Chapter 16;First aid, emergency care and diaster management

Primary survey sequence
1. asses the ABC
2. initiate cardiopulmonary resuscitation or rescue breathing as
needed
3. look for uncontrolled bleeding, identify the source, and apply direct pressure
4. systematically examine for injuries from the heat to the feet and immobilize the spine,limbs or both as indicated
5. Look for a medical alert tag usually a necklace or braclet

Guidelines for first – aid treatment
1. protect the airway
2. splint injured parts in the position they are found
3. prevent chilling but don not add excessive heat
4. do not remove penetrating objects
5. do not give anything by mouth to an unconscious
6. stay with the injured person in til medical care or transportation arrives

Anthrax Characteristics
after exposure sympthoms may apperar in 7-42 days.
3 types
1. skin- painless lesion beguns as small sore and then a blister, ulcerates, and blackens
2. Lungs- sore thoart, mild fever, muscle aches, cough, shortness of breath.
3. Digestive tract- nausea, anorexia, bloody diarrhea, severe stomach pain

Anthrax treatment
antibiotic treatment with fluroroquinolones used for prevention following exposure; antibiotics alone for infection.
Cutaneous- usually responds to antibiotic
Gastrointestinal- fatal in 25% to 50% of cases
Inhalation- fatal in about one half of all cases

Botulism Characteristics
Toxins are ingested in foods. Onset pf symptoms 6 hours to 2 weeks after ingestion. Causes progressive paralysis with double vision, dropping eyelids,slurred speech, dry mouth. Progresses downward to arms chest and legs. Can paralyze muscles of respiration

Botulism Treatment
Centers for Disease Control and Prevention stocks antitoxin which can reduce severity of symptoms if given early.Most people recover after weeks to month of supportive care.

Pneumonic Plague Characteristics
Normally spread by rodents but can be spread in aerosol form and then transmitted from person to another. causes fever weakness rapidly developing pneumonia shortness of breath and cough

Pneumonic Plague Treatment
prompt antibiotic therapy within 24 hours after onset of symptoms may be effective in prevention after exposure. antibiotics include tetracyclines, chloramphenicol, streptomycin and gentamicin

Smallpox characteristics
caused by virus transmitted from person to person. Onset of symptoms 10-12 days after exposure includes high fever and pain. Rash with small papules progresses to pustules and then to scabs

Smallpox Treatment
can be prevented with vaccine but is not routinely given now in the US. No specfic treatment is available. among infected persons who have not been vaccinated 25%- 30% die.

Tularemia characteristics
In nature is carried by rodents and rabbits. as a weapon can be made into an aerosol or dispersed in food or water. onset symptoms usually 3-5 days after exposure. Manifestations: sudden fever chills headache diarrhea muscle aches joint pain dry cough progressive weakness

Tularemia Treatment
Antibiotics usually are effective. Efforts to have a vaccine approved are underway.

Human bite effect
are potentially very dangerous because of the risk of infection. the most common site is the hand or fingers caused by hitting a person in the mouth.

Human bite interventions
clean thoroughly and apply a dressing. advise the victim to seek medical attention for antibiotic therapy

Tick bite effect
require attention because ticks carry organisms that cause Lyme disease and Rocky Mountain spotted fever.
Lyme Disease
Early localized Stage- influenza like symptoms with or without a ringed shaped.
Early disseminated stage- fatigue anorexia vomiting neurological symptoms.
Late disseminated stage- Joint and muscle involvement progressive neurological symptoms

Rocky Mountain
symptoms- appear 3 to 10 days after bite: chills fever headache pain behind the eyes, joint and muscle pain, and a rash that begins on the wrists and ankles and spreads to the exterminates the trunk and sometimes the face. Can be fatal if not treated.

Spider bite effect
most cause only local irritaion

Spider bite interventions
for any bite wash the site and apply cool compress. Transport the victim for medical care if bite was by black widow or brown recluse.

Black Widow effect
Venom is neruotoxic- causes pain nausea and vomiting fever weakness muscle cramps headache
More serious effect- respiratory distress hypertension seizures and shock

Black window interventions
shinny black with red hourglass on abdomen. Antivenin is available for black widow spider bites. not recommended : constricting bands

Brown recluse effect
bite not especially painful. area usually swells within a few hours. Initially a bluish ring appears around bite . Later it is surrounded by a white ring with a red halo.
some people experience nausea and vomiting fever and joint pain. severe cardiac, renal and neurological reactions are uncommon. In 3 – 4 days after a bite the affected tissue becomes necrotic.

Brown recluse treatment
is light brown with a fiddle shapedn= mark on the thorax. Medical attention should be sought for these bites. No specific antivenin is available to counteract the venom. Eventually the tissue sloughs off or needs to be debrided. the injury can be so extensive the reconstruction surgery is needed.

animal bite effect
should be taken seriously because of the risk of wound infections and rabies. rabies is an infection of the central nervous system that is almost always fatal.

animal bite intervention
clean the wound thoroughly apply a bulk dressing.

Insect bite or sting effects
common reactions: local itching,edema, and eyrthema. People with serious allergies react with systemic symptoms of uticaria,edema, and possibly fatal anaphylaxis.

Insect bite or sting interventions
mild reactions- calamine lotion or a paste of baking soda or meat tenderizer is soothing.

severe allergic responses- the patient with severe allergies should be taken to a medical facility.Epinephrine, diphenhydramine choloride,aminophylline, and hydrocorisone may be administrated.

Prevention- people who are severely allergic to insect venom should carry emergency epomephrine that can be given subcutaneously Remove stinger with a scraping motion if its a honeybee.

Snake bite intervention
seek medical care immediately. immobilize the part where the bite is located and keep it below the level of the heart.

Foreign body in eye
remove by irrigation or by gently touching the object with the corner of a clean cloth or gauze pad or moistened cotton-tipped applicator.

Chemical contact in eye
immediately flush the eye for 30 min. sterile normal saline or water is ideal but tap water can be used. direct the irrigation fluid from the inner canthus to the outer.

Perforation of the globe of the eye
don’t attempt to remove an object that has perforated the eye. you could cause additional harm. instead limit movement of the object and the eye and the transport. Patch the unaffected eye.

eyelid trauma
seek medical evaluation because injury of the globe as well as the lid is always possible. don’t apply direct pressure to a bleeding eyelid. if the globe has been injured pressure could cause additional harm. apply a loose dressing and transport the victim for medical care.

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