First Aid Flashcards
Describe how to care for minor cuts
Apply pressure to stop the bleeding
Clean the wound with cool water
Remove any debris with tweezers
Gently was around the wound with soap and a washcloth
Cover with band-aid
Check daily for infections. Change dressings daily for first few days
When caring for a minor cut, what agents should be used to clean the wound? WHich agents should be avoided?
USe fresh, clean water
Do not use idoine, alocohol or hydrogen peroxide
How long does it take for a wound to heal? Symptom while wound is healing? Recommendation for dressings?
Wounds may take 2-4 weeks to heal
Patients frequently experience itching after their wounds have appeared to have healed
All wounds normally drain and therefore daily dressing changes are recommended
WHy is hydrogen peroxide not recommended for minor cut care?
Hydrogen peroxide can slow healing by dmaging healthy cells
Use mild soap and water instead
Is an anti-septic required for a minor cut? Examples?
NOOOOO
Rubbing alcohol
Iodine
Hydrogen Peroxide
Dettol Anti-septic
Describe the manufacturing label of Dettol? Is this our recommendation>
Can be used as a gentle antispetic wound cleansing and antiseptic skin cleansing
Not recommended for wounds
Describe the contect for use of rubbing alcohol?
Pre-injection –> YES
Post-injury –> NO
What is betadine? Uses?
Providone-iodine
Complex of iodine
Not for cuts or wounds; not needed for minor first aid
Pre-surgical –> FAir game as effective for killing bacteria
When caring for a minor cut, should one use a betadine spray directly into the wound?
No need to spray directly into the wound
Warm soapy water around the edges is good enough
Describe the overall concept of anti-septic use in caring for a minor wound
DO not need to use an anti-septic solution to prevent an infection
Avoid using an antispetic
Regarding polysporin, is there a difference in therapy efficacy between a cream and an ointment?
No difference between a cream and ointment
Is polysporin recommended for a clean wound?
Decent and clean wound, vast majority of references state that polysporin is not needed
Describe the antibiotic agents in polysporin
Gram Positive - Bacitran, Gramcidin
Gram Negative - Polymyxin
Describe the avilable polysporin agents?
When selecting a polysporin agent, what is the main considering factor for a pharamcist? Are certain agnets better than others?
Just want to have a gram positive and gram negative agent
Lidocaine–> Anasthetic
“One has a pain killer in it, one does not. Which do you want?”
Three ingredients is just as effective as two ingredients
IS polysporin kids any different than the other agents?
No - Exact same as Polysporin PAin Relief
How often should polysporin be dosed?
Directions state to apply 1-3 times a day
Just go with TID –> Unlikely to have resistance here
Is the polysporin band-aid a more effective agent?
No
Just a marketing strategy
Go for simple band-aid instead
Describe the decision process for whether a topical antibiotic is necessary?
1) Is one needed? Unlikely –> Go with vaseline
2) Cream or ointment - Do not care
3) Lidocaine needed or not –> Patients decision
Describe the rate of infection of topical antibiotic usage?
If wound is dirty assuming you have not washed things out –> 20-30% chance of infx
If wound is “clean” –> 1-5% of infection and alcohol, HP are not needed
Describe caring for a wound in regards to promoting healing and ineffective strategies
Promote Healing:
Small cuts and scrapes can be left uncovered but moisture is usally needed to help speed up the healing process
Do not apply a topical antibiotic (vaseline just as effective as antibiotic ointment for non-inf wounds)
Do not douse a minor wound with antispetics
Which is more useful: Vaseline or Topical Antibiotics
What is the risk?
Topical ointments with antibiotics in them do not prevent infections any better than vaseline
More expesnive and risk of dermatitis rxn and allergic rxn
Describe the best way to heal a minor cut? What is the benefit? Is a bandaid needed?
Moist healing is the way to go
Moist healing can help prevent scars
Moist healing promoted greater rate of revascularization leading to:
Less necrosis, faster healing, and better quality of healing
A bandaid on a wound is not better than off a wound - Do not require oxygen for wound healing
Describe the benefit of vaseline in minor cuts
Use vasleine to help the injured skin heal and keep the wound moist
Vaseline helps prevent the wound from drying out and froming a scab
Wounds that form scabs take longer to heal
Describe the agents that can be sued to help create a moist environment for a wound?
Band-Aid Non-Stick Pads
–> Protection, but minimal occlusion
Opsite
–> Sure
Vaseline
–> Yes but put on top of the wound; not driving it into the wound
Polysporin Ointment
–> Ointment so occlusive but the antibiotic aspect is not required
Describe how vaseline should be applied to a wound?
Do not drive the vaseline into the wound; going only over top of the wound
Do not slather the wound with vaseline
When should vaseline be added to a minor wound? Is this factual? If not, what do we do?
It is best to let the the cut clot for half and hour to let the film (scab) form
–> 2-3 minutes after a cut is enough, clots happen fast
Clean it if needed
After that it can be beneficial to add vaseline
How should vaseline be applied to a minor cut?
Vaseline is not jammed into the cut
Get the wound mostly closed then add the vaseline on top
Can put vaseline on a band-aid, then use that to close the wound
Change once a day and check for infection
Describe the use of honey as a wound treatment?
USed since ancient times
ANtispetic
Promotes healing
Describe the properties of honey
Honey has specific physiochemica; properties that favour its use as a therapeutic agent to combat several microbial infections
These properties of honey are also associated with its wound healing effect, anti-inflammatory potency, anti-oxidant and free radical scavenging ability
What types of wounds is honey commonly used for?
Leg Ulcers
Burns
Pressure Ulcers
Infected Wounds (via injury or surgery)
Diabetic foot ulcers
Describe MEDIHONEY
Medical Grade Honey
Broad Spectrum of antimicrobial efficacy
Hospital Territory
Not the honey in the pantry
Describe the criteria that MEDIHONEY must meet:
Describe the indication of MEDIHONEY
2nd or 3rd line after debridement of the wound
Is manuka honey useful for first aid? Is it the same as regular honey?
NOT THE SAME AS REGULAR HONEY –> Do not use regular honey on wounds –> MUST BE MEDICAL GRADE
Can be effective for treating serious infx, ranging from skin rashes, boiled and scalded skin
Do not attempt to use regular honey as an option for wound care
The high fructose corn syrup in regular honey is more likely to make the infection spread
What type of honey can be sued for first aid?
MEDICAL GRADE HONEY
- Specilaly sterilized and prepared as a dressing
Manuka honey in the pantry should not be used
How should honey be applied in a minor cut first aid? What type of honey?
Apply honey to a clean dressing first - reduces mess of application
MEDICAL GRADE HONEY
How can a pharmacist be involved in tattoo and piercing care? Examples?
Get them whatever is on the page they bring in
Vitamin A and D ointment –> No anti-septic properties, just use vaseline (ointment base)
Describe the assessment for a need of a dressing in the pharmacy
What are some signs that a wound is infected?
Redness and swelling
Worsening PAin
Pus or fluids coming out of the wound
Wounded area feels hot
When selecting a BAND-AID, how should a pharmacist decide?
Do not waste time in this area
Go with the regular one
Children –> Go with favourite character
Silver and Cooper - has antibacterial properties but do not recommend unless someone is asking for these agenrs
Are the hydroseal bandages more effective than regular bandages?
NO
Go for the regular ones
Save money
What is a new trend that band-aid companies are hoping onto?
Mositure Seal
Hydrocolloid Adhesive Pads
Just regular bandaids here
Is a silver bandaid more effective than other bandaids?
NO
Silver is anti-septic
Expensive here
Just keep it clean and regular bandaid
How can one banadage the knuckles,, heels and fingers?
Difficult to banadage
Keep them clean and free of dirt
Banadages that are hourglass shaped or notched can prevent folds and bunching
Go with nexcare instead (liquid banadage)
Describe the agent nexcare: Application S/E, Indication and Duration of use
Should not sting on contact
Waterproof
For larger scapres and abrasions that are difficult to cover with traditional bandages
Not for large, deep punctures
Lasts about 5 days
What is OPsite? Indication?
Transparent adhesive film
For superificial wounds (sllow pressure sores, minor burns, cuts and abrasions)
Describe the critical benefit of OPSITE?
Mosisture-vapor permeable (allows excess exudate to evaporate to prevent skin maceration)
Provides a moist environment for healing
Describe the benefical reasons of OPSITE for the patient? When is it changed?
Waterproof –> Allows patient to bathe and aids in prevention of bacterial contamination
Easily cut into strip[s for awkward areas
Dressing can be left for 7 days. Minimizes interference at the wound site
Where is opsite more commonly used?
Nursing/medical care on more significant wounds
What is a tegaderm?
Same idea as opsite
Protects minor wounds (cuts and scrapes)
ALlows the skin to breathe
Can be left on for 7 days
When would we choose ceratin nexcare tegarderm products?
If only need protection, Nexcare Tegaderm
If oozing and bleeding, Nexcare Tegaderm + Pad
What type of gauze is used for protecting wounds?
Telfa
Describe the layers of Telfa
Outside LAyer: Covers the wound, pad won’t stick
- Protects and helps keep out water, dirt and germs
Middle layer –> Absorbent
TEFLA pad should be placed at the site of the wound
What is Tefla used for? Benefit?
Used for covering wounds and controlling blood or fluid leaking from them
Non-stick surface allows for easier removal during dressing changes
How is TEFLA applied?
TEFLA First
Then back up with guaze then wrap the bandage with tape or clip
Describe the sue of GAuze pads in first adi?
No covering on these gauze pads
Used for cleaning a wound or ‘packing’ a dressing
Catches some fluids
Gauze pads or Tefla
Tefla
When does a cut not require stsitches?
Lacerations that are:
Superficial (do not involve fat or muscle tissue)
Are not bleeding heavily
Les sthan 1/2 inch long
Do not involve the face
CAn be managed ta home without stitches
When would a butterfly bandage be appropriate?
Edges of a cut are seperated but will move together
Can use butterlfy banadage to help close the wound
Placed across the cut long its length
If wound is long more than on emay be required
Takes the place of a sticth
When would a butterfly banadage not be appropriate?
Cuts that are gaping, longer than half an inch or do not stop bleeding after 15 minutes
How long after a cut can a wound be stistched?
Most wound sthat require closure should be sticthed, stapled or closed with a skin adhesive within 6 to 8 hours after the injury
Some wounds can be closed as long as 24 hours after the injury
When do certain wounds get closed via stictches?
Wounds that have an increased risk of infection (dirty cuts, crush injuries) are usually closed within 6 hours after injury
Occasionally a wound that has an incraesed risk of infection will not be closed until 24 hours, or not at all, so that adequate clenaing and antibiotic treatment can be done to initially prevent infection
What are some other options besides stitches for minor cuts?
Krazy Glue - Slightly more irritating but well tolerated; no industrial chemicals here
Dermabond (not oTC in CAnada)
- Allows it to be done without stitches, one less chemical than Krazy Glue
Is alcohol (such as vodka) recommended for cuts?
NOOOO
How to treat a burn in general?
COOL WATER FIRST
If an ointment or cream is used, wait a few hours first
How should stitches be cared for?
Keep the stitches completly dry
Likely leave the hospital or clinic with stitches covered; leave the dressing on for 2-3 days. Avoid getting the dressing wet.
Once you remove the dressing, likely do not need to put anything on the sticthes such as vaseline or HP
Stitches may become itchy as healing is occuring
Describe the difference between a scar and a keloid
A cut that is kept moist is less likely to have a visible scar
Scar removal products are really keloid products
Keloids are ana reaction to the area of cuts that people get and is hyper-kerototic tissue
–> Purplish/blue lesions on people
How can keloid be treated?
Injection of a steroid into the keloid can help bring down inflammation
What are some ways to minimize a scar from forming?
Use vaseline to keep the wound moist
- New reference –> Wait 30 min to apply it (as in allow clot to form first)
As long as wound is cleaned daily, no necessary to use bacterial ointments
After cleaning teh wound and applying petroleum jelly, cover the skin with an adhesive banadage
Change the bandage daily
What is the difference between aquaphor and vaseline?
Aquaphor is an emulsion and therefore has a little water in it
Totally fine to use for cuts
When should one stop applying vaseline to a wound?
Continue applying until teh wound has completly healed
A large wound can take 4 weeks to heal
A dressing can be applied toprotect teh wound and keep it clean
Describe the treatment options for reducing scars? Are these effective agents? Recommendation?
Silicone Sheet
- TX for keloid; 18 months of tx to bring down the keloid
Mederna
- USe befpre to prevent a keloid or placed on top of already formed keloid (unlikely)
Vaseline and Aquaphor is likely to be good enough for treatment here
Are silicone sheets effective for keloids? ANy treatment of keloids?
Keloid scars are difficult to treat
Uncertain whether use of silicone sheets comapred with no tx, treatment with non-silicone sheets or intralesional injections with traiamcinolone acetonide makes any difference in the treatment of keloid scars
How to use the Elastoplast Scar reducer patch?
Keloid front of therapy here
More effective for older scars
Describe the different types of burns
1st Degree Burns: Red and Painful; tend to swell slightly and turn white when apply pressure to skin
2nd –> Produc blisters, thicker, very painful, skin may turn red, splotchy, or swollen
3rd degree - Skin is white or charred, may cause little or no pain (damage to nerves)
Describe the pathology of 1st degree burns
Surface of the skin is damage but epidermis is still intact
Can perform its fucntions such as control temp, protect from injury or infection
What types of burns are the most painful? Common sign?
2nd degree are the most painful
Blisters are the first sign
Loss of skin fucntion here
What is a concern with 3rd degree burns?
Trouble with fluid loss, heat loss and infection
May not be able to feel anything in the burned area
What are the different classificiations of burns?
Thermal
Chemical
Radiation
Electrical
What is the most common type of radiation burn?
Radiation from the sun
How are burn degreess determined?
Depth of skin that is impacted
Describe a first degree sunburn. Treatment?
Red, irritated and dry
No blister
Cool compress, aloe vera (just a cooling effect on the skin - evaporating off the skin)
When a burn blisters, what degree is it?
2nd Degree
Shallow Second Degree burn
Describe a third degree burn? Concerns?
Full thickness burn
Damage has completly destroyed the thick layer of skin and reached fatty tissue underneath
No way to tell outside a hospital
Once top layer of skin falls off, bacteria and fluid can leak out
Risk of infection here =–> COVERRRR
How should one care for a burn?
1) FLush the burned area with cool running water for 10 min if possible to extract the heat
2) CAll 911 for a svere burn
3) Apply a burn ointment or spray for pain
4) Take ibuprofen or acet for pain releief if necessary
Describe the initial step for burn management
Run cool water over the area for atleast 10 min if possible
Cold water or a cool compress
What should be avoided in cooling a burn?
Do not use an ice pack to cool a burn
Can cause frostbite quickly as skin already damaged
Describe the care for burns? What agents should not be used? What is one instruction that is up for debate?
RInse the area with cool water as this keeps the skin from holding heat and continuing to burn
Never use butter, grease or powder on a burn
Leave any blisters that form ALONE
Cover the burn with a thin layer of antibiotic ointment (some suggest not to do this)
Should an ointment be used on a burn? COntroversy?
One reference suggests Ointments should be water soluble
Oils will trap heat and make the burn deeper over time
Ointments and oils are the same thing
Both oil and ointments will hold heat in
How should one bandage a burn?
If the burned skin or blisters have not broken open, a bandage may not be necessary
If broken open, apply a clean banadage whenever bandage gets wet or soiled
If banadage is stcuk to a burn, soak in warm water to make it easier to remove.
If available, use a non-stick dressing
Describe the overall cocnept of ointments on burns
Can use petroleum jelly (vaseline) but depends on the timing
–> Want to delay use
–> 20 minutes of cooling and wait until the burn is completly cooled
Do not put it on a fresh burn as will trap in heat and cause further damage
Wait until burn is completly cooled before applying a dressing
Not a lot of therapeutic gain with vaseline here –> keeps the area supple
How often can vaseline be applied to a burn?
Apply vaseline two to three times daily (up to 3 times daily)
When are antibiotics required for a burn?
Antibiotics are addition
Consider if wound is open/broken
What if the sun burn is a big area or on the back?
Go with a cream (cooling) or a lotion
What other agents can be used for a burn? Are they effective?
1) Ozonol - Non-stinging Ointment
- Phenol, Zinc oxide
No compelling need for this agent
- VAseline is fine (or any un-medicated cream)
- Just thicker than vaseline
2) Mecca
- Phenol 0.5%, Camphor 0.5%, Zinc Oxide 1.25%
- Thick agent
- Same as ozonol
- Go for vaseline
What are some options for treatment of a first degree burn or sun burn? What agent should not be used?
Soak a facecloth in water to make a cool compress
Use a moisturizer to smooth areas where skin rubs against skin to prevent chaffing
Do not use a light powder on a burn
Do not use calamine lotion for itching as dries the skin
What is heat rash also known as? Pathology?
Also known as prickly heat
Salt trapped in the pores leading to occlusion
Sweat glands become blocked and trapped sweat irritates the skin and produces a rash
How is prickly heat treated?
Same excat treatment as a sunburn
Looks the excat same as a sun burn
When does prickly heat occur?
Hot day (sweaty)
Infanats with too many blankets
What are some symptoms of heat rash (prickly heat). Do the sx change between adults and children?
Small, raised spots
An itchy, prickly feeling
Mild swelling
Rash looks red or white on skin
Sx same in adults and children
Describe the specific treatment of prickly heat?
Apply something cool such as a damp cloth or gel pack (fridge) for up to 20 mins
- Cold and ice pack here are overkill
Cold shower or bathe
Tap or pat the rash instead of cratching it
Unlikely:
Calamine lotion or HC cream
What are some causes of fainting?
Drop in BLood pressure
Low blood sugar
Standing in one position for too long
How to manage fainting?
1) Lay the person on back
2) Elevate legs to restore blood flow to the brain
3) Loosen tight clothing
4) try to awaken individual - Shake or yell
5) No response - call 911
6) Not breathing - CPR
What to not do if someone has fainted?
Give person any food or drink
Slap face or splash water to try and wake individua;l
Leve the person alone
Why are puncture wounds a concern? Is it our call as pharamcists?
Tetanus:
Clostridium Tetanti (spores) - found in dirt, rusty nails
- Deep narrow wound sincraeses the risk
Can lead to lock jaw
Not our call
Tetanus Therapy
DTP vaccine (diphtheria, tetanus, pertussis)
Series of 5 shots till age 6, booster at 16, then q10 years
Tetanus Booster every 5-10 years
Puncture WOund - Tetanus vaccine right away
What is a myth for management of nose bleeds that should not be done?
Do not tilt the head backwards
Leads to clots and gag risk
How should nose bleeds be handled?
1) Lean forward slightly with the head tilted forward (tilting back can make blood run back into throat and cause gagging)
2) Spit out any blood that collects in mouth or throat
3) Gently blow any blood clotting out of the nose. Nosebleed may worsen slightly when you do this, but this is expected
4) Pinch all the soft parts of the nose together between thumb and index finger
5) Hold nose like that for atleast 5 mins (judgement call - likely 10 mins). Repeat as necessary until bleeding has stopped.
6) DO not lay plat or put head between legs.
7) Apply ice (warapped in towel) to nose and cheeks afterwards)
8) Stuffing cotton or tissue into the nsoe is not recommended
Describe the difference between a wasp and a bee sting
Bee’s leave the stinger in the skin; wasps do not
What is the first step in managing a bee sting?
get the stinger out of teh skin
How can one get a bee stinger out of the skin?
Use tweezers to remove the stinger
- CAre to not squeeze the exposed end of the stinger as will release more venom (almost impossible to not squeeze venom sac)
USe a flat card (e.g. credit card) and scarpe across the stinger - prevents venom sack from releasing more venom
Treatment for bites and stings
Use second generation anti-histamines for itch and inflammation
Benadryl is not any better for skin itch (not fdaster acting or better)
Local anasthetics (Benzocaine, lidocaine, pramoxine)
And
Conuter-irritants (Camphor, menthol)
And
Atringents (Ammonia/baking soda)
Provid eonly minor relief
Topical diphenyhydreamine is not recommended for relief of itching
Corticosteroids:
- HC is not enough here (not strong enough)
- Go with spectro ecezema
- Safe –> No steroid effects
What OTC topical astringent agents are recommended for bug bites? WHich to avoid?
Afterbite and topical benadryl are all the same –> Astringents
Afterbite. (any one) is fine but rather other agent
Topical Benadryl –> NOOOO
Calamine –> Cheap, just a few dabs can help
Describe the differences between angiodema and hives. Epi-Pen?
Angiodeema –> Swelling of the face, lips, mouth, eyes
–> GIVE EPI-PEN
Hives -> Localized reaction that is sometimes allergic nature
“Cusp of analphylaxis” - If only one system ivolved, not worried (e.g. hives on back). If moves to anotehr system (face), give EPI-PEN
–> Likely will give EPI-PEN and not take the. chance
What are the two common signs of a severe allergic reaction?
Hives/Welts (same thing)
Plus:
Swealling of throat, lips, tongue, or arpound the eyes
Difficulty breathing or swallowing
SECOND SYSTEM INVOLVEMENT
What are hives?
Not raised
Move around the body
Extremly itchy
Hard to treat topically
TX of Hives. Example?
Second Gen NAti-histamines are the DOC
Can increase the dose
e.g. 40 mg of Claritin (loratidine)
Does the risk of local skin reactions such as hives leading to anaphylaxis related to size of reaction?
Examples:
Local reactions “even big ones” are not anaphylaxis
Must see the local reaction jumpt to a 2nd system (like changes to breathing) to worry about anaphylaxis and use an epi-pen
Local reactions are just that, no matter how severe they get
e.g. Angioedema, rhinitis/cough + rash –> 2 systems
Donot worry about rash if it becomes large if no other system induced
How is an EPi-pen used?
Blue to the sky, orange to the thigh
Hold firmly
Swing and push orange tip firmly into mid-outer thigh until hear a click
Call 911 after using (*****)
What is the main cocnept regarding epi-pen usage?
When in doubt, give it
120 kids die yearly via anaphylaxis
Zero incorrect EpiPen usage
Describe expiry of Epi-Pens and usage. Is this a legal recommendation?
Ones sold by pharamcy should have about a year expiry date
Made to go through clothes/denim, but open skin is ideal
Does not reduce in potency after expiry
If looks okay, ok to use (not a legal recommendation)
If in doubt, what to do regarding epi-pen?
When in doubt, give the shot
Especially if they have an epi-pen and allergen is present
Different types of Epi-Pen dosages
Describe anaphylaxis and treatment
Anaphylaxis is a severe allergic reaction
Sx occur within minutes
Give epinephrine as soon as possible
Transport patient to the hospital immeditaely
A second dose of epinephrine should be adminstered within 5-20 minutes if patient has not reponded adequately
Up to 20% of insect bite anaphylatic reactions are biphasic
Oral anti-histamines should not be used as first line tehrapy in emergency situations
–> Considered a secondary med to help with hives and itching
Descriibe the anaphylaxis reaction regarding timing and antigen exposure
iphasic reaction
Call 911 after EpiPen (even if two shots)
New epinephrine agents
Voice Assissted
Is an anti-histamine required in the anaphylaxis process?
Epi-Pen is KEY
ANti-hist is unecessary
Do not give anti-histamine prophylatically - unsure what the allergen is
What used to be sued histrocially for anphlaxis in the uSA?
Ana-kit
Epinephrine
Chlorpheniramine
Anti-hsitamine Indication and Anaphylaxis recommendation
Anti-histamines are intended for mild or early allergic sx such as hives –> Go with cetirizine
No necessary for anaphylaxis
If no epi-pen present, take anti-histamine if new allergic reaction
Anphylaxis - Epi-pen every time
What is the charcteristic symptom of LYme’s Disease?
Bull’s Eye RAsh develops at the site of tick bite
- 70-80% of individuals
Rsik of Lyme’s disease in SK
Low but not zero
96% - american dog tick - Not capable of transmitting Lymes DX
Rocky Mountain and WInter tick(moose tick) also in SK
Black-legged ticks are the ones that can carry Lyme’s disease; however, not all of them carruy the bacetria responsible for lymes dx
Lyme Disease Prevention - Nova Scotia
Have a tick - pharamcist can assess need for tx to help prevent Lyme’s Dx
- Dtermine whether a prevtative antibiotic is necessary
How can frost bite be managed initially?
Get out of cold and seek tx ASAP
If unable to get out of the cold, do not try rewraming the area if its in danger of re-freezing
Freeze-thaw-freeze cycle causes more damage
Leave alone if cant get to care or warmth
Tx of Frost-Bite
Rewram the area by submerging it into warm water
Submerge for 30 mins
Water should feel very warm
Do not re-warm the area for less than 15-30 minutes
As the area unthaws, you may experience severe pain (pain signals kick in). However continue to important to continue rewarming
If stop rewarming too early, could cause further damage
Describe some recommendations of the rewarming process for frost bite
Thawing takes 20-40 minutes for superfifical frost bite and as long as 1 hour for deep injuries
Encourage gentle moving of the frostbitten area during re-warming
What should be avoided in re-warming of frost-bite?
Massaging the area by hand or with ice are detrimental to viable tissue and should be avoided
Direct dry heat (a fire or heater) can lead to burns and hsould be avoided
Common Mistake in rewarming of frostbite
A common mistake during rewraming is too stop to soon
Pt’s will start to complain of re-perfusion pain
Risk of frost bite injuries
Forstbite injuries that result in blisters are prone to tetanus and thus tetanus prohylaxis is indicated
Can a sprain and a broken ankle be easily distingiuisable?
Often hard tpo tell the difference
Describe the difference in signs between an ankle fracture and an ankle sprain
Unable to [put weight in it is likely both
What is the new acronym for injury management?
No longer RICE
Moevemnt towards MHCE
Movement, Heat, Compression, Elevation
(DO NOT ICE)
Why is there a ovement away from RICE?
MICE Now
Rest replaced with movement
Once a fracture or catastrophic injury is excluded, movement is best and not rest
Immediate but gentle restoration of acttive range of motion
Remodelling is better with light movement
Ice is also wrong and delays healing as it inhibits the inflammatory response needed to intitate healing
Are anti-inflammatory medications useful in ankle sprains?
NSAIDs > Acet for joints and nati-inflamm
Ibu –> 400 mg –> Cieling of pain
600 mg required for anti-inflamm
Topical diclofenca has been comsistently demonstrated to be an effective agent
Improve pain; but want inflammation to help remodel the joint
Describe the differences in tennis elbow and golders elbow? Where is the pain?
Tennis –> Back Hand
Describe the treatment of tennis/golfers elbow?
Brace Band
- 2 fingers ahead of the elbow (forarm)
- Moves the pressure to help with relief
- Counterforce brace compressees muscles to prevent pulling on pain location
Can alternatively use volatren
- inflammation is not being useful here (such as seen in an ankle sprain)
Which knee brace should be choosen and why?
OPEN PATELLA - Daily SUe
Check for fit and comfort
Less pressure on the patella than closed (compresses patella agaist thigh bone)
Knit material in patella spot is still considered open
Cutout behind the knee can help prevent sleeve from bunching
What is CArpal Tunnel?
Tingling and numbness in the fingers
Decraesed grip strength
Nerve compression in the hand so try to decraese the pressure
Tx of CArpal Tunnel. Use, duration, and fit?
Wrist Splints
- Keep the wrist neutral
Can use 24/7 or just HS (more common)
6-8 weeks of use is common
Fit the device for comfort
Ice pack/NSAIDs are tried too
MD assess after 6 months
What is kep for wrist guards for carpal tunnel?
Need the metal bar to keep the hand in the correct position
Are pre-made first aid kits useful?
No - MAke your own
What to do if someone has a seizure?
Protect their head and protect them from hurting themselves
Do not put a spoon in mouth or pull the tongue
Choking management
In a road accident, should you move the person?
Do not pull a road accident victim from the cat or help them move into a more comfortable position
neck and spine injuries –> Slightest movement may kill them or render them paralyzed
Tourniquet and first aid
An incorrect tourniquet can stop blood flow and lead to necrosis
Applyiong pressure with gauze or clothe to the ount and pressing tightly should be enough until ambulance arrives
Should you drive someone to the hospital?
Call an ambulance if multiple hospitals - operator will tell you where to go
Still likely to drive in a small town
