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Chapter 6 Bleeding and Wounds External Bleeding (1 of 2) • Three types • Capillary (oozing) • Venous (flowing) • Arterial (spurting) External Bleeding (2 of 2) • Open Wounds • Abrasion • Laceration • Incision • Puncture • Avulsion • Amputation Care for External Bleeding (1 of 2) • Wear gloves. • Expose wound. • Cover with clean cloth or gauze. • Apply direct pressure. • Elevate the area. Care for External Bleeding (2 of 2) • DO NOT remove blood-soaked dressings. • Apply a pressure bandage. • Apply pressure at a pressure point if needed. Internal Bleeding • Skin is not broken and blood is not seen. • Recognizing internal bleeding • Bruising • Painful, tender, rigid, bruised abdomen • Vomiting or coughing up blood • Black or bright red stool Care for Internal Bleeding • Call 9-1-1. • Care for shock. • If vomiting occurs, roll victim on his or her side. Wound Care • • • • • • Wash with soap and water. Flush with water. Remove small objects. Apply direct pressure. Apply antibiotic ointment. Cover wound. • Seek medical care. Wound Infection • Signs of Infection • Swelling • Reddening • Warmth • Throbbing • Pus discharge • Seek medical care for infected wounds. • Tetanus booster shot every 5 to10 years Special Wounds • Amputations • Embedded (impaled) objects Care For Amputations • Control bleeding. • Treat for shock. • Recover amputated part. • Wrap part in gauze, place in a bag, and keep bag cool. • Transport the part with the victim. Care For Embedded (Impaled) Objects • Expose area. • DO NOT remove the object. • Control bleeding around the object. • Stabilize the object. Wounds That Require Medical Attention • Arterial bleeding • Uncontrolled bleeding • Deep wounds • Large or deeply embedded objects • Foreign matter in wound • Human or animal bite • Possibility of noticeable scar • Cut eyelid • Slit lip • Internal bleeding • Uncertain how to treat • Need a tetanus shot Dressings and Bandages Dressings Bandages Dressings • Functions • Control bleeding. • Prevent infection. • Absorb blood. • Protect the wound. • Types • Gauze pads • Adhesive strips • Trauma dressings • Improvised dressings Bandages • Functions • Hold dressing in place. • Apply pressure to control bleeding. • Prevent or reduce swelling. • Support and stabilize an extremity or joint. • Types • Roller • Self-adhering, conforming bandages • Gauze rollers • Elastic roller bandages • Triangular • Adhesive tape Signs That Bandage May Be Too Tight • Blue tinge found on fingernails or toenails • Blue or pale skin color • Coldness of extremity • Inability to move fingers or toes Chapter 7 Shock Shock • Circulatory system failure • Pump (heart) failure • Fluid loss • Pipe failure (blood vessels) • Permanent damage to body parts possible if untreated Recognizing Shock • • • • • Altered mental status Pale, cold, and clammy skin Nausea and vomiting Rapid breathing and pulse Unresponsive in late stages Care for Shock • Treat severe and life-threatening injuries. • Position victim on his or her back. • Raise victim’s legs 6 to 12 inches. • Prevent heat loss. Anaphylaxis • Type of shock • Powerful reaction to substances that enter the body • Causes • Medications • Foods • Insect stings • Plants Recognizing Anaphylaxis • • • • • • • • Breathing difficulty Skin reaction Swelling of tongue, mouth, or throat Sneezing, coughing Tightness in chest Blueness around lips and mouth Dizziness Nausea and vomiting Care for Anaphylaxis • Check breathing. • Seek immediate medical care. • If victim has his or her own medication for auto-injection, help with its use. • EpiPen Chapter 8 Burns Types of Burns • Thermal (heat) burns • Chemical burns • Electrical burns Thermal Burns • Depth (degree) • First-degree (superficial) • Second-degree (partial thickness) • Third-degree (full thickness) • Extent (Rule of palm) • Parts of body burned • Other injuries or medical conditions • Whether patient is elderly or very young First-Degree Burns (Superficial) • • • • Redness Mild swelling Tenderness Pain Second-Degree Burns (Partial Thickness) • • • • Blisters Swelling Weeping fluids Intense pain Third-Degree Burns (Full Thickness) • Dead nerve endings • Leathery, waxy skin • Pearly gray or charred skin Care for Thermal Burns • Stop the burning process. • Open airway and check breathing. • Seek medical attention if: • Victim is younger than 5, older than 55 • Victim has difficulty breathing • There are other injuries or electrical injury • Face, feet, hands, or genitals are burned • Child abuse is suspected • Second-degree burn is larger than 20% BSA • Burn is third degree First-Degree Burns • Cool burn. • Apply moisturizer such as aloe vera gel. • Administer ibuprofen to relieve pain (acetaminophen for children). Small Second-Degree Burns • Cool burn. • Apply antibiotic ointment. • Cover burn with dry, nonstick, sterile dressing. • Administer ibuprofen to relieve pain (acetaminophen for children). Large Second-Degree and Third-Degree Burns • Monitor breathing. • Cover burn with dry, nonstick, sterile dressing. • Care for shock. • Seek medical care. Chemical Burns • Results from caustic or corrosive substance • Acids, alkalis, and organic compounds • Continue to burn as long as they are in contact with the skin; remove quickly Care for Chemical Burns • Flush skin. • Remove contaminated clothing. • Cover burn. • Seek medical care. Electrical Burns • Thermal burn (flame) • Arc burn (flash) • True electrical injury (contact) Care for Electrical Burns • • • • • • Make the scene safe. Open airway and check breathing. Check for spinal injuries. Cover burns. Care for shock. Call 9-1-1. Contact With Electrical Current • Downed power lines • Turn off power before approaching patient. • Must have training and appropriate tools • Faulty electrical equipment or careless use of electrical appliances • Turn off electricity at the circuit breaker, fuse box, or outside switch box. • Unplug appliance if plug is undamaged. • Do not touch the patient until current is