# Disaster Medical Operations > [!Info] Objectives > 1. Identify [[#life-threatening conditions]] > 2. Apply correct life-saving techniques > 3. Provide basic first aid for non-life-threatening injuries ## Common Injuries - [[#Burns]] - [[#Wound Care|Wounds]] - Amputations - [[#Fractures, etc.]] - [[#Heat-Related Injuries]] - [[#Cold-Related Injuries]] ## Life-Threatening Conditions - Severe bleeding and airway obstruction cause death. Prioritize [[#Controlling Bleeding]] and [[#Opening the Airway]] - Spurting/steady bleeding - Arterial bleeding spurts - Venous bleeding flows - Capillary bleeding oozes - Pooling blood - Blood soaking through clothes - Blood soaking through bandages - Amputation - Prior to providing care: - Do you feel safe at this spot? - Should you move to a safer location, or can you stay to help immediately? - If you leave, can you take anyone with you? ## Primary Life-saving Measures - [[#Controlling Bleeding]] - [[#Opening the Airway]] - Maintaining temperature (See [[#Cold-Related Injuries]] and [[#Heat-Related Injuries]]) ## Approaching Patients - Approach visibly - Identify yourself and your role - Ask permission to treat - Respect cultural differences - Protect privacy ## Head to Toe Assessment - Determine the extent of the injury - Deformities? - Open wounds? - Tenderness? - Swelling? - Check for Medical ID bracelet - Determine the type of treatment needed - Document any injuries discovered, checking for pulse, movement, and sensation 1. Head 2. Neck 3. Shoulders 4. Chest 5. Arms 6. Abdomen 7. Pelvis 8. Legs - Notation best practices: - Patient - Condition - Report - If head/neck/spine injuries are suspected, *do not move the victim* ## Controlling Bleeding 1. Find the source of the bleeding 2. Cover the source with sterile gauze (if you have it) or something clean (if you don’t) 3. Apply pressure with *all* your weight. 4. Maintain pressure until the bleeding stops (usually about five minutes) 5. Check for numbness or tingling after the bleeding stops (the pressure might be too much) ### Tourniquet 1. Place on injured limb as high as possible 2. Pull strap through the buckle 3. Twist the rod until the bleeding stops 4. Secure the rod 5. Apply a second tourniquet if bleeding continues 6. Leave in place until EMS takes over ## Shock - Hypoperfusion: low blood transport of key elements like oxygen - Signs of shock - Rapid, shallow breathing - Capillary refill greater than two seconds - Failure to follow simple commands - ==Untreated shock results in death== ### Treating Shock - Get them to emergency medical services! - Keep warm (remove wet clothes, place a barrier between patient and ground, wrap in dry layers, shield from wind) ## Opening the Airway - Tongue is the most common airway obstruction - Tilt head upward - Perform “jaw thrust maneuver” on an *un*conscious patient to move the jaw forward without moving head or neck ## Positioning a Conscious Patient - Let them determine a comfortable position for themself. - Sitting on a raised platform or standing is fine, if that’s what they prefer. ## Positioning an Unconscious Patient 1. If breathing, move into the [[N2 recovery position 20240127|recovery position]] 2. If not breathing, do CPR (if you know CPR) or move patient into the [[N2 recovery position 20240127|recovery position]] ## Provide Comfort - Keep warm - Offer a hand to hold, if they’d like - Maintain eye contact (if culturally appropriate) - Be patient and understanding - If you have to move on to someone else, communicate those changes early and often ## Burns - Prevent hypothermia - Manage pain - Reduce infection risk - Burn severity is determined by a combination of factors: - Temperature - Time period of exposure - Area of body, size of area (consider hands, feet, etc. as being especially sensitive, since they’re used for more stuff) - Depth of burn - Superficial: epidermis (redness) - Partial thickness: dermis and epidermis (blistering) - Full thickness: subcutaneous and all higher layers (white, leathery, or charred) ### Chemical Burns - Remove jewelry - Flush with lots of cool running water unless it’s a dry chemical - Apply cool, wet compress for pain, but be mindful of hypothermia - Cover wound loosely with dry, sterile dressing ## Wound Care - [[#Controlling Bleeding|Control bleeding]], apply dressing - Dressing goes directly onto the wound, bandages hold dressings in place - If there’s active bleeding, redress *over* existing dressing, if not, maintain pressure - Monitor for swelling, discoloration, discharge, striations—all signs of potential infection If an amputated body part is found: - Save it, wrap it in clean material, place it in a plastic bag, then keep cool but not directly on ice. Label the bag to travel with the patient. ## Impaled objects - Immobilize the affected body part - ==Don’t remove the impaling object!== - [[#Controlling Bleeding|Control bleeding]] at entrance wound - Clean and dress wound, stabilizing the impaled object ## Fractures, etc. - Immobilize injury and the joints above and below the injury - If uncertain, treat it like it’s fractured - Avoid splinting unless you really know what you’re doing - Open fractures protrude from the skin - Don’t try to stick it back in! - Don’t irrigate the wound - Cover with a sterile dressing - Place moist dressing over bone ## Dislocation - Immobilize the joint - Check pulse, movement, sensation, and circulation before *and* after splint/immobilization ## Cold-Related Injuries - [[N2 Hypothermia 20240127|Hypothermia]] - [[N2 Frostbite 20240127|Frostbite]] ## Heat-Related Injuries - Heat cramps - [[N2 NET Heat Exhaustion 20240127|Heat Exhaustion]] - [[N2 NET Heat Stroke 20240127|Heat Stroke]] ## Bites and Stings - Remove stinger by scraping (like with a credit card) - Wash with soap and water - Ice on site for 10 minutes on, 10 minutes off - ==Never ice skin directly!== ## Anaphylaxis - Try to help the individual stay calm - If available, find and administer the Epi-pen—and call 911/EMS! - Don't administer any other medications! You are not trained for that. --- - [[N2.21 Portland NET Basic Training Index 20240120|NET Basic Training]]