Int: MED Semester 1 Final

First Aid

the immediate, temporary care given to an ill or injured person until professional medical care can be provided

Responsive

Someone who speaks, moves, or reacts to a task

Unresponsive

Someone who does not speak, move, or react to a task

What does an AED do?

checks the heart rhythm and can send an electric shock to the heart to try to restore a normal rhythm

Class A kit

Suitable for small households or minor scrapes

Class B kit

Set in larger places at higher risk

Tips for calling 911

- call and do NOT hang up until the dispatcher says it is okay
- be AWARE of your surroundings

Tips for scene assesses

- only move someone if there is DANGER, such as a road
- call EMS if not sure what to do
- Call anyways if there is a seizure, shock, or patient is unresponsive

Removing gloves

EZ

Tips for Universal Precautions

- treat all BODY FLUIDS as infectious
- Remember PPE like gloves or a mask if needed
- keep a first aid kit restocked with items
- remove gloves properly, wash hands, rinse eyes/mouth, and report to healthcare provider if there is exposure

Finding the problem

1) Check that the scene is safe and look for signs of a cause of the problem.
2) Tap the victim and shout, "Are you okay?" to check response. If the victim responds and is awake, say you are there to help, ask for consent, and ask what the problem is. If the victim only moves, groans, or doesn't respond, phone or send someone to phone emergency response number and get first aid kid. If victim doesn't respond, also get AED.
3) If victim only move, groans, or doesn't respond, use headtilt/chin lift to open airway.
4) Check if victim is breathing.
5) Look for obvious signs of injury.
6) Look for medical information jewelry.

Asthma symptoms

-Resonant to percussion
-Cough
-Chest tightness
-Wheezing
- noisy breathing

How to use an inhaler

Take off cap and shake. Then breathe out all the way.
As you breathe in slowly press down on the inhaler one time, keep breathing in slowly and as deeply as you can. Hold your breath and count to 10. For quick-relief meds wait 15-30 seconds between puffs; no need to wait for other meds. Rinse mouth and spit after steroid inhalation

Steps to treat an allergic reaction

If there is choking, encourage coughing because there IS AIR FLOW
- Signs include stuffy nose, itching, rash, sneezing (mild)
- For SEVERE reactions, they can cause SHOCK

when to use an epinephrin pen

in severe cases such as:
1) skin symptom/swollen lips + trouble breathing/shock
2) suspected exposure + 2 signs of symptoms
3) known exposure + any signs/shock

Heart Attack symptoms

chest pain, chest heaviness, pale skin, weak pulse, nausea, vomiting, pain radiating to left arm, indigestion, short of breath, cold sweating.

What is cardiac arrest

When the heart stops effectively pumping blood - VERY SEVERE!!!

How to treat a heart attack

Give 1 or 2 doses of ASPIRIN, then always call EMS

Fainting

partial or complete loss of consciousness caused by a temporary reduction in the supply of blood to the brain
- put their head between their knees
- have a person cross one leg over another if they lie down.
- Call EMS is they are unresponsive

Diabetes

A condition in which the body is unable to produce enough insulin, the hormone required for the metabolism of sugar

How to treat diabetes

If someone CAN, sit up, give them SUGAR. If someone CAN'T sit up, do NOT give them any food or drink

Stroke

Damage to the brain from interruption of its blood supply

How to recognize a stroke

FAST (face, arms, speech, time)
- f (face drooping)
- a (Arm weakness)
- s (speech difficulty)
- t (time to call 911)

Steps to treat a seizure

Call EMS

Signs of seizure

-Sudden falling
-Unresponsiveness
-Rigid body and back arching
-Jerky muscle movements

External bleeding

when blood drains to the outside of the body through a break in the skin
- Phone 911 if there are signs of shock, head or neck injury, or you're not sure what to do

Dressing vs Bandage

Dressing - covering applied directly to
wounds.
Bandages - coverings that hold dressings
in place; they do NOT touch the wound

What to do if the bleeding is NON LIFE THREATENING

Apply DIRECT pressure to the wound - If bleeding continues press harder

What is used for severe bleeding in limbs?

tourniquet

Shock

A condition in which the circulatory system fails to provide sufficient circulation to enable every body part to perform its function; also called hypoperfusion

Signs of shock

Decreased blood pressure; rapid, weak pulse; mottled to gray skin color; changes in mental status, dizziness, faint feeling

What causes shock?

inadequate circulation, heart attack, or SEVERE allergic reaction

Amputation

An injury in which part of the body is completely severed
- put in a sealed bag then in an cold water container

Epitaxis

bleeding from the nose
- lead FORWARD not backwards

Bleeding from the mouth

STEP 1 make sure that the scene is safe get the first aid kit. wear PPE
STEP 2 If you can easily reach the bleeding apply pressure to the area with dressings
STEP 3 Phone or ask someone to phone your emergency response number or (911) if
1. you cant stop the bleeding or...
2. the person has trouble breathing

Tooth Injuries

STEP 1 make sure the scene is safe get the first aid kit Wear PPE
STEP 2 Check the mouth for any missing teeth loose teeth or parts of teeth
STEP 3 clean the wound with saline or clean water
STEP 4 if a tooth is loose have the person bite down on a piece of gauze to keep the tooth in place and call a dentist
STEP 5 if a tooth is chipped gently clean the injured area and call a dentist
STEP 6 Apply pressure with qauze to stop any bleeding at the empty tooth socket
STEP 7 if a tooth has come out put the tooth in a cup of milk or clean water and immediately take the injured person and tooth to a dentist or emergency department
STEP 8 tell the person to talk with a dentist if a tooth changes color after an injury

Eye Injuries

Make sure the scene is safe, get the first aid kit and wear personal protective equipment, call 911 if the eye is hit hard or punctured, have the person keep both eyes closed. Use running water to wash out irritants such as sand. Call 911 if the object cannot be removed or complains of extreme pain. Have the person keep both eyes shut until EMS arrives.

Internal Bleeding

Bleeding inside the body when a blood vessel tears

Signs of internal bleeding

discoloration, tenderness, swollen, hard tissues, anxiety, restlessness, rapid breathing, cool, moist, pale skin, nausea, vomiting, excessive thirst, declining level of consciousness. They could have fallen from a height or gotten into a crash of some sort

concussion treatment

Mental and physical rest, often under home or hospital observation to watch for development of more serious neurological problems

Signs of Concussion

Appears dazed or confused.
Acts confused about assignments.
Forgets plays.
Is unsure of game, score, or opponent.
Moves clumsily.
Answers questions slowly.
Shows behavior or personality changes.
Can't recall events prior to hit.
Can't recall events after hit.

Head, neck, or back injury

NEVER move an injured person unless there is an aspect of danger

Signs of head, neck, or back injury

- strong head blows
- Diving injuries
- Involved in a car crash

Broken Bones signs

a deformed limb
- Put a towel on the injured part, then an ice bag for 20 minutes

Splinting

use of a rigid device to immobilize or restrain a broken bone or injured body part; provides less support than a cast, but can be adjusted more easily to accommodate swelling from an injury

Burns

injury to tissues caused by heat contact or chemicals

How to treat small burns

cool the area with cool, but NOT ICE COLD water and keep running it if it doesn't hurt, cover with a dressing, and follow healthcare provider's instructions

Electrical Injuries

Make sure the scene is safe, get the first aid kit and AED and wear personal protective equipment, call 911, do not enter the area until the power has been turned off, when it is safe to touch the victim see if he needs CPR.

Bites/Stings

Clean wound with plenty of soap and water
Place ice pack wrapped in tail on area
If skin is broken call healthcare provider
If bitten by snake, DO NOT lance bite marks or attempt to suck poison out.

What do do for venomous snake bites

CALL EMS

Heat Emergencies

Heat cramps, heat exhaustion, and heat stroke.
- Signs and symptoms:
*Muscle cramps (common in legs and abdomen), *Dizziness, *Nausea/vomiting, *Fatigue, *Severe headache, *Extreme thirst, *Hot skin (either wet or dry), *Rapid pulse, *Mental confusion (including unconsciousness), *Seizure
- Care:
* Have guest stop strenuous activity and rest in a cool location.
* Remove any heavy or restricting clothing
* Provide cool water or sports drink (about half a glass every 15 minutes) if guest is alert and not nauseous
* Gently stretch affected muscles if heat cramps are suspected.
* Apply cool, wet towels or sheets.
* Put ice packs at armpits, groin, or sides of the neck if guest has a decreased level of consciousness.
* If condition does not improve quickly, activate EAP.

Cold Emergencies

Hypothermia.
- Signs:
*Uncontrollable shivering, *Confusion, *Sluggishness, *Cold skin
- Care:
1. Move guest out of the cold and make guest comfortable
2. Replace any wet clothing with dry clothing, covering guest's head, and insulating guest with towels or blankets.
3. Provide warm, sugary beverages if guest is alert and able to swallow
4. Seek medical attention if condition is severe.

Poison Emergencies

Give the antidotes the dispatcher says. If you know the name of the poison, tell them. If not, then describe it as best as possible. Remove all jewelry from the person and call help no matter what
- For eye poisoning, lower that eye so it does not rinse anything into the other eye
- A dispatcher may ask you:
- name of poise, patient, or you
- How much poison was injested
- How old is the person
- How much do they weigh
- Time of poisoning

Poison control number

1-800-222-1222

List the 6 functions of the integumentary system

- Protection from pathogens
- Excretion of sweat and Oil
- Maintenance of body temperature
- Synthesis of Vitamin D
- Storage of Nutrients
- Detection of touch, pressure, pain, and temperature

Skin is the largest \______ in the body.

Organ

State the order of epidermis layers from superficial to deep

- Stratum Corneum
- Stratum Lucidum
- Stratum Granulosum
- Stratum Spinosum
- Stratum Germinativum

State the layer thin epidermis lacks

Stratum lucidum

State the layer of the epidermis in which cells die once they leave

Stratum Granulosum - Keratin and Keratohyalin help resist and prevent movement of water

List the 3 pigments that cause skin coloration

Melanin (brown)
Carotene (yellow)
Hemoglobin (blue)

Describe the dermis layer of the skin

- location of blood vessels, nerve endings, hair follicles, and exocrine glands. Consists of the papillary and reticular layer. Major function is to HOUSE ORGANS

Describe the papillary layer of the dermis

Contains LOOSE CONNECTIVE TISSUE. Dermal papillae are responsible for fingerprints and help bind the dermis and epidermis together

Describe the reticular layer of the dermis

Dense IRREGULAR CONNECTIVE TISSUE. Not technically skin. COLLAGEN and ELASTIN improve mechanical strength of skin. Fibroblasts make connective tissue fibers/cells

Describe the structure of the hypodermis

Loose and irregular areolar tissue, with some adipose tissue in places

Explain the structure and function of sudiferous glands

Consists of Eccrine and Apocrine glands. Sudiferous glands are sweat glands that cover virtually all the skin. Eccrine glands secrete watery sweat to eliminate wastes and maintaining body temperature, and apocrine glands secrete a thick milky substance that creates body odor when broken down by bacteria located in genital areas, armpits, and nipples

State the major function of ceruminous glands

Secreting earwax

Describe the structure and function of sebaceous glands

An exocrine gland that secretes sebum into hair follicles (oily lubricant that repels water and kills bacteria)

Describe hair as an accessory organ

Hair is made of keratin, shafts that project from the skin, roots embedded in the skin, and consist of melanocytes: Vellus, the most common fine pigment that is softer, and Terminal, which is coarse and thicker

Define the hair follicle

A tube-like depression of the epidermis that extends down into the dermis, containing the hair root, nerve endings, and arrector pili muscles (smallest muscle)

Describe the structure and function of nails

Act as protection for the ends of fingers and toes during detection, including a nail root, cuticle, nail body, nail bed, and free edge

List 5 mechanical forces that cause injury

- Compression
- Piercing
- Tension/stretching
- Shearing/friction
- torsion/twisting

State the difference between tension and shearing

With tension, forces move on the same plane, whereas shearing is the forces moving towards each other on DIFFERENT planes

Define abrasion

Scraping of the skin against a rough surface. Increased probability of infection due to exposure of dirt and foreign material

Define a puncture

Direct penetration of skin with a pointed object

Define a laceration

When an object tears tissue, giving the wound appearance a jagged edge

Define an incision

A smooth cut in the skin usually caused by a SHARP OBJECT

Define an avulsion

When skin is torn away from the body, transport in moist gauze in a plastic bag

What is the most common cause of blisters?

Breaking in new shoes

Explain the cause and treatment of blisters

Caused by a SHEARING FORCE that produces a raised area that accumulates fluid. Signs are a hot spot, sharp burning, pain, raised skin with clear fluid. Treatment varies according to the type of blister

List the 3 types of blisters and treatments

- Intact blister - leave intact and clean, may need a small incision to drain fluid, use a doughnut to prevent irritation and monitor for infection
- Open Blister - Keep clean to avoid infection, keep skin in place and apply sterile dressing
- Denuded Blister - Clean and expose area, apply occlusive dressing and antiseptic

State methods to prevent a blister

Use of dust, powder, or lubricant in sock, 2 pairs of socks, doughnut padding, appropriate shoes

Explain the nature of an Ingrown Toenail

- Caused by improper cutting (most common), improper shoe size
- Signs are reddened skin, swollen tissues, pain, puss, and infection
- Treat by iodine or epsom salt soak, sterile cotton, keep clean and dry, add a pad for comfort, educate on nail cutting
- To prevent, cut nail straight across, and wear appropriate shoes

Explain the nature of epistaxis

- caused by a direct blow to the nose or a dried out nasal cavity
- signs are bleeding from the nose and deviated septum
- to treat, lean FORWARD, insert nose plug, apply pressure at the bridge of the nose

Describe NATA Open Wound Management mechanisms

- all wounds must be assumed contaminated
- use universal precautions
- clean all wounds
- avoid touch of the dressing that contacts a wound
- may need a tetanus shot or treatment by a physician
- use antibiotic ointment to prevent infection

Explain a contusion

Also called a bruise, a contusion is caused by a compressive force or direct blow. Signs include discoloration, possible swelling, and tenderness. To treat, use ice and padding to prevent the area from additional blows and to provide comfort. Contusions are difficult to prevent, but make sure to wear protective equipment

Explain a subungual hematoma

This is the pooling of blood under a nail, caused by a compressive force or direct blow. Signs include dark discoloration under a nail and possible swelling. To treat, keep the foot clean and use a pad and ice, and let heal on its own. If painful, drain it, soak in epsom salt, dry well, and apply antibiotic ointment. To prevent, wear steel toed shoes and pay attention

Describe a cautery unit

A machine that uses heat to destroy abnormal tissue

Explain hyperkeratosis of the hands and feet

Also called calluses, it is caused by friction and pressure being applied over bony protuberances. Signs include a thick layer of skin, ocular shape. To treat, use moisturizer, use a callus shaver, use padding, and avoid emery boards. Prevention includes use of cushioning, wearing 2 layers of socks, and use of protective gear or gloves

Explain an auricular hematoma

Also called cauliflower ear, this is caused by repeated blunt trauma from contact sports like wrestling. Signs include discoloration, and a cauliflower like deformity. To treat, ensure properly fitted headgear, and a doctor referral for aspiration to reduce pressure. Prevention is mainly using protective headgear.

Explain impetigo contagiosa

This is caused by A-beta-hemolytic streptococci, a bacteria, and is EXTREMELY contagious. Signs include mild itching and soreness followed by the eruption of small vesicles and pustules that rupture and crust. Can develop in body folds commonly, and can be treated by cleansing and using topical antibacterial agents

Explain folliculitis

The INFLAMMATION of a hair follicle that is caused by infectious or non infectious means, especially warm and moist environments. Signs are redness around a follicle followed by development of a popular or pustule, and development of crust that sloughs with hair. To treat, use moist heat to increase circulation, and topical antibiotics depending on the condition

Explain a furuncle

The INFECTION of a hair follicle that results in pustule formation, generally the result of a staph infection. Signs are a pustule that becomes red and enlarged as well as hard from internal pressure. Pain and tenderness increase with pressure. To treat, protect it from further infection, keep an athlete out of contact of others, and refer to physician for antibiotics.

Explain a carbuncle

A bigger and deeper infection with multiple openings. Signs include pustule formation, production of a fever and elevated white blood cell count, discharges yellow pus. Treatment involves surgical drainage with antibiotics, and a warm compress to promote circulation

Describe fungal infections

- A group of organisms form these including yeast and molds
- grow best in moisture, warmth, and DARKNESS
- DERMATOPHYTES are the cause of most skin, nail, and hair infections
- Proper hygiene is the number one prevention

Explain tinea capitis

Also called ringworm of the scalp, this includes having a small popular that spreads peripherally, and appears as small gray scales. It is scattered with balding and can be easily spread. To treat, use topical agents and systemic anti fungal agents

Viral infections are \__________

PERMANENT

Explain tinea corporis

The common ringworm fungus, commonly on extremities, containing itchy red and brown scaling plaques that expand. Treatment includes topical anti fungal cream and hygiene

Explain tinea unguium

Also called tinea of the nail, this is shown through a thick nail that is brittle and separated from its bed. It is common among those who participate in water sports. To treat, use topical anti fungal agents, systemic medications, or in serious cases, surgical removal.

Explain tinea cruris

Shown through mild to moderate itching, a symmetric red and brown scaling plaque with a snake like border. Treatment includes possible referral to a physician, and additional topical medications and oral prescriptions. Avoid wearing synthetic or tight clothing

Explain Tinea Pedis

Also called athletes foot, this is caused by a superficial fungal infection, where the webs of toes may become infected by yeast and dermatophytes. Signs include extreme itching, a scaling patch or inflammatory scaling red papules. This may develop secondary infection. To treat, use anti fungal agents and practice good foot hygiene - allow for breathing