Trauma Management

Figure 6

Do the following to apply a tourniquet:

1. Wear personal protective gear.
2. Apply the tourniquet approximately 2 inches above the wound.
3. Tighten until the bleeding stops.
4. Check and take note of the time when the tourniquet was applied.
5. Call 911/EMS.
6. Until advanced help arrives, wait with the person and do not release the tourniquet.

When handling another person’s teeth, always use gloves, as the teeth may be chipped or broken, or sometimes completely knocked from the mouth.

When transporting the person to the medical facility or dentist, their teeth should travel with them, as these can sometimes be re-implanted. Avoid touching the roots when handling teeth; always be gentle. Never scrub the tooth or the roots, but you may gently wash it with clean water. Storing in milk, saline solution, or under a tongue are viable options for transporting a tooth. The person must see a dentist or medical provider as soon as possible.

Call the dentist and have the person bite down on a piece of gauze if dealing with a loose tooth. It can be quite painful to deal with cracked or chipped teeth. To prevent loss of the tooth when blood is visible at the crack, the person requires prompt dental care. Teeth that have an injury to the nerve may later begin to change color, requiring a trip to the dentist.

The injured person is at a special risk from impaled objects and puncture wounds. Sensitive structures such as blood vessels, tendons, muscles, or nerves may be injured by puncture wounds, which usually penetrate deeper than is apparent. Seek further medical attention after you use direct pressure to control the bleeding from puncture wounds. Serious infections can be caused when puncture wounds carry germs deep into a wound. A professional must therefore evaluate the puncture wound immediately.

Do not remove an impaled object. This may result in massive blood loss from an injured blood vessel, as the object may pinch off the blood vessel and prevent bleeding until it is removed. Transfer the person to the emergency department while using gauze and dressings to stabilize impaled objects.

Figure 8

Inadvertent scratching of the eye, foreign bodies, and direct blows are some of the causes of common eye injuries. Redness, changing vision, tearing, and immediate pain are some of the symptoms of this type of injury, as well as bleeding and bruising from punctures and lacerations, and other more serious injuries.

Water can be used to flush away dust, debris, and other simple irritants. You should call 911/EMS if the eye comes in contact with any chemical, and also flush with a lot of water. Professional care is important, as adequately irrigating the eye sometimes requires special equipment.

Call 911/EMS if you suspect there is a more serious injury to the eye. A bandage or eye shield is enough to protect both eyes. You must cover both eyes, as leaving one eye uncovered still forces both eyes to move as one eye looks around because eyes work in pairs; it is essential to minimize the damaged eye’s movement. If a person has both eyes bandaged, never leave them alone. They require reassurance and verbal cues about their environment. To evaluate serious eye injuries, a skilled physician specializing in eye care is needed.

Common occurrences in daily life, bone, and joint injuries can be experienced by physically active people and people playing sports. Breaks, strains, and sprains are also commonly experienced by the disabled and elderly, who are at high risk of falling. When a joint is stretched beyond its normal range of motion with abnormal motion or excessive force, sprains occur. Pain, bruising, and swelling are frequently caused by a sprain, but without an X-ray, it is impossible to rule out a fracture.

• Open wound over a joint
• Bent extremity or abnormal position
• Obvious joint dislocation

When the bone breaks through the skin, an open or compound fracture occurs. Straightening the extremity and/or pushing the bone back in are not recommended; bones in these abnormal positions require splinting. An abnormally positioned bone or join should not be manipulated or corrected.

Protecting an injured extremity requires a splint. Rolled-up towels, pieces of wood, or rolled-up magazines can make a temporary splint. If possible, use a towel or cloth to pad the injured extremity. Use tape or gauze to secure the splint material in place; the material which should be placed on either side of the injured extremity. The fingertips or toes should still be warm and pink in a splinted extremity, so don’t make the splint too tight. Seek immediate care.

If a part of someone’s body is accidentally cut off, this is called an amputation. Always transport the body part to the hospital with the person, as sometimes surgeons can reattach it.

1. Put on personal protective equipment, get the first aid kit, and assess the scene’s safety.
2. Call 911/EMS and activate the emergency response system.
3. Use gauze to apply direct pressure to the bleeding area.
4. Use the instructions below to care for the amputated body part.
5. Wait until the arrival of advanced care.

1. Put on personal protective equipment.
2. Locate the amputated body part.
3. Use clean water to gently rinse it.
4. Wrap it in gauze, then seal it in a place bag.
5. Place the first bag in a second bag that has been filled with ice, then seal the second bag.
6. On the bag, write the person’s name.
7. Transport both the amputated part and the person to the hospital.

Direct contact with certain chemicals, electricity, or any heat source can cause burns. While some burns are minor superficial wounds, very deep burns can damage bones, nerves, tendons, and muscles. Devastating and sometimes fatal injuries can be caused by high-voltage electrical injuries. The emergency department must evaluate anyone who has sustained an electrical injury.

• A large burn
• Burns on someone’s genitals, hands, or face. Special treatment is required for skin over joints like the backs of knees, as healing will be complicated by constant motion.
• Troubled breathing
• A fire
• Potential carbon monoxide exposure

1. Ensure the safety of the scene.
2. Call 911/EMS.
3. Get the first aid kit and put on your personal protective equipment (PPE). Remove jewelry and clothing from the person.
4. Remove any part of the clothing which is not stuck, and if you have suitable alternative coverings, i.e., a clean plastic film, sheet, blanket, etc., cover them. Do not remove clothing that is attached to their skin as it may tear the injury further.