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First aid

First aid. MUDr. Stanislava Pingorová Department of trauma surgery LF UPJŠ. Fractures. closed open Status assessment : Deform ation , swelling a nd hematomas Pain a nd difficulty by motion with injured part , shortened or bending extremities Crepitations of bone fragments

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First aid

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  1. First aid MUDr.Stanislava Pingorová Department of trauma surgery LF UPJŠ

  2. Fractures • closed • open Status assessment: • Deformation, swelling and hematomas • Pain anddifficulty by motion with injured part, shortened or bending extremities • Crepitations of bone fragments • Signs of shock – fractures of pelvis or femur • Wounds with protruding bone fragments

  3. Fractures • Closed fractures – intact skin + aims • avoidof motion with injured part • managethe transport to hospital • firm fixation of brokenpart through the transport

  4. Fractures • Immobilisation • Fix to healthy side • Transport to the hospital • Check the circulation arround the bandage • Not allowed eating, drinking and smoking Extreme state: • Broken part is bending that there is no chance to immobilisate • Carefull stretching of muscels/traction/ in axis of extremity • Immobilisation • Not continue in case of unbearable pain

  5. Fractures • Open fracture + aims • Prevent of blood loss, motion and infection • Immobilisation and transport to hospital • Gently covering of wound with sterile or clean bandage • Not press on protruding bone fragment • immobolisation • In case of need treat the shock

  6. Fractures

  7. Fractures Extreme state: • Protruding of bone fragment • Place the small pads arround the bone fragment • Fix the pads with wrapping dressing

  8. Dislocation • Complete separation of articular surfaces Status assessment : • Pain andtrouble to move with injured extremity • Swelling and bruises arround the joint • Shortening or bendinng of injured part

  9. Dislocation +aims • Prevention of movement with injured part • Transport to the hospital with support injured part • Support injured part in optimal position for pacient • Immobilise injured extremity /sling/ • Check circulation every 10min • Transport to the hospital

  10. Distorsions/sprains • Injury of ligamentous aparat Status assessment: • Pain and tenderness • Difficulties with movement especially in joint • Swelling and hematoma arround the joint

  11. Distorsions/sprains • R – restfor injured part • I– icein bag or cold poultice • C – compression • E – elevationof injured part +aims • Reduce the swelling and pain • In case of needing take to hospital

  12. Head injury Failure of consciousness !!! Unconsciousness !!!

  13. Head injury A B C system • A airway • B breathing • C circulation • D dysfunction/disability • E exposure

  14. Head injury A: uncontrolled airway head tilt unconsciousness

  15. Head injury A: head tilt chin lift open the mouth

  16. Head injury Clean up the airway

  17. Head injury • listen and feel normal breathing • chest movement B:

  18. Head injury B: • resuscitation

  19. Head injury • C :circulation Pulse: • A. carotis • A. femoralis • A. radialis

  20. Poranenie hlavy C: resuscitation

  21. Head injury

  22. Head injury • Recovery position • spontaneous breathing !!!

  23. Position for head injury in consciousness

  24. Head injury • Head trauma can be associated with injury of brain tissue, brain vessel injury and skull fracture • Clear fluid leaking out of nose or ears suggest serious injury • Do not forget on cervical spine injury Status assessment: Commotio cerebri /concussion of the brain /: • Short unconsciousness after hit the the head • Dizziness and nauseaor vomiting • Amnesia • Gentle diffuse head pain

  25. Head injury Contusio cerebri: • Worsening levels of responses passing to the unconsciousness • Note about recent head trauma • Intensive head pain • Noisy breathing • Puppilary response, size of pupillas • Unilateral weakness • Fever • Evident changes of personality and behaviours

  26. Head injury Skull fracture: • Wound or hematome on head • Soft and depression place on skull • Hematomas arround eyes • Leaking clear fluid out of nose or ears • Deformation or asymetry of head • Worsening level of responses

  27. Head injury Concussion of the brain: + aims: • Keep guiet pacient • Transport to the hospital if needed • If recovery in not complete or if following neurologic deterioration is present /transport to the hospital/ • Advise later control in emergency department in case of persisting headache and dizzness

  28. Head injury Contusion of the brain: • Serious injury • May require operation + aims: • Immediate transport to the hospital • If pacient is unconsciousnes: open airway • Check the breathing • CPR

  29. Head injury Skull fracture: + aims: • Maintain open airway • Immediate transport to the hospital • Consciousness – think about cervical spine injury • Stop bleeding from wound by pressure dressing • Leaking cleer fliud from nose and ears – cover with sterile or clean dressing • Watch the vital signs • Unconsciousness – as upper

  30. Head injury

  31. Head injury Injury of scalp

  32. Head injury

  33. Head injury

  34. Serious facial fractures • In most cases hard collision Status assessment: • Pain of injured part, injury of mandibula – troubles with speaking and chewing • Distressed breathing • Swelling and face deformation • Bruises arround eyes

  35. Serious facial fractures +aims • Maintain open airway • Minimize swelling of face • Immediate transport to hospital • Call emergency 112 • If he responses- spue blood, teeth, denture • Apply cold poultice – reduce swelling and pain • Do not wrap chin if paciet is vomiting or he has disstressed breathing

  36. Serious facial fractures Fracture of mandibule

  37. Serious facial fractures • If he is not responses • Open airway and check breathing • Cardiopulmonary resuscitation • If he is breathing – recovery position to allow body fluids drain out • Remember to CERVICAL SPINE INJURY

  38. Injury of shoulder • Falls on arms or outstretched arm • Very painfull Status assessment: • Pain and tenderness • Swelling and deformation of shoulder • Relaxing muscles can decresed pain + aims: • Immobilisation of shoulder • Transport to hospital

  39. Injury of shoulder • Immobilisation • Triangulare sling • Never do reposition of dislocated joint • Do not allow the victim to eat, drink and smoke

  40. Triangle sling

  41. Triangle sling

  42. Injury of elbow • Fall on elbow • Regulary controlling of circulation • Never do forced stretching of elbow Status assessment: • Pain increased by movement • tenderness • Swelling, hematomas and deformation • Movement of elbow joint is not possible

  43. Injury of ribs and breastbone • Fracture of one or more ribs /blunt trauma/ • Penetrating injury • Unstable “flail” segments of chest wall • Injury of parenchyma organs as liver and spleen by fractured lower ribs

  44. Injury of elbow + aims: • Immobilize injured upper extremity • Transport to the hospital • Check the pulse on wrist • if you do not find pulse carefuly stretch the elbow as long as you will feel it • Support the arm in that position

  45. Injury of ribs and breastbone Status assessment: • Sharp pain in place of broken rib • Painfull breaths • Superficial breathing • Air suction throughout open chest wall • Signs of shock and internal bleeding

  46. Injury of ribs and breastbone + aims: • Support the chest wall • Immediate transport to the hospital • Make a sling support on injured side • In case of penetrating injury close the wound from three sides • Tilt the pacient on injured side

  47. Penetrating chest injury • Cause of pnemothorax- air in pleural cavity • Tension pneumothorax- increasing pressure on injured side compromise heathly side and pacient has depressed breathing, air enters a pleural space without a means of exit Status assessment: • depressed, painfull, superficial breathing • Feeling jeopardize life • Sign of preterminal hypoxemia- /cyanosis/ • Crepitation in subcutaneous tissue • Chest wall bleeding • Jugular venous distension

  48. Penetrating chest injury + aims • Cover the wound and reassess the breathing • Minimaze the shock • Immediate transport to the hospital • Cover the wound with dressing • Dressed with occlusive plastic film (bag) on three sides to allow gas exit from the pleural space only • Watch vital signs • Unconsciousness - CPR

  49. Penetrating chest injury

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