FINALS MODULE

HEAD INJURY
Head injury is a common injury suffered by people of all age groups, especially children.
Fortunately, most head injuries are mild, temporary, and curable without persisting health problems.
Some head injuries may, however, affect the brain or the tissue surrounding it, resulting in long-term
complications.
A head injury is any sort of injury to the brain, skull, or scalp. This can range from a mild bump or
bruise to a traumatic brain injury.

TYPES OF HEAD INJURIES

Concussion: This is a jarring injury to your brain. Most of the time, people remain conscious. They may
feel dazed and lose balance for a brief time.
Brain contusion: This is a bruise of your brain. Minor bleeding in your brain causes swelling.
Skull fracture: This is a crack in the skull. Sometimes, the broken skull bones can
cut into the brain.
Hematoma: This is bleeding in your brain that collects and clots, forming a bump. A hematoma may not
appear for a day or as long as several weeks.
CAUSES OF HEAD INJURY
Falls (most common cause);
• Exercising and sports-related accidents.
• Physical assaults.
• Traffic accidents.
WHO HAS THE HIGHEST RISK
• Children;
• The elderly;
• Drug and alcohol users.
First aid when the injured person is conscious
Encourage the injured person to minimize any movement of their head or neck. Scalp injuries
can bleed profusely, so control any significant blood loss from head wounds with direct pressure and a
dressing. While examining the wound, avoid disturbing blood clots forming in the hair. Reassure the
person and try to keep
them calm.
First aid when the injured person is unconscious
The person should not be moved unless they are in immediate danger. Any unnecessary
movement may cause greater complications to the head injury itself, the spine or other associated
injuries. A good rule is that if the head is injured, the neck may be injured too.
Your role is to protect the injured person from any potential dangers at the scene. You should
also monitor their airway and breathing until the arrival of an ambulance. If the person’s breathing
becomes impaired due to a problem with their airway, you may need to very carefully tilt their head
back (and support it) until normal breathing returns. If the person stops breathing or has no pulse,
cardiopulmonary resuscitation (CPR) may be required.
CONCUSSION
A concussion is a type of traumatic brain injury—or TBI—caused by a bump, blow, or jolt to the
head or by a hit to the body that causes the head
and brain to move rapidly back and forth.
Balance problems or dizziness, or double or blurry vision. Bothered by light or noise. Feeling
sluggish, hazy, foggy, or groggy. Confusion, or concentration or memory problems.
Treatment of concussion
Concussion is a mild traumatic brain injury that follows some trauma to the head. It is a
diagnosis made by a doctor when it is certain a more serious head injury has not occurred.
Symptoms of concussion can persist for up to three weeks after trauma. Your doctor or hospital
will provide advice for yourself and your family regarding your ongoing care when being discharged for
home.
Most importantly, be alert for any danger signs over the next one or two days, such as
persistent vomiting, loss of coordination, or bad or worsening headaches despite analgesia (pain-
relieving medication). Seek medical attention immediately.
SPINAL INJURY
A spinal cord injury damages the spinal cord itself or nearby tissues and bones. Depending on
the severity of the injury, you may lose function or mobility in different parts of your body. Treatments
include surgery, medication, and physical therapy. A newer approach looks to tap working nerves.
Is a spinal cord injury the same as a back injury?
A spinal cord injury isn’t the same as a back injury. Back injuries may damage bones or soft
tissues in the spine, but they don’t affect the spinal cord.
TYPES OF SPINAL CORD INJURY
Spinal cord injuries can be complete or incomplete (partial):
• Complete: A complete injury causes total paralysis (loss of function) below the level of the injury. It
affects both sides of the body. A complete injury may cause paralysis of all four limbs (quadriplegia) or
the lower half
of the body (paraplegia).
• Incomplete: After an incomplete injury, some function remains on one or both sides of the body. The
body and brain can still communicate along certain pathways.
SPINAL INJURY
A person who has sustained a head injury may have also injured their spine. In elderly people,
the force required to cause neck injuries is much less than in younger people. It can even occur from a
standing height fall in the elderly.
It is important to keep the injured person’s head in line with their neck. Avoid twisting their
head or allowing their head to roll to the side. If you can, roll a t-shirt, towel or similar soft item and
place it around their neck to keep their head straight. Don’t try to move them unless there is an urgent
need to.
HOW DO SPINAL INJURIES HAPPEN?
Some possible causes of spinal cord injuries (from most to least common)
include:
• Motor vehicle accidents.
• Falls.
• Gunshot wounds.
• Sports injuries.
• Surgical complications.
BONES, JOINTS, AND MUSCLE INJURY
 A fracture is a broken bone.
 A potential complication is compartment syndrome.
 Fractures are usually caused by traumas like falls, car accidents or sports injuries. But some
medical conditions and repetitive forces (like running) can increase your risk for experiencing
certain types of fractures.
 If you break a bone, you might need surgery to repair it. Some people only need a splint, cast,
brace, or sling for their bone to heal.
 How long it takes to recover fully depends on which of your bones
are fractured, where the fracture is and what caused it.
BONE FRACTURE BASICS
Open Fracture: A fracture in which the bone breaks through the skin and can be seen outside the leg. Or
there is a deep wound that exposes the bone through the skin. This is also called a compound fracture.

Closed Fracture: A fracture that does not break the skin. This is also called a simple fracture.

Partial Fracture: An incomplete break of the bone.

Complete Fracture: A complete break of the bone causing it to be separated into two or more pieces

Stable Fracture: The broken ends of the bone line up and have not moved out of place.

Displaced Fracture: There is a gap between the broken ends of the bone. Repairing a displaced fracture
may require surgery.
TYPES OF BONE FRACTURE
1. Transverse Fracture
Transverse fractures are breaks that are in a straight line across the bone. This type of fracture
may be caused by traumatic events like falls or automobile accidents.

2. Spiral Fracture
As the name suggests, this is a kind of fracture that spirals around the bone. Spiral fractures
occur in long bones in the body, usually in the femur, tibia, or fibula in the legs. However, they can occur
in the long bones of the arms. Spiral fractures are caused by twisting injuries sustained during sports,
during a physical attack, or in an accident.

3. Greenstick Fracture
This is a partial fracture that occurs mostly in children. The bone bends and breaks but does not
separate into two separate pieces. Children are most likely to experience this type of fracture because
their bones are softer and more flexible.

4. Stress Fracture
Stress fractures are also called hairline fractures. This type of fracture looks like a crack and can
be difficult to diagnose with a regular X-rays. Stress fractures are often caused by repetitive motions
such as running.
5. Compression Fracture
When bones are crushed it is called a compression fracture. The broken bone will be wider and
flatter in appearance than it was before the injury. Compression fractures occur most often in the spine
and can cause your
vertebrae to collapse. A type of bone loss called osteoporosis is the most common cause of compression
fractures.
6. Oblique Fracture
An oblique fracture is when the break is diagonal across the bone. This kind of fracture occurs
most often in long bones. Oblique fractures may be the result of a sharp blow that comes from an angle
due to a fall or other trauma.
7. Impacted Fracture
An impacted fracture occurs when the broken ends of the bone are driven together. The pieces
are jammed together by the force of the injury that caused the fracture.

8. Segmental Fracture
The same bone is fractured in two places, leaving a “floating” segment of bone between the two
breaks. These fractures usually occur in long bones such as those in the legs. This type of bone fracture
may take longer to heal or cause complications.

9. Comminuted Fracture
A comminuted fracture is one in which the bone is broken into 3 or more pieces. There are also
bone fragments present at the fracture site. These types of bone fractures occur when there is a high-
impact trauma, such as an automobile
accident.

10. Avulsion Fracture

An avulsion fracture occurs when a fragment is pulled off the bone by a tendon or ligament.
These types of bone fractures are more common in children than adults. Sometimes a child’s ligaments
can pull hard enough to cause a growth plate to fracture.
 A dislocation is a disruption of a joint in which the bone ends are no longer in contact.
 Trauma that forces a joint out of place causes a dislocation. Car accidents, falls,
and contact sports such as football are common causes of this injury.
 Dislocations also occur during regular activities when the muscles and tendons
surrounding the joint are weak. These injuries happen more often in older people who have weaker
muscles and balance issues.
A sprain is an injury to ligaments, articular capsule, synovial membrane, and tendons crossing the joint.
A strain is a stretching or tearing of the muscle, causing:
 Pain
 Swelling
 Bruising
AMPUTATIONS
 Can occur as a result of trauma or a surgical intervention.
 You must control bleeding and treat for shock.
 Be aware of the victim’s emotional stress.
Emergency Medical Care
 Perform a primary assessment.
 Stabilize the patient’s ABCs.
 Perform a rapid scan or focus on a specific injury.
 Follow standard precautions.
 Suspect internal bleeding
SPLINTING
A splint is a flexible or rigid device that is used to protect and maintain the position of an injured
extremity.
Rigid Splints
 Made from firm material
 Applied to the sides, front, and/or back of an injured extremity
 Prevent motion at the injury site
 Takes two EMTs to apply
 Follow the steps in Skill Drill 29-3.
Formable Splints
Most commonly used formable splint is the precontoured, inflatable, clear plastic air splint
 Comfortable
 Provides uniform contact
 Applies firm pressure to a bleeding wound
 Used to stabilize injuries below the elbow or knee
Traction Splints
Used primarily to secure fractures of the shaft of the femur.
Several different types:
 Hare splint
 Sager splint
 Reel splint
 Kendrick splint
PELVIC BINDER
 Used to splint the bony pelvis to reduce hemorrhage from bone ends, venous disruption, and
pain.
 Meant to provide temporary stabilization
 Should be light, made of soft material, easily applied by one person,
and should allow access to the abdomen, perineum, anus, and groin
HOW TO APPLY A SPLINT
1. Follow DRABC
2. Check for other injuries such as open, closed and complicated fractures
3. If there is an open wound; apply gauze, pressure and cover to control bleeding
4. Ask the casualty to refrain from moving
5. Handle casualty with care
6. Immobilise fracture with broad bandages to prevent movement at the joints above and
below the fracture by:
 Supporting the limb – gently wrap bandages around the natural hollows of the limb
 Position a padded splint along the injured limb
 Place padding between the splint and the natural formation of the limb and secure firmly with
bandages
 If a leg fracture, also immobilize foot and ankle
 Check that bandages are not too tight or too loose every 15 minutes (too tight the skin is
bulging outside the bandage, too loose – you can get multiple fingers underneath the bandage)
7. Watch for signs of loss of circulation to foot (if leg injury) or hand (if arm injury)
8. Observe the casualty closely
9. Seek medical assistance
6 Steps to Follow in an Emergency for an
Organized Response
Step 1: Assess Your Risk
When designing an emergency plan, you will first identify all of the assets you need to protect.
Your people are by far your most important assets. Others may include your facilities, parts and
products, intellectual property, technology, office furniture and supplies, and company vehicles. All of
these assets are at risk when an emergency arises.
Step 2: Survey the Work Environment
Each facility likely differs in design, evacuation routes, surrounding area, and even the
demographics of the staff located in each building. Some locations may have handicapped employees,
the elderly, or even children in an office daycare. Are there elevators or stairwells? Cubicles or remote
rooms? An easy route for emergency vehicles? A staffed front reception desk or onsite warehouse? Are
there any hazardous materials stored at any of the locations?
Step 3: Identify Leaders and Administrators
In an emergency, there needs to be designated leadership. Choose people in each facility to
carry out different aspects of your plan and to keep people informed. You may want to identify multiple
leaders on each floor or area of the building to ensure that no matter where employees are located at
the time of the critical event, they have someone nearby who knows what to do.
Step 4: Choose an Emergency Notification System Vendor
Your chosen administrators and leaders need more than email or phone to reach every
employee. A mass alert system distributes important information quickly to everyone or to a specific
group of people. It is important that the software enables these admins to send and receive information
across multiple communication channels—such as text, email, phone, social media, and app push.
Depending on your employees’ workflow, you may also want to be able to use desktop takeover to relay
time-sensitive emergency messages.
Step 5: Design an “All-hazards” Plan
A common pitfall of many planning efforts and emergency notification systems is that they are
too narrowly focused. Most companies have regular fire drills to test out their solutions, but fewer
prepare for active shooters. And even fewer prepare for something like a gas leak. While it’s good to
plan for specific contingencies, that’s not enough to be truly prepared for the myriad possible threats to
business continuity. For that, you need an all-hazards plan.
Step 6: Practice the Plan
Once the plan is in place, it’s time to practice. An old military adage refers to “The Six P’s of Success”:
5 phases of emergency management
Prevention
Prevention focuses on preventing hazards from occurring, whether they are natural,
technological or caused by humans. Not all hazards are preventable, but the risk of loss of life and in jury
can be limited with good evacuation plans, environmental planning and design standards.
Prevention
Prevention focuses on preventing hazards from occurring, whether they are natural,
technological, or caused by humans. Not all hazards are preventable, but the risk of loss of life and injury
can be limited with good evacuation plans, environmental planning, and design standards.
Mitigation
Mitigation is the effort to reduce loss of life and property by lessening the impact of disasters
and emergencies. It refers to measures or actions that can prevent an emergency, reduce the chance of
an emergency or reduce the damaging effects of unavoidable emergencies. The establishment of
building codes and zoning requirements or the creation of defensible space around homes to protect
them from wildfire are examples of mitigation efforts.
Preparedness
Preparedness is a continuous cycle of planning, organizing, training, equipping, exercising,
evaluating, and taking corrective action. Training and exercising plans is the cornerstone of
preparedness, which focuses on readiness to respond to all hazards, incidents and emergencies. Training
and emergency preparedness plans increase a community’s ability to respond when a disaster occurs.
Typical preparedness measures include developing mutual aid agreements and memorandums of
understanding, training for both response personnel and concerned citizens, conducting disaster
exercises to reinforce training and test capabilities, and presenting all- hazards education campaigns.
Response
The response phase is a reaction to the occurrence of a catastrophic disaster or emergency. It
consists of actions which are aimed at saving lives, reducing economic losses, and alleviating suffering.
The response phase comprises the coordination and management of
resources utilizing the Incident Command System. Response actions may include activating the
emergency operations center, evacuating
threatened populations, opening shelters and providing mass care, emergency rescue and medical care,
firefighting, and urban search
and rescue.
Recovery
Recovery consists of those activities that continue beyond the emergency period to restore
critical community functions and begin to manage stabilization efforts. The recovery phase begins
immediately after the threat to human life has subsided. The goal of the recovery phase is to bring the
affected area back to some degree of normalcy, including the restoration of basic services and the repair
of physical, social, and economic damages. Typical recovery actions include debris cleanup, financial
assistance to individuals and governments, rebuilding of roads and bridges
and key facilities, and sustained mass care for displaced human and animal populations.
MEDICAL AND ENVIRONMENTAL
EMERGENCIES
Stroke is a disease that affects the arteries leading to and within the brain. It is the No. cause of death
and a leading cause of disability in the United States.
A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either
blocked by a clot or bursts (or ruptures). When that happens, part of the brain cannot get the blood (and
oxygen) it needs, so it and brain cells die.
Three Things to Do When Someone Is
Having a Stroke
1. Call 911 immediately
2. If you do nothing else, act quickly to call 911.
3. Note the time you first see symptoms
4. Perform CPR, if necessary
Three Things Not to Do When Someone Is
Having a Stroke
1. Do not let that person go to sleep or talk you out of calling 911
2. Do not give them medication, food, or drinks
3. Do not drive yourself or someone else to the emergency room.
Diabetes
People with diabetes can run into trouble if their levels of blood sugar and insulin are out of
balance. Usually they can take steps to correct what's going on and stop the symptoms.
Hypoglycemia
This is what doctors call low blood sugar. It happens when someone has too much insulin
compared with glucose in their blood. Sometimes hypoglycemia is called "insulin shock.“
What you can do: Ask them to check their blood sugar if you think they're going "low." Help them get
what they need to follow the 15/15 rule: Eat 15 grams of fast-acting carbs (3-4 glucose tablets or gels, 4
ounces of fruit juice or regular soda, or a tablespoon of honey
or sugar) and wait 15 minutes. If they don't feel better, they should have more carbs and
test their blood sugar again.
Diabetic Ketoacidosis
Diabetic ketoacidosis, or DKA, is a life-threatening emergency caused when you don't have enough
insulin and your liver has to break down fat into ketones for energy, but too fast for
the body to handle. A buildup of ketones can change your blood chemistry and poison you.
You could fall into a coma.
If someone has early signs, encourage them to test their pee with a ketone test kit. If their
ketones are high, they should call their doctor. If they have serious signs, take them to the emergency
room or urgent care right away.
SEIZURE
A seizure is a sudden, uncontrolled electrical disturbance in the brain. It can cause changes in your
behavior, movements or feelings, and in levels of consciousness. Having two or more seizures at least 24
hours apart that aren't brought on by an identifiable cause is generally considered to be epilepsy.
These are general steps to help someone who is having any type seizure:
 Stay with the person until the seizure ends and he or she is fully awake. After it ends, help the person
sit in a safe place. Once they are alert
and able to communicate, tell them what happened in very simple
terms.
 Comfort the person and speak calmly.
 Check to see if the person is wearing a medical bracelet or other emergency information.
 Keep yourself and other people calm.
 Offer to call a taxi or another person to make sure the person gets home safely.
Anaphylaxis
Anaphylaxis causes the immune system to release a flood of chemicals that can cause
you to go into shock — blood pressure drops suddenly and the airways narrow, blocking
breathing. Signs and symptoms include a rapid, weak pulse; a skin rash; and nausea and vomiting
 A severe allergic reaction (anaphylaxis) is life-threatening and requires urgent action.
 Lay the person flat – do not allow them to stand or walk.
 Give adrenaline injector (such as EpiPen® or Anapen®) into the outer mid- thigh.
 Phone an ambulance – call triple zero (000).
 Phone family or emergency contact.
 Further adrenaline may be given if there is no response after 5 minutes.
 Transfer person to hospital for at least 4 hours of observation.
FAINTING
Fainting is when you lose consciousness for a short time. It’s caused by a sudden drop in blood flow to
the brain. A fainting episode usually lasts a few seconds or minutes, then the person wakes up and
returns to normal.
 Fainting is also called:
• Decreased consciousness.
• Loss of consciousness.
• Passing out.
• Syncope.
If someone else faints
• Position the person on his or her back. If there are no injuries and the person is breathing, raise the
person's legs above heart level — about 12
inches (30 centimeters) — if possible. Loosen belts, collars or other constrictive clothing.
• To reduce the chance of fainting again, don't get the person up too quickly. If the person doesn't
regain consciousness within one minute, call 911 or your local emergency number.
• Check for breathing. If the person isn't breathing, begin CPR. Call 911 or your local emergency number.
Continue CPR until help arrives or the person begins to breathe.
 If the person was injured in a fall associated with a faint, treat bumps, bruises
or cuts appropriately. Control bleeding with direct pressure.
Generalized Hypothermia
Exposure to cold reduces body heat
Body is unable to maintain proper core temperature
May lead to death
Predisposing factors of hypothermia
Injury
Chronic illness
Geriatric/pediatric
Rewarming
Passive
Cover patient
Remove wet clothing
Active
Apply external heat source
Central
Apply heat to lateral chest, neck, armpits,
Effects of Heat on Body
Heat not needed for temperature maintenance, and not lost, creates
hyperthermia
Left unchecked, leads to death
Heat cramps and heat exhaustion
-Moist, pale, normal-to-cool skin
Heat stroke
-Hot, dry, or possibly moist skin
HEAT EXHAUSTION
Heat exhaustion is a condition whose symptoms may include heavy sweating and a rapid pulse,
a result of your body overheating. It's one of three heat-related syndromes, with heat cramps being the
mildest and heatstroke being the most severe.
Causes of heat exhaustion include exposure to high temperatures, particularly when combined
with high humidity, and strenuous physical activity. Without prompt treatment, heat exhaustion can
lead to heatstroke, a life-threatening condition. Fortunately, heat exhaustion is preventable.
Heat Exhaustion: Treatment
Remove from hot environment
Administer oxygen
Loosen or remove clothing
Position supine
Small sips of water
Transport
HEAT STROKE
-Heatstroke is a condition caused by your body overheating, usually as a result of prolonged exposure to
or physical exertion in high temperatures. This most serious form of heat injury, heatstroke, can occur if
your body temperature rises to 104 F (40 C) or higher. The condition is most common in the summer
months.
-Heatstroke requires emergency treatment. Untreated heatstroke can quickly damage your brain, heart,
kidneys and muscles. The damage
worsens the longer treatment is delayed, increasing your risk of serious complications or death.
Heat Stroke:
Signs and Symptoms
-Rapid, shallow breathing
-Full, rapid pulse
-Generalized weakness
-Little or no perspiration
-Altered mental status
-Dilated pupils
-Seizures
Heat Stroke: Treatment
-Remove from hot environment
-Remove clothing
-Apply cool packs to neck, groin, and armpits
-Administer oxygen
-Transport immediately
EMERGENCY PREPAREDNESS
The term refers to the steps you take to make sure you are safe before, during and after an
emergency or natural disaster. These plans are important for your safety in both natural disasters and
man-made disasters. Examples of natural disasters are floods, blizzards, tornadoes
and earthquakes. Man-made disasters can include explosions, fires, chemical and biological attacks.
12 ways to prepare
Sign up for alerts and warnings
Make a Plan
Save for a rainy day
Test Family Communication Plan
Safeguard Documents
Plan with Neighbors
Make your home safer
Know evacuation routes
Assemble or update supplies
Get involved in your community
Document and Insure Property
EMERGENCY CHILD BIRTH
-If your baby is coming and you can’t make it to the hospital, call 911 as soon as you can.
-Then remove your pants and underwear.
- Lie down or sit propped up (standing or squatting could result in the baby falling and suffering serious
injury).
-Try to stay calm, and practice deep breathing.
-When the urge to push becomes overwhelming, push for counts of five then pause and breathe.
-Do your best to gently guide the baby out as it emerges from your pelvis, and carefully unloop the
umbilical cord if it’s wrapped around the baby’s body or neck.
Immediately after the baby comes, follow these steps:
• Dry off the baby and place the baby directly on your chest to keep it warm.
If the baby doesn’t immediately start to cry, run your fingers along either side of its nose to ease away
mucus, and stimulate the baby’s skin as Jenea did by rubbing firmly but gently on its back with a piece of
clothing or a dry towel.
• If you have two strings of any kind handy (a shoelace, thread, or a ribbon, for example), tie one string
around the umbilical cord four to five inches away from the baby’s belly. Tie the other further from the
baby two to three inches past the first string. Then cut the cord with a scissors or knife between the two
ties. This way, when you do skin-to-skin contact against your chest, the baby is protected from potential
bleeding if the cord were to tear away from the belly button.
• Seek medical care as soon as possible after delivery. Home births, whether planned or unplanned, can
be risky for mothers and babies during and after delivery.
AQUATIC EMERGENCIES
Reach
-Hold object for patient to grab
Throw
-Throw object that will float
Row
-Row boat to patient
Go
-Swim to patient (last resort)
Emergency Moves
If you are in a situation where an ill or injured person is in need of first aid or CPR, but they are
in a unsafe environment (such as a building that is on fire or a room with carbon monoxide fumes), you
will need to move the person to a safer area. So how do you properly move that victim from Point A to
Point B, especially if you are the only rescuer there?
-First things first, it is always advised that if the surroundings are safe, you should NOT move a victim
and provide first aid or start CPR right where they collapsed. The reason that we want to prevent any
movement, is so that we do not make an existing injury any worse (i.e. spinal injury).
-But if you HAVE to move a victim from an unsafe area to a safer area, here are three techniques you
can use:
Extremity Drag – Grasp and pull on the ankles and forearms
Clothing Drag – Pull on a person’s shirt in the neck and shoulder area
Blanket Drag – Roll the person onto a blanket and drag the blanket