Emergency Management

MS HASSEN ZABALA, RN, MAN

SEPT 2, 2013

EMERGENCY MANAGEMENT
HEMORRHAGE
HEAD/CHEST/ABDOMINAL TRAUMA
POISONING & OVERDOSE
SPINAL CORD INJURY

HEMORRHAGE

MANAGEMENT
Wash hands well before administering to
patient
Wear synthetic gloves
Make the victim lie down
Slightly elevate the legs
If possible keep the affected area
elevated

 Remove any obvious debris/particle

Apply direct pressure using clean
cloth/bandage
Use hand if cloth is not available
Apply pressure continuously for at least
20 minutes
Do not remove the cloth to check the
bleeding

 Hold the bandage in place

using an adhesive tape
If bleeding seeps through
bandage, do not remove it
Add extra bandage on top
of the first one
Apply direct pressure on
the artery if necessary

 Squeeze the artery keeping finger flat

Continue applying pressure on the
wound
Once bleeding stops immobilize the
affected part
See a doctor

SIGNS OF INTERNAL BLEEDING

Bleeding from body cavities

Vomiting or coughing up blood
Bruising on neck, chest, abdomen or side
Wounds penetrating skull, chest or abdomen
Abdominal tenderness, possibly accompanied
by spasm of abdominal muscles
Fractures
Shock, indicated by weakness, anxiety, thirst
or skin that's cool to the touch

PLEASE AVOID.
Do not try to replace a displaced
organ
Just cover the wound with a clean
cloth
Do not try to remove an embedded
object

HEAD/CHEST/ABDOMINAL
TRAUMA

HEAD TRAUMA

SIGNS & SYMPTOMS

Loss of consciousness - for short/long duration

Bleeding
Vomiting, Fluid discharge from nose
Loss of hearing, vision, taste, smell
Speech-related problems
Irregular heart beat
Seizures, Paralysis, Coma
Change in personality, Mental health-related
problems

MANAGEMENT - MILD
Apply ice to injured area
The size of the bump is not related
to the severity of injury

Observe carefully for signs of

bleeding

MANAGEMENT MODERATE TO
SEVERE

Check the patient's breathing pattern

If necessary do CPR
If bleeding, press area with a clean cloth
If vomiting, turn on side and lower the head
To minimize spine injury - hold head, neck and
body in one line; Immobilize the patient
If unconscious, treat it like a spinal injury
Keep the head in alignment with spine

PLEASE AVOID
X shaking/moving one w/ head injuries
X washing wound/removing debris
Do not remove helmet in case of head
injury
Do not consume alcohol immediately
after a head injury
Do not pick up a fallen child with head
injury

CHEST TRAUMA

MANAGEMENT
1. Begin CPR, if Necessary
2. Cover an Open Wound
Use a cloth, pad, or whatever is at hand.
If possible, cover 2 inches beyond the edge of the wound.
If blood bubbles up from the wound, tape cover down on
three sides to prevent air from building up in the chest.
Do not remove any objects that have penetrated the chest.

3. Stop Bleeding, if Necessary

4. Position Person to Make Breathing Easier
If possible, place person on the injured side or sitting up.

5. Monitor Breathing

ABDOMINAL TRAUMA

SIGNS & SYMPTOMS - TRAUMA

Pain in the stomach

Feeling sick in the stomach
Nausea or vomiting
Pale cold skin
Evidence of bleeding or obvious
injury.

SIGNS & SYMPTOMS NON-TRAUMA

RL abdominal pain, evidence of mild fever
appendix;
RU abdominal pain gallstones;
Referred back pain kidneys;
Severe tearing mid/U abdominal pain - artery
tear;
Severe R/L L abdominal pain in a female
casualty - possible ectopic pregnancy;
Red flushed skin if infection present.

MANAGEMENT
Control bleeding using direct pressure or
bandages.
Consider internal bleeding - pale, cold,
clammy skin.
If in shock, lay them down and keep still
and warm.
Flex knees, which may help reduce pain.
Do not allow VICTIM to eat or drink.

 Assist VICTIM into a comfortable

position.
If stomach contents are visible, cover
with plastic wrap, a non-stick dressing or
a wet dressing.
If an object is embedded in abdomen,
pad around the object. Leave object in
place.

POISONING & OVERDOSE

SIGNS & SYMPTOMS

Abdominal pain
Bluish lips
Chest pain, Heart
palpitations
Confusion
Cough, DOB
Diarrhea
Dizziness, Double vision
Drowsiness
Fever
Headache

Irritability
Loss of appetite
Loss of bladder control
Muscle twitching
n/v
Numbness or tingling
Seizures
Skin rash or burns
Stupor, Unconsciousness
Unusual breath odor
Weakness

MANAGEMENT - ORAL

Check and monitor ABC. If necessary, do CPR.

If possible, identify the poison.
Do NOT make a person throw up unless told to do.
If the person vomits, clear airway.
With convulsions, give convulsion first aid.
The person should be rolled onto the left side, and
remain there while getting or waiting for medical
help.
If the poison has spilled on the person's clothes,
remove the clothing and flush the skin with water.

MANAGEMENT - INHALATION
Call for emergency help.
If it is safe to do so, rescue. Open windows & doors.
Take several deep breaths of fresh air, and then hold
breath. Hold a wet cloth over nose and mouth.
Do not light a match or use a lighter.
After rescue, check & monitor ABC. If reqd, do CPR.
If necessary, perform first aid for eye injuries or
convulsions.
If the person vomits, clear the person's airway.
Even if perfectly fine, get medical help.

PLEASE AVOID
Do NOT give an unconscious person anything
by mouth.
Do NOT induce vomiting unless you are told to
do so.
Do NOT try to neutralize the poison with
lemon juice or vinegar, or any other
substance, unless you are told to do so.
Do NOT use any "cure-all" type antidote.
Do NOT wait for symptoms to develop if you
suspect that someone has been poisoned.

SYMPTOMS

N/V
Abdominal cramps, Diarrhoea
Dizziness, Loss of balance
Seizures (fitting)
Drowsiness, Confusion
Breathing difficulties
Internal bleeding
Hallucination, Visual disturbances
Coma

MANAGEMENT

Contact ambulance/help.
If unconscious, check v/s. If needed, begin CPR.
Check the airways and clear out (remove any pills, vomit, etc)
Once stable, place in recovery position (lying on their side)
and wait for help.
Ask what happened & keep them as alert as possible.
DO NOT try to induce vomiting unless instructed to do so.
DO NOT give the person anything to eat or drink unless
instructed
DO NOT leave the person alone
Try to figure out the time when the drug was taken and what
quantity was taken.

SPINAL CORD INJURY

Classification

Description

Complete: no motor or sensory function is preserved below

the level of injury, including the sacral segments S4-S5

Incomplete: sensory, but not motor, function is preserved

below the neurologic level and some sensation in the sacral
segments S4-S5

Incomplete: motor function is preserved below the

neurologic level, however, more than half of key muscles
below the neurologic level have a muscle grade less than 3
(i.e., not strong enough to move against gravity)

Incomplete: motor function is preserved below the

neurologic level, and at least half of key muscles below the
neurologic level have a muscle grade of 3 or more (i.e., joints
can be moved against gravity)

Normal: motor and sensory functions are normal

SIGNS & SYMPTOMS

CERVICAL
Breathing probs, arms, legs & torso

THORACIC
BP probs, abN sweating, trouble
maintaining N temp.

LUMBO-SACRAL
Bladder & bowel control, lower extremities

MANAGEMENT

Methylprednisolone
Rigid brace/ axial traction
Breathing mgt
Immobilization
Shock tx

MANAGEMENT
Victim reports severe pain in
neck or back.
Victim cannot or will not move
neck.
Victim has fallen on, or has
suffered trauma to the back,
neck or head.
Head trauma with ongoing
effects on consciousness.
Loss of bladder or bowel
control.
Paralysis, weakness, or
numbness of limbs.
Neck or back is at an unnatural
angle.

 Do not move the victim

unless he is in
immediate danger of
further injury or you
need to open an airway
for them to breathe.

 Stabilize the victim to

prevent any movement
of the head, neck, or
body.

Do first aid without

moving the victim's
head or neck.

If the victim must be moved.

Pull them by their clothing. Grab a shirt collar and use your
forearms to support their head while pulling the body in a
straight line. This is a preferred method as the victim's head
is braced while moving.
Pull the victim with their feet or shoulders. Use both feet,
both shoulders, or both arms pulled over the shoulders.
Keep the neck and torso of the body as straight as
possible, and pull the victim in a straight line. Do not pull
the body sideways!
Use at least two people if you must roll a victim over. If
you must roll a spinal injury victim over to prevent choking
on blood or vomit or other harm, use two people. Roll the
victim over in such a way that the neck, back, and torso
move as one unit. Do not allow the body to twist.