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156 Cards in this Set

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Duty to Act
A legal responsibility of certain people to provide a reasonable standard of care when called upon or presented with the opportunity to do so
Negligence
The failure to perform an action that a reasonable prudent person would do. Your performance will be based on what any other individual with similar education and experience would do under similar circumstances.
In order to establish negligence, the court must decide that:
1. There was a duty to act.
2. There was a breach of duty
3. Damage occurred
4. There was immediate cause – the injury that the patient suffered was caused by your actions or inactions.
Act of Commission
You do wrong from which serious medical complication develops.

i.e. perform some medical treatment not trained or certified to do
Act of Omission
You fail to do something that should have been done.

i.e. Fail to check for safety of different playing areas, check equip., failure to refer victim.
What are the six Vital Signs?
1. Blood Pressure
2. Pulse Rate
3. Respiration Rate
4. Pupils
5. Body Temperature
6. Skin Color
Vitals

Blood Pressure
Measured by a sphygmomanometer (B.P. cuff)

1. Systolic – pressure against walls as heart contracts –usually the “higher” pressure.
-Normal systolic pressure is 120 mm Hg.

2. Diastolic- residual pressure in arterial walls while the heart is between beats.
-Normal diastolic pressure is 80 mm Hg.
*Females usually 8-10 mm/hg lower.
Vitals

Pulse Rate
The wave of pressure in the blood generated by the pumping of the heart in one minute.
Normal-
Adult (60 – 80)(bpm)
Child (70-115)
Infant (80-140)
Vitals

Respiration Rate
One breath is the complete cycle of moving air in (inhalation) and out (exhalation).

Adults = 12-20
Children = 15-25
Infants = 20-40
Vitals

Pupils
Responsiveness to light:
Exposed to light – constrict (get smaller)
Remove light – dilate (get bigger)

*Constricted - drugs/narcotics, heat stroke
*Dilated -shock, heat exhaustion, hemorrhage drugs- cocaine, speed
*Unequal –head injury - stroke
Vitals

Body Temp
Assess skin temperature by placing the back of your
hand against the patient’s skin.

*Hot/dry - heat stroke
*Cool/moist (clammy) - heat exhaustion, shock

Core temp = 98.6 F
97-100 - low grade fever/virus
100-104 - bacterial/later stages viral
Vitals

Skin Color
Assess skin color in the nail beds, oral mucosa (inside the
mouth), and conjunctiva (inside the lower eyelid)

For infants/children, assess the soles of the feet or the palms of the hands.
Vitals

What do the different skin colors mean?
*Red (flushed)- heat stroke or carbon monoxide
*White (Pale) – poor perfusion – lack of effective blood flow reaching tissues.
*Yellow (Jaundiced) – improper liver function
*Blue-Gray (Cyanotic) – lack of oxygen reaching the cells, poor perfusion
Cardiac arrest
heart stops - no blood, no oxygen – No Pulse!!!
Heart attack
blockage in a vessel(s) of the heart – tissue damage occurs.
Angina
heart muscle not receiving proper oxygen – usually goes away with rest and/or nitroglycerin
S/S of a Heart Attack

Nine of them...
1. Things out of the ordinary (Feeling of impending doom) 2. Erratic/irregular pulse - rapid/slow
3. *Chest pain* - like someone standing on the chest
4. Sick to stomach (Nausea/Vomiting)
5. Headache
6. Denial - says its indigestion, panic attack etc.
7. Pain across back, chest, or arms
8. Sudden onset of sweating
9. Difficulty breathing
Care for someone having heart attack
1. Call 811/911
2. Get the person to relax (loosen tight clothing)
3. Talk to the person – calm them
4. Tell them help is coming
5. Cover if cold
6. Check and monitor vital signs
7. OPQRST Questions
8. Aspirin Therapy
What is OPQRST?
0– Onset,
P – Provocation,
Q – Quality,
R – Radiation,
S – Severity,
T - Time
Ventricular Fibrillation
v-fib - quivering heart -cannot move blood

total disorganized electrical activity in heart
Ventricular Tachycardia
v-tac – three or more beats in
a row at a rate of 100 beats or more per minute that
originates in the ventricles - cannot pump blood properly
Asystole
the stopping of all electrical activity in the heart.

1. Not corrected by defibrillation
2. Very unlikely to be resuscitated
Two causes of Stroke are:
Cerebral Infarction

and

Hemorrhage
Cerebral Infarction
Thrombus – blood clot forms in a cerebral vessel

Embolus – (an undissolved mass of material i.e. fat globule, blood clot, etc. breaks loose from another site in the body and lodges in a cerebral artery).
Hemorrhage
Cerebral Hemorrhage – one of the cerebral arteries
ruptures.

Subarachnoid Hemorrhage – one of the brain’s surface
vessels ruptures.
S/S of Stroke

14!
1.Decreased consciousness
2.Severe headache
3.Drooping eyelid and drooping mouth on one side
4.Paralysis or weakness
5.Respiratory distress
6.Slow, bounding pulse
7.Loss of bowel/bladder
8.Change in personality
9.Unequal pupils
10.Loss of vision, dimness
11.Difficulty speaking
12.Inability to speak
13.Nausea or vomiting
14.Possible seizures
Emergency Care for a Stroke Victim
1. Handle victim calmly and carefully
2. Don’t increase anxiety
3. Position victim on back with head and shoulders slightly raised
4. Monitor ABC’s
5. Keep victim warm
6. No food or drink
Transient Ischmemic Attack (TIA)
(MINI STROKES)
*as many as 75% of all thrombus strokes are preceded by one or more TIA(s). Symptoms of a TIA last for less than 24 hours and usually less than 1 hour. TIA’s do not cause nausea or vomiting, and headache is not often present. Most signs and symptoms are similar to those of a stroke.
What are the 3 Types of Blood Vessels?
Arteries = bright red (hard to control

Veins = dark red (easier to control)

Capillaries = not as bright as arteries (clots easily)
How many liters of blood does the human body have?
about 5 liters
AVULSION
a flap of skin that is torn or pulled loose
CUT
incision (smooth edges) / laceration (jagged edges)
SCRAPE
abrasion, road rash, rug burn, strawberry
PUNCTURE
does not usually bleed a lot, therefore easily
infected
S/s – Internal Bruising
1.Tender, swollen, or abdomen rigidity
2.Anxiety or restlessness
3.Rapid weak pulse
4.Rapid breathing
5.Skin is cool / moist, looks pale or bluish
6.Nausea / vomiting
7.Excessive thirst
8.Declining level of consciousness
9.Rest in comfortable position
Treatment of Internal Bruising
1. Get him/her to rest in a comfortable position
2. Minimize shock, keep victim from getting chilled/overheated
3. Reassure and comfort victim
Dressings
Pads placed directly on wound to soak up blood, keep germs out (should be sterile - usually loose to let air in)
If sterile dressing not available - use clean cloth, towel,handkerchief, tie, sock etc.
Bandages
(Band-Aid, triangular band, roller band) – material
used to wrap/cover any part of body, holds dressing in place; apply pressure which helps control bleeding, support injured part of body
Roller Bandage
when used to control bleeding, a bandage is called a pressure/roller bandage
Care for external bleeding
a.Obtain consent
b.Cover wound with sterile dressing
c.Secure bandage over dressing
d.Use overlapping turns to cover dressing completely
e.Tie or tape the bandage in place (try not to cover toes / fingers-check if too tight)
f.Check fingers for warmth color and feeling
What happens if blood soaks thru bandages?
Apply more dressing/bandage - *removing stops clotting*
The musculoskeletal system is composed of:

4
1. Muscles
2. Tendons
3. Bones
4. Ligaments
Four main types of musculoskeletal injury:
1. Fractures
2. Dislocation
3. Sprains
4. Strains
Fractures
disruption in the continuity of a bone

Closed – little or no movement or displacement of the broken bones.
Open (Compound) – enough movement that bone actually breaks through the surrounding tissues.
Dislocation
a complete displacement of a bone from a joint

Subluxation – a partial displacement of a bone from its joint (will go back to its normal position most of the time)
Sprains
Stretching or tearing of a ligament (inelastic band of tissue that connects bone to bone).
Strains
Stretching or tearing of a muscle or tendon (tough band of connective tissue that attaches muscle to bone.)
Things to look for when you have an injured victim: DOTS
1. Discoloration
2. Obvious deformity – could tell you if something is fractured or dislocated
3. Tenderness
4. Swelling
Care for the injured individual

if the injury is not very
serious – RICE.
1.Rest
2.Ice - First ask the victim if he/she is allergic to ice
3.Compression
4.Elevate the injured part -must be done w/o caused more harm
5.Always refer the injured victim to a physician
-liability issue
6.Monitor vital signs and treat for shock
Five reasons for splinting
1.Prevents further damage to muscle, spinal cord, peripheral nerves, and blood vessels by the broken bone ends
2.Prevents laceration of the skin by broken bones, converting a closed fracture into an open one
3.Prevents restriction of distal blood flow resulting from pressure of the bone ends on blood vessels
4.Prevents excessive bleeding into tissues at the fracture site
5.Prevents against shock by decreasing pain
Rules 1-4 for splinting
1.The clothing should be removed from the area of any suspected fracture or dislocation – w/o causing more harm
2.Note and record the circulatory and neurological status distal to the fracture site. (capillary refill)
3.In a fracture, the splint should immobilize the joint above andbelow the fracture
4.In a dislocation or sprain, the splint should immobilize the bone above and the bone below the injured joint
Rules 5-8 for splinting
5.During splinting minimal movement of the limb should be allowed
6.Cover all wounds with a dry, sterile dressing before applying the splint
7.Pad the splint to prevent local pressure
8.Do not move or transport the victim before splinting
SHOCK
-a state of collapse or depression of the cardiovascular system
Review of the Circulatory System – 3 Components – Main Causes
1.Working Pump – the heart is damaged so it fails to pump properly
2.Pipes – blood vessels dilate so that blood “pools” in the larger vessels, resulting in a diminished amount of fluid available to provide efficient circulation.
3.Fluid – blood is lost, so there is an insufficient volume of fluid in the circulatory system.
7 Types of Shock
1. Hypovolemic
2. Neurogenic
3. Anaphylactic
4. Septic
5. Cardiogenic
6. Metabolic
7. Psychogenic
Hypovolemic shock
Most common form.
---Brought on by a drop in blood volume or body fluids---
-usually caused by hemorrhage – blood loss – hemorrhagic shock
-dehydration from excessive sweating
-excessive vomiting/diarrhea
-excessive loss of fluid by diseased kidneys
Neurogenic shock
-blood vessels dilate markedly therefore not enough blood to fill them
-B.P. leads to decreased venous return which results in venous pooling (lack of blood flow back to the heart)
-loss of vasomotor tone – primary cause
-caused by deep anesthesia/spinal cord or brain damage/fever
Anaphylactic shock
-results from an allergic reaction (most severe form)
-antibodies come into contact with substance and release histamine (vasodilator)
-result in a great reduction in venous return leading to blood pooling
S/s – Difficult breathing, swollen tongue, mouth/throat (rash)
Septic shock
-caused by some form of serious illness and is caused by severe infection
-blood poisoning - system infection
-high fever
Cardiogenic shock
-Results from heart failure
-cardiac output itself falls too low to supply the body with adequate blood flow
-results in tissue deterioration and death
Metabolic shock
-loss of fluid from a change in biochemical equilibrium
-insulin shock/diabetic coma

S/s - vomiting/diarrhea
Psychogenic shock
-blood pressure falls and reduces blood flow to brain
-causes the person to faint (syncope)
-caused by strong emotional excitation
-standing in one position for extended time
3 Stages of Shock
1. Compensatory stage
2. Progressive 2nd stage
3. Irreversible 3rd stage
Compensatory stage
As BP begins to drop, HR mechanisms try to correct to normal circulation

Blood vessels constrict to increase BP, usually corrects itself within 24 hrs.
Progressive 2nd stage
a.Body can only compensate so much
b.In an attempt to keep organs supplied, blood is shunted away from the extremities to the heart and lungs
c.Result is that other tissues produce toxic byproducts – need medical intervention
Irreversible 3rd stage
a.Organs die or stop functioning
b.Blood shunted away from kidneys/liver to heart/brain
c.Blood vessels are no longer able to sustain the pressure needed to supply heart and brain
S/s of Shock

8
1.Skin color - pale
2.Dark skinned individuals - grayish color
3.Skin temp – cool clammy/heavy sweating?
4.Pulse – rapid/weak
5.Respiration Rate – shallow
6.Blood pressure – low
7.Pupils – dilated
8.Later stages – loss of consciousness
Treatment of Shock

8
1. Reassure victim
2. Elevate feet above the level of the heart and head to increase venous return from lower extremity to heart
3.Breathing difficulty – semi-reclining position
4.Control bleeding
5.Minimize pain – splinting fractures
6.Maintain body temperature
7.Traumatic situations – anti shock trousers
8.No food – why?
---complications if surgery is needed (anesthesia)
Why are burns serious?
1.Infection
2.Lead to fluid loss
3.Lead to a decreased ability to maintain normal body temperature
4.Shock due to pain from exposure to damaged nerves
4 mechanisms of causes of burns
1. Thermal
i.e. touching a hot stove
2. Electrical
i.e. coming in contact with exposed wires, lightning
3. Chemical
i.e. coming in contact with acid, chlorine, bleach
4. Radiation
i.e. staying in the sun too long
Do's of burns
DO:
a.Cool a burn by flushing with cool water (except for electrical)
b.Cover the burn with a dry clean cloth covering such as a sterile dressing.
c.Keep the victim comfortable and from being chilled or overheated.
Don'ts of burns
DON'T
a.Apply ice directly to any burn unless it is very minor.
b.Touch any burn with anything other than a sterile covering.
c.Remove pieces of cloth that stick to the burned area.
d.Break blisters
e.Use any kind of ointment on a severe burn.
Three types of burns
1st Degree or superficial burns

2nd Degree or partial thickness burns

3rd Degree or full thickness burns
1st Degree or superficial burns
a.Can be painful because nerves are exposed - swelling may occur.

b.Takes approximately 5-6 days to heal.
2nd Degree or partial thickness burns
a.Blisters with clear fluid inside. Can be painful. Swelling also may occur.

b.Takes approximately 3-4 weeks to heal.
3rd Degree or full thickness burns
a.Destroys all layers of the skin including muscles, nerves, and bones.

b.May not be painful because nerves are destroyed.
Where do more than 90% of all poisonings take place?
the Home
General S/s of Poisoning

11
1.Nausea, vomiting, diarrhea
2.Chest or abdominal pain
3.Sweating, changes in consciousness, seizures
4.Headache
5.Dizziness
6.Irregular pupil size
7.Burning/tearing of eyes
8.Abnormal skin color
9.Burns around the lips, tongue, or on the skin
10.Unusual odors, flames, smoke
11.Unusual behavior suggesting drug use
S/s of Allergic reactions

4
1.Breathing difficulty
2.Tightness in the chest
3.Rash, hives, or itching
4.Swelling in face, neck or tongue
4 Types of Poisonings
1.INGEST (swallow) – ex. Foods-certain mushrooms / shellfish, medicine, household items (cleaning products)
2.INHALE (breath in) – ex. Carbon monoxide (engine or car exhaust)
3.ABSORB (touch it) – Come in contact with skin or other membrane ex. Plants - poison ivy, poison oak
4.INJECT – Bites or stings ex. Insects, spiders (black widow and brown recluse), snakes
activated charcoal
For a victim who has swallowed a petroleum product (kerosene or gasoline) use activated charcoal after vomiting to counteract poison - vomiting removes only about half of the poison, PCC might have you try to counteract the remaining poison – using activated charcoal liquid / powder forms (looks like mud-might be hard to get victim to drink-use straw or cover).
NEVER INDUCE VOMITING FOR:
A victim who has swallowed a corrosive (acid) ex. Draino or caustic (alkali) ex. Strychnine, the substance
will burn the tissues esophagus/throat/mouth (again) if vomited
What are epinephrine pens used for?
used to dilate the bronchioles to help the patient breath easier
HEAT / COLD EXPOSURE Factors:

6
1.Activities
2.Clothing
3.Weather – wind and humidity
4.Length of exposure
5.Working / living conditions
6.Persons’ age and state of health
Heat Related Emergencies
1. HEAT CRAMPS - least severe
2. HEAT EXHAUSTION – more severe
3. HEAT STROKE - most severe, least common!!!
HEAT CRAMPS
painful spasms of skeletal muscles (usually legs / abdomen – could be warning) - 1st sign body overcome by heat
S/s of Heat Cramps
a.muscle twitching and spasms in arms, legs, or abdomen
b.wet and warm skin as a result of excess sweating
c.temperature, pulse, and respiratory rate should be normal or slightly elevated
Treatment of Heat Cramps
a. rest in a cool place
b. encourage to drink liquids
c. apply ice and gentle stretch or massage
d. monitor for S/s of heat exhaustion/stroke
e. do not drink salt water or take salt tablets
Heat Exhaustion
long exercise / work in sun - sitting in sun too long, prolonged sweating from strenuous activity in a hot environment resulting in
inadequate replacement of fluid losses
S/s of Heat Exhaustion
a.rapid strong pulse, heavy sweating
b. normal or slightly lowered body temperature
c. cool, moist, pale or red skin
d. headache, nausea, dizziness, weakness, exhaustion
Treatment of Heat Exhaustion
a. treat as if in shock
b. take out of hot environment
c. place on back with feet elevated
d. sponge or towel victim with cool water
e. remove as much clothing as possible
f. if conscious allow victim to drink fluids
g. if symptoms persist or no improvement within 30 minutes get help or transport to medical facility
HEAT STROKE
body systems overwhelmed by heat - they begin to stop
functioning
S/s of Heat stroke
a. rapid and weak pulse
b. no sweating
c. core temp above 103 F.
d. shallow breaths
e. red, hot and dry skin
f. changes in consciousness (dizziness, weakness, loss of
consciousness), seizures

CLASSIC - (lose ability to sweat)-affects elderly, chronically ill and obese
EXERTIONAL (retain ability to sweat) – strenuous work or play in a warm environment
TREATMENT FOR HEAT EXHAUSTION / STROKE
a.Get victim out of the hot environment
b.Cool body – use cool, wet cloths
c.Loosen tight clothing
d.If the victim is conscious give cool water, not too fast 4 ounces every 15 minutes
e.Minimize shock - keep lying down with legs up
f.Call EMS
g.Watch for changes in
h.Do not return to activity
i.If the victim vomits - stop giving fluids - sign they are
getting worse, put on side; watch for breathing problems,
keep victim lying down
j.Anything cold - ankles, armpits, groin, neck, to cool large blood vessels
Why should we not use rubbing alcohol to cool someone with heat stroke/exhaustion/cramps?
it will close pores and prevent heat loss***
FROSTBITE
literal freezing of the body parts exposed to cold (water in between bodies cells freezes and swells
Treatment of Frostbite
re-warming is necessary and needs to be done by a physician, if this is not possible, try rapid re-warming
Rapid re-warming
handle gently, put frostbitten part in warm (not hot) water (100-105 F thermometer / or hand), apply warm moist cloths and change them frequently for ear or facial injuries - if fingers / toes are frostbitten place cotton/gauze between them - after re-warming bandage area with dry, sterile dressing
NO NOs of Frostbite treatment

5
1.Don’t break any blisters
2.Don’t rub the part to warm-ice crystals can cause more damage
3.Don’t let area touch sides / bottom of container if soaking
4.Don’t allow victim alcohol / smoking
5.Don’t allow area to refreeze
HYPOTHERMIA
life threatening cold injury, thermal control is lost once body temp is below 95 F.

If below 80 F, coma or death
Types of Hypothermia exposure:
1.Acute exposure (mild hypothermia)
-six hours or less in duration victim loses heat rapidly, usually water immersion
2.Subacute exposure (profound hypothermia)
- exposure is 6 to 24 hours
3.Chronic exposure (profound hypothermia)
- long term cooling, more than 24 hours
Mild hypothermia
core temp above 90 F
Raise core temp by:
a.Use tub of hot water, leave victims arms and legs out
b.Place hot packs against the body’s areas of high heat loss
c.In Wilderness - have rescuer lie trunk to trunk with the victim in a sleeping bag
Profound Hypothermia
core temp. below 90 F
a.Do not re-warm victim if they can be transported within 12 hours, keep victim from getting colder (do not elevate feet causes cold blood to go to heart)
b.Do not jostle during transportation
c.Avoid CPR unless you are POSITIVE victim has no pulse
d.Example of slow faint pulse – someone with hypothermia
S/s of Different Types of Hypothermia
1.mild – numbness, shivering, slurred speech, memory lapses, fumbling hands, cold abdomen and backs

2.profound – shivering has stopped, decreasing levels of consciousness
-muscles become still and rigid
-skin has blue appearance
-no response to pain
-pulse and respiration drop
-pupils dilate
Treatment of hypothermia
1.Get victim out of cold environment
2.Have a source of heat - use barrier (warm gradually)
3.Add insulation beneath and around the victim (blankets, cloths, towels etc.)
4.Replace wet clothing
5.Handle victim gently
DIABETES
A condition which person’s body does not produce enough of the hormone insulin, causing too much sugar in blood
Diabetic emergency
person becomes ill due to imbalance of insulin and sugar in body
2 Major Types Diabetes
Type I Insulin Dependent Diabetes

Type II Non-Insulin Dependent Diabetes
Type I Insulin Dependent Diabetes
a.Body produces little/or no insulin
b.Usually starts in childhood
c.Need to inject insulin daily into body
d.Must regulate use of insulin
Type II Non-Insulin Dependent Diabetes
a.Body doesn’t produce enough insulin
b.Usually occurs in older adults
HYPOGLYCEMIA
insulin reaction - high insulin, low blood sugar (low sugar can make a person ill)
HYPERGLYCEMIA
- diabetic coma - low insulin, high blood sugar
MORE SERIOUS – happens when diabetics fail to take insulin
S/s of Diabetic emergencies
1.Rapid Pulse / Rapid Breathing
2.Feeling / Looking Ill
3.Changes in level of consciousness - dizziness, drowsiness, confusion
Difference btw Insulin reaction and diabetic coma?
***YOU DON’T NEED TO DIFFERENTIATE BETWEEN INSULIN
REACTION AND DIABETIC COMA – the treatment is the same

Sugar will not hurt!
SEIZURES
a sudden involuntary muscle contraction, usually due to uncontrolled electrical activity in the brain
S/s of seizures
1.Brief blackout or confused behavior (“petit mal” seizure)
2.Sudden falling – loss of consciousness
3.Drooling, frothing at the mouth
4.Vigorous spasms, twitching, jerking limbs, stiffening (“grand mal”)
5.Grunting, snorting
6.Loss of bladder or bowel movement
Care for seizures
First aid is aimed at protecting the victim from injury and getting medical help.
1.Do not restrain
2.Do not place anything in their mouth
3.Clear area of hard/sharp objects – chairs, tables
4.Do not try to make the victim “snap out of it”
After the seizures stops....
1.If you don’t suspect head/neck/spine injury – place in recovery position.
2.Protect the airway
3.Monitor the victim while recovering
4.Stay with the victim until consciousness is fully regained or you have medical help.
What to look for in a head injury?
a.depressions & bruising
b.fractures & lacerations
c.check pupils and if fluid is draining from nose, ears,
or mouth
Don't move victim if...
1.Any loss of consciousness or change in level of consciousness
2.Unequal pupils or fluid loss
3.Extreme pain or loss of sensation
CONCUSSION
immediate loss or transient impairment of the brain’s ability to function
3 Mechanisms of concussions
1.Direct blow – head contacts a fixed object or struck in the head by object
i.e. helmet/helmet
2.Indirect blow – sudden force that causes twisting or swirling of the brain within the skull.
3.Contrecoup – results from a blow to the opposite side.
-2 sites of head/brain injury-
1. pt. of impact
2. pt. opposite side where brain hits the skull
Grade I Concussion
mild - “bell rung” dazed/disoriented, memory loss at time of impact, no loss of consciousness
Grade II Concussion
moderate - loss of consciousness < 4 minutes
retrograde amnesia
Grade III Concussion
severe - unconscious > 4 minutes
S/s of concussions

7
1.deepening headache 2.blurred vision
3.nausea / vomiting 4.restlessness / confusion
5.unequal pupils 6.ringing in ears 7.unable to wake victim
Treatment of concussions
1.Keep quiet - do not leave alone
2.Awake @ 2 - 4 hours - observe for above symptoms to develop
3.No aspirin (thins blood)
4.If victim is unconscious assume a neck injury
SKULL FRACTURE
-spherical, 1/4 inch thick

-mechanism - direct blow
Four Types of skull fracture:
1.Depressed – fragments driven into membranes or brain itself
2.Linear – thin line - most common, least serious, most difficult to detect
3.Comminuted – egg shell – pt. of impact, cracks radiate from center
4.Basal – floor of skull – extensive damage
S/s of Skull fracture
-palpable deformity - pain / swelling
-discoloration under eyes – sunken (raccoon) – gradual
-bruising behind ear – gradual
-blood / fluid (CSF) - nose / ears /scalp - bleeding
-unequal pupils
Treatment of Skull Fracture
-do not stop flow (CSF out
nose/ears)
-check out flow for “halo sign”
-CSF will always form a pink ring target
-EMS transport to ER
CERVICAL SPINE INJURIES

Unconscious
UNCONSCIOUS - basic protocol -call EMS!! a.stabilize head/neck in position found
b.log roll if on stomach c.primary survey--how?
d.no ammonia inhalants
CERVICAL SPINE INJURIES

Conscious
CONSCIOUS- basic protocol
a.Make an observation b.Stabilize - head/neck in position found
c.Get a History
d.evaluate quickly short term, long term memory
e.evaluate clarity of their responses, state of mind
confused? head injury? happened before?
INJURY REMOVAL

One Rescuer
1.Clothes drag
2.Foot drag
3.Blanket drag
4.One person crutch
INJURY REMOVAL

Two Rescuers
1.Crutch method (buddy carry)
2.Seat carry
3.Extremity lift

** Remember--stabilize head and neck 1st!
INJURY REMOVAL

Four Rescuers
1.Log roll--if spinal injury, provide cervical traction.

2.Be sure to roll body in unison--use the backboard
INJURY REMOVAL

Four-Six Rescuers
1.Man lift - slide board feet head
2.Scoop stretcher
WHY DO WE MOVE SOMEBODY?
-when faced with immediate danger
-you have to get to another victim who may have a more serious problem
-you may have to remove in order to provide proper care
Poison control center phone #
(412) 681-6669

CHOP
When is consent implied?

Three things
1. Person's unconscious
2. Person's confused
3. Person's seriously ill and cannot grant consent
Do you have to obtain consent when dealing with an infant or child?
Consent is implied if parent or guardian is not present
Without oxygen brain cells begin to die after how many minutes?
Approximately four minutes
Several bleeding to lower leg can be controlled by finger pressure to what artery?
Femoral Artery
How far do you tilt the head back for an adult?
Enough to open airways (past neutral0
How far do you tilt the head back for a child?
Slightly past neutral
How far do you tilt the head back for an infant?
To neutral
Rescue Breathing: Adult
-1 breath every 5 seconds
-Breath should last 1 second
Rescue Breathing: Child & Infant
1 breath every 3 seconds
How deep should chest compressions be with an infant?
.5 to 1 inch
How deep should chest compressions be with a child?
1 to 1.5 inches
How deep should chest compressions be with an adult?
1.5 to 2 inches
CPR: Adult
30 compression & 2 breaths
CPR: Child & Infant with one rescuer
30 compression & 2 breaths
CPR: Child & Infant with two rescuers
15 compression & 2 breaths
What is the rate for compression?
100 compressions per minute