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FMF CORE > 106 First Aid and Field Sanitation > Flashcards

106 First Aid and Field Sanitation Flashcards

1
Q

9 General First Aid Rules

A

TUMER RANA

Take a moment to get organized

Unless contraindicated, make your prelim exam in the position and place you find the victim

Multi victim - limit prelim survey to observing for ABC’s

Examine for fractures (esp. skull, neck, spine, rib)

Remove enough clothing to see the full extent of injury, respect PT modesty, don’t let them get cold

Reassure victim and make them comfortable

Avoid touching wounds and burns with fingers or unsterile objects

Never give an unconscious PT anything by mouth. Position unconscious or semiconscious on side or back with head turned to the side to prevent choking or breathing vomit.

Always carry a litter PT feet first

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2
Q

Define Triage (which is french for “to sort’’)

A

quickly assessing multiple casualties in an incidence and assigning a PT priority or classification based on the severity of injuries

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3
Q

Class I Sorting for Tactical Treatment

A

MINOR

require MINOR treatment that can be done outpatient or ambulatory.

can be returned to duty in a short period of time

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4
Q

Class II Sorting for Tactical Treatment

A

IMMEDIATE

require IMMEDIATE life sustaining measures or are of a moderate nature.

require minimum amount of time, personnel, and supplies

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5
Q

Class III Sorting for Tactical Treatment

A

DELAYED

definitive treatment can be delayed without jeopardizing life or loss of limb

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6
Q

Class IV Sorting for Tactical Treatment

A

EXPECTANT

wound or injuries require extensive treatment beyond immediate medical capabilities

treatment of these casualties would be detrimental to others

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7
Q

Priority I Sorting for Non Tactical Treatment

A

IMMEDIATE

Immediate correctable life threatening injuries or injuries like

respiratory arrest or obstruction
open chest or abdomen wounds
femur fractures
critical burns

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8
Q

Priority II Sorting for Non Tactical Treatment

A

DELAYED

Delayed serious but non life threatening injuries like

moderate blood loss
open or multiple fractures
eye injuries

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9
Q

Priority III Sorting for Non Tactical Treatment

A

MINIMAL

Minor injuries like

soft tissue injury
simple fracture
minor to moderate burns

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10
Q

Priority IV Sorting for Non Tactical Treatment

A

EXPECTANT

dead of fatally injured PTs

exposed brain matter
decapitation
incineration

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11
Q

Primary survey

A

rapid initial assessment to detect and treat life-threatening conditions that require IMMEDIATE care

*followed by a status decision about PT stability and priority for transport to MTF

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12
Q

A = Airway

A

obstructed airway can lead to respiratory arrest and death

assess responsiveness. open if necessary

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13
Q

B = Breathing

A

Respiratory arrest leads to cardiac arrest.

assess breathing. provide rescue breathing if needed

look for and treat conditions that compromise breathing like penetrating chest trauma

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14
Q

C = Circulation

A

if heart is stopped. no blood to brain

  • irreversible changes to brain in 4-6 min.
  • cell death in 10 min.

Assess circulation and do CPR if necessary.

Check for profuse bleeding that can be controlled.

Assess and begin treatment for severe shock or the potential for severe shock.

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15
Q

D = Disability

A

Serious CNS injuries can result in death.

Assess PT level of consciousness

If head or neck injury suspected, apply rigid neck collar

Observe the neck before covering up

Do quick assessment of extremity mobility

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16
Q

E = Expose

A

You can’t treat injuries you can’t see.

Remove clothing to check for life threatening injuries.

Protect PT privacy and keep PT warm w/ blanket if necessary.

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17
Q

What do you do after ABCDE is completed?

A

Make a status decision of the PT’s condition.

The ABCDE and status/transport decision should take 10 minutes to complete from arrival on scene.

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18
Q

The essence of shock control and prevention?

A

To recognize onset of condition and start treatment before the symptoms fully develop

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19
Q

Signs and symptoms of Shock

A

PT’s B-E-S-T Puls and BP

PT status: Restlessness and apprehension followed by apathy(lack of interest/concern)

Breathing: rabid or labored –shallow/irreg in late stage

Eyes: Glassy and dull; pupils may dilate

Skin: cool and clammy sweat

Temp: continuous fall

Pulse: rapid weak and thready.
NEUROGENIC=60bpm HEMORRHAGIC=140bpm

Blood Pressure: severely lowered

  • surface veins may collapse
  • systolic blood pressure falls below 80 for long periods
  • kidneys may shut down
  • person may faint from inadequate venous blood return to the heart..may be from standing up to quickly
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20
Q

What are the ways to control hemorrhage?

A

3

Pressure dressing
Pressure Points
Tourniquet

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21
Q

Pressure dressing

A

Best way to control EXTERNAL bleeding

Apply compress to wound and exert direct pressure to the wound

Can use Pressure Point if pressure dressing doesn’t stop the bleeding

Elevating extremity and splints can help

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22
Q

Pressure Point

A

A spot where the main artery to an injured part lies near the skin surface over the bone

Apply pressure to this point with fingers or heel of hand

Object is to compress the artery against the bone, thus shutting off blood flow of blood from the heart to the wound.

11 points on each side of the body. Hard to maintain for more than 15 min.

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23
Q

Tourniquets

A

Constricting band that cuts of blood supply to an injured limb

Last Resort

Always applied above the wound and as close to the wound as practical

24
Q

Head Wounds

A

Never give any medications

Keep victim laying flat w/head at body level
Do not raise the feet if face is flushed

If victim is having trouble breathing, elevate head slightly

If wound is at the back of the head, turn victim on his side

Watch for vomiting-position head to avoid aspiration of vomit or saliva

No direct pressure if the skull is depressed or fractured

25
Q

Facial wounds

A

MAINTAIN airway

Cover both eyes for eye injury to prevent sympathetic movement

Only pull out embedded object if obstructing airway

26
Q

Chest wounds

A

Victims showing signs of difficulty breathing without signs of airway obstruction should be inspected for CHEST injuries

Sucking Chest wound is the most serious chest injury. (Penetrating chest wound that produces hole in chest cavity).

  • seal the wound with hand or airtight material (eg ID CArd)
  • tape the material in place and secure with pressure dressing
  • give oxygen if available
  • place victim in Fowlers position (lazy boy)
  • watch for shock
  • do not give drinks
  • transport to mtf immediately
27
Q

Abdominal Wound

A

Take to MTF immediately (time is crucial)

Only basic first aid should be given

DO NOT push intestines back in
*If intestines are exposed, taco them in a moistened sterile dressing. Lay that on the PT and secure with a bandage.

DO NOT give drinks (moisten mouth with a little water)

Put PT in supine position with knees up (place pillow or bulky item to maintain position)

Watch for shock

If intestines are exposed, use sterile dressing moistened with sterile water and “taco” the intestines into the dressing-then lay it on PT-hold in place with bandage

apply JUST sterile dressing if unexposed

28
Q

Closed fracture

A

injury is entirely internal

broke bone - no break in skin

29
Q

Open fracture

A

open wound in the tissues and skin near broken bone site

30
Q

Forearm fracture

A

2 long bones in the forearm: radius/ulna

When both are broken arm looks deformed
When 1 is broken the other acts like a splint and the arm retains somewhat natural appearance

  • Stop bleeding ASAP
  • Carefully straighten arm
  • Apply pneumatic splint(inflatable) or two well padded splints from elbow to wrist
  • bandage splint to hold in place
  • forearm should be across chest with palm turned in and thumb pointed up.
  • use a wide sling to support the arm in position
  • hand will be 4 INCHES above elbow level
  • treat for shock/evac ASAP
31
Q

Upper Arm fracture

A

Signs of fracture include pain, tenderness, swelling, and wobbly motion

-if fracture is on the upper arm near shoulder, place folded towel in the armpit, bandage the arm to the body, and support with narrow sling

  • if fracture is in the middle part of arm, use a well padded split on the outside of arm(shoulder to elbow)
  • Fasten arm to body and support forearm with NARROW sling
  • if no distal pulse, apply traction and THEN splint
  • Treat for shock
32
Q

Thigh fracture

A

Carefully straighten leg

2 splints: 1 on outside of leg/1 on inside

  • outside splint should reach from armpit to foot
  • inside splint should reach from crotch to foot

Splint is fastened in 5 places:

  • around the ankle
  • over the knee
  • just below the hip
  • around the pelvis
  • just below the armpit
  • DO NOT MOVE VICTIM until leg is immobilized

*Hare or Thomas splint are best- but can improvise

33
Q

Lower leg fracture

A

Carefully straighten leg

Apply pneumatic splint if available
If not; apply 3 splints-1 on each side and 1 underneath

Make sure splints are padded under the knee and at the bones on each side of the ankle

This can be done by putting a pillow under the leg and bringing the sides of the pillow around the front of the leg.
-splint each side of the leg(over the pillow) and fasten in place with bandage or adhesive tape.

  • treat for shock
  • Hare or Thomas splints can be used
34
Q

Clavicle Fracture

A

When the victim stands, the injured shoulder is LOWER than the uninjured one.

Victim cannot usually raise arm above shoulder
May attempt to hold elbow of injured shoulder to side

If OPEN fracture: stop bloodflow and treat wound first

Apply sling and swathe splint(outside arm on injured side to between inside arm/side of chest on uninjured side)

Arm should be bent across chest, palm turned in with thumb pointed up.
Hand raised 4 inches above elbow

  • Figure 8 bandage may also be used
  • treat for shock and evac ASAP
35
Q

Rib fracture

A

Make the victim comfortable and quiet to minimize further damage to lungs, heart, or chest wall by the broken ends of the ribs

Ask PT to point out the exact area of the pain. There may or may not be a rib deformity, chest wall contusion(bruising), or laceration.

Ordinarily rib fractures are not bound, strapped, or taped if the victim is comfortable, but maybe splinted by use of external support

If PT more comfortable with ribs immobilized, use a SWATHE (wide strip bandage) and strap the arm on the injured side to the chest. Palm flat, thumb up, forearm raised 45 degrees.

Do not use adhesive plaster directly on skin of chest for immobilization as it limits ability of chest to expand thus interfering with proper breathing.

Treat for shock and evac

36
Q

How is the seriousness of a burn injury estimated?

A

Depth, extent, and location of burn

Also age and medical complications

37
Q

Burns and scalds are essentially the same injury, but what is the one thing that makes them different?

A 
Burn = dry heat
Scald = moist heat
38
Q

Describe First Degree Burn

A

Epidermal layer = irritated, red, tingling

Skin is sensitive to touch; blanches(white) with pressure

Pain: mild-severe
Edema: minimal
Healing within a week

39
Q

Describe Second Degree burn

A

Epidermal blisters, mottled appearance, red base

Damage extends into but not through the dermis

Recovery 2-3 weeks

Body fluids may be drawn into injured tissue causing EDEMA(swelling)

40
Q

Describe Third Degree burn

A

Full thickness injury penetrating into muscle and fatty tissue..even down to the bone.

Tissues and nerves destroyed

Shock and blood in urine are likely.

Pain is absent in the burn site(nerves destroyed) and the surrounding tissue is painful.

Tissue color: white(scalds) to black(char burn).
Skin grafting may be needed afterwards to replace skin

41
Q

First aid for Thermal Injuries

A

Kept to a minimum after removal from thermal source

  • Maintain open airway
  • control hemorrhage, treat for shock
  • remove constricting clothing/jewelry
  • do not remove clothes adhering to the wound
  • protect burn from contamination w/clean sheets, dry dressing
  • for serious burns over 20 percent BSA(body surface area) and when in shock start IV with electrolytes (Lactated Ringers) in an unburned area.

Pain Relief
mild: aspirin
moderate: cool, wet compress. ice water immersion
severe: morphine or demerol injections
small burns: anesthetic ointment (unbroken skin)

42
Q

Aid Station care for Thermal injuries

A
  • continue to monitor airway, hemorrhage, shock
  • maintain iv to control shock, replace lost fluids
  • monitor urine output
  • shave body hair that’s away from the burned area and cleanse area with disinfectant soap/water
  • apply sterile dressing
  • place bulky dressing around the burned parts to absorb serous exudate (clear,thin,watery plasma)
  • Tetanus booster for infection/antibiotics
  • If evac to a definitive care facility is delayed 2-3 days, start TOPICAL ANTIBIOTIC therapy after PT stabilizes and after DEBRIDEMENT (remove tissue and foreign objects) and wound care.
  • Use sulfamylon or silvadene every 12 hours
  • treat minor skin reactions with antihistamines
43
Q

Describe Heat cramps and treatment

A

Excessive sweating can result in cramps in the the ab, leg, and arm muscles

Heat Cramps can also occur when drinking cold drinks too quickly or in too large a qnty after exercise.

Heat Cramps = early sign of heat exhaustion

Treatment:

  • move PT to cool place
  • give victim plenty of cool(not cold) water w/ 1 tsp of salt to a liter of water
  • apply manual pressure to cramped muscle or massage gently to relieve spasm
  • take to medical if it gets more serious
44
Q

Describe Heat Exhaustion and treatment

A

the most common condition caused by working/exercising in hot environments.

PT’s BEST Pulse and BP

PT status: weak, dizzy, headache, nausea; victim may faint but will regain consciousness as head is lowered

Breathing: rapid and shallow
Eyes: dilated pupils
Skin: ashen gray; cool-moist-clammy
Temp: below normal
Pulse: weak
BP: vitals usually normal; treat as if shock

Treatment:

  • loosen clothing and cool wet cloths to head, axilla, groin, and ankles. FAN the victim
  • do not let the victim become chilled
  • 1 tsp salt in 1 liter cool water if conscious
  • NO fluids if vomiting
  • IV therapy to combat shock
45
Q

Describe Heat stroke and treatment

A

20 percent mortality rate

Body’s sweating mechanism is broken and unable to eliminate excessive body heat while exercising

Brain(esp), kidneys, and liver become permanently damaged the longer the body is overheated(life/death)

PT status: headache, nausea, dizzy, weak
Breathing: deep and rapid at first; then shallow and almost abs.
Eyes: pin point pupils; constricted
Skin: flushed, very dry, very hot
Temp: 105 or higher
Pulse: fast and strong

Treatment:

  • douse body w/cold water
  • move victim to cool place, remove as much clothing as possible, placing on back;head/shoulders raised slightly
  • cold packs: axillary,neck,ankles,groin
  • cool drinking water if conscious;no stimulants
  • DISCONTINUE cooling at 102 rectal temp (check every 10 min after for rise)
  • continue cooling measure en route to MTF
  • IV may be needed to combat shock
46
Q

Describe Hypothermia and treatment

A

general cooling of the whole body is caused from continued exposure to low or rapidly falling temperature.

First symptom is SHIVERING

PT status: lethargic, indifference, drowsy, unconscious
Eyes: glassy stare
Skin: susceptible to freezing
Temp: death results as body core temp approaches 80
Pulse: weak or absent
Blood Pressure: slow and shallow

Treatment:
-observe respiratory effort/heart beat; CPR may be required during the warming process

  • Rewarm PT ASAP
  • Replace wet or frozen clothing; remove constricting clothing to keep circulation

-Most EFFECTIVE method of warming is immersion in
tub of warm (100-105) water. Not hot

  • observe for REWARMING shock (minimized by rewarming body trunk before the limbs to prevent extremity vasodilation)
  • if no tub available BUDDY warm on both sides
  • hot water bottles/electric warming blanket(no bare skin contact)
  • give warm liquids to drink
  • dry victim if water used for rewarming
  • keep warm during transport/watch for respiratory or cardiac arrest
47
Q

Describe Immersion foot and treatment

A

Can occur in hands

  • Results from prolonged exposure to wet/cold conditions at above freezing temps to 50 F
  • Limited motion of extremities; water soaked protective clothing

Signs/Symptoms: tingling,numbness,swelling, bluish discoloration of skin, painful blisters, and gangrene.

Treatment:

  • get victim off feet ASAP
  • remove wet shoes,socks,gloves(improve circulation)
  • expose affected area to warm air
  • keep victim warm

Unbroken skin=leave exposed
Broken=wrap in sterile sheet to protect sensitive tissue

Treat as LITTER PT

48
Q

Describe Frostbite

A

Ice crystals form in the skin on deeper tissues after exposure to temperatures of 32 or lower.

Victims generally incur injury without knowing

Affected skin reddens and coldness is uncomfortable

*As ice crystals form, the frozen extremity appears WHITE, YELLOW-WHITE, or mottled(thick spider vein looking) BLUE-WHITE and is cold-hard-sensitive to touch.

Classified as SUPERFICIAL or DEEP

49
Q

What are the two types of frostbite?

A

Superficial and Deep

50
Q

Describe Superficial frost bite and treatment

A

The surface of the skin will feel HARD, but underlying tissue will be SOFT allowing it to MOVE OVER BONY RIDGES.

-Take victim inside

-Place hands under armpits, between legs, against
abdomen to rewarm

  • Rewarm feet by placing them under armpit or against abdomen of buddy.
  • Gradually rewarm by warm water immersion, skin to skin contact, or hot water bottles
  • Never rub frostbite area
51
Q

Describe Deep frostbite and Treatment

A

Freezing temps reach the DEEP TISSUE LAYERS

Ice crystals form in the entire thickness of extremity

Skin will not move over bony ridges and feels hard and solid.

  • Monitor pulse/breathing. CPR if necessary
  • DO NOT thaw the frostbitten area if there exists a possibility of refreezing
  • TREAT all PT with foot/leg injuries as LITTER PT
  • Remove gloves, boots,socks for rewarming

**Boots and clothing frozen to the body should be thawed BY WARM-WATER IMMERSION in 100-105F water.

  • Do not pour water directly on injured area, ensure its completely submerged; not resting on side or bottom of tub
  • Pat dry, soft towel
  • keep skin dry with sterile dressings. Place cotton balls between toes to prevent them from sticking together
  • give hot stimulating fluids like tea or coffee. no smoking
  • transfer and elevate and keep injury warm
52
Q

Purifying water under field conditions.

Where should you draw water from?

A

Upstream from other activites.

53
Q

How do you use Iodine tablets?

A

One tablet for clean water

Two tablets for cloudy water
(Double the amount for a 2 quart canteen)

Replace cap. Wait 5 MINUTES

Shake canteen

loosen cap and flip canteen upside down and allow leakage around the threads

tighten the cap and wait another 25 minutes.

54
Q

Boiling water

A

Use this method when no purification compounds exist.

Disadvantages:

  • boiling requires fuel
  • water takes a long time to boil and then cool
  • boiled water needs protection against recontamination
  • water needs to be at a rolling boiling for 15 seconds to be safe to drink
55
Q

How do you construct a cat hole?

A

Dig a cat hole

1 foot wide by 1 foot deep

Completely cover and pack down with dirt after each use

Used when on the march

56
Q

How do you construct a straddle trench?

A

Dig a straddle trench

4 foot long - 2 1/2 feet deep - 1 foot wide

Cover with a shovel of dirt after each use

Completely cover and pack down with dirt after each bivouac

Used for 1-3 day bivouac sites

FMF CORE (9 decks)

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