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3
orces overwhelm a
community.
ervices are compromised.
utside assistance is
required.
2
V Natural disaster
5
!
O
j
estimates that as many as 2!
nations possess chemical or
biological agents.
ë countries are believed to
possess biological agents as
weapons
ë
V rubonic plaque
V rotulism
V Anthrax
V ars
V HëNë
V ALL P
ëë
O
O
ë2
V ire
V rioterrorism
V Illegal logging
V Nuclear attack or bombing
V Etc.
ë3
ë2
Pre-disaster
arning
Impact
Emergency
isolation
rescue
remedy
ecovery
ë5
alidate what you hear
Perform a thorough
assessment
ëO
PINCIPLE HEALTH EICE DUING DIATE
Ƙe· esponse
Period immediately after the disaster
AI of ¶e· esponse
DIATE ITIGATIN
EHArILITATIN ANING
ECNTUCTIN PEENTIN
DEELPENT
A CAUALTY INCIDENT
ituation in which the number of
casualties exceeds the number of
resources
25
V To afford the great number of
people the greatest chance of
survival.
2!
V To properly triage a group of
patient, you shared quality classify
each patient into one of four
groups.
2O
CATEGIE
2j
V UNTArLE CHET AND ArDINAL
UND
V INCPLETE APUTATIN
V PEN ACTUE LNG rNE
V 2ND & 3D DEGEE rUN ë5-2
TTAL rDY UACE AEA
3
V table Abdominal wounds with out evidence
of hemorrhage
V oft tissue injuries
V axillofacial wounds with out airway
compromise
V ascular injuries with adequate collateral
circulations
3ë
V Genito-urinary tract disruption
V fractures requiring open
reduction
V Debridement and external
fixation
V ost eyes or CN injuries
32
3rd PIITY (INIAL)
GEEN ² Injuries are minor and treatment
can be delayed hours to days; moved away
from the triage area
32
V Unresponsive patients with penetrating head
wounds
V High spinal cord injuries
V ounds involving multiple anatomical sites
and organs
V 2nd &3rd degree burns in excess of ! of total
body surface area
35
V eizures or vomiting with in 22 hour after
radiation exposure
V profound shock with multiple injuries
V Agonal respirations
V No pulse
V No rP
V Pupils fixed and dilated
3!
LE NUE IN DIATE EPNE PLAN
3j
V An elderly man with a
respiatory rate of
breaths
per minute, color ashen,
tense abdomen and only
carotid pulse present
2
VAO year old childwith a
bleeding scalp laceration
who has a glasgow coma
score of
and needs
intubation
2ë
V3 year old mother of a
child, who is crying
hysterically, is walking and
appears to have no pain or
visible injuries
22
VA ë5 year-old girl who
complains of pain in her left
leg , with obvious deformity
of the calfbut good pulses in
the foot
23
V !5-year-old woman who
arrives in a police car
holding her right wrist
which is cool,
ecchymoticand painful, with
good pulses
22
DECNTAINATIN
Process of removing accumulated
contaminants
tep
ë. emove the patient·s clothing and
jewelry
2. oap and water wash, then rinse
V Cell destruction of the layers
of the skin and the resultant
depletion of fluid and
electrolytes
V Thermal
V kin grafting
V ehabilitation
An acute medical
emergency caused by
failure of the heat
regulating mechanism
of the body
V CNDUCTIN-the
transfer of heat from
one material to another
through direct contact
V Ex.cup of coffee
Carrying away of heat by
currents of air or water
or other gases or liquids
Ex. poon
ending out energy, such
as heat, in waves into
the space
Ex. The sun
V The change to liquid to
gas, when the body
perspires or gets wet,
V evaporation of the
perspiration or other
liquid into the air has s
cooling effect on the
body
V rreathing, during
respiration body heat is
lost as warm air is
exhaled from the body
People at risk those
not acclimatized to
heat, elderly & very
young
V CN dysfunctions
Confusion, delirium,
bizarre behavior, coma
V Temp - 2 .! C / ë 5 or
higher
V Hot dry skin
V Anhidrosis ( absence of
sweating)
V Tachypnea,
hypotension,
tachycardia
V Numbness or reduced
sense of touch
V tiff or rigid posture
V Drowsiness
V Loss of motor
coordination
V Joint muscle stiffness
V ELECTLYTE
V ArG
V ECG
V U/A
ATE CHILL- chilling
caused by conduction of
heat from the body
when the body or
clothing is wet
V Chilling
caused by
convection of heat from
the body in The
presence of air currents
Exposure to freezing Temp;
actual freezing of intra &
intercellular fluid,
resulting to cellular &
vascular damage.
Commonly affects the ears,
nose, hands & feet
Affected part is hard,
cold and insensitive to
touch may appear white
or mottled blue white
VGoal restore normal
body temp
VConstrictive clothing
are removed
VIf lower ext are
involved the patient
should not be
allowed to ambulate
V Controlled yet rapid
rewarming is done
(extremity is placed in a
3O-2 C / j
.!- ë 2
circulating bath for 3 -2
minute). epeated until
circulation is restored
V During rewarming
analgesics are given
(affected part may be very
painful during procedure)
V assage is contraindicated
V Drowsiness
V Pulmonary edema
V Coma
V Continuous monitoring
V ewarming
V arm blankets
V verbed heaters
Vonitor for fib as
px temp increases
from 3ë to 32 C
Defibrillation is
ineffective in px w/
temp of lower than
3ëC; px must be
rewarmed ëst
After Underwater
diving/ high altitude
flying
High altitude flying
within 22 hrs after
underwater diving
Nitrogen bubbles are
formed within
muscles tendons or
within blood
vessels(embolus)
Assessment
V Joint ext. pain
V Numbness
V Loss of
V Neurologic (similar to
stroke)
V Hx of diving or high alt
flying
V anagement
V Patent airway
Vë 2 ( while in transit)
V I L
V 66
V
V 6
V rlood loss/ml V ë5 -2
V rlood loss blood V 3 -2
volume V ë2
V P V decreased
V rP V delayed
V Capillary refill V 3 -2
V V 5-ë5
V U V anxious and confused
V ental status V Crystalliod and blood
V luid replacement
CLA 2
V rlood loss/ml V 2
V rlood loss blood V 2
volume V ë2
V P V decreased
V rP V delayed
V Capillary refill V 35
V V 3
V U V Confused, lethargic
V ental status V Crystalliod and blood
V luid replacement
V ecure or support a patent airway
V ptimize breathing
V aintain circulation
V Establish intravascular access
V eplace intravascular volume(blood products
or crystalliod
V anage bleeding by applying direct pressure
on a compression site
TEATENT
V 6+!&#$
Toothache.
Tooth that is very sensitive to pressure,
temperature (hot or cold), or tapping.
You may also feel pain when eating or
drinking something sweet or sour.
V 6+##' You may have a
tooth that is cracked, chipped, loose,
out of position, or missing.
You can feel a sharp or rough edge
on your tooth. This can rub against
the inside of your mouth or your
tongue.
issing tooth or teeth.
V 6+"+#$' This is a
change in how your teeth fit
together when you bite.
cr
%
!
cv
c %
!
"
!
c r#+$' ake sure nothing is
blocking your ability to breath. This
can include knocked out teeth or
blood in your throat.
$#'!! These include different kinds of
medicines that help decrease pain, such as
acetaminophen. The kind of analgesic that may
be given to you will depend on how bad your
pain is. ome analgesics may also be used to
decrease swelling and fever (high body
temperature).
V $"! This medicine is given to fight or
prevent an infection caused by bacteria. Always
take your antibiotics exactly as ordered by your
caregiver. Keep taking this medicine until it is
completely gone, even if you feel better. topping
antibiotics without your caregiver's K may make
the medicine unable to kill all of the germs.
"save" antibiotics or take leftover antibiotics that
were given to you for another illness
6#$!!+ This is medicine to keep
you from getting tetanus. It is given as
a shot. You should have a tetanus shot
if you have not had one in the past 5 to
ë years. Your arm can get red,
swollen, and sore after getting this
shot.
V +-#!+ Your caregiver may want
you to use a germ-killing mouth wash 2
to 3 times a day. This may help your
injury heal faster by treating other
problems, such as gum swelling or
infection. A germ-killing mouth wash
may also be used to clean your mouth
before a procedure
cÄ
!
"
#
!
"!
c &$$'+ A splint may be
placed on your teeth for a period of
time. This helps support the position
of your damaged tooth while its
supporting tissues heal
l 6+"$$' This is l 6+&#$#$ A
done if a small part of tooth that completely
your tooth chipped off. came out from its
A special glue will be socket may be put back.
used to put the pieces This should be done
of tooth back together. within five minutes
after the trauma or as
soon as possible.
6+!+#&$' This is
done to make the sharp
edge of your broken
tooth smoother.
V #)$() V !$')
+%'+#-#), ##'+,
eeing a caregiver Chewing food on
right away may help your damaged tooth
you from having may put too much
dental or other pressure and worsen
problems later. These your injury.
include tooth loss or
dental infections.
c ï
"
&
!
'&
Ò
&
c Limit your diet to soft
foods for ë to 2 weeks if you have a
loose tooth. oft foods include
applesauce, baby food, bananas,
cooked cereal, cottage cheese, eggs,
gelatin, pudding, and yogurt
V v&)-$!#$, oft tissue
cuts and other wounds must be kept
clean. Gargle using a salt water
solution. You can also clean your
wounds using hydrogen peroxide
swabs. Ask your caregiver for more
information on how to clean your
wounds.
V HEN THE ICTI ECE
PNTANEULY I
UCCEULLY
EUCITATED(ATLEAT
TEPAILY)
V DEATH CAUED rY
EULTING IN IEIN
ATE
V Persons struggles to keep afloat in the water
V )&#
V $
V )!!
V 6.6
V )&$
V )&#
V $$#$
V $#$r
V Immediate quality CP
V Cold water
V Clean water
V No associated injuries
onitor patients Ar C(cervical spine
precautions
Initiate CP
Establish I access
V Correct hypoxia
V Correct acidosis
V Correct hypotension
V Determinethe duration of
submersion
onitor ICP
6
V If victim demonstrates the universal choking
sign, quickly ask, ´Are you choking?µ
ild bstruction evere bstruction
V In response to V In response to
question victim question victim
speaks & answers unable to speak or
´yesµ nods
V ictim able to speak, V ictim unable to
cough, & breathe breathe
V heezing
V ilent Cough
V Unconscious victim
ild bstruction evere bstruction
V Encourage victim to V INTEENE!
continue coughing
V Do NT interfere
with patient·s
spontaneous efforts to
cough & breathe
V Do NTHING else
V Intervene I with signs of severe airway
obstruction
ilent cough, cyanosis, inability to speak or breathe
espiratory difficulty increases or victim becomes
unresponsive
V Activate E
V Apply abdominal thrusts in rapid succession
until obstruction is relieved
V tand behind victim & put
both hands around upper
part of abdomen
V Lean victim forwards
V Clench fist & place it thumb
side against victim·s
abdomen between the
umbilicus & xiphoid
V Grasp this hand with the
other
V Pull sharply inwards &
upwards
V epeat until object is
expelled or victim becomes
unresponsive
V If you find a
CNCIU
choking victim
lying on the
ground, do
abdominal
thrusts in the
supine position
V Do CHET THUT if
Abdominal thrusts are
NT effective
escuer is unable to
encircle obese victim·s
abdomen
ictim is in late stages
of pregnancy
V If victim becomes unresponsive
Carefully support patient to the ground
Activate E
regin CP
V Initiate chest compressions even if pulse is
present in the UNCNCIU CHKING
ICTI
V Look for object in victim·s mouth each time
airway is opened
V Use finger sweep if solid material is EEN
obstructing airway of unresponsive patient
V rA victims treated with abdominal thrusts
should be examined by a doctor
Can cause internal injuries
V Insect
stings, spider bites,
and scorpion stings are
typical sources of injected
poisons
V &$!*#)/
V Not all scorpions are poisonous, but those that
are can be deadly. corpions are found mostly
in the outhwest and estern states.
ymptoms of a sting include pain, swelling,
itching, vomiting, increased sweating, and
vision problems. Get medical care
immediately.
l Toxins-substance produce by
animals or plants that are
poisonous to humans
V rlotchy skin
V eakness/collapse
V Dr
V H/A, DIZZINE
V CHILL
V EE
V N/
V UCLE CAP
V ECEIE ALIA
V ANAPHYLAI
V Treat for shock
V Pull the stinger/venom sac-
avoid using tweezers
V emove jewelry
V Coral snakes
h
!ll
!