Chapter 26, 7-10

Question 1

EARTHQUAKE: WHAT TO DO

Answer 1

• IF INDOORS IF INDOORS
  ** TAKE COVER OR CROUCH NEXT TO A LARGE, STURDY OBJECT OR AGAINST A WALL.TAKE COVER OR CROUCH NEXT TO A LARGE, STURDY OBJECT OR AGAINST A WALL.
  ** AVOID WINDOWS AND OUTSIDE DOORS.AVOID WINDOWS AND OUTSIDE DOORS.
  ** CROUCH, AND COVER FACE.CROUCH, AND COVER FACE.
  ** STAY INDOORS UNTIL SHAKING STOPS.STAY INDOORS UNTIL SHAKING STOPS.
  ** BEWARE OF AFTERSHOCKS.BEWARE OF AFTERSHOCKS.
  ** IF IN BED, STAY THERE.IF IN BED, STAY THERE.
  ** IF IN HIGH-RISE BUILDING, USE STAIRS.IF IN HIGH-RISE BUILDING, USE STAIRS.
  ** IF OUTDOORS, LIE IN A SPOT CLEAR OF BUILDINGS, TREES, POWER LINES.IF OUTDOORS, LIE IN A SPOT CLEAR OF BUILDINGS, TREES, POWER LINES.
  ** IF IN A VEHICLE, PULL OVER AND STAY THERE WITH YOUR SEAT BELT FASTENED.IF IN A VEHICLE, PULL OVER AND STAY THERE WITH YOUR SEAT BELT FASTENED.
  ** IF YOU ARE TRAPPED IN DEBRIS, DO NOT PANIC.IF YOU ARE TRAPPED IN DEBRIS, DO NOT PANIC.
  ** COVER MOUTH AND NOSE WITH CLOTH.COVER MOUTH AND NOSE WITH CLOTH.
  ** TAP ON WALL OR PIPE.TAP ON WALL OR PIPE.
  ** LEARN TO TURN OFF YOUR GAS SUPPLY.LEARN TO TURN OFF YOUR GAS SUPPLY.

Question 2

FLOOD

Answer 2

COMMON NATURAL DISASTERCOMMON NATURAL DISASTER
** RAINS CAN CAUSE RUN-OFFRAINS CAN CAUSE RUN-OFF
** CAN OCCUR EVEN WHEN WATERCAN OCCUR EVEN WHEN WATER
SOURCE IS MILES AWAY

WHAT TO DOWHAT TO DO
** MOVE TO HIGHER GROUND.MOVE TO HIGHER GROUND.
** CHECK RADIO, TELEVISION, ANDCHECK RADIO, TELEVISION, AND
SOCIAL MEDIA.SOCIAL MEDIA.
** IF FLOOD WATCH IS ISSUED, PREPAREIF FLOOD WATCH IS ISSUED, PREPARE
TO EVACUATE.TO EVACUATE.
** DO NOT WALK THROUGH MOVINGDO NOT WALK THROUGH MOVING
WATER.WATER.
** DO NOT DRIVE INTO FLOODED AREAS.DO NOT DRIVE INTO FLOODED AREAS.
** IF FLOOD WATER RISES, ABANDONIF FLOOD WATER RISES, ABANDON
CAR.CA

Question 3

HEAT WAVE

Answer 3

WHAT TO DO
** STAY IN THE COOLEST LOCATION.STAY IN THE COOLEST LOCATION.
** DRINK PLENTY OF WATER; AVOID ALCOHOL.DRINK PLENTY OF WATER; AVOID ALCOHOL.
** NEVER LEAVE CHILDREN OR PETS INNEVER LEAVE CHILDREN OR PETS IN
VEHICLES.VEHICLES.
** DRESS IN LOOSE-FITTING CLOTHES.DRESS IN LOOSE-FITTING CLOTHES.
** PROTECT YOUR FACE AND HEAD FROM SUN.PROTECT YOUR FACE AND HEAD FROM SUN.
** AVOID TOO MUCH SUNSHINE.AVOID TOO MUCH SUNSHINE.
** AVOID STRENUOUS WORK DURING THEAVOID STRENUOUS WORK DURING THE
HOTTEST PART OF THE DAY.HOTTEST PART OF THE DAY.
** SPEND AT LEAST 2 HOURS IN AIR-SPEND AT LEAST 2 HOURS IN AIR-
CONDITIONING.CONDITIONING.
** CHECK ON FAMILY AND FRIENDS.CHECK ON FAMILY AND FRIENDS.

Question 4

HURRICANE: WHAT TO DO

Answer 4

CHECK FOR HURRICANE WATCH.CHECK FOR HURRICANE WATCH.
** SECURE YOUR HOME.SECURE YOUR HOME.
** IF NOT EVACUATING, PREPARE FORIF NOT EVACUATING, PREPARE FOR
THE WORST.THE WORST.
** IF EVACUATING:IF EVACUATING:
** PREPARE BACKPACKS WITH DISASTERPREPARE BACKPACKS WITH DISASTER
SUPPLIES.SUPPLIES.
** FUEL YOUR VEHICLE; REVIEWFUEL YOUR VEHICLE; REVIEW
EVACUATION ROUTES.EVACUATION ROUTES.
** EVACUATE EARLY IF:EVACUATE EARLY IF:
** AUTHORITIES ANNOUNCE EVACUATION.AUTHORITIES ANNOUNCE EVACUATION.
** YOU LIVE IN MOBILE HOME OR HIGH-YOU LIVE IN MOBILE HOME OR HIGH-
RISE.RISE.
** YOU LIVE NEAR WATER.YOU LIVE NEAR WATER.
** YOU THINK YOU ARE IN DANGER.YOU THINK YOU ARE IN DANGER.
** IF LOCAL AUTHORITIES ORDERIF LOCAL AUTHORITIES ORDER
AN EVACUATIONAN EVACUATION
** LEAVE IMMEDIATELY.LEAVE IMMEDIATELY.
** FOLLOW EVACUATION ROUTES.FOLLOW EVACUATION ROUTES.
** IF NOT EVACUATING, PROTECTIF NOT EVACUATING, PROTECT
FROM STRONG WIND.FROM STRONG WIND.
** AVOID USING PHONE.AVOID USING PHONE.

Question 5

LANDSLIDES

Answer 5

WHAT TO DO
** STAY ALERT.STAY ALERT.
** CONSIDER EVACUATING.CONSIDER EVACUATING.
** LISTEN FOR UNUSUAL SOUNDS.LISTEN FOR UNUSUAL SOUNDS.
** WATCH FOR CHANGES IN WATERWATCH FOR CHANGES IN WATER
FLOW.FLOW.
** BE ALERT WHEN DRIVING.BE ALERT WHEN DRIVING.
** IF AT HOME, MOVE TO SECONDIF AT HOME, MOVE TO SECOND
LEVEL.LEVEL.

Question 6

TORNADO

Answer 6

WHAT TO DO
** GO TO WINDOWLESS INTERIOR ORGO TO WINDOWLESS INTERIOR OR
BELOW-GROUND ROOM.BELOW-GROUND ROOM.
** GET UNDER STURDY FURNITURE.GET UNDER STURDY FURNITURE.
** IF OUTDOORS, GET INDOORS OR LIEIF OUTDOORS, GET INDOORS OR LIE
IN A DITCH.IN A DITCH.
** IF AT WORK, GO TO DESIGNATEDIF AT WORK, GO TO DESIGNATED
SHELTER.SHELTER.
** IF YOU ARE IN A VEHICLE, GET OUTIF YOU ARE IN A VEHICLE, GET OUT
AND TAKE SHELTER IN A NEARBYAND TAKE SHELTER IN A NEARBY
BUILDING.BUILDING.

Question 7

TSUNAMI

Answer 7

WHAT TO DO
** LISTEN FOR EMERGENCYLISTEN FOR EMERGENCY
INFORMATION.INFORMATION.
** STAY AWAY UNTIL TOLD IT IS SAFE TOSTAY AWAY UNTIL TOLD IT IS SAFE TO
RETURN.RETURN.
** DO NOT GO TO THE SHORELINE.DO NOT GO TO THE SHORELINE.
** DO NOT ASSUME TSUNAMI IS OVERDO NOT ASSUME TSUNAMI IS OVER
AFTER FIRST WAVE.AFTER FIRST WAVE.

Question 8

VOLCANO ERUPTION

Answer 8

• FOLLOW EVACUATION ORDERS.FOLLOW EVACUATION ORDERS.
  ** IF INDOORS, CLOSE ALL WINDOWS AND DOORS.IF INDOORS, CLOSE ALL WINDOWS AND DOORS.
  ** IF OUTDOORS, SEEK SHELTER.IF OUTDOORS, SEEK SHELTER.
  ** PROTECT YOURSELF.PROTECT YOURSELF.
  ** STAY OUT OF VOLCANO AREA.STAY OUT OF VOLCANO AREA

Question 9

WILDFIRE

Answer 9

WHAT TO DO
** LISTEN FOR EMERGENCYLISTEN FOR EMERGENCY
INFORMATION.INFORMATION.
** FOLLOW EVACUATION ORDERS.FOLLOW EVACUATION ORDERS.
** CHOOSE A ROUTE AWAY FROM FIRE.CHOOSE A ROUTE AWAY FROM FIRE.
** WATCH FOR DIRECTION OF FIRE.WATCH FOR DIRECTION OF FIRE.
** DO NOT BLOCK FIREFIGHTINGDO NOT BLOCK FIREFIGHTING
ENTRANCE ROUTES.ENTRANCE ROUTES

Question 10

WINTER STORM

Answer 10

WHAT TO DO
** LISTEN FOR EMERGENCY INFORMATION.LISTEN FOR EMERGENCY INFORMATION.
** CONSERVE FUEL.CONSERVE FUEL.
** EAT AND DRINK REGULARLY.EAT AND DRINK REGULARLY.
** NEVER USE OUTSIDE HEAT SOURCES INDOORS.NEVER USE OUTSIDE HEAT SOURCES INDOORS.
** IF OUTDOORS:IF OUTDOORS:
** DRESS WARMLY IN LAYERS.DRESS WARMLY IN LAYERS.
** AVOID OVEREXERTION.AVOID OVEREXERTION.
** BE AWARE OF SIGNS OF FROSTBITE OR HYPOTHERMIA.BE AWARE OF SIGNS OF FROSTBITE OR HYPOTHERMIA.
** CHANGE OUT OF WET CLOTHING.CHANGE OUT OF WET CLOTHING.
** IF TRAPPED IN A VEHICLE:IF TRAPPED IN A VEHICLE:
** PULL OVER, TURN ON HAZARDS, STAY IN VEHICLE.PULL OVER, TURN ON HAZARDS, STAY IN VEHICLE.
** RUN THE ENGINE AND HEATER 10 MINUTES PER HOUR TO KEEP WARM.RUN THE ENGINE AND HEATER 10 MINUTES PER HOUR TO KEEP WARM.
** EXERCISE.EXERCISE.
** TAKE TURNS SLEEPING.TAKE TURNS SLEEPING.
** AVOID DEHYDRATION.AVOID DEHYDRATION.
** CONSERVE BATTERY POWER.CONSERVE BATTERY POWER

Question 11

HAZARDOUS MATERIALS INCIDENT

Answer 11

CALL 9-1-1.
** STAY AWAY FROM THE INCIDENT SITE.STAY AWAY FROM THE INCIDENT SITE.
** STAY UPSTREAM, UPHILL, AND UPWIND.STAY UPSTREAM, UPHILL, AND UPWIND.
** IF IN A VEHICLE, GO INSIDE OR CLOSEIF IN A VEHICLE, GO INSIDE OR CLOSE
WINDOWS AND VENTS.WINDOWS AND VENTS.
** FOLLOW EVACUATION INSTRUCTIONS.FOLLOW EVACUATION INSTRUCTIONS.
** IF REQUESTED TO STAY INDOORSIF REQUESTED TO STAY INDOORS
** CLOSE DOORS AND WINDOWS.CLOSE DOORS AND WINDOWS.
** SHUT OFF AIR-CONDITIONING AND VENTS.SHUT OFF AIR-CONDITIONING AND VENTS.
** SEAL YOURSELF IN ABOVE-GROUND ROOM.SEAL YOURSELF IN ABOVE-GROUND ROOM.
** LISTEN TO EMERGENCY BROADCASTS.LISTEN TO EMERGENCY BROADCASTS.
** WHEN DANGER HAS PASSED, FLUSH OUTWHEN DANGER HAS PASSED, FLUSH OUT
AIR.AIR.

Question 12

NUCLEAR OR RADIOLOGIC ATTACK

Answer 12

NUCLEAR EXPLOSIONS CAUSE
BLINDING LIGHT, INTENSE HEAT,BLINDING LIGHT, INTENSE HEAT,
RADIATION, AND FIRES.RADIATION, AND FIRES.
** A RADIOLOGIC DISPERSION DEVICEA RADIOLOGIC DISPERSION DEVICE
(DIRTY BOMB) IS DESIGNED TO(DIRTY BOMB) IS DESIGNED TO
SCATTER SUBLETHAL RADIATION.SCATTER SUBLETHAL RADIATION.
** AVOID LOOKING AT THE FLASH ORAVOID LOOKING AT THE FLASH OR
FIREBALL.FIREBALL.
** TAKE COVER AS SOON AS WARNED.TAKE COVER AS SOON AS WARNED.
** IF OUTSIDE, LIE ON GROUND ANDIF OUTSIDE, LIE ON GROUND AND
COVER HEAD.COVER HEAD.
** BEWARE OF BLAST WAVES.BEWARE OF BLAST WAVES.
** PROTECT FROM FALLOUT.PROTECT FROM FALLOUT.
** KEEP A BATTERY-POWERED RADIOKEEP A BATTERY-POWERED RADIO
WITH YOU.WITH YOU

Answer 13

Shock occurs when the body tissues do not receive enough oxygen-rich blood
■ Shock (hypoperfusion) describes a state of collapse and failure of the
cardiovascular system in which blood circulation decreases and eventually
ceases

Question 14

DAMAGE CAUSED BY SHOCK

Answer 14

Without oxygen…
■ Brain will be damaged
– 4-6 minutes
■ Abdominal organs will be damaged
– 45-90 minutes
■ Skin and muscle will be damaged
– 3-6 hours

Question 15

PERFUSION TRIANGLE

Answer 15

Shock occurs when one or more
sides of the triangle isn’t working
properly
■ Damage to any of the circulatory
components can lead to shock

Question 16

CAUSES OF SHOCK:
CARDIOVASCULAR

Answer 16

1. Pump failure
   – Cardiogenic shock
2. Blood or fluid loss from blood
   vessels
   – Hypovolemic shock/hemorrhagic
   shock (can be from injury or burns)
3. Poor vessel function
   – Neurogenic shock (often from spinal
   cord injuries)
4. Combined vessel and content
   failure
   – Septic shock (usually from severe
   bacterial infections

Question 17

CAUSES OF SHOCK:
NON-CARDIOVASCULAR

Answer 17

Respiratory insufficiency
– Chest injury or airway obstruction
■ Anaphylactic shock
– Medications; food; insect bites
■ Psychogenic shock
– Fainting/syncope

Question 18

PROGRESSION OF SHOCK

Answer 18

Stages of shock:
1. Compensated shock- when the
body can still compensate for blood
loss
2. Decompensated shock- when blood
pressure is falling
3. Irreversible shock- when shock is
terminal

Question 19

SHOCK: WHAT TO LOOK OUT FOR

Answer 19

Altered mental status
■ Pale, cold, and clammy skin
■ Pale or cyanotic lips and/or nail beds
■ Nausea/vomiting
■ Rapid breathing and heart rate
■ Unresponsiveness when shock is severe

Question 20

SHOCK: WHAT TO DO

Answer 20

Treat injuries
■ If responsive and breathing
normally, keep the person flat on
his or her back
■ If no sign of injury, raise the feet
6–12 inches
■ If unresponsive, roll the person
onto his or her side
■ Prevent the loss of body heat
■ Call 9-1-1
■ Do not give anything to eat or
drink

Question 21

ANAPHYLAXIS

Answer 21

WHAT TO LOOK FOR
■ Shortness of breath
■ Swelling of tongue, mouth, nose
■ Intense itching
■ Flushed skin or swollen face
■ Sneezing, coughing, wheezing
■ Tightness and swelling in the throat
■ Tightness in the chest
■ Shortness of breath
■ Swelling of tongue, mouth, nose
■ Intense itching
■ Flushed skin or swollen face
■ Sneezing, coughing, wheezing
■ Tightness and swelling in the throat
■ Tightness in the chest
WHAT TO DO
■ Call 9-1-1
■ Monitor breathing
■ If the person has an epinephrine auto-injector, help
administer it
■ If the person can swallow, give an antihistamine

Question 22

USING AN EPINEPHRINE AUTO-
INJECTOR

Answer 22

Find the injection site on the outer
midthigh
■ Remove the safety cap
■ Push against the outer midthigh
■ Hold in place for 10 seconds
■ Pull the auto-injector straight out
from the leg
■ Rub the area for 10 seconds

Question 23

MILD ALLERGIC REACTION

Answer 23

WHAT TO LOOK FOR
■ Red, itchy eyes
■ Itchy, sneezing, runny nose
■ Rash on skin, usually on one part
of the body
WHAT TO DO
■ Help the person:
− Self-administer his or her asthma
“rescue” inhaler
− Take an antihistamine

Question 24

FAINTING: WHAT TO DO

Answer 24

If a person suddenly collapses:
− Check breathing
− If breathing stops, call 9-1-1 and give CPR
− If person is breathing:
■ Keep the person flat on his or her back
■ Monitor breathing; if it stops, give CPR
■ Check and treat any injuries
■ Wipe the person’s forehead with a cool, wet
cloth
■ If a person is about to faint:
− Prevent a hard fall
■ If you feel faint:
− Lie down or sit down
− Do not place your head between your
knees

Question 25

INTRODUCTION TO BLEEDING

Answer 25

Average-size adult has 5 to 6 quarts (5 to 6 L) of blood. − Rapid blood loss can lead to shock and death.  External bleeding is... blood coming from an open wound  Hemorrhage is...the loss of a large quantity of blood in a short amount of time

Question 26

TYPES OF EXTERNAL BLEEDING

Answer 26

Arterial (spurting)  Most serious type of bleeding  Bright red color 2. Venous (flowing) 1. Dark red 3. Capillary (oozing)  Most common type of bleeding

Question 27

BODY’S RESPONSE TO BLEEDING

Answer 27

Blood vessel spasm  Severed blood vessels draw back into the tissue and constrict, slowing bleeding  If an artery is only partially cut, constriction is incomplete, and the loss of blood may not slow dramatically  Clotting  Special elements in blood called platelets form a clot  Serves as a protective covering for a wound until the tissues underneath can repair themselves  Healthy people usually clot within 10 minutes.  Clotting may take longer for those who have a great deal of blood loss, are taking aspirin, are anemic, have hemophilia or severe liver disease.

Question 28

CARE FOR EXTERNAL BLEEDING

Answer 28

Wear gloves; If no gloves, improvise with other materials 2. Expose wound to find source of bleeding 3. Place sterile gauze pad or clean cloth over wound 4. Apply pressure; Hold direct pressure for at least 5 minutes 5. If the bleeding does not stop within 10 minutes:  Add dressings and press harder over a wider area 6. Apply a pressure bandage over the dressing 7. If the bleeding continues, call 9-1-1.  Consider using a tourniquet if severe bleeding from an arm or leg cannot be stopped. 8. Dispose of gloves and wash your hands.

Question 29

BLEEDING IS CONTROLLED: WHAT TO DO

Answer 29

Care for the wound  If needed, seek medical care for:  Cleaning  Stitches  Tetanus immunization

Question 30

BLEEDING CONTINUES

Answer 30

Apply a manufactured tourniquet  If a manufactured tourniquet is not available, apply an improvised tourniquet  DO NOT cover, release, or remove  Write “TQ” and the time it was applied on a piece of tape, and apply it to the forehead  Call 9-1-1, or drive the person to a medical facility

Question 31

BLEEDING STILL CONTINUES

Answer 31

Apply a hemostatic dressing if:  Direct pressure is not effective  A tourniquet is not available, is ineffective, or cannot be applied

Question 32

APPLYING A MANUFACTURED TORNIQUET

Answer 32

1. Apply the tourniquet about 2 inches above the wound 2. Twist the rod until the bleeding stops  Secure the rod in place 3. Write “TQ” (for tourniquet) and the time it was applied on a piece of tape, and stick it on the person’s forehead

Question 33

APPLYING AN IMPROVISED TOURNIQUET

Answer 33

. Use a triangle bandage, wide roller bandage, or similar cloth folded into a long band about 2 inches wide and several layers thick 2. Wrap the band twice around the arm or leg about 2in above the wound and tie a knot (do not apply this over a joint) 3. Place a short rigid object onto the knot and then tie a square knot over it 4. Twist the object until the bleeding stops  Secure the object 5. Write “TQ” (for tourniquet) and the time it was applied on a piece of tape, and stick it on the person’s forehead

Question 34

INTERNAL BLEEDING

Answer 34

WHAT TO LOOK FOR  Bright red blood from mouth or rectum, or blood in urine  Vaginal bleeding (nonmenstrual)  Vomited blood  Black, foul-smelling, tarry stools  Pain, tenderness, bruising, or swelling  Broken ribs, bruises over chest, or rigid abdomen

Question 35

INTERNAL BLEEDING

Answer 35

WHAT TO DO  Monitor breathing  Expect vomiting  Treat the person for shock  Treat internal bleeding in an extremity by applying a splint  Seek immediate medical care

Question 36

What Are Open Wounds?

Answer 36

A break in the skin’s surface resulting in external bleeding  May allow bacteria to enter the body, causing an infection

Question 37

Types of Open Wounds

Answer 37

. Abrasion  Top layer of skin removed  Little or no blood loss  Painful 2. Laceration  Cut with jagged, irregular edges  Tearing away of skin tissue

Question 38

Types of Open Wounds Cont

Answer 38

3. Incision  Smooth edges 4. Puncture  Deep, narrow  High risk of infection

Question 39

Types of Open Wounds Cont.

Answer 39

5. Avulsion  Flap of skin torn loose 6. Amputation  Cutting or tearing off of body part

Question 40

Care for an Open Wound

Answer 40

1. Protect yourself from disease (exam gloves, etc.) 2. Expose the wound 3. Control bleeding with direct pressure

Question 41

Cleaning a Wound

Answer 41

1. Scrub hands with soap and water 2. Clean wound  For shallow wound:  Wash with soap and water  Flush with clean water under pressure − For wound with higher infection risk:  Clean wound  Seek medical care for additional cleaning 3. Use tweezers to remove remaining embedded debris 4. If bleeding restarts, apply direct pressure

Question 42

True or False  If infection is a concern you should use hydrogen peroxide or an antiseptic solution to clean the wound

Answer 42

False The use of substances such as hydrogen peroxide or other antiseptic solutions can irritate the injury and destroy cells that are being sent by the body to repair the tissue. Consult a doctor before administering any type of ointment

Question 43

Covering a Wound

Answer 43

Dressing: applied over a wound to control bleeding and prevent contamination − Should be sterile or as clean as possible  Bandage: holds dressing in place  Need not be sterile  If the wound is small, apply thin layer of antibiotic ointment  Cover with a sterile dressing  Do not close gaping or dirty wounds with butterfly tape – this can lead to infection  Do not pull off dressing that has become stuck  If you must remove, soak in warm water  Change wet or dirty dressings

Question 44

When to Seek Medical Care

Answer 44

High risk wounds  Embedded foreign material  Animal and human bites  Puncture wounds  Ragged, large, or deep wounds  Visible bone, joint, muscle, fat, or tendon  Wound entering joint or body cavity  “Fight bite”  Wounds needing sutures  Best placed within 6 to 8 hours  Anyone who has not had a tetanus vaccination within 10 years  5 years in the case of a dirty wound

Question 45

True or False

Answer 45

Sunblock should be used on a new wound for at least 3 to 6 months True

Question 46

Risk of Infection

Answer 46

Which types of wounds carry the largest risk of infection?  Wounds with foreign material  Ragged or crushed tissue  Injury to underlying nerves, tendons, joints  Bite wounds  Hand and foot wounds  Puncture wounds or wounds that cannot drain

Question 47

Infected Wound

Answer 47

What to Look For?  Swelling and redness around the wound  Sensation of warmth  Throbbing pain  Pus discharge  Fever  Swelling of lymph nodes  Red streaks leading from wound toward heart

Question 48

Infected Wound

Answer 48

What to Do?  Soak wound in warm water, or apply warm, wet packs over infected wound  Apply antibiotic ointment  Change dressings several times per day  Give pain medication  Seek medical care if the infection persists or worsens

Question 49

Amputations and Avulsions

Answer 49

In many cases, an amputated extremity can be successfully reattached  Avulsions most often involve ears, fingers, and hands  Can bleed heavily

Question 50

Types of Amputations

Answer 50

1. Clean  Clean-cut, complete 2. Crushing  Crushed or mashed off 3. Degloving  Skin is peeled off

Question 51

Amputations

Answer 51

What to Do? 1. Call 9-1-1 2. Control bleeding and treat for shock 3. Care for the part:  Wrap in a wet sterile gauze or a clean cloth  Put in a waterproof container of ice  Do not bury it in ice  Send to the medical facility Body parts left uncooled for more than 6 hours have little chance of survival

Question 52

Avulsions

Answer 52

What to Do?  Gently move the skin back to normal position.  Cover with sterile or clean dressing and apply pressure.  If bleeding continues, apply tourniquet or hemostatic dressing, if available

Question 53

Blisters

Answer 53

A collection of fluid in a bubble under the outer layer of skin  Caused by repeated rubbing of the skin  Treatable and preventable

Question 54

What to Do?

Answer 54

Hot spot  Hot spot  Relieve pressure by applying:  Blister bandage  Surgical tape  Elastic tape  Trim and round edges of tape

Question 55

What to do? Hot spot

Answer 55

Closed...Not Painful  Blister that is closed and not very painful  Use the most appropriate method discussed

Question 56

True or False You should poke several small holes in a painful blister to release the fluid inside

Answer 56

True

Question 57

What to Do?

Answer 57

Closed...Very Painful  Blister that is closed and very painful  Clean blister and needle with alcohol pad  Make several small holes at base of blister with needle  Do not remove blister roof unless it is torn  Apply paper tape and cover with elastic or adhesive tape.  Trim and round edges of tape.  Watch for signs of infection. Open...Painful and Torn  Trim off dead skin.  Place blister pad over raw skin; cover with paper tape.  Cover with elastic or adhesive tape.  Round edges of tape.  Watch for signs of infection.

Question 58

Impaled (Embedded) Objects

Answer 58

Embedded objects should be stabilized to prevent internal damage  Large Impaled Objects  What to Do? 1. Stabilize object 2. If bleeding, apply direct pressure around base of object 3. If necessary, reduce length or weight of object by cutting or breaking it 4. Call 9-1-1

Question 59

Sliver (Splinter)

Answer 59

What to Do? 1. Remove with tweezers 2. Wash the area with soap and water 3. Apply antibiotic ointment 4. Apply adhesive bandage

Question 60

Impaled Object in Cheek

Answer 60

If you are more than 1 hour from medical help, consider removing it  To remove object:  Place two fingers next to object  Gently pull it in the direction from which it entered  If it cannot be removed easily:  Leave it in place  Secure with bulky dressings  Control the bleeding  After removing object, place dressings over wound inside mouth  Place dressing over outside of wound

Question 61

Impaled Object in Eye

Answer 61

What to Do?  Do not exert pressure on eyeball  Stabilize object  If long: use bulky dressing and place paper cup or cone over eye  If short: surround eye with ring pad held in place with roller bandage  Cover undamaged eye  Call 9-1-1

Question 62

Cactus Spines

Answer 62

What to Do?  Removal methods:  Tweezers  Glue or rubber cement  Apply in thin layer.  Allow to dry and roll up dried glue.  Combination of tweezers and glue most effective  Adhesive, duct, or cellophane tape

Question 63

True or False When no other glue is available, you can use super glue to pull cactus spines from your skin

Answer 63

False Super glue doesn’t roll up and welds the spines into the skin.

Question 64

Fishhooks

Answer 64

What to Do? * Tape fishhook in place * If barb has not penetrated skin: Remove by “backing out” Treat as puncture wound Seek care for tetanus * If barb has entered skin: * Transport person * If far from medical care, remove hook with pliers or string-jerk method Pliers Method * Apply an ice pack or hard pressure * Push further in until it emerges through skin * Cut off barb with pliers and push hood back out through entry String-jerk Method * Loop fishing line over curve of hook * Stabilize and apply pressure * Press down on shank and eye; jerk line out * Movement parallel to skin’s surface

Question 65

Closed Wounds

Answer 65

What are they?  Caused by strike with blunt object  Skin is not broken, but tissue and blood vessels are crushed  Types of closed wounds:  Bruises and contusions  Hematomas  Crush injuries What to Do?  Apply an ice pack  Injured limb  Apply elastic bandage for compression  Splint limb  Check for fractures  Elevate extremity above heart level

Question 66

Wounds Requiring Medical Care

Answer 66

What are They?  Long or deep and needs stitches  Over a joint  Animal or human bite  Impairs function of eye, eyelid, or lip  All layers of skin removed  Caused by a metal object or a puncture wound  Over possible broken bone  Deep, jagged, or gaping open  Involves damage to underlying bones, joints, or tendons  Foreign material embedded  Cuts that show signs of infection  Cuts that include issues with movement or sensation, or increased pain What to Do?  Call 9-1-1 immediately if:  Bleeding does not slow within 15 minutes.  Signs of shock  Cut to neck or chest causes difficulty breathing.  Deep cut to abdomen, painful  Eyeball cut  Amputation or partial amputation

Question 67

Sutures (Stitches)

Answer 67

Within 6 to 8 hours of injury  Benefits  Faster healing  Reduced infection and scarring  Wound does not require sutures if:  Cut edges of skin fall together  Cut is shallow

Question 68

Gunshot Wounds

Answer 68

What are they?  At the scene of an active shooter: run, hide, fight  Bullet causes injury by:  Laceration and crushing  Shock waves and temporary cavitation What to Look For?  Penetrating wound—entry only  Perforating wound—entry and exit points

Question 69

Gunshot Wounds Cont

Answer 69

What to Do?  Monitor person’s breathing  Expose the wound(s)  Control bleeding with direct pressure  Apply dry, sterile dressings and bandage  Treat person for shock; keep calm  Seek immediate medical care Legal Implications  Keep accurate record of observations  Preserve evidence, such as shells or casings  Do not touch or move anything unless it is necessary  All gunshot wounds must be reported to police

Question 70

Dressings

Answer 70

What are Dressings?  A dressing covers an open wound and touches the wound  Dressings should be:  Sterile  Larger than the wound  Thick, soft, and compressible  Lint free Purpose of a Dressing  Purpose of a dressing:  Control bleeding  Prevent infection and contamination  Absorb blood and drainage  Protect wound

Question 71

Types of Dressings

Answer 71

Gauze Pads  For small wounds Adhesive Bandages  Small cuts and abrasions Trauma Dressings * Large, thick, absorbent

Question 72

Bandages

Answer 72

Purpose of a Bandage  Should be clean but need not be sterile  Can be used to:  Hold a dressing in place  Apply direct pressure  Prevent or reduce swelling  Provide support and stability for an extremity or joint Signs A bandage is too tight...  Blue tinge on fingernails or toenails  Blue or pale skin color  Tingling, loss of sensation  Coldness of extremity  Inability to move fingers or toes  Pulse felt before bandaging, but not after

Question 73

Types of Bandages

Answer 73

1. Roller bandages * Various widths, lengths, and types of material 2. Self-adhering, conforming bandages * Elastic, gauzelike 3. Gauze rollers * Nonelastic cotton 4. Elastic roller bandages * Provide compression 5. Triangular bandages * Slings, Cravats 6. Adhesive tape and bandages

Question 74

Applying a Cravat Bandage To the Head

Answer 74

1. Place middle of bandage over the dressing and wrap around the head 2. Cross the two ends snugly 3. Bring ends back around and tie knot

Question 75

Applying a Cravat Bandage to the Arm or Leg

Answer 75

1. Wrap the center of bandage over the dressing 2. Turn one end going up the extremity and the other end going down 3. Tie bandage off over dressing

Question 76

Applying a Cravat Bandage to Palm of Hand

Answer 76

1. Fill palm with bulky dressing or pad, and close fingers 2. Wrap one end around fingers, other around wrist 3. Wrap bandage, crossing over fingers and around wrist 4. Tie bandage off at the wrist

Question 77

Applying a Roller Bandage: Spiral Method

Answer 77

1. Start at narrow part of an arm or a leg and wrap upward 2. Make two straight, anchoring turns 3. Make overlapping crisscross turns 4. Finish with two straight turns and secure

Question 78

Applying a Roller Bandage: Figure Eight Method

Answer 78

For Elbow or Knee 1. Make two straight turns over joint 2. Make one turn above joint; overlap first turn 3. Make one turn below joint; overlap first straight turn 4. Continue alternating turns 5. Finish with two straight turns to secure end For Hand 1. Make two straight turns around palm 2. Carry bandage diagonally across back of hand, around wrist, and back across palm 3. Make several figure-eight turns, overlapping each 4. Finish with two straight turns around wrist; secure end

Question 79

Applying a Roller Bandage: Figure Eight Method Cont’d

Answer 79

For Ankle (p.159) 1. Make two straight turns around instep 2. Make figure-eight turn across front of foot, around ankle, and under arch 3. Make several figure-eight turns, overlapping each turn and advancing up the leg 4. Finish with two straight turns around leg; secure end

Question 80

Securing a Roller Bandage

Answer 80

Materials needed:  Adhesive tape  Safety pins  Clips provide with bandage  2 methods:  Loop Method  Split-Tail Method

Question 81

Securing Bandages Cont’d

Answer 81

Loop Method  Loop tape around thumb or finger and work backward  Encircle body part with the looped and free ends and tie together Split-Tail Method  Split end of bandage lengthwise  Knot to prevent further splitting  Wrap ends in opposite directions around body part and tie together