Unit 4: Disaster Medical Operations
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Transcript of Unit 4: Disaster Medical Operations
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Unit 4: Disaster Medical Operations
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Unit 4 Introduction
Topics: Public health concerns Organization of disaster
medical operations Establishing treatment
areas Conducting head-to-toe
assessments Treating injuries
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Public Health Considerations
Maintain proper hygiene. Maintain proper sanitation. Maintain pure water.
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Isolation Precautions
If there is any reason that some victims may be contagious, isolate them immediately.
DO NOT forget about them. Delegate someone to “stand guard” to lesson the chance of accidental exposures.
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Steps to Maintain Hygiene
Wash hands frequently using soap and water. Sing The Pledge of Allegiance
Wear latex gloves; change or disinfect after each patient. 1:10 ratio of bleach to water
Wear a mask and goggles. Keep dressings sterile. Avoid contact with body fluids.
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Maintaining Sanitation
Control disposal of bacterial sources. Put waste products in plastic bags, tie off, and
mark as medical waste. Bury human waste.
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Water Purification
Mix 8 drops of bleach per gallon of water (16 drops if water is cloudy).
Let the solution stand for 30 minutes.
If the solution does not smell or taste of bleach, add an additional 6 drops.
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Functions of Disaster Medical Operations
Triage Treatment Transport Morgue
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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.
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The Alley
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Treatment Area Organization
CERT Leaders MUST assign Supervisors to maintain control in the functional areas. These Supervisors will: Ensure orderly placement.
• Head-Toe configuration
• 2-3ft between victims Direct assistants head-to-toe
assessments.
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Treatment Area Documentation
Supervisors need to oversee and make sure thorough documentation is being performed on all victims. Use a Treatment Documentation Form
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Consent To Treat
CERT members need to ask the victim for permission to conduct the assessment. The victim has a right to refuse treatment (make sure you document it!).
If the victim is unconscious treat the injuries under implied consent and assume they have a spinal injury.
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Conducting Head-to-Toe Assessments
Head-to-Toe assessments are performed to go beyond “the killers” to gain more information to determine the nature of the victims injury.
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Head-to-Toe Assessment
1. Head2. Neck3. Shoulders4. Chest5. Arms6. Abdomen7. Pelvis8. Legs9. Back
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Multiple Assessments
If medical teams run out of or low on latex gloves, use rubber gloves and clean between treatment of victims in a bucket of bleach-water solution (1:10 ratio) to reduce the risk of cross contamination.
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Indicators of Injury
Bruising Swelling Severe pain Disfigurement
CERT members need to pay careful attention to how the victim has been hurt (mechanism
of injury) because it provides insight to probable injuries suffered.
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Head, Neck and Spinal Injuries
CERT members main objective with a suspected head or spinal injury patient is to do no harm.
Minimize movement of the head and spine while treating any of “the killers”.
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Closed-Head Injury Signs
ALOC Inability to move a body part Severe head, neck or back pain(s) Tingling or numbness Difficulty seeing or breathing Facial trauma Bruising behind ears (late sign)
Bruising under the eyes Equal pupils Unexplained seizures Nausea or vomiting Mechanism of injury
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Spinal Immobilization
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Burn Severity
May be from heat, chemical, electrical or radiation.
Severity depends on: Temperature of the burning agent Period of exposure Area effected Depth of burn
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Layers of Skin
Epidermis Dermis Subcutaneous layer
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Classification of Burns
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Rule of 9’s: Burn Surface Area (BSA)
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Treatment of Burns
Remove or cut away the burning source. Cool skin or clothing (if still hot) by immersing in water for
no more then 1 minute or cover with a clean compress. Cover with a dry sterile dressing. Elevate the extremity, if possible. Remove rings, bracelets, watches! Do not use ice Do not apply butter or antiseptics Do not remove skin or break blisters
TREAT FOR SHOCK!
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Wound Care
Control bleeding (discussed in Unit 3) Prevent secondary infection
Wear gloves Clean wound—don’t scrub
Use a turkey baster or bulb syringe to irrigate Mild soap and water
Apply dressing and bandage
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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.
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Treating Amputations
Control bleeding Treat for shock Save tissue parts, wrapped in clean cloth Keep tissue cool (do not place directly on ice) Keep tissue with the victim
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Treating Impaled Objects
Impaled Objects: Immobilize the body part. Don’t move or remove. Control bleeding. Clean and dress wound. Wrap with bulky dressings. Treat for shock.
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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.DO NOT: Irrigate the wound. Draw the exposed bones back under the skin.
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Dislocation
Displaced or misaligned joint. Ligaments always become damaged.
Do not try to reduce the injury.
Immobilize the joints.
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Strain
Muscle fibers tear as a result of overstretching.
Pain Stiffness Inflammation Bruising
R-Rest
I- Ice
C- Compression
E-Elevation
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Sprain
Overstretching or tearing of a ligament at a joint. Tenderness at injury site Swelling and/or bruising Restricted use or loss of use
R-RestI-IceC- CompressionE-Elevate
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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.
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Creative Splinting
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Nasal Bleeding
Causes: Blunt force Skull fracture Nontrauma-related conditions
Blood loss can lead to shock. Victims may become nauseated and vomit if they swallow
blood. Treatment:
Lean forward Apply ice to bridge of nose Allow drainage
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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
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Symptoms of Hypothermia
At later stages, hypothermia will be accompanied by: Slurred speech. Unpredictable behavior. Listlessness.
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Treatment for Hypothermia
Remove from wind and rain
Remove all wet clothing Give warm drinks by
mouth (if conscious) Bundle in warm blankets,
cover the head
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“Break” Time