Download September 11, 2001 Lessons Learned

Unit 4 – Disaster Medical: Unit Objectives
 Protect YOUR health.
 Establish a treatment area.
 Perform head-to-toe patient assessments.
 Apply splints to suspected fractures and sprains,
and employ basic treatments for other wounds.
Visual 4.1
Steps to Maintain Hygiene
 Wash hands frequently using soap and water.
 Wear latex gloves; change after each patient.
 Wear a mask and goggles.
 Keep dressings sterile.
 Avoid contact with body fluids.
Visual 4.2
Maintaining Sanitation
 Control disposal of bacterial sources.
 Put waste products in plastic bags, tie off, and
mark as medical waste.
 Bury human waste.
Visual 4.3
Establish Treatment Areas
The site selected should be:
 In a safe area.
 Close to (but upwind and uphill from) the hazard.
 Accessible by transportation vehicles.
 Expandable.
Visual 4.4
Establishing Treatment Areas
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Colored TARPS – Green, Yellow, RED, Black
Visual 4.5
Steps--Disaster Medical Operations
 Re-Triage
 Treatment – Control ABS, Immobilize
 Transport [to South Bay]
 Morgue [not at SCC CERT]
Visual 4.6
First—Let’s Review
The “Killers”:
 Airway obstruction
 Bleeding, excessive
 Shock
ABS
All “immediates” receive airway control, bleeding
control, and treatment for shock.
Visual 4.7
Indicators of Injury
 Bruising
 Swelling
 Severe pain
 Bleeding
 Disfigurement
Provide immediate treatment for life-threatening
injuries!
Visual 4.8
Conducting Victim Assessment
A head-to-toe assessment:
 Determines the extent of injuries and treatment.
 Determines the type of treatment needed.
 Document injuries.
Visual 4.9
Head-to-Toe Assessment
1.
2.
3.
4.
5.
6.
7.
8.
9.
Head
Neck
Shoulders
Chest
Arms
Abdomen
Pelvis
Legs
Back
FRISK them!
Visual 4.10
Head-to-Toe Assessment
1.
2.
3.
4.
5.
6.
7.
8.
9.
Head
Neck
Shoulders
Chest
Arms
Abdomen
Pelvis
Legs
Back
Visual 4.11
S- Signs, symptoms
A- Allergies
M- Medications
P- Past Medical history
L- Last meal eaten
E- Events leading to this
Talk to the VictimAsk these questions!
Treating Burns
 Cool the burned area.
 Cover to reduce infection.
Visual 4.12
Layers of Skin
 Epidermis
 Dermis
 Subcutaneous layer
Visual 4.13
Wound Care
 Control bleeding
 Prevent secondary infection
 Clean wound— don’t scrub
 Apply dressing and bandage
Visual 4.14
Classification of Burns
 First degree

 Second degree 
 Third degree

Visual 4.15
Sunburn
Blisters
Ash
Treating Amputations
 Control bleeding
 Treat for shock
 Save tissue parts, wrapped in clean cloth
 Keep tissue cool
 Keep tissue with the victim
Visual 4.16
Rules of Dressing
1. In the absence of active bleeding, remove
dressing and flush, check wound at least every
4-6 hours.
2. If there is active bleeding, redress over existing
dressing and maintain pressure and elevation.
1. VIDEO PC
Visual 4.17
Treating Impaled Objects
Impaled Objects:
 Immobilize.
 Don’t move or remove.
 Control bleeding.
 Clean and dress wound.
 Wrap
PC
Visual 4.18
VIDEO
Treating Fractures, Dislocations,
Sprains, and Strains
 Objective: Immobilize the injury and joints above
and below the injury.
 If questionable, treat as a fracture.
 Intro VIDEO PC
Visual 4.19
Treating an Open Fracture
 Do not draw exposed bones back into tissue.
 Do not irrigate wound.
Visual 4.20
Treating an Open Fracture
DO:
 Cover wound.
 Splint fracture without disturbing wound.
 Place a moist 4" x 4" dressing over bone end to
prevent drying.
Visual 4.21
Signs of Sprain
 Tenderness at injury site
 Swelling and/or bruising
 Restricted use or loss of use
Immobilize and elevate.
Visual 4.22
Guidelines for Splinting
1. Support the injured area.
2. Splint injury in the position that you find it.
3. Don’t try to realign bones.
4. Check for color, warmth, and sensation.
5. Immobilize above and below the injury.
CHECK Pulse, movement, sensation (PMS)
Pillow, duct-tape!  VIDEO PC
Visual 4.23
Wrist Immobilization





Always care for wounds before
immobilizing the injured
extremity.
Splint the injury in the
position you found it.
Immobilize an injured arm or
wrist by splinting with a
well-padded support secured
above and below the injury by
bandaging material.
Support the extremity by
applying a sling.
A sling can be held in place
by placing chest tie around
the chest and under the arms.
Visual 4.24
Padded magazine
Collarbone & Shoulder Blade
Immobilization
 Place an open
triangular bandage
between the forearm
and chest with its
point toward the
elbow and stretching
well beyond it.
Injured shoulder
or collarbone.
VIDEO PC
 Pull the upper end
over the shoulder on
the injured side.
 Bring the lower end of
the bandage over the
forearm and under  Bring both side
the armpit on the
together and secure.
injured side.
Visual 4.25
Bring one end
over forearm
and under
armpit on
injured side.
Immobilizing a Knee or Lower Leg



Place well padded board splinting
material on each side of the
injured leg. This material
should extend from the hip to
below the injured foot.
Secure splints in at least 4 places
using folded triangular
bandages or other suitable
material.
OR
Use a rolled up blanket placed
between the patients leg and
secured, min. 4 places.
Visual 4.26
SHOCK! Symptoms of Hypothermia
Primary signs and symptoms:
 A body temperature of 95o Fahrenheit (37o
Celsius) or less
 Redness or blueness of the skin
 Numbness accompanied by shivering
Visual 4.27
Symptoms of Hypothermia
At later stages, hypothermia will be accompanied by:
 Slurred speech.
 Unpredictable behavior.
 Listlessness.
Visual 4.28
SUMMARY- Review
 Do set up a Medical Treatment area by color code
 Do a head to toe examination
 SAMPLE
 Treat wounds – do no harm
 Be
creative– duct tape, bags
 Immobilize/splint -- >Pulse, Movement, Sensation
 Maintain your own safety!
Visual 4.29