FIRST AID

MANAGEMENTS

BURN
-IS A TYPE OF INJURY
TO FLESH CAUSED BY HEAT, ELECTRICITY, CHEMICALS, LIGHT, RADIATION OR FRICTION. MOST BURNS ONLY AFFECT THE SKIN (EPIDERMAL TISSUE AND DERMIS). RARELY DEEPER TISSUES, SUCH AS MUSCLE, BONE, AND BLOOD VESSELS CAN ALSO BE INJURED.

BURNS CAN BE CLASSIFIED MANY WAYS:

INTO

According to the depth of the burns injury:

y y y

Superficial- superficial partial thickness burns Deep-Deep partial thickness burns Full thickness burns

According to the degree of the burns: y First degree burns:

It is also called as superficial burns.

The epidermis that is the outer layer of the skin is destroyed; the some portion of the dermis may be involved in the damage. The wound is usually red in color, dry, slightly edematous and may be painful. It is considered to be the minor burns; not a serious one. Complete recovery is possible; almost within a weeks duration. when the entire outer layer and major portion of the dermis of the skin are destroyed or burned, it is termed as the second degree burns. There is the formation of the blisters, the area involved becomes severely painful, and moderate to severe edeme is present. The blisters may break to thus predisposing the wound area to infections. If left untreated, such wound becomes infected and may get transformed into a third degree burns which is even more complicated to treat.

Second Degree Burns

If the wound is too large, immediately seek medical help; else treat it as minor burns.

Third Degree Burns

It covers the entire epidermis dermis, subcutaneous tissues and muscular tissues may also be involved in the burns area. Bones may be involved. These are the most serious of all the burns which calls for an emergency first aid to save victims life.

The wound is generally dry, pale, painless and edematous.

Due to the excessive loss of fluids from the body the person may go in the state of hypovolemic shock.

According to extent of burn injury:

y

Percentage of the total body surface area involved is calculated to determine the extent of the injury using the rule of nines.

FIRST

AID MANAGEMENT FOR THE

BURNS INJURY:
There are certain aims of the first aid treatment of the burns wound: y To prevent the infection, and further destruction, of the skin. y To preserve the safe skin, maintain its integrity. y To reduce the anxiety of the patient. y To immediately provide the medical assistance. y When you are at the site where you are witnessing the burns, you can help out the needy by managing that situation, at the scene; providing the first aid care.

MANAGING

THE MINOR BURNS (FIRST

AND SECOND DEGREE BURNS):

The immediate step is to get the person out of the fire or the burns area. If the clothes have caught the fire, you can remove that clothes or instantly wrap the patient with the woollen cloth. This usually accounts for the major burns; however the basic concept is to remove the heat source. You may sometimes need to call 911 immediately. The second important step is to cool the burns; the cool water may be poured or the area burned submerged into the cool water; this reduces the oedema and provides transient pain relief. Never directly put ice on the burned areas as it further damages the area.

After the cold application, you can wrap the burned areas using the sterile gauze bandages; take care to see that it is neither too tight nor too loose. The wounds can thus be protected against the infection. If the chemical burns have taken place, you should splash out the area with appropriate liquids. (Acids diluted with bases.) Provide pain relief with the over -the -counter analgesics. Some dos:
Call 911 immediately in case of major burns. y Assess the persons level of consciousness; give sips of water, if conscious. y Remove the clothing, personal assets such as jewelry, etc. y Cool the area with cool water. Always keep the burnt area covered.
y

 Some

donts: Do not apply ice on the burned areas; it may cause frostbite and further damage the area. Do not apply flour, baking soda, butter, ink or any antiseptics on the affected area; Minimal touch is done to prevent further damage, promote wound healing and prevent the infection. Do not disturb or break the blisters; they are vulnerable to acquire infection.

MANAGING THE MAJOR BURNS:

Call 911 immediately or any other medical emergency assistance. Better not to remove the clothing that has burned. Such patients are prone to go in a state of shock, so it is advisable not to immerse them in the water. Elevate the extremities to reduce the oedema or swelling. Cover the burns areas using sterile gauze bandages, moist clean cloth or gauzes. CPR may be performed if the airway, breathing and circulation has impaired.

SPRAIN
is

an injury to ligaments that is caused by being stretched beyond their normal capacity and possibly torn. A muscular tear caused in the same manner is referred to as a strain. In cases where either ligament or muscle tissue is torn, immobilization and surgical repair may be necessary. Ligaments are tough, fibrous tissues that connect bone to bone across the joints. Sprains can occur in any joint but are most common in the ankle.

SIGN AND SYMPTOMS:

Pain Swelling Bruising Hemarthrosis Decreased ability to move the joint If the ligament is ruptured, one may hear a popping sound Difficulty using the affected extremity

FIRST AID MANANGEMENT

The

first modality for a sprain can be remembered using the acronym RICE. The treatment of sprains depends on the extent of injury and the joint involved. Medications like non-steroidal antiinflammatory drugs can relieve pain. Weight bearing should be gradual and advanced as tolerated.

RICE:

Rest: The sprain should be rested. No additional force should be applied on site of the sprain. In case of, for example, a sprained ankle, walking should be kept to a minimum. Ice: Ice should be applied immediately to the sprain to minimize swelling and ease pain. It can be applied for 20-30 minutes at a time, 3-4 times a day. Ice can be combined with a wrapping to minimize swelling and provide support. Compression: Dressings, bandages, or ace-wraps should be used to immobilize the sprain and provide support. Elevate: Keeping the sprained joint elevated (in relation to the rest of the body) will also help to minimize swelling.

Ice and compression (cold compression therapy) will not completely stop swelling and pain, but will help to minimize them as the sprain begins to heal itself. Careful management of swelling is critical to the healing process as additional fluid may pool in the sprained area. The joint should be exercised again fairly soon, in milder cases from 1 to 3 days after injury. Special exercises are sometimes needed in order to regain strength and help reduce the risk of ongoing problems. The joint may need to be supported by taping or bracing, helping protect it from re-injury.

MUSCLE
is

STRAIN

an injury to a muscle or tendon in which the muscle fibers tear as a result of overstretching. Strains are also colloquially known as pulled muscles. The equivalent injury to a ligament is a sprain.

SIGN AND SYMPTOMS:

localized stiffness discoloration

pain

and; bruising around the strained muscle

FIRST AID MANAGEMENT

The first-line treatment for a muscular strain in the acute phase include four steps commonly known as R.I.C.E. Rest: Stop all unnecessary activities, especially those that cause pain, to prevent the strain from progressing. Ice: Apply ice to reduce swelling by increasing blood flow to the injury site. Never ice for more than 1015 minutes at a time. Place a layer of fabric or paper between the ice and the injury to avoid freezing the skin. Compression: Wrap the strained area to reduce swelling. Elevation: Keep the strained area as close to the level of the heart as is conveniently possible to keep blood from pooling in the injured area.

The ice and compression (cold compression therapy) will stop the pain and swelling while the injury starts to heal itself. Controlling the inflammation is critical to the healing process and the icing further restricts fluid leaking into the injured area as well as controlling pain. Cold compression therapy wraps are a useful way to combine icing and compression to stop swelling and pain. This immediate treatment is usually accompanied by the use of nonsteroidal anti-inflammatory drugs(e.g., ibuprofen), which both reduce the immediate inflammation and relieve pain. It is recommended that the person injured should consult a medical provider if the injury is accompanied by severe pain, if the limb cannot be used, or if there is noticeable tenderness over an isolated spot. These can be signs of a broken or fractured bone, a sprain, or a complete muscle tear. Therapeutic ultrasound can be used to break down poorly healed muscle strains and permit them to heal properly.

 Wounds

Is a type of injury in which skin is torn, cut or punctured (an open wound), or where blunt force trauma causes a contusion (a closed wound). In pathology, it specifically refers to a sharp injury which damages the dermis of the skin.

Open wound
degree of injury sustained from a direct blow depends upon the force of the blow and its direction. Obviously the degree of damage increases with increasing force; the effects of direction are equally important, although not so readily appreciated. y Sign and Symptoms
y

Pain and tenderness Swelling Discoloration Hematoma Uncontrolled restlessness Thirst Symptoms of shock Vomiting or cough-up blood Passage of blood in the urine or feces Sign of blood along mouth, nose and ear canal

First Aid Management I- Iced application C- Compression E- Elevation S- Splinting Wound a break in the skin or mucous membrane; or the protective layer is damage.

Closed

CLASSIFICATION OF OPEN WOUND

Puncture y Caused by penetrating pointed instruments such as nail, ice picks, daggers, etc. y Characterized by deep and narrow, serious or slight bleeding. Abrasion y Scrapping or rubbing against rough surfaces. y Shallow, wide, oozing of blood, dirty. Laceration y Blunt instruments such as shrapnels, rocks, broken glasses, etc. y Torn with irregular edges, serious or slight bleeding. Avulsion y Explosion, animal bites, mishandling of tools, etc. y Tissue forcefully separated from the body. Incision y Sharp bladed instruments such as blades, razors, etc. y Clean cut, deep, severe bleeding, wound is clean.

 Dangers:

y Hemorrhage y Infection y Shock

Kinds

of Bleeding: y Arterial bleeding y Venous bleeding y Capillary bleeding

FIRST AID MANAGEMENT

C-

Control bleeding C- Cover the wound C- Care for shock C- Consult or refer to physician

PUNCTURE

ABRASION

LACERATION

AVULSION

INCISION

BONE FRACTURE

Is a medical condition in which there is a break in the continuity of the bone. A bone fracture can be the result of high force impact or stress, or trivial injury as a result of certain medical conditions that weaken the bones, such as osteoporosis, bone cancer, or osteogenesis imperfecta, where the fracture is then properly termed a pathologic fracture.

TYPES OF FRACTURE
Open fracture: Skin breaks causing open wound Closed fracture: Skin not broken Complicated fractures: Damage of adjacent organs Stress fracture: Hairline crack due to repeated stress Greenstick fracture: In children's flexible bones

SIGN AND SYMPTOMS

Severe

pain Difficulty in movement Swelling/ bruising / bleeding Deformity / abnormal twist of limb Tenderness on applying pressure

FIRST AID MANAGEMENT

For open fracture

Control bleeding before treatment y Rinse and dress the wound
y

For open / closed fracture

y y y y y y

Check the breathing Calm the person Examine for other injuries Immobilize the broken wound Apply ice to reduce pain / swelling Consult a doctor

OPEN FRACTURE

CLOSED FRACTURE