Lesson 1 of Injury Managment Flashcards
What does ESM stand for?
Emergency Scene Management
What are the 4 steps of ESM
Scene Survey (8 steps)
Primary Survey
Secondary Survey
Ongoing Casualty Care
What do you for Scene survey in order (8 steps)?
- Take charge (Person in Charge) Get to the scene
- Call out for help to attract bystanders (asking public for assistance)
- Asses Hazards and make sure the area is safe (traffic cones, blockades, make sure scene is safe from traffic)
- History of emergency (casualties, vehicles, passengers) How the accident occurred
- Identify yourself as a first aider and offer to help (tend to most severe casualty first)
___________________________________ - Asses responsiveness/level of consciousness (Can u hear me, ( if no vocal response) squeeze my hand)
- Assume neck injury (Brace cervical spine before treatment)
- Activate EAP: send call person to contact EMS and have them report back to you
How do you asses consciousness (list 6 ways) and what step of scene survey was that?
Step 6 and if they respond to you by opening eyes and speaking they’re conscious; if not tap shoulders and say open your eyes; if unresponsive call 911 immediately
- Alert or Oriented
- Confused or disoriented
- responds appropriately to verbal commands
- responds to touch/ gentle hand squeeze
- Obtunded? (Mumbling or moving without purpose)
- Unconscious/unresponsive?
What are the 5 ways to assume neck injury?
- If the patient has lost conscious at any point or is, then assume head/neck injury
- Complaint of neck pain = assume neck injury
- do not move their head/neck
- Stabilize the neck in the position found unless (unconscious, not breathing and airway is blocked)
- Ensure elbows are firmly supported on thighs or ground while holding patients neck
What are 10 things a bystander can do?
- Make the area safe
- Find all the people involved
- Find a first aid kit
- Control the crowd
- Call for medical help
- Help give first aid (Under Control person’s order)
- Gather and protect patients belongings
- Take notes
- Reassure patients relatives
- Lead paramedics to scene of emergency
What do you do in Primary Survey?
ABC’S
A- Airway - Ask and if unresponsive; head tilt
B- Breathing -
Unconscious: 5-10 seconds look, listen feel
do CPR if no breath detected
Conscious: Ask
C- Circulation
Assess skin condition & temp (check for shock)
Control major bleeding
Do rapid body survey for internal bleeding
How do you check airway (4)?
Is mouth open or obstructed?
Finger sweep thru mouth to clear obstructions suspected
Abdominal thrusts to loosen an obstruction if completely blocked
Refer to standard First Aid and CPR guidelines
How do you check breathing?
Look, Listen, Feel
Listen for sounds escaping nose/mouth
Feel by cheek for air coming out
What do you do if someone if not breathing but airway is clear?
Begin rescue breathing by CPR regulations
2 rescue breaths, 30 chest compressions repeat
How do you check circulation (6)?
- Check pulse - radial or carotid
- Do CPR if no pulse
- Control bleeding with firm pressure, Keep area still
- Blue/grey/ discolored limb or extremities? Can indicate lack of circulation to that area and can lead to shock
- Feel temp and condition of patients cheek/forehead with back of hand
- Be aware of signs of shock
Why is shock life threatening?
because the brain and organs are not receiving enough oxygenated blood and cannot function properly.
What are 6 signs of shock?
- Pale skin (grey-blue)
- Blue purple lips, ears, tongue, fingernails
- Cold Clammy skin
- Breathing shallow or unregular/uneven; gasping for air
- Changes in level on consciousness
- Weak rapid pulse/ no pulse
What are 7 symptoms of shock?
Restless Anxious Disorientated Confused Afraid Dizzy Thirsty
What are the 7 steps to do to give first aid for shock?
- Give first aid to injuries that caused the shock
- Reassure the casualty often
- Minimize pain by handling them gently
- Loosen tight clothing at neck, chest and waist
- Keep them warm
- Moisten lips
- Place them in best position for their condition
What are the best positions for each situation?
No head/spinal injury and full conscious: On back, don’t overheat
No head/spinal injury and somewhat conscious: Place in recovery position
Head/spinal injury: Do not move them and monitor ABC’s
What are the 4 steps to doing the recovery position?
- Put arm closes to you above casualties head
- Fold arm furthest from you onto casualties chest, tuck hand under cheek
- Bend knee furthest from you upwards and place foot on floor
- Gently and slowly roll the casualty towards you, keeping their
top hand underneath their cheek and securing casualties top leg onto the floor
If casualty’s condition is under control, follow with secondary survey and what is that?
The three steps are (HIT)
- History
- Inspection
- Touch
How do you check history?
SAMPLE S- Symptoms: Pain (PQRST), numbness, tingling, blurred vision, headache, memory loss, difficulty breathing stuff) A - Allergies M - Medications P - Past or Present Medical History L - Last meal eaten E - Events leading to incident
How do you asses pain?
PQRST
P- Provoked; what’s the factor
Q-Quality: Describe pain/discomfort, characteristics
R - Radiate: Where is the pain, does it radiate
S- Severity; rate pain 1-10
T- Time; how long have they had it, what makes it better or worse
What do you do to inspect the patient?
Visual check to determine type of injury
- Bleeding - arterial is life threatening
- Skin Changes - bruising, cuts, abrasions
- Deformity - Abnormal bulging, comparing etc
- Swelling - compare to uninjured limb/joint
How do you figure out the pain by touch?
Start away from injured site or gentle touch
What do you check for in the “T” part of secondary Survey
- Point Tenderness
- Skin Changes - “Dough” skin, temp (warm-inflammation, cool - lack of circulation)
- ROM - Don’t if fracture suspected
- Crepitus - Air under skin/bones & feeling of crunching/grinding
- Pulse
What happens in step 4 of ESM?
- Hand over control to another bystander
- Stand by for medical help
- Transport casualty yourself
