness through - signs of shock
AVPU process. What to do:
- call emergency
Primary Survey - secure/ support the injured part with
● DR ABC PROCEDURE: Danger, Response, sling
Airway, Breathing, and Circulation. - place padding on the injury for support
What to do: If Open Fracture:
- scene safety - cover the wound
- check the px responsiveness - secure with bandage
- check LOC - apply pressure around the wound not
Checking Responsiveness: AVPU PROCESS over the bone
● If unresponsive; Leg Fracture:
- gently shake the shoulders of the px; - the injured leg can be tied with the
- if still no response, pinch the earlobe for uninjured leg
pain assessment; - keep checking for shock
- check and open the airway; - do not raise injured leg
- check breathing for 10 sec; - if necessary raise uninjured leg
- if not breathing normally call for
emergency and ask them to bring AED.
- start CPR if necessary. How to Treat Sprains and Strains
● If breathing normally: ● Sprain- ligament is twisted or torn.
- check circulation ● Strain- muscle has been overstretched
- perform rapid scan to spot What to look for:
bleeding/other injuries - pain and tenderness
- control bleeding if there is - difficulty moving
- call emergency - swelling and bruising
What to do with px: RICE PROCEDURE: Rest, Ice,
Recovery Position Compression, Elevation
What to do: - sit them in comfortable position
- kneel beside the px - cool the area
- both legs of the px should be - wrap a soft layer of padding around the are with
straightened the ice pack/ cool towel
- place the other hand of the px in his/her - bandage the area
other side of the cheek then lift or bend - elevate the area
the leg at the same side with the hand - support the injury
that had been moved.
- slowly move the px towards you.
How to Bandage a Sprain
What to do:
maejunejuly
 - raise and support the injury
How to Treat Asthma Attack
- use roller bandage
- apply ice pack and padding What to look for:
- put the bandage on the inside of the foot - difficulty breathing or speaking
- wrap 1.5 times to secure it - wheezing
- bandage to the joints above and below the injury - coughing
(joint before and after the injury site) - distress, anxious
- check circulation - grey blue tinge in lips, earlobes and nail beds
What to do:
- reassure px and help them use inhaler
How to Sling (Triangular Bandage) - encourage px to breathe slowly and deeply
2 Types: - sit them down in a comfortable position
● Arm Sling if condition does not get better expect a severe attack;
- holds the forearm horizontally/ slightly raised - use reliever inhaler, 1/2 puffs every 2 mins and
position up tp 10 puffs
- treats upper injured arm, wrist injuries, - call emergency
somebody who can bend their elbow, rib fracture - check abc, LOC, response
What to do:
- ask patient to support the injured part
Spinal Cord Injury
- pass triangular bandage under the arm
- bring the top end around shoulder Possible causes:
- bring loose end up to meet it then tie using reef - fallen from height
knot - injury to head or face
- make sure fingers are visible for assessment - falling object in their back
What to look for:
● Elevation Sling - pain in neck or back
- support the forearm and hand in raised position - bruising/tenderness in skin by the spine
- control bleeding from the forearm or hand and - irregular twist in normal curve of spine
swelling - difficulty breathing
What to do: - loss of bladder/bowel control, limbs, sensation
- ask the px to support the injured arm What to do:
- injured arm should be placed diagonally - Advise px not to move
- lay triangular bandage over arm - call emergency
- come underneath the arm and behind then tie - kneel by their head, hold either side of the px
To check for circulation: head but do not cover the ears
- squeeze the finger for 5sec and color should - support the head, then ask for help to place
return in 2 sec rolled blankets either side of their head

How to Bandage a Hand Head Injury Ssx and Tx

What to do: What to look for:

- start at the inside of the wrist and wrap bandage - period of unresponsiveness
twice to secure - scalp wound
- place the bandage from the inside of wrist - dizziness/ nausea, loss of memory, headache,
diagonally across the back of the hand confused
- wrap underneath the fingers and back across Severe head injury:
the back of their hand - unresponsive/ deteriorating level of response
- pass the bandage under the wrist then repeat - leakage of fluid/blood
- each layer should be covering 1/3 of new skin - unequal pupil size
- secure the bandage - seek emergency
- check for circulation What to do:
- sit the px
- give ice pack for the injury/ cool cloth
maejunejuly
 - assess AVPU - itching
- apply direct pressure to the wound - rash
- mild swelling
- prickling/burning feeling
Seizures or Convulsions
What to do:
Causes: - cold bath or shower
- epilepsy - px can buy calamine lotion or hydrocortisone
- alcohol poisoning cream
- lack of oxygen - loose clothing
- after head injury - advise the px to drink plenty of water
- after taking certain drugs
- low glucose level in diabetic px
What to look for: Heat Exhaustion Ssx and Tx
- suddenly unresponsive What to look for:
- rigid body - headache, dizziness, confusion, loss of appetite,
- arched back sweating with pale clammy skin, cramps in
- noisy, difficulty breathing arms/legs/stomach, fast and weakening pulse
- convulsive movements and breathing
- saliva at mouth What to do:
- loss of bladder/bowel control - get the px in a cool place
- after they could fall into a deep sleep - lie the px down with legs raised
What to do: - give lots of water to drink/isotonic drink
- make space around casualty, remove potential - check level of response
dangers - if condition gets worse; place in recovery
- don’t restrain or move the px position
- note the time the seizure started and how long it - call emergency
last
- protect their head, loose clothing in their neck
Heat Stroke
After seizure:
- check ABC What to look for:
- if breathing; put the px in recovery position - hot flushed skin
- call emergency if: px first seizure, unknown - restlessness and confused
cause, repeated seizures, longer than 5mins, - headache, dizziness
unresponsive for more than 10mins, sustained - bounding pulse
an injury. - high temp above 40 deg
- rapid decrease in level of response
What to do:
Ssx and Tx for Dehydration - move the px in cool area
What to look for: - remove outer clothing
- headaches and lightheadedness - call emergency
- dry mouth, eyes, and lips - wrap the px in cold wet sheet/ cold bottles until
- small amounts of dark urine temp falls below 37.5 deg
- muscle cramps - if temp returns normal: replaced wet sheets to
What to do: dry
- help them sit down - monitor level of response
- give plenty water
- give them oral rehydration solution
Cuts and Grazes
- encourage to rest
- check the px condition What to do:
- apply pressure to the wound using gauze
- raise the injury then clean the wound
Heat Rash - apply sterile dressing
What to look for: aq chs
maejunejuly
 - call emergency and ask to bring AED
Bumps and Bruises
- 30 chest compressions (2 inch)
Tx: - give 2 rescue breaths
- place something cold to the skin no longer than - AED
10 mins What to do: Child px
- raise the injury above heart level to reduce - call emergency and ask to bring AED
swelling - 30 chest compressions (2 inch); one hand
- seek emergency - give 2 rescue breaths
- AED
Faint
Causes: Sunburn
- pain, exhaustion, hunger, emotional stress, What to look for:
standing or sitting when hot for longer time - reddening of skin
What to look for: - pain in the injured area
- briefly unresponsive - blisters
- slow pulse What to do:
- pale cold skin and sweating - cover the skin
What to do: - encourage px to drink cold water
- lie the px down - cool the area down
- raise their legs - if blisters are seen treat w/ calamine lotion
- as recovered: sit the px slowly
- if unresponsive: check ABC then treat for
unresponsiveness Diabetes
● Hyperglycemia
What to do:
Heart Attack
- call emergency
Ssx: - check LOC
- pain in chest spreading to the jaw, neck and arm - if unresponsive: open airway and asses ABC;
- breathlessness prepare to treat unresponsiveness.
- stomach discomfort ● Hypoglycemia
- collapse w/o warning What to do:
- feeling faint or dizzy and impending doom - sit the px down
- pale skin, blue lips, sweating, gasping for air - give sugar or glucose tablets
Tx: - check LOC and response
- call emergency
- help the px in comfortable position (sitting while
knees bend) Conscious Adult Choking
- give aspirin 300 mg if can and not allergic What to do:
remind the px to chew slowly (SHOULD NOT - encourage the px to relax and cough to remove
BE GIVEN UNDER THE AGE OF 16) the object
- if the px have angina medication help them to - position yourself behind the victim making sure
take it that the px is upright
- encourage the px to rest - perform abdominal thrusts and back blows
- monitor ABC and LOC - check for foreign body expel after every set of 5
If unresponsive: abdominal thrusts
- open airway
- check ABC
Obese/Pregnant Choking
- perform cpr in necessary
What to do:
- encourage the px to relax and cough to remove
CPR (Unresponsive and Abnormal Breathing) the object
What to do: Adult px
maejunejuly
 - position yourself behind the victim making sure - bandage the area an inch above the wound
that the px is upright followed by below the wound
- place your arms under the victim’s armpits and - roller bandage should be pulled a bit while
place the thumb of your fist on the sternum bandaging for the need compression
- grasp the fist with your other hand and give - tuck the end
successive backward thrusts (5 sets)
- check for foreign body expel Hand Pressure Bandage
- put gauze or clean cloth on the wound
- bandage the wrist area tucking the first end and
Bandaging for Closed Wound
continue for 2 round
Bandaging Techniques - bandage over the pressure pad by going in
● One fold cravat between the thumb and index finger then under
● Two fold cravat/ broad bandage the hand and over the pressure pad again to
● Three fold cravat/ narrow bandage below the thumb.
● Reef Knot - repeat the process (following an “x” bandaging)
- Lay the right end over the left end.
- Insert the right end into the loop
- Pull both ends to secure a knot Amputation
- to check, pull the other end of the cloth What to do:
and undo the knot by pulling it outward. - if possible, clean the amputated part with water
● Splinting - wrap the amputated part with gauze/sterile cloth
- Hold the injury to minimize movement then place in a plastic bag and put it in a cooler
- put the splint to support the injury but do with ice.
not put it directly to the injury
- ask the px/other to hold the splint and
Nose Bleeding
injury together
- use roller bandage to secure (do not tie What to do:
on the injury and do not cover fingers). - ask the px to sit on the edge of the chair
● Arm Splint - tilt the body and head forward
- ask the px to hold the forearm, elbow - instruct pc to pinch the soft part of the nose and
bent open his mouth to breathe
- using triangular bandage, spread the
bandage on the victim having the tip on Tx Impaired Objects
the elbow of px.
Bandaging Techniques
- put the bandage below the px arm and
● Folding a Donut/Ring Pad
fold it towards the px neck
- fold the triangular bandage in a 3 fold
- tie reef knot
cravat
- make a loop at the center of the
Bandaging Techniques for Open Wound bandage
What to do: - grab the 1st end and wrap it around the
- apply direct pressure on the wound loop, tuck the tip
- elevate the injury - wrap the other end around the ring pad,
- if bleeding did not stop apply pressure on keep pulling before wrapping around
pressure point - tuck the loose ends
- apply pressure bandage ● Immobilizing the Impaled Object
- gently insert the ring pad on the impaled
Simple Pressure Bandage object to minimize movement
- put gauze or clean cloth on the wound - use a roller bandage to bandage the
- roller bandage should be held with roll facing donut by rolling an inch above it tucking
upwards the first end
- bandage the wound first, tucking the first end - continue bandaging around the ring pad
around the impaled object
maejunejuly
 - end the bandage by bandaging an inch - using a moist triangular bandage fold an
below the ring pad tucking the last end inch of the base of the bandage
of the roller bandage - put the bandage on the px head, base
just above the eyebrows
- cross both ends of triangular bandage
Head Injury
on the back of head w/ the tip of the
Bandaging Techniques bandage on the bottom of or tucked in
● Head Injury Bandage the crossing
- put a pressure pad on the wound of the - bandage to the forehead, tie a knot and
victim tuck loose end
- using a roller bandage, roll the bandage - pull the tip of triangular bandage at the
on the anchoring side first back gently then tuck the excess.
Anchoring
- for wound; top of the head, side of the head, ● Hand Injury Bandage for Burns
ears, cheek or chin - put the moist triangular bandage on a clean
- around the forehead and back of head table
- gently put the px burnt hand on the triangular
- ask the px/other to hold first the loose bandage with the base of the triangular bandage
end on the wrist
- roll the bandage in 2 rounds around the - fold the triangular bandage by putting the tip of
forehead and back of the head the bandage on the wrist
- cross the bandage on the first loose end - roll one side of the folded triangular bandage
- repat then tie until the fold touches the px hand
- roll the other side of triangular bandage
Eye Injury - cross both ends on top bandaging the below
followed by crossing and making a knot on top.
What to do:
- bandage on the hand should be loose
- put a pressure pad on the wound of the victim
- using a roller bandage, bandage to the anchor
point on the head first and forehead to the back Other Bandaging Techniques
of the head ● Palm Injury Bandage
- after 2 rounds, bandage over the injury and - using the triangular bandage, fold to the narrow
below the ear or the affected area bandage
- continue bandaging on top of the ear of the - put the folded bandage on the px palm, one side
other side, until all the roller bandage has been of the bandage should be between the thumb
used. and index finger
- cross the opposite end to below the hand and
Soft Tissue Injury through the bottom of the thumb and onto the
palm
Bandaging Technique
- the other side should be bandaged below the
● Figure of 8 foot Bandage
hand and then in between the thumb and index
- using a roller bandage, bandage more
finger
than an inch above the ankle or elbow
- if both ends are facing down cross below the
making 3 rounds
hand
- roller bandage should be pulled a bit for
- cross on top of the px wrist and tie a knot
compression
- continue bandaging through the ankle or
● Jaw Injury Bandage
elbow, below then above
- using triangular bandage, fold the
narrow bandage
Burns - bandage through the chin and top of the
Bandaging Technique for Minor Burns head
● Head Injury Bandage for Burns
maejunejuly
 - cross to either left or right side of the
head
- bandage across the forehead and back
of the head
- tie a knot crossing the other side

● Shoulder Injury Bandage

- using triangular bandage, fold to broad
bandage
- put the center of the bandage below the
px armpit on the shoulder injury side
- tie both ends of the. bandage on the
other side under the armpit

● Leg Injury Bandage

- ask the px to immobilize the leg
- use the other leg to immobilize the
injured leg
- using 2 triangular bandages, fold the
narrow bandage
- without moving the px legs, insert the
first bandage below the knee
- insert the 2nd triangular bandage above
the knee
- once all bandages are inserted, tie the
bandages using reef knot

● Feet Immobilization Bandage

- using triangular bandages, fold the
narrow bandage
- insert the triangular bandage below the
px ankles
- cross the bandage on top of the ankles
- continue bandaging on the sole of the
feet then tie reef knot

maejunejuly