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The victim is raised to a standing position and his or her arms are positioned around the re ghter s neck as the rescuer rotates 180 degrees to carry the
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CHAP 14: EMERGENCY MEDICAL CARE
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victim off The re ghter leans slightly forward while walking to support the person s weight and raise the victim off the ground
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Transport Equipment
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Portable stretcher a simple transport device commonly consisting of two wooden poles and a canvass attachment Scoop stretcher composed of two pieces of light metal that can be separated and placed on either side of the victim to be transported and then reattached when properly positioned Basket stretcher made from plastic, berglass, or lightweight metal, this type of device is used to remove victims vertically from con ned spaces Wheeled stretcher provides easy transfer of a victim to, into, and out of an ambulance Stair chair used to transport victims down stairs Long backboard used for victims who are lying down or standing up and to immobilize victims with spinal column and neck injuries prior to transporting
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COMMON INJURIES, ILLNESSES, SYMPTOMS, AND TREATMENT
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Below is a brief listing of some of the more common rst-aid, trauma, and medical emergency incidents encountered by re ghters during a typical tour of duty Signs and symptoms of the injury are noted where applicable Basic stabilization and treatment procedures are provided to give the reader a fundamental knowledge of emergency medical care techniques It should be noted that personal protective equipment (latex gloves, glasses/goggles, face shields, and high ef ciency particulate air (HEPA) masks) is essential to be worn by all rst responders where necessary to protect against infection, disease, and both airborne and blood-borne pathogens Asthma dif culty breathing as a result of muscle spasms, which are triggered by an allergic reaction to pollen, dust, smoke, animal fur, medications, certain foods, mold, and cold air Symptoms include wheezing, coughing, anxiousness, or distress Sit the patient up and leaning forward to facilitate breathing Calm the person and have him take his own medication (aerosol spray or puffer) to ease the condition Bleeding (external) apply direct pressure onto the wound using a protected hand or sterile dressing to control the ow of blood Elevate, if the wound involves an extremity Bandage the wound (to hold the dressing in place) Burns (thermal) Classi cation of burns is based on depth First degree (super cial) burns involve only the epidermis (top) layer of the skin The top layer of the skin contains sweat ducts and blood capillaries Sunburn is the standard example given for rst degree burns The skin appears reddened and is dry and warm to the touch Other symptoms include
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PART III: REVIEW FOR THE WRITTEN EXAMINATION
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swelling, elevated body temperature, and pain Application of cool water will help to reduce the patient s pain and discomfort Second degree (partial-thickness) burns involve both the top layer and middle (dermis) layer of the skin The middle layer of the skin contains nerve endings and hair follicles Symptoms of second degree burn include intense pain, pink or reddish skin, and blistering Leave blisters intact and cover the burn area with a dry, sterile dressing Third degree (full-thickness) burns involve the epidermis, dermis, and subcutaneous tissue (fat cells and blood vessels) The skin can appear charred, yellow-brown, dark red, or white The patient feels no pain because the nerve cells of the skin are destroyed Flush the damaged area with water and remove smoldering clothing Cover the burn area with a dry, sterile dressing For burns to the hands or feet, separate the ngers or toes with dressings Burns that involve muscle and bone are sometimes referred to as fourth degree burns To determine the percentage of body surface that the burn covers, use the rule of nines The rule of nines accounts for approximately 100 percent of the total body surface The head (9%), chest (9%), abdomen area (9%), upper back (9%), lower back (9%), each arm-anterior and posterior (9% 2 = 18%), each leg-anterior (9% 2 = 18%), and each leg-posterior (9% 2 = 18%) account for 99 percent of an adult s body surface The groin area (calculated as 1%) raises the total to 100% For children the rule of nines is slightly modi ed The head counts for (18%) The calculations for the chest (9%), abdomen area (9%), upper back (9%), lower back (9%), and arms-anterior and posterior (9% 2 = 18%) remain the same as for adults Each leg-anterior and posterior, however, accounts for (135% 2 = 27%) The estimate for the groin area (1%) of a child is similar to adults Chest injury indicators include dif culty breathing and chest pain Treat the patient by assisting with breathing and provide supplemental oxygen as needed Contusion (bruise) apply cold or an ice pack to inhibit swelling and elevate the injured part Eye wound to protect against eye movement and further injury, bandage both eyes of the patient, even if only one eye is injured, because the eyes move in unison Fracture (broken bone) classi ed as either an open (skin is broken) or closed (skin is not broken) fracture Indicators include open wound, deformity, pain with movement, tenderness, and swelling Initially the rst responder should cut away clothing to expose the injury using trauma shears Also check for dislocation (separation of the bone from its joint) Treatment involves stabilizing the area above and below the site of injury Apply a dressing to open wounds, administer cold or an ice pack to inhibit swelling, and splint the injury as required A splint is a device used to immobilize the area around the broken bone(s) and joint In general, bones should be splinted in the position found Splints can be either rigid (wood, padded cardboard) or soft and exible (foam, air) Frostbite is the freezing of a body part caused by unprotected or inadequately protected skin exposed to cold weather or cold water It usually
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