EMERGENCY MEDICINE LECTURE

EMERGENCY MEDICINE LECTURE : 

EMERGENCY MEDICINE LECTURE

EMERGENCY RESPONSE: STEP-BY-STEP PROGRESSION CHART : 

EMERGENCY RESPONSE: STEP-BY-STEP PROGRESSION CHART 1. Danger 1.1 Assessment O Situation O Personal safety O Injuries 1.2 Containment O Take steps to prevent further casualties/injuries/death 1.3 Call for Help O Shout for Help while assessing and containing the emergency CALL 911 OR YOUR LOCAL EMERGENCY SERVICE 2. Respond O Assess patient’s responsiveness O *Start CPR / First Aid 2.1 Airway 2.2 Breathing 2.3 Circulation 2.4 Bleeding 2.5 Burns 2.6 Broken bones *NB!! Self-protective measures e.g. gloves and other barriers It is essential for emergency medicine professionals to proceed in a specific way when confronted with an emergency situation in order to maximize the survival of the injured individuals as well as themselves. “A dead hero can't save lives and an injured hero is a nuisance…” Nico Stapelberg

ASSESS – DANGER - RESPOND : 

ASSESS – DANGER - RESPOND The first step is to quickly assess the emergency. A few seconds spent in assessing the situation and planning an appropriate response will be time well spent. Answer the following questions briefly:   What is my own personal safety status? Accept that you can only assist other injured people if you remain alive and uninjured. A brave dead person is of no use to himself or other injured people. Are there any people with injuries / casualties? Is there any imminent danger of further injuries?

CONTAIN – MINIMIZE RISKS : 

CONTAIN – MINIMIZE RISKS Next the emergency worker needs to contain the situation so as to prevent or minimize the risk of any further injuries. Examples are: Switch off the electricity mains; use a fire extinguisher to extinguish flames; making a road traffic accident site relatively safe by waving down traffic, etc. Once the immediate dangers have been contained and the emergency worker has summoned help, it is time to pay full attention to any injured individual/s present.   Establish responsiveness and categorize the patient in one of two categories – conscious and unconscious.

CONSCIOUS PATIENTS : 

CONSCIOUS PATIENTS Always get permission from a conscious patient before assisting or helping him or her with a simple sentence like “Sir/madam I am a emergency worker (if you have done a recent First Aid/BLS course), may I be of assistance?” Frequently put the person’s mind at ease, while assessing and managing life-threatening emergencies like severe external or internal bleeding. Simple comments like “you will be fine” or “help is on its way” will go a long way towards keeping the patient calm.

UNCONSCIOUS PATIENTS : 

UNCONSCIOUS PATIENTS Follow the easy A, B, C… steps of emergencies that you have memorized. A = Airway Is the person able to get Air from the nose and/or mouth to the lungs? Are there any obstructions like foreign objects in the mouth/nose/throat? Remove obvious obstructions if possible! B= Breathing Is the patient breathing? If not start CPR (cardio-pulmonary resuscitation) immediately! C = Circulation Is there a palpable pulse (see project 21 on how to determine the heart rate)? If not start CPR (cardio-pulmonary resuscitation) immediately!

VASOVAGAL ATTACK : 

VASOVAGAL ATTACK In general, the most common cause of unconsciousness in people is simple fainting.   Fainting occurs due to the brain being deprived of oxygen, and the treatment consists of positioning the patient with the head lower than the rest of the body, thereby restoring the blood (oxygen) supply to the brain – e.g. lifting the legs Warning: Under no circumstances should you try to keep a person who has fainted upright – you will increase the oxygen deprivation of the brain with potentially grave consequences!

OTHER “B”s IN TRAUMA : 

OTHER “B”s IN TRAUMA B = Bleeding Sufficient pressure always stops/contains bleeding. Apply pressure directly to the bleeding site with a clean dressing/gauze/clothe (or your clean hand if necessary!) B = Burns Use specific burns dressing if available. Use cool water, e.g. water from the cold tap, to cool down any burnt area of the body. B = Broken bones Apply temporary splints to reduce pain, minimize movement and facilitate transport of the injured person.

OTHER INJURIES IN TRAUMA : 

OTHER INJURIES IN TRAUMA Bruising: or diffuse bleeding within the tissue just below the epithelium of the skin. The bruised area will appear bluish (un-oxygenated blood), then turns greenish, and will eventually become yellowish in color as the hemoglobin is being metabolized. Hematoma (Blood clot): a well-circumscribed space in the body filled with blood/ a blood clot. A hematoma of any significant size is usually surgically evacuated.

OTHER INJURIES IN TRAUMA : 

OTHER INJURIES IN TRAUMA Other injuries may be: Abrasion: the partial or total loss of the surface or the skin or mucous membrane. A medical professional will assess the abrasion, stop any bleeding if necessary, clean it with an antiseptic preparation, dress it to protect it from the environment and assess it for further management e.g. skin grafting. Laceration: A laceration is a cut in an epithelial lining like the skin or mucous membrane. Treatment by a medical professional usually consists of: stopping the bleeding if necessary, clean (debridement), suturing and then dressing it to protect it from the environment and finally assessing it for further management e.g. scar revision.

OTHER INJURIES IN TRAUMA : 

OTHER INJURIES IN TRAUMA Other injuries may be: Penetrating injuries: Care of these injuries takes specialized knowledge and pertains to variables like the cause of the injury e.g. high/low velocity missile injury as well as the affected area of the body e.g. the braincase, the neck, the thoracic/abdominal body cavities, the extremities, the face and the hands and feet. All these specific regions require specialized knowledge and specific considerations regarding optimal management.

IMPORTANT NOTE: : 

IMPORTANT NOTE: Warnings: Do NOT move an unconscious patient who may have sustained a spinal (vertebral column) injury! Specialized equipment to stabilize the neck and spine will be required. Do not contaminate a burn with fat, butter or any other unclean substance. *In all situations where people are injured, call for professional help as soon as possible!

TAKE NOTE: : 

TAKE NOTE: Remember, there are people specifically trained and equipped to handle various types of emergencies, so call for help while you assess and contain the emergency situation. Shout for help! Call a dedicated emergency facility like 911 or your local fire/ambulance department per phone. Cell phones have become a valuable tool for getting help quickly in emergencies!

DO THE TRAINING : 

DO THE TRAINING It is strongly recommended that the apprentice doctor enlist for an accredited first aid and BLS (Basic Life Support) course. Take note: Cell phones should be able to handle emergency numbers like 911 even without a SIMM card.

CPR in Adults and Babies… : 

CPR in Adults and Babies…