First Aid for Accidents and Injuries - Vocabulary Flashcards
Overview
Purpose: Provide essential first aid knowledge for accidents and injuries.
Learn to respond quickly and calmly to incidents.
Determine whether simple first aid is sufficient or if professional medical help is required.
Outcomes:
Facilitate a quick and efficient response.
Avoid overreaction in emergency situations.
Accurately determine if an incident can be managed with basic first aid or necessitates a healthcare provider/EMS.
Approach:
Offer initial care based on the injury.
Obtain additional professional help as needed (e.g., call 911 or transport to a doctor, depending on severity).
Screening/Triage by Phone: Revisit concepts from Chapter 53; gather critical information over the phone to assess the emergency status.
Emergency information gathering (phone triage)
Key questions for phone triage to determine the necessary level of care (emergency, office visit, or home management):
Ask for a brief history of the victim’s situation.
Clarify the nature of the injury or accident (e.g., mechanism of injury).
Determine when the accident occurred or when the illness began.
Assess the current condition and how the victim is doing now, noting any changes.
Foreign bodies in the body
Definition: Substances or objects lodged in any part of the human body.
Common foreign bodies: Metal shavings, dirt, eyelashes in the eye; small items children often place in their mouth, nose, or ears; splinters; fishhooks in the skin.
Eye foreign body
Surface debris removal:
Carefully remove surface debris with a folded tissue or a moistened cotton swab.
Techniques for eyelid manipulation:
Pull the upper lid down over the lower lid to encourage tearing and dislodgement.
Gently grasp the eyelid and pull it over a cotton-tipped applicator.
Use top-to-bottom motions with a moistened swab to help remove the object.
If embedded in the cornea:
Seek provider immediately; this requires professional medical attention.
Stabilization: The object should be stabilized with a sterile compress.
Coverage: Cover both eyes to prevent unintended movement, as eyes move together.
If object protrudes:
Cover with a rigid barrier: Use a plastic or styrofoam cup over the eye to prevent deeper penetration or further injury.
Crucial Caution: Do not rub the eye—rubbing can embed a surface object deeper into the cornea.
Chemicals in the eye:
Immediate irrigation: Flush the eye immediately and continuously with a sterile eye irrigation solution to dilute and neutralize the chemical.
Flushing duration: Irrigate for at least 20 ext{ minutes}. Many offices have prepackaged sterile solutions available for emergencies.
Alternative solutions: If sterile solution isn’t available, use clean tap water or bottled water.
Post-flushing evaluation: A healthcare provider should evaluate the eye as soon as possible after flushing, even if symptoms improve, to check for corneal damage.
Ear foreign body
Visible and non-embedded objects: If the object is visible and not embedded, use warmed mineral oil or baby oil to encourage the object to float out.
Objects that swell:
If the object is hydrophilic and swells (e.g., peas, beads), avoid putting any liquid/water into the ear canal, as this can worsen the swelling and complicate removal.
Never attempt to dig to remove the object yourself.
Professional removal: Seek professional medical removal for swelling objects.
Drainage assistance: Tilt the head toward the unaffected side to help facilitate natural drainage.
Crucial Caution: Do not attempt to dig out the object with tweezers or other instruments, as this can push it deeper or damage the eardrum.
Professional care: If the object is not easily removable, seek a provider’s assistance.
Nose foreign body (often seen in kids)
Water irrigation: Water irrigation is generally not recommended in some cases because hydrophilic objects (like peas or beads) can swell, worsening the obstruction and complicating professional removal.
Removal attempts: Avoid aggressive attempts to flush or remove the object.
Professional removal: Seek professional medical removal if the object is not easily expelled or if swelling occurs.
Splinters
Initial cleaning: Wash the skin with soap and water around the splinter.
Removal: Use a sterile needle and splinter forceps to remove the splinter carefully.
Post-removal care: After removal, wash the area again, apply antibiotic ointment, and cover with a bandage.
Protruding fish hooks (embedded)
Removal procedure: In-office procedures may be required, often using local anesthetic, especially for larger hooks.
Post-removal care: Clean the area with antimicrobial soap/solution, apply antibiotic ointment, and cover with a dry dressing.
Tetanus consideration: Assess the need for a tetanus booster if the patient is not up to date within the last 5 ext{ years}, especially for puncture wounds.
Strains, sprains, and basic first aid rules
Strain vs. sprain
Strain: Overuse or overstretching of a muscle or tendon.
Example: A pulled hamstring muscle.
Sprain: Tearing of ligaments around a joint.
Example: A twisted ankle leading to ligament damage.
Causes: Both injuries can be caused by improper lifting, moving heavy objects, or slips and falls.
Treat all sprains, strains, and dislocations as if they are a fracture until evaluated by a professional.
First aid approaches: RICE and PRINCE
RICE: An acronym for immediate first aid.
Rest: Immobilize the injured area to prevent further damage.
Ice: Apply ice packs to the affected area to minimize swelling and pain.
Compression: Wrap the area with an ACE bandage to reduce swelling. Ensure it is not too tight to avoid cutting off circulation; periodically check for signs of impaired circulation (e.g., coolness, numbness, pallor).
Elevation: Elevate the injured limb above heart level to reduce swelling.
Goal: The primary goal is to minimize swelling and pain and to stabilize the injury.
Referral: Seek later medical evaluation for proper diagnosis and long-term treatment planning.
PRINCE: An expanded approach incorporating additional measures.
Protection: Protect the injured area from further injury (e.g., with a brace or splint or supportive wrap).
Rest: Immobilize the injured area.
Ice: Apply ice to reduce inflammation. Apply ice to the affected area for the first 48-72 ext{ hours} after the injury, or until swelling significantly reduces.
NSAIDs: Administer Non-Steroidal Anti-Inflammatory Drugs (like ibuprofen) or acetaminophen for pain and swelling management.
Compression: Apply compression using wraps (e.g., ACE bandage). Ensure even pressure and avoid excessive tightness.
Elevation: Elevate the injured limb above heart level.
Dislocations
Definition: When bones move out of alignment from a joint.
Severity: Pain can be severe.
First aid: Primary first aid is immediate immobilization of the dislocated joint until professional medical care can be obtained.
Crucial Caution: Do not attempt to reduce (put back in place) a dislocation yourself, as this can cause further injury.
Fractures
Definition: Breaks in a bone; various types exist (review as needed from prior chapters).
Treatment: Plan to cover in-class practice and practical competencies for fracture management.
Bites and stings
Animal bites
Injury characteristics: Animal bites can tear the skin, cause bruising, and carry a significant risk of infection or rabies.
First aid:
Clean thoroughly: Wash the wound thoroughly with antiseptic soap and water.
Bandage and immobilize: Apply a clean bandage and immobilize the affected area.
Medical care: Seek medical care promptly for evaluation of infection risk and need for rabies prophylaxis/tetanus booster.
Reporting: Animal bites should be reported to local health authorities or police, who will coordinate veterinary checks for rabies risk.
Snake bites
Identification: Look for two distinct fang marks, which indicate a venomous snake bite.
First aid:
Clean area: Gently clean the area to remove any surface venom with antimicrobial soap and water.
Immobilize victim: Keep the victim calm and still to slow venom spread.
Positioning: Elevate the bitten extremity below heart level to minimize venom flow toward the heart.
Actions to avoid:
Do not cut the wound or attempt to suck out venom: This is ineffective and can introduce more infection.
Do not apply ice: Ice can cause tissue damage and does not help with venom.
Do not use a tourniquet: This can concentrate venom in the area, leading to severe tissue damage or amputation.
Human bites
Key risk: High risk of serious infection due to the diverse bacteria in the human mouth. Potential for transmission of bloodborne pathogens like Hepatitis B or HIV.
First aid: Clean thoroughly with soap and water and seek immediate medical evaluation for antibiotic treatment and tetanus/bloodborne pathogen risk assessment.
Stings (bees, wasps, hornets, etc.)
Allergic reactions: Allergic reactions (anaphylaxis) can be severe and life-threatening. Individuals at risk should have immediate access to and know how to use an EpiPen.
Honeybee stinger removal:
Method: Do not grasp the stinger with fingers or tweezers, as this can squeeze the venom sac and inject more venom.
Technique: Use a rigid surface (e.g., a credit card edge or fingernail) to scrape out the stinger.
Stinger remedies: Apply a paste of baking soda and water or an anti-itch cream/gel (e.g., Benadryl) to reduce local discomfort.
Repeated stinging: Note that some insects (wasps, hornets, yellow jackets) do not leave their stingers behind and can sting repeatedly; therefore, no stinger can be removed.
Signs of severe sting reaction (anaphylaxis):
Restlessness, headache, dizziness.
Shortness of breath, wheezing, difficulty breathing.
Mottled or pale skin, hives, swelling of the face, lips, or throat.
Signs of shock (rapid pulse, low blood pressure).
Severe nausea/vomiting, abdominal cramps, diarrhea.
Individuals carrying Epinephrine (EpiPen) should administer it immediately and seek emergency medical care.
Burns: types, assessment, and first aid
Types of burns
Thermal burns: Caused by contact with flames, hot liquids (scalds), hot surfaces, fuels, sun exposure (sunburn), steam, space heaters, curling irons, etc.
Chemical burns: Result from contact with acids or alkalis via ingestion, inhalation, or direct contact with skin/eyes.
Electrical burns: Caused by electrical current from faulty wiring, chewing on cords, or high-voltage exposure. Can cause deep tissue damage not immediately visible on the surface.
Lightning injuries: A rare but severe type of electrical burn.
Rule of Nines (adult) for estimating burn size
Used to estimate the percentage of total body surface area (BSA) affected by burns in adults:
Head: 9 ext{%} (front 4.5 ext{%}, back 4.5 ext{%})
Each arm: 9 ext{%} (front 4.5 ext{%}, back 4.5 ext{%})
Anterior trunk: 18 ext{%}
Posterior trunk: 18 ext{%}
Each leg: 18 ext{%} (front 9 ext{%}, back 9 ext{%})
Genitalia/Perineum: 1 ext{%}
The sum of these areas equals 100 ext{%} for an adult.
London/Browder chart (pediatric considerations)
This specialized chart is used for estimating burn size in children and individuals not at adult maturity, as body proportions (e.g., head size relative to body) differ by age, causing percentages to vary.
Burn depth classifications
First-degree (superficial):
Involvement: Involves only the epidermis (outermost layer of skin).
Appearance: Redness, dry, no blisters.
Pain: Mild-to-moderate pain, tender to touch.
Examples: Typical sunburn, brief exposure to heat.
Second-degree (partial thickness):
Involvement: Involves the epidermis and part of the dermis.
Appearance: Red, moist, often characterized by blisters, significant edema (swelling).
Pain: Mild to moderate pain, very sensitive to touch and air.
Third-degree (full thickness):
Involvement: Extends through the entire epidermis, dermis, and into the subcutaneous tissue, including fat and muscle tissue.
Appearance: Skin may appear white, leathery, charred, or waxy. Thrombosed (clotted) vessels may be visible. No blisters appear.
Pain: Often there is no pain in the immediate burn area due to complete nerve damage.
Fourth-degree (full thickness):
Involvement: Extends through epidermis, dermis, subcutaneous tissue, and possibly into muscle or bone.
Appearance: Charred, black, often involves underlying structures.
Pain: Also typically no pain in the immediate burn area due to severe nerve destruction.
Burn severity categories (adult norms)
Minor burns:
Third-degree area: Less than 2 ext{% of BSA}
Second-degree area: Less than 15 ext{% of BSA}
Moderate burns:
Third-degree area: 2-10 ext{% of BSA}
Second-degree area: 15-25 ext{% of BSA} in adults (over 10 ext{%} in children)
Major burns:
Third-degree area: Greater than 10 ext{% of BSA}
Second-degree area: Greater than 25 ext{% of BSA} in adults (over 20 ext{%} in children)
All burns involving the face, hands, feet, genitalia, perineum, or major joints.
All electrical or chemical burns.
All inhalation injuries.
All burns in patients with pre-existing medical conditions.
Burns complicated by fractures.
First aid by burn depth
First-degree burns: (Superficial)
Cooling: Cool the burn immediately with cold water (not ice) to stop the burning process.
Protection: Dress the burn with a clean, sterile, non-adhesive dressing to protect it.
Blisters: Avoid breaking any small blisters that may form.
Second-degree burns: (Partial thickness)
Shock management: Treat for shock if present (e.g., keep the patient warm and elevate legs).
Remove restrictions: Remove restrictive jewelry or clothing from the affected area before swelling occurs.
Hydration: Ensure adequate fluid intake if the patient is conscious and able to drink.
Dressing: Cover the burn with a sterile dressing. Do not break blisters.
Third/fourth-degree burns: (Full thickness)
Immediate medical attention: Call 911 immediately. These are severe, life-threatening injuries.
Do not undress: Do not remove clothes that are stuck to the burn, as this can cause further injury or contamination.
Cover: Cover the burn loosely with a clean, dry cloth or sterile dressing.
Hospitalization: Patient will likely require hospital care and surgical intervention (e.g., skin grafting), IV fluids, pain medication, and possibly a tetanus antitoxin or toxoid booster if it has been longer than 5 ext{ years} since the last shot.
Special cautions
Photosensitivity drugs (e.g., doxycycline): Advise patients taking these medications to avoid direct sun exposure. Recommend using sunscreen and protective clothing. Pharmacy labels often include these warnings, and patient education is crucial.
Electrical and chemical burns first aid
Electrical burns:
Rescuer safety: Never touch the victim while they are still in contact with the electrical source. Remove the victim from the source only after the power is turned off.
Environmental safety: If in a wet environment, ensure the area is dry to prevent electrical conduction to the rescuer.
CPR: Cardiopulmonary Resuscitation (CPR) may be needed if respiratory or cardiac arrest occurs after the victim is detached from the source.
Assess: Electrical burns can cause severe internal damage not visible externally, requiring thorough medical evaluation.
Chemical burns:
Remove clothes: Immediately remove any clothing from the burn area that has come into contact with the chemical.
Flood with water: Flood the affected skin area with copious amounts of water for at least 15 ext{ minutes}. Continue flushing during transport if possible.
Dry chemical: If the chemical is in a dry powder form, brush it off the skin before flushing with water, as some chemicals (e.g., lime) are activated by water.
Wounds and bleeding: types and first aid
Abrasion
Definition: A superficial skin scrape involving only the epidermis, sometimes extending to the superficial dermis.
First aid:
Clean: Clean the wound with soap and water or an antiseptic solution (e.g., Betadine).
Protection: Apply antiseptic ointment and cover with a dressing.
Avulsion
Definition: A wound where skin or tissue is torn away, often resulting in heavy bleeding.
First aid:
Clean: Gently clean the wound area with soap and water.
Realign: If possible and the tissue is still attached, carefully realign the skin flap to its original position.
Control bleeding: Apply direct pressure to stop bleeding.
Pressure bandage: Use a pressure bandage if bleeding persists or is severe.
Tetanus: Tetanus status should be checked and updated if necessary.
Incision
Definition: A clean-cut wound with smooth edges, typically caused by a sharp object like a knife or glass.
First aid:
Clean: Clean the wound with antiseptic soap and water.
Protection: Apply antibiotic ointment.
Closure: Cover with a sterile dressing. May require sutures or Steri-Strips for closure, especially if deep.
Laceration
Definition: A tearing of body tissue with irregular, jagged edges, which typically bleeds easily and often heavily.
First aid:
Control bleeding: Apply direct pressure to the wound with a clean cloth or sterile dressing.
Elevate: Elevate the injured limb above heart level to help reduce blood flow.
Indirect pressure: If bleeding persists despite direct pressure, apply indirect pressure at the nearest proximal artery (e.g., femoral artery in the groin for leg injuries, brachial artery in the upper arm for arm injuries).
Puncture wound
Definition: A wound caused by a sharp, pointed object (e.g., ice pick, knife, nail, animal bite) that penetrates the skin, often deeper than it appears on the surface.
First aid:
Clean: Clean the area around the wound.
Irrigation (superficial): If the wound is superficial and not actively bleeding severely, it may be possible to slightly enlarge the opening with a probe to facilitate irrigation.
Antiseptic flush: Use an antiseptic solution (e.g., Betadine) to flush the wound.
Severe bleeding/Impaled object: If bleeding is severe or an object is impaled, do not attempt further cleaning or removal of the object (this can reopen bleeding or cause more damage). Prioritize applying a pressure bandage and transporting the victim for professional medical care.
Pressure bandages
Construction: Made from multiple layers of sterile gauze squares or pads, tightly fastened to the skin with medical tape or bound with a roller bandage or ACE bandage.
Purpose: To apply sustained pressure to control severe bleeding and provide support to an injury during transport to medical care.
Tetanus considerations
General rule: A tetanus booster is generally recommended every 10 ext{ years}.
Injury-specific guidance: In the event of certain injuries (especially dirty wounds, deep punctures, or burns), some providers may advise a booster within 5 ext{ years} of the last shot. Always follow provider guidance based on the injury and exposure history.
Bandaging and dressing techniques
Applying dressing: After a professional has treated the wound, it may be your responsibility to apply the dressing.
Bandaging the wound:
Instruct the patient on how to keep the dressing dry and clean.
Advise on when to change the dressing.
Educate on signs of infection to watch for (redness, pain, swelling, pus, fever) and when to seek medical care.
Tube gauze technique (for digits/limbs):
Apply tube gauze over the injury (commonly used for fingers and toes).
Use a splint as needed to secure the injured digit/limb.
Reposition and reapply as indicated; ensure proper padding to prevent pressure sores.
Spiral bandage (for limbs):
Used to secure dressings on cylindrical body parts like arms or legs.
Start wrapping below the injury and overlap in a spiral fashion, moving upwards.
Avoid tightness that cuts off circulation; ensure even pressure.
Cravat (triangular) bandage (versatile):
Used for ears, eyes, head injuries, or as a sling for arm injuries.
For head injuries, fold into a cravat, wrap around the head, with the ends securing behind the neck and bringing back to the front.
Documentation and patient education
Documentation: Accurately document the bandaging process, the type of dressing used, and any patient education provided.
Patient education: Ensure patients receive clear instructions on wound care, dressing changes, specific signs of infection, and when to seek further medical help.
Practical notes and summary for exams
Prioritize life-threatening conditions first and call for professional help when necessary.
Eye and ear injuries require careful stabilization and professional follow-up, especially with signs of corneal involvement, embedded objects, chemical exposure, or suspected eardrum damage.
For burns, thoroughly understand the depth classifications and percentage of body surface area involved to guide appropriate triage and first aid actions. Seek urgent care for all moderate to major burns and immediately for all third/fourth-degree burns.
For bites and stings, accurately identify the type of bite or sting, manage local symptoms effectively, and diligently monitor for systemic allergic reactions (anaphylaxis); be prepared to use an EpiPen where indicated.
When in doubt, err on the side of caution and always seek professional medical care; remember that many injuries necessitate tetanus status checks or antibiotic considerations to prevent infection.
Key numerical references (for quick study)
Eye irrigation duration for chemical exposure: At least 20 ext{ minutes}.
Eye flushing solution fallback: Use sterile solution or clean tap water if sterile water is unavailable.
Burn size categories (adult):
Minor: Third-degree area less than 2 ext{% of BSA}; Second-degree area less than 15 ext{% of BSA}.
Moderate: Third-degree area 2 ext{%} - 10 ext{% of BSA}; Second-degree area 15 ext{%} - 25 ext{% of BSA}.
Major: Third-degree area greater than 10 ext{% of BSA}; Second-degree area greater than 25 ext{% of BSA}. (Note: These percentages vary for children and other factors also define major burns.)
Tetanus booster (general): Every 10 ext{ years}.
Tetanus booster (injury-specific): Every 5 ext{ years} (for dirty