Class7.txt

Results from cartilage loss and ware and tear of the joints (common in the elderly)

• Sprain: The stretching or tearing of ligaments. Occurs at a joint, most commonly the knee and ankle
• Strain: The stretching or tearing of tendons or muscles. AKA: “muscle pull”

• 1. C-Spine
• 2. Deadly Bleed
• 3. Fracture

an autoimmune disorder that damages joints and surrounding tissues

A fracture that does not break the skin

external wound associated with fracture

Simple crack of the bone with no deformity

Appearance of a joint where there shouldn’t be one

Fracture in which there is actual deformity

Hunch-back - unusual curvature of upper spineMinute fractures in the spine (usually as a result of osteoporosis) causes bone growth and change of spinal shape

Still do CMS, but for Motor limit it too "Can you wiggle your toes?"

An abnormal curvature of the spine, results in S-curving of the spine laterally

• Rest
• Immobilize
• 1. Assess CMS function
• 2. Prepare equipment prior to Pt movement
• 3. 1 move allowed to position patient for splinting
• 4. If resistance is met or pain increases, splint in deformed position
• 5. Generously pad the splint
• 6. Splint above & below injury site
• 7. Immobilize the joint above & below
• 8. Cover the minimum amount of anatomy required, ensure visibility of deformity site
• 9. Reassess pulse, motor & sensory function
• 10. Requires one EMS practitioner to maintain stabilization as the other applies splinting materials
• Cold
• Elevate

• grossly deformed MID-SHAFT fractures of extremities
• Never EVER EVER EVER realign if it could be a JOINT
• Only 1 attempt can be made

• More than 1 hand-width (the patients hand!) away from the joint
• If they have a pulse - leave it in place!

out (lateral)

in (medial)

• Hip, knee, lower-leg or ankle injury on affected side
• Inability to properly size the device (really tall Pt’s)
• Ensure the rear-ambulance doors to not impact the traction splint as it sticks out about 12” past the Pt’s heel (ouch!)

• Used only for mid-shaft femur fracture, single or bilateral if you have a bilateral sager splint
• Injury must be located one hand-width distal to the hip joint and one hand-width proximal to the knee

outside - not touching the Pt.

• Brain
• Heart
• Lungs
• Kidneys

• Muscles
• GI tract

• Direct Pressure
• ↓
• Pressure dressing (same as above really, but a ∆ bandage holds the gauze - check CMS)
• ↓
• Pressure point (push on a pulse area - check CMS)
• ↓
• Elevation
• ↓
• Tourniquet (call medical control 1st!)

Transport

Gauze it to absorb, but don’t plug the leak - it could be a pressure relief response

because it helps cool the wound & control their pain, not because the wounds are moist any way

• during PRIMARY you get your partner to cool and deal with the burn.
• As it has been dealt with, you don’t need to do anything extra during secondary

• The body will tolerate a 10%loss of blood rapidly, or a 20%loss of blood over a period of time
• Adults: 10% is ≈ 500 mL
• Children: 10% is ≈ 150 mL

• Re-prioritization of blood flow
• Radical change in vital signs
• BP DOWN (late finding in Decompensated shock)
• Increased Heart Rate
• Increased Respiratory Rate

• Dressing: Thing next to the wound
• Bandage: Thing that holds the dressing onto the wound

Between brain and DuraS/S may not present for many days or even weeks (VENOUS bleed)

Use occlusive dressing to stop air getting in (which'd cause air embolisms in the brain etc)

• Between Dura and Skull
• brief period of unconsciousness and headache, followed by a “lucid period” then rapid decline in LOC, to a point where the patient is unresponsive (ARTERIAL bleed)

• In the brain itself
• Varies with location within the brain (stroke-like symptoms)

• A blow to the head that causes a temporary loss or
• alteration of part or all of the brain’s abilities to function without actual physical damage to the brain

• MOIST sterile dressing if they cant close their eye (say a
• pencil stuck through it) so it doesn't dry out.
• If they can close their eye then just use a dry dressing
• Don’t squish it!

If Skull # suspected don’t apply lots of pressure! You will force bits into the brain!

in the Primary

• HEAD: 9
• CHEST: 9
• ABDOMEN: 9
• UPPER BACK: 9
• LOWER BACK: 9
• EACH WHOLE ARM: 9
• EACH WHOLE LEG: 18
• GROIN: 1

• HEAD: 18
• CHEST: 9
• ABDOMEN: 9
• UPPER BACK: 9
• LOWER BACK: 9
• EACH WHOLE ARM: 9
• EACH WHOLE LEG: 14
• GROIN: 1

The Aorta, Vena Cava, and Pulmonary Arteries

• Do Pt. Overview
• Delegate C-Spine
• Now flip 'em
• 1. C-Spine EMS holds head with thumbs facing in the direction of person is face
• 2. You at shoulders
• 3. One EMS at feet
• 4. You assess DCAPPBTLS and TIC Posterior
• 5. Move back board next to patient on side that they are facing away from (unless contraindicated by injuries to a side)
• 6. Keep backboard like one inch away from the Pt. to give them space to rotate onto the board
• 7. You and leg EMS knee on BBoard
• 8. At Head EMS's timing roll them onto their side
• 9. Get off the board one at a time
• 10. Roll onto back
• 11. V slide
• 12. Etc