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Chapter 3: Traumatic Injuries

Video 3a: Controlling Bleeding
Script: Welcome to the lesson on Controlling Bleeding. In this video, we will discuss various ways to control bleeding.

Blood loss often gets the most attention from all of the traumatic injuries. Many times, the amount of bleeding is overestimated and draws attention to wounds when more serious injuries should be dealt with first. Whenever you are confronted with bleeding, first perform a quick overview of the individual to make sure something more serious is not being overlooked.

When caring for a bleeding individual, always use personal protective equipment. The individual can be instructed to perform some self-care while you put on your protective gear.

Very small wounds such as scrapes can heal more rapidly by using an antibiotic salve. Ask the individual if they have any allergies before applying the antibiotic salve. Thoroughly wash minor scrapes and abrasions with soap and water before bandaging.

The most effective way to stop bleeding from a wound is to apply direct pressure. Use a dressing and your gloved hand to apply firm and direct pressure to the injured area. Continue holding the pressure until the bleeding stops. If there are multiple wounds, apply pressure dressings to the worst injuries first, and then to the lesser bleeding injuries. The injured individual may be able to temporarily assist by holding pressure on some areas.

When direct pressure does not control bleeding, a tourniquet may be required. Understand that the application of a tourniquet is painful but may be necessary to prevent life-threatening blood loss. Tourniquet use is difficult and can be dangerous if done incorrectly. Always start with applying direct pressure first.

To apply a tourniquet, first put on personal protective gear.

Then, apply tourniquet approximately two inches above the wound.

Tighten until the bleeding stops.

Record the time the tourniquet was applied.

Call 911.

Stay with the individual and do not release the tourniquet until advanced help arrives and assumes care.

Certain situations may produce massive internal bleeding that is not visible when examining the individual. This may occur from trauma, falls from a height, car accidents, or crush injuries. Penetrating injuries caused by a knife or gunshot may produce devastating internal bleeding with very little external blood loss. Any time you suspect these injuries, immediately call 911 and help the individual lie down and remain still. Check for signs and symptoms of shock. You may need to cover the individual to keep them warm. Stay with them until advanced help arrives.

This concludes our lesson on Controlling Bleeding. Next, we will review Teeth Injuries.

Video 3b: Teeth Injuries
Script: Welcome to the lesson on Teeth Injuries. In this video, we will discuss how to handle teeth injuries.

Firstly, always use gloves when handling teeth.

Sometimes teeth can be re-implanted and should be transported with the individual to the dentist or the medical facility. A tooth can be transported in milk, saline solution, or under a cooperative individual’s tongue.

Always handle teeth gently and avoid touching the roots. Gently wash the tooth with clean water but never scrub it or its roots.

If a tooth is simply loose, have the individual bite down on a piece of gauze and call their dentist. Chipped or cracked teeth can be quite painful. If blood is visible at the crack, prompt dental care is required to prevent loss of the tooth. Injured teeth may later begin to turn colour, which can be an injury to the nerve.

This concludes our lesson on Teeth Injuries. Next, we will review Nosebleeds.

Video 3c: Nosebleeds
Script: Welcome to the lesson on Nosebleeds. In this video, we will discuss how to handle nosebleeds.

Nosebleeds can be quite dramatic and are often messy. When attending to nosebleeds, be sure to wear personal protective equipment and eye protection.

Individuals with nosebleeds often swallow a fair amount of blood, which can result in vomiting. Therefore, you should prepare for the worst.

After ensuring that the scene is safe and protective equipment is on, press both sides of the nostrils just below the bony portion of the nose for a minimum of 5 to 10 minutes. Make sure that the individual does not tilt their head backwards while holding during a nosebleed.
If bleeding continues, try holding pressure for an additional 10 minutes. If bleeding continues, seek further medical care.

If the individual has trouble breathing, or if they show signs of severe distress, then call 911.

This concludes our lesson on Nosebleeds. Next, we will review Punctures and Impaled Objects.

Video 3d: Punctures and Impaled Objects
Script: Welcome to the lesson on Punctures and Impaled Objects. In this video, we will discuss how to handle cases of punctures and impaled objects.

Puncture wounds and impaled objects pose a special risk to injured individuals.

Puncture wounds may penetrate deeper than is apparent and injure sensitive structures such as nerves, muscles, tendons, or blood vessels.

To control bleeding from puncture wounds, apply direct pressure, and seek further medical attention. Puncture wounds may carry germs deep within a wound and may result in serious infections. Therefore, any serious puncture wounds should be evaluated by a professional as soon as possible.

Impaled objects must be left in place. It is important to understand that the object may pinch off a blood vessel, and removal of the object may result in massive blood loss from an injured blood vessel.

Stabilize impaled objects with gauze and dressings and transport the individual to the emergency department.

This concludes our lesson on Punctures and Impaled Objects. Next, we will review Eye Problems.

Video 3e: Eye Problems
Script: Welcome to the lesson on Eye Problems. In this video, we will discuss the causes and symptoms of eye injuries and how to handle them.

Common eye injuries can result from direct blows, foreign bodies, or inadvertent scratching of the eye.

Symptoms of eye injuries include immediate pain, tearing, changing of vision, and redness.

Bruising and bleeding can also occur. Simple irritants such as dust or debris can be flushed using water. Any chemical exposure to the eye should be flushed with copious amounts of water. Special equipment can be required to adequately irrigate the eye, so you should seek professional care.

If a more serious injury to the eye is suspected, call 911. Protect both eyes with a bandage or eye shield. Because the eyes work in pairs, leaving one eye uncovered causes both eyes to move when the good eye tracks objects. Covering both eyes minimizes the movement of the injured eye. However, doing so leaves the individual effectively blind, which can be dangerous and frightening. Never leave an individual with both eyes bandaged alone. They will require verbal cues and reassurance about their surroundings. Seek help from an eye care specialist to evaluate these injuries.

This concludes our lesson on Eye Problems. Next, we will review Head Injuries.

Video 3f: Head Injuries
Script: Welcome to the lesson on Head Injuries. In this video, we will discuss the signs and symptoms of head and traumatic brain injury and learn how to handle them.

Head injuries can accompany any traumatic event. Signs and symptoms of a head injury or a traumatic brain injury include confusion, headache, nausea and vomiting, memory loss, seizure, loss of balance and coordination, and loss of consciousness.

Any individual demonstrating any of these signs or symptoms should be evaluated by a physician.

If you come across an individual suffering from a head injury, protect them from further injury by manually stabilizing the head and the neck and preparing them for transport to advanced medical care. Observe them closely for changes in condition. Be prepared to start CPR if the individual becomes unconscious.

This concludes our lesson on Head Injuries. Next, we will review Spine Injuries.

Video 3g: Spine Injuries

Script: Welcome to the lesson on Spine Injuries. In this video, we will discuss the causes and increased risks of spine injuries.

Spine injuries can occur from a fall, car accident, sporting event, or almost any other physical activity. Head injuries may accompany spine injuries. A high index of suspicion must be maintained, and efforts must be made to protect against further injury to the spine and the spinal cord.

Increased risks for spine injury include: age of 65 years or older, bicycle or motorcycle crash, pain in the middle of neck or back overlying the bony prominences, intoxication or substance use, and numbness, tingling, or weakness.

Injuries to the spine can be unstable; and, unstable movement can result in spinal cord injury and permanent paralysis. When performing first aid in someone with a suspected spine injury, be sure to avoid bending, flexing, or twisting their head or neck. If they begin to vomit, stabilize their head and neck by placing both hands on the side of the head and neck and assist them to their side. Maintain stabilization until advanced help arrives, and call 911 as soon as possible.

This concludes our lesson on Spine Injuries. Next, we will review the Bone and Joint Injuries.

Video 3h: Bone and Joint Injuries

Script: Welcome to the lesson on Bone and Joint Injuries. In this video, we will discuss first aid care for sprains and broken bones and special circumstances of bone and joint injuries.

Bone and joint injuries are common occurrences in daily life. Physically active people are more likely to suffer these types of injuries. The elderly and the infirm are also at high risk for all fall-related sprains, strains, and breaks.

To care for sprains and broken bones, first ensure that the scene is safe and wear personal protective equipment. Then, apply gauze to any open wounds. Apply an ice pack to the injured area for up to 20 minutes. Then, have the injured individual be evaluated by a health care provider and avoid the use of the injured part. Additionally, call 911 if there’s an open wound over a joint, abnormal position or bent extremity, or obvious joint dislocation.

Please refer to the full CPR guide to learn more about caring for open or compound fracture, for using a splint to protect an injured extremity, and for amputations.

This concludes our lesson on Bone and Joint Injuries. Next, we will review Burns and Electrical Injuries.

Video 3i: Burns and Electrical Injuries

Script: Welcome to the lesson on Burns and Electrical Injuries. In this video, we will discuss how to treat small and large burns.

Burns can occur from direct contact with any heat source, electricity, or certain chemicals. Burns can vary from minor superficial burns to very deep burns that damage muscles, tendons, nerves, and even bones. High-voltage electrical injuries can produce devastating injuries and can be fatal. Any electrical injury requires an evaluation in the emergency department.

To treat small burns, first, ensure that the source of the burn has been dealt with, and the scene is safe.

Make sure to wear personal protective equipment and get the first aid kit.

Rinse the burn in cool or cold water.

Apply antibiotic or burn cream, if no allergies exist.

Cover with a clean, dry non-sticking dressing.

Lastly, have the individual follow up with a health care provider.

Do not apply ice to a burn—it will result in a cold injury on top of a burn and cause further tissue damage.

Call 911 if there’s a large burn if there are burns on face, hands, or genitals if an individual is having difficulty breathing, if there’s a fire, or if there’s a possibility of carbon monoxide exposure.

The stop, drop, and roll technique is the best way to put a fire out. Also, you can smother the individual with a wet blanket to extinguish flames. Remove the blanket after the fire is out.

To treat large burns, first ensure that the scene is safe. Then, call 911.

Put on personal protective equipment and get the first aid kit.

Remove the individual’s clothing and jewellery, if possible, while you wait for advanced care.

This concludes our lesson on Burns and Electrical Injuries. Next, we will review Bites and Stings.