Emergencies
An emergency situation occurs when a person suddenly becomes ill or is injured and requires an immediate medical response. Emergencies can happen at any time.
For example, imagine two friends at an amusement park, talking and laughing while waiting in line to ride a rollercoaster. One friend tells the other that she does not feel well. She looks pale. Suddenly, she falls to the ground. If her friend knows what to do, she may be able to prevent further harm to her friend, or even save her life.

First Aid
In many cases, emergency care may require some form of first aid. In a best-case scenario, emergency care is performed by an emergency care professional. However, in some cases, emergency care procedures are required before a professional can arrive on the scene.
For this reason, it is important that the general population and, more importantly, all health care workers know how to perform emergency care. Agencies such as the American Red Cross and the American Heart Association train people to perform these life-saving procedures.

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Question # 1
An emergency situation occurs when a person suddenly becomes ill or is injured and requires an immediate medical response. • [pic]True • [pic]False
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Correct Answer.
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Question # 2
In a best-case scenario, emergency care is performed by whom? • [pic]An emergency care professional • [pic]The general population • [pic]A health care worker • [pic]All of the above
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Correct Answer.
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Effective First Aid Providers
To be an effective first aid provider, an individual should understand some essential first aid factors.
Obtain proper first aid training
First and foremost, anyone who expects to encounter an emergency situation should be properly trained.This clearly includes emergency care professionals, but it also includes anyone in the health and medical field.
Other people who should be trained for emergency situations include people in jobs that involve child care. Additionally, people who are responsible for others in areas where medical care may be some distance away, such as park guides, camp counselors, and scuba diving instructors, should be prepared to administer first aid.

Effective First Aid Providers (continued)
Be alert for emergency situations.
For those who do have first aid training, they must keep alert for signs of an emergency, which include: • Unusual sounds, such as breaking glass, screeching tires, or calls for help. • Unusual sights, such as an empty medicine bottle or smoke from a fire. • Unusual odors, such as natural gas or fumes. • Unusual behaviors, such as clutching the chest or throat, or slurred speech

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Question # 3
Signs of an emergency are unusual sounds, sights, odors, and ____. • [pic]silence • [pic]time • [pic]behaviors • [pic]crowds
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Question # 4
What is the "first and foremost" essential first aid factor? • [pic]Be alert for emergencies • [pic]Get proper first aid training • [pic]Assess the emergency situation • [pic]All of the above
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Effective First Aid Providers (continued)
Assess the situation before taking action.
Before taking any action at an emergency scene, the first aid provider must assess, or evaluate, the situation. The first aid provider should have a reason for every action that is taken. Treatment depends on several factors, including: • The type of injury • The environment • Witnesses • Available first aid supplies and equipment • How quickly medical help will arrive
If conscious, the patient should be questioned for injuries and a full explanation of the situation. This information should be passed on to emergency care professionals when they arrive on the scene.

Effective First Aid Providers (continued)
Remain calm in emergency situations and observe safety precautions.
First aid providers should observe some basic precautions when treating a patient, including: • If possible, get the patient's consent before performing any care. • If possible, wash their hands and put on gloves before handling a patient. • Make sure supplies, such as water or bandages, are clean. • If possible, explain the procedure to the patient. • Be careful when lifting heavy objects. • If any solutions come in contact with their skin or eyes, they should immediately flush them with water. • Only perform care that they have been trained to do.

Check Your Understanding
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Question # 5
Emergency care treatment depends on which factor? • [pic]Type of injury • [pic]Environment • [pic]How quickly medical help will arrive • [pic]Available first aid supplies • [pic]All of the above
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Correct Answer.
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Question # 6
First aid providers should try to create as clean an environment as possible by washing their hands and making sure that supplies are clean. • [pic]True • [pic]False
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Correct Answer.
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Effective First Aid Providers (continued)
Perform a safety check of the scene before taking action.
Some emergency scenes are unsafe to enter, such as a burning building or a collapsed tunnel. A would-be first aid provider should immediately call for professional help and remain clear of any dangerous areas.
Prioritize tasks and triage.
After calling Emergency Medical Services, EMS, or telling another person to call, the first aid provider may have to perform triage. Triage is a way to prioritize treatment. In cases involving two or more patients, triage determines who is treated first. In cases with only one patient who has several injuries, triage determines which injury is addressed first. Life-threatening injuries, such as excessive bleeding, should always be attended to first.

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Question # 7
First aid providers should risk their own safety to retrieve patients from dangerous areas. • [pic]True • [pic]False
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Correct Answer.
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Question # 8
What is the term used for prioritizing emergency care? • [pic]Treat worst first • [pic]Sterilization • [pic]Emergency prioritization • [pic]Triage
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Principles of Care
In addition to first aid essentials, there are also some guidelines for first aid care that should be applied in every emergency situation. • Get professional care as soon as possible. • Do not move a patient unless it is required for safety reasons. • Keep the patient calm. • Do not give unconscious or vomiting patients any food or fluids, unless the first aid procedure requires it. • Regulate the patient's temperature by adding blankets or removing layers of clothing. • Administer first aid quickly and efficiently. • To avoid compromising the patient's right to privacy, do not attempt to diagnose the patient or discuss the patient's condition. • Avoid further injury if possible

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Question # 9
Principles of care are guidelines that should be applied to only some emergency cases. • [pic]True • [pic]False
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Emergency Care Legal Issues
The very nature of emergency care implies that it occurs quickly. The haste in which it occurs often leaves the caregivers with little or no time to consider the legal consequences of their actions. And yet in today's atmosphere of malpractice claims, it does deserve some consideration. Emergency care professionals, other health care workers, and anyone else who has first aid training should be aware of some basic legal issues related to emergency care

The Good Samaritan Acts
All 50 states have adopted Good Samaritan Acts. Good Samaritan Acts offer some protection to caregivers who respond to emergency medical situations. With these acts, physicians and first responders are not required to acquire patient consent before performing life-saving procedures in the case of an emergency. Therefore, in the unfortunate event that the patient should have some permanent damage or die, the "good Samaritan" who stopped to help is not legally responsible.
However, all caregivers must follow these basic rules in order to be protected by a Good Samaritan Act: • Give care in good faith. • Act within the scope of their training and knowledge. • Use as much care as possible according to the circumstances. • Do not bill the patient.
Because of Good Samaritan Acts, people do not need to hesitate before helping in an emergency situation.

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Question # 11
The Good Samaritan Act encourages people to help out during an emergency. • [pic]True • [pic]False
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Good Samaritan Act: A Case Study
Sean, a medical student, is taking the train to visit his family. During the trip, a woman sitting a few seats ahead of him cries out and clutches at her chest. She is pale and perspiring heavily. Then she falls to the floor. The woman's husband calls out for help.
Sean suspects the woman is having a heart attack. He checks for breathing and performs CPR. He calls 911 on her cell phone. He sends another passenger to ask the driver to stop at the next station, which is fifteen minutes away. Although an ambulance is waiting at the station, it is too late, and the woman dies on the way to the hospital.
In his grief, her husband threatens to sue Sean for failing to save his wife's life. However, Sean did everything he could to help, according to what he had learned in nursing school. He did not charge a fee for his services. Sean is protected by the Good Samaritan Act, and he is not legally responsible for the woman's death.

Scope of Practice
Even a Good Samaritan Act cannot protect caregivers who perform procedures outside of their scope of practice. Therefore, emergency care providers should only perform tasks for which they have been trained. Simply put, they should only do things that they know how to do.
For example, if a caregiver performs CPR without any CPR training, he could cause serious harm to the patient. If damages occur, in this case the patient could sue the caregiver because the caregiver acted outside of his scope of practice.

Question # 12
First aid providers who act outside their scopes of practice are protected under the Good Samaritan Acts. • [pic]True • [pic]False

Keeping Records
Emergency care professionals must fill out an event report after each emergency.
This report becomes a part of the patient's medical record. It includes: • The patient's name • The patient's address • The date and time of emergency • The location of emergency • A description of the emergency and its cause • A description of actions taken • The names, addresses, and signatures of any witnesses • The name and signature of the person preparing the report

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Question # 13
Which of the following should be included in an emergency care event report? • [pic]Patient's name and address • [pic]Details of the emergency • [pic]Description of treatment • [pic]Witness information • [pic]All of the above

Procedure for a Circular Bandage
It is important to learn the correct procedure for a circular bandage. Individual agencies may have specific procedures that their employees must follow. The following process is an example of a circular bandage procedure that might be found at any agency.[pic] 1. Cleanse your hands.[pic] 1. Put on gloves.[pic] 1. Apply a dressing to the injury.[pic] 1. Fold a triangular bandage to create a cravat bandage. o Lay the triangular bandage on a flat, clean surface with the longest side of the bandage facing you.[pic] o Fold down the point of the bandage to the bottom middle of the long side.[pic] o Fold the bandage in half towards you again.[pic] o Continue to fold the bandage until it is the width you need.[pic] 1. Arrange the center of the cravat bandage over the dressing.[pic] 1. Wrap the two ends of the bandage around the body part.[pic] 1. Cross the ends at the back of the body part and wrap them back around to meet over the dressing.[pic] 1. Secure the ends with a square knot over the dressing. Always avoid wrapping any body part too tight, which will slow or stop circulation. Never use a circular bandage on a neck injury, which could strangle the patient![pic] 1. Below the bandage, check the patient's circulation. Look for signs of poor circulation, including swelling, coldness, numbness or tingling, pallor, or cyanosis. Undo the bandage immediately if any signs of poor circulation are present.[pic] 1. If needed, get medical help.[pic] 1. Remove gloves.[pic] 1. Cleanse your hands.[pic]
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Question # 6
Always check the patient's circulation after applying a circular bandage. • [pic]True • [pic]False
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Correct Answer.
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Question # 7
Circular bandages are a good option for a neck injury. • [pic]True • [pic]False
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Correct Answer
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Elastic and Roller Gauze Bandages
Elastic and roller gauze bandages come in a variety of widths. They are used to secure dressings and to support injured areas. They can be used on just about any part of the body.
Elastic bandages have the advantage of stretching and molding to the body part. However, elastic bandages can also pose a disadvantage because their elasticity makes it easy to wrap an injury too tightly. First aid providers must be careful not to stretch elastic bandages as they are wrapping an injury.
Particularly when wrapping the foot or ankle, health care workers must be careful that there are no wrinkles in the bandage. Wrinkles in the bandage wrap can cause skin irritation

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Question # 8
What are elastic and roller gauze bandages used for? • [pic]Secure dressings • [pic]Support injuries • [pic]All of the above
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Correct Answer
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Procedure for a Spiral Wrap Bandage
It is important to learn the correct procedure for a spiral wrap bandage. Individual agencies may have specific procedures that their employees must follow. The following process is an example of a spiral wrap bandage procedure that might be found at any agency.[pic] 1. Cleanse your hands.[pic] 1. Put on gloves.[pic] 1. Apply a dressing to the injury.[pic] 1. Hold the roller gauze or elastic bandage with the loose end hanging from the bottom of the roll.[pic] 1. Starting at the bottom of the limb, place the end of the bandage on the limb at an angle pointing up. Hold the end in place with one hand.[pic] 1. With the other hand, wrap the roll around the limb one time, allowing a tip of the end of the bandage to stick out above the first wrap.[pic] 1. Fold the tip down over the first wrap, and then wrap the roll around the limb a second time covering the tip. The bandage is now anchored in place.[pic] 1. Continue to wrap the limb in a spiral method, moving up the limb. Overlap each wrap by half the width of the bandage.[pic] 1. At the end of the limb, wrap it twice in a circular pattern.[pic] 1. To secure the end, tape, pin, or tie the bandage. If a pin is used, place your hand between the bandage and the patient's skin to protect the patient from injury. To tie the bandage, cut the end in half for several inches and then wrap the ends in opposite directions around the limb and then tie them.[pic] 1. Below the bandage, check the patient's circulation. Look for signs of poor circulation, including swelling, coldness, numbness or tingling, pallor, or cyanosis. Undo the bandage immediately if any signs of poor circulation are present.[pic] 1. If needed, get medical help.[pic] 1. Remove gloves.[pic] 1. Cleanse your hands

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Question # 9
When applying a spiral wrap bandage, always start at the bottom of the limb and then wrap in a spiral method moving up the limb. • [pic]True • [pic]False
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Correct Answer
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Procedure for a Figure-Eight Ankle Wrap Bandage
It is important to learn the correct procedure for a figure-eight ankle wrap bandage. Individual agencies may have specific procedures that their employees must follow. The following process is an example of a figure-eight ankle wrap bandage procedure that might be found at any agency.[pic] 1. Cleanse your hands.[pic] 1. Put on gloves.[pic] 1. Apply a dressing to the injury.[pic] 1. Hold the elastic bandage with the loose end hanging from the bottom of the roll.[pic] 1. Place the end of the bandage on the instep of the foot at an angle pointing towards the ankle. Hold the end in place with one hand.[pic] 1. With the other hand, wrap the roll around the foot one time, allowing a tip of the end of the bandage to stick out above the first wrap.[pic] 1. Fold the tip down over the first wrap, and then wrap the roll around the foot a second time covering the tip. The bandage is now anchored in place.[pic] 1. This time, as you wrap the foot and bring the bandage up from the bottom of the foot, cross the top of the foot in a diagonal and wrap it around the back of the ankle. As you bring the bandage around the ankle, wrap it across the top of the foot to complete the figure-eight pattern. 1. Repeat the pattern around the foot and ankle, moving toward the heel of the foot. Overlap each wrap by half the width of the bandage. Wrap the ankle firmly, but avoid wrapping so tightly that circulation is affected. When using an elastic bandage, do not stretch it as you wrap.[pic] 1. At the end, wrap the bandage around the ankle twice in a circular pattern.[pic] 1. To secure the end, tape, pin, or tie the bandage. If a pin is used, place your hand between the bandage and the patient's skin to protect the patient from injury. To tie the bandage, cut the end in half for several inches and then wrap the ends in opposite directions around the limb and then tie them.[pic] 1. Below the bandage, check the patient's circulation. Look for signs of poor circulation, including swelling, coldness, numbness or tingling, pallor, or cyanosis. Undo the bandage immediately if any signs of poor circulation are present.[pic] 1. If needed, get medical help.[pic] 1. Remove gloves.[pic] 1. Cleanse your hands.[pic]

Question # 10
When using an elastic or roller gauze bandage, by how much should you overlap the bandage with each wrap? • [pic]¼ the width of the bandage • [pic]½ the width of the bandage • [pic]¾ the width of the bandage • [pic]All of the above

Procedure for a Recurrent Wrap Bandage
It is important to learn the correct procedure for a recurrent wrap bandage. Individual agencies may have specific procedures that their employees must follow. The following process is an example of a recurrent wrap bandage procedure that might be found at any agency.[pic] 1. Cleanse your hands.[pic] 1. Put on gloves.[pic] 1. Apply a dressing to the injury.[pic] 1. Hold the roller gauze or elastic bandage with the loose end hanging from the bottom of the roll.[pic] 1. Hold the end of the gauze in position at the bottom of the finger on the outside or inside of the finger.[pic] 1. Drape the gauze along the length of the finger, over the tip, and down the opposite side.[pic] 1. Fold the gauze over and overlap the first layer of the gauze along the length of the finger, over the tip, and back down the original side.[pic] 1. Repeat this process three or four times, creating a recurrent wrap. 1. Holding the recurrent wrap in place, begin a spiral wrap at the bottom of the finger. Move towards the tip of the finger, and then move back towards the bottom.[pic] 1. At the bottom of the finger, wrap the gauze across the back of the hand, around the back of the wrist, across the back of the hand again, and around the finger to create a figure-eight pattern 1. Repeat the figure-eight pattern two or three more times. 1. At the end, wrap the bandage around the wrist twice in a circular pattern.[pic] 1. To secure the end, tie the bandage. Cut the end of the gauze in half for several inches and then wrap the ends in opposite directions around the wrist and then tie them.[pic] 1. Below the bandage, check the patient's circulation. Look for signs of poor circulation, including swelling, coldness, numbness or tingling, pallor, or cyanosis. Undo the bandage immediately if any signs of poor circulation are present.[pic] 1. If needed, get medical help.[pic] 1. Remove gloves.[pic] 1. Cleanse your hands

Question # 11
What other wrap technique is used to secure a recurrent wrap bandage? • [pic]Spiral • [pic]Figure-eight • [pic]Circular • [pic]All of the above

Question # 12
The type of bandage and wrapping technique depend on the location and type of injury. • [pic]True • [pic]False
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Correct

Splints
A splint is a rigid device that supports and immobilizes an injured body part. Splints are used to secure suspected bone or joint injuries to legs, forearms, fingers, and toes. Splints can be used alone or in combination with bandages and slings.
Commercial splints work best. However, if none are available, a splint can be created using anything that will support the injured area. Some examples of materials that can be used to improvise a splint include heavy cardboard, bubble wrap, folded newspapers or magazines, and blankets or towels.
Because you should limit moving an injured body part, do not apply a splint if professional medical help is on the way. In this case, keep the patient still until professional help arrives.

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Question # 1
What are splints used for? • [pic]Support and immobilize injured body parts • [pic]Support injured body parts • [pic]Keep injured body parts flexible • [pic]Immobilize injured body parts
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Correct Answer.
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Question # 2
Even if professional medical care will soon arrive, create a splint for the injured body part. • [pic]True • [pic]False
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Correct Answer.
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Procedure to Make a Splint
It is important to learn the correct procedure for making a splint. Individual agencies may have specific procedures that their employees must follow. The following process is an example of a splint procedure that might be found at any agency.[pic] 1. Cleanse your hands.[pic] 1. Locate a splint. If a commercial splint is not available, find materials that can support and immobilize the injury. Some examples of supportive materials include blankets, pillows, newspaper or magazines, boards, or cardboard. Both commercial and improvised splints must be long enough to support the joints above and below the injury. 1. Place a splint on each side of the limb. Avoid moving the limb as much as possible. Do not allow the splints to put any pressure on the injured area. If you are using a blanket or pillow, you may need only one, as it can be wrapped around the limb.[pic] 1. Pad the splints with thick dressings or towels and blankets. Apply an extra cushion at bony areas. Commercial splints may already contain padding.[pic] 1. Tie strips of cloth or triangular bandages folded into cravats to secure the splints. Place ties above and below the upper and lower joints and one in the center of the splint.[pic] 1. Inside and below the splint, check the patient's circulation. Look for signs of poor circulation, including swelling, coldness, numbness or tingling, pallor, or cyanosis. Undo the ties immediately if any signs of poor circulation are present.[pic] 1. If needed, get medical help.[pic] 1. Cleanse your hands.

Question # 3
Always check the patient's circulation inside and below a splint, looking for swelling, coldness, numbness or tingling, pallor, or cyanosis. • [pic]True • [pic]False
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Correct Answer.

Slings
A sling is a device used to keep an injured hand, forearm, arm, or shoulder immobilized. Slings can be used in combination with a cast or used in place of a cast or splint until one can be applied. Commercial slings are available. However, a sling can be created using a triangular bandage. If a commercial sling or a triangular bandage is not available, a belt, handkerchief, or scarf can also be used.

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Question # 4
A sling is used to keep injury immobilized. • [pic]True • [pic]False
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Correct Answer.
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Question # 5
If a commercial sling is not available, a modified sling can be created from common items. • [pic]True • [pic]False
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Correct Answer
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Procedure to Make a Sling
It is important to learn the correct procedure for making a sling. Individual agencies may have specific procedures that their employees must follow. The following process is an example of a sling procedure that might be found at any agency.[pic] 1. Cleanse your hands.[pic] 1. Try to find help to immobilize the injured arm while you work. 1. If a commercial sling is available, follow the manufacturer's instructions.[pic] 1. If creating a sling using a triangular bandage, drape one corner of the bandage over the shoulder opposite of the injury with the long side of the bandage facing the uninjured arm.[pic] 1. Drape the short edge of the bandage across the patient's chest and under the injured arm. Avoid moving the injured arm as much as possible. 1. Take the corner of the long side of the bandage that is hanging in front of the patient and fold it up over the injured arm towards the shoulder of the injured side.[pic] 1. Check that the patient's hand is elevated above the elbow by about five to six inches. The fingers should be exposed at the end of the bandage.[pic] 1. Tie the two ends of the bandage behind the neck. Do not allow the knot to rest against a bone. If possible, place padding under the knot.[pic]

1. At the elbow, find the point of the bandage. Fold it forward and pin it in place. Place your hand between the sling and the patient's skin to protect the patient from injury. If a pin is not available, twist the point of the bandage and then tie it in a knot.[pic] 1. Inside and below the sling, check the patient's circulation. Look for signs of poor circulation, including swelling, coldness, numbness or tingling, pallor, or cyanosis. Undo the sling immediately if any signs of poor circulation are present.[pic] 1. If needed, get medical help.[pic] 1. Cleanse your hands

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Question # 6
Which of the following items can be used to improvise a sling? • [pic]Triangular bandage • [pic]Belt • [pic]Scarf • [pic]All of the above
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Correct Answer.
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Question # 7
After applying a sling, make sure the patient's hand is elevated above the elbow by two inches. • [pic]True • [pic]False
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Crutches
Crutches are supports that help a patient ambulate, or walk. Patients use crutches when they are unable to put weight on an injured or impaired leg, knee, ankle or foot. With crutches, patients transfer some or all of their weight to the crutches.
It is important that crutches fit the patient properly and are used correctly by the patient. All medical professionals need to know how to fit and use crutches properly so that they can teach their patients.

Types of Crutches
Three types of crutches are axillary, forearm, and platform. All crutches require coordination. Axillary and forearm crutches require some upper body strength.
Axillary crutches are placed under the axilla, or underarms, with the patient's weight being applied to the hands.
Likewise, with forearm crutches, a patient inserts arms through holders, grasps handles, and then supports weight on the hands.
Platform crutches are designed for patients who cannot grasp handles or bear weight on their hands. The patient rests the forearm on a flat surface at the top of the crutch and then bears weight on the forearm.

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Question # 1
Crutches are supports that help a patient ambulate, or walk. • [pic]True • [pic]False
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Correct Answer.
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Question # 2
Which type of crutches requires patients to bear weight with their hands? • [pic]Axillary • [pic]Forearm • [pic]Platform • [pic]Axillary and forearm • [pic]All of the above
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Correct Answer
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Adjusting crutches
To avoid injury, it is important that crutches are adjusted properly for the patient's height.
With axillary crutches, the top of the crutch should reach two inches below the patient's underarm. The handle should fall comfortably at the patient's wrist.
With forearm crutches, the handle should fall to just above the patient's hand, when the arms are down and extended.
With platform crutches, the top of the platform should reach the patient's elbows.

Procedure to Assist a Patient with Crutches
It is important to learn the correct procedure for ambulating a patient with crutches. Individual agencies may have specific procedures that their employees must follow. The following process is an example of a procedure that might be found at any agency for ambulating with crutches.[pic] 1. Verify which gait has been authorized by a doctor or therapist. 1. Assemble and check the crutches for rubber suction tips on the bottom. The tips should not be torn or worn down. Check the handle and axillary bars for padding.[pic] 1. Cleanse your hands.[pic] 1. Introduce yourself, identify the patient, and explain the procedure. 1. Check that the patient is wearing good walking shoes that have a 1 to 1 ½ inch heel, are low and broad, and have non-skid soles. If needed, help the patient put on shoes. 1. Help the patient to stand. 1. Instruct the patient never to rest weight on the axillary bars, which can cause nerve damage. 1. Instruct the patient to move only small distances with each step. Moving too far forward can disrupt balance and result in a fall. 1. Instruct the patient to bear weight on the uninjured leg.
Question # 5
Which of the following should you instruct a patient to do when using crutches? • [pic]Never rest weight on the axillary bars • [pic]Move only small distances with each step • [pic]Bear weight on the uninjured leg • [pic]All of the above
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Correct Answer.

1. Position the crutches under the patient's arms. The bottom of the crutches should be placed 4 to 6 inches in front of and 4 to 6 inches to the side of the patient's feet.[pic] 1. Check if there are 2 inches between the axillary bars and the patient's underarm. 1. If the height of the crutches must be adjusted, first check with a supervisor. If permission is given, adjust the height of the crutches. 1. With the patient's hands on the handles, check if the elbow is at a 25º to 30º angle. If the height of the handles must be adjusted, first check with a supervisor. If permission is given, adjust the height of the handles

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Question # 6
When adjusting crutches for fit, how many inches should there be between the axillary bars and the patient's underarms? • [pic]1 inch • [pic]2 inches • [pic]4 to 6 inches • [pic]All of the above
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Correct Answer
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Procedure to Assist a Patient with Crutches (continued)
To instruct the patient how to perform a four-point gait: 1. Begin the demonstration by standing on both legs with crutches at both sides.[pic] 1. Move the right crutch forward.[pic] 1. Move the left foot forward.[pic] 1. Move the left crutch forward.[pic] 1. Move the right foot forward.[pic] 1. Have the patient try the four-point gait.[pic]

1. Begin the demonstration by standing on both legs with crutches at both sides.[pic] 1. Move both crutches and the injured leg forward. 1. Transfer weight to the crutches.[pic] 1. Move the uninjured leg forward.[pic] 1. Have the patient try the three-point gait.[pic]
To instruct the patient how to perform a two-point gait: 1. Begin the demonstration by standing on both legs with crutches at both sides.[pic] 1. Move the right foot and left crutch forward together.[pic] 1. Move the left foot and right crutch forward together.[pic] 1. Have the patient try the two-point gait

1. Begin the demonstration by standing on both legs or on one leg with the injured leg bent slightly at the knee to raise the foot a few inches. Place the crutches at both sides. 1. Bear weight on the leg or legs.[pic] 1. Move both crutches forward.[pic] 1. Transfer weight forward. 1. Use shoulders and arms to swing the feet forward to the crutches.[pic] 1. Have the patient try the swing-to gait 1. Begin the demonstration by standing on both legs or on one leg with the injured leg bent slightly at the knee to raise the foot a few inches. Place the crutches at both sides. 1. Bear weight on the leg or legs.[pic] 1. Move both crutches forward. 1. Transfer weight forward.[pic] 1. Use shoulders and arms to swing feet forward up to and through crutches, resting the feet a few inches in front of the crutches.[pic] 1. Have the patient try the swing-through gait 1. Remind the patient never to rest weight on the axillary bars, which can cause nerve damage. 1. Remind the patient to move only small distances with each step. Moving too far forward can disrupt balance and result in a fall. 1. Report the patient's progress with crutches to a supervisor or therapist. 1. At the end of the training session, assist the patient back to the bed or a chair. 1. Check the patient, observing all safety precautions. 1. Cleanse your hands. 1. Document on the patient's chart how well the patient adapted to the crutches.

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Question # 8
A health care worker teaching a patient how to use crutches will determine which gait the patient should use. • [pic]True • [pic]False
[pic]
Correct Answer
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Question # 7
Which crutch gaits require that the patient use the shoulders and arms to move? • [pic]Swing-to and swing-through • [pic]Two-point and four-point • [pic]Three-point and four-point • [pic]Two-point and swing-through
[pic]
Correct Answer
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Question # 9
A health care worker must demonstrate the proper crutch gait before having the patient attempt it. • [pic]True • [pic]False
[pic]
Correct Answer
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|Question |Your Answer |
|Which of the |Incorrect Selection: |
|following is true| |
|of crutches? |Crutches immobilize an injured limb. |
|Which of the |Incorrect Selection: |
|following is NOT | |
|true of dressings|A bandage is material used to secure dressings and splints. |
|and bandages? | |
|How should a |Incorrect Selection: |
|spiral wrap be | |
|applied? |Start by covering the dressing, then alternate the bandage up and down the limb |
|Which type of |Incorrect Selection: |
|crutches requires| |
|patients to bear |Axillary |
|weight with their| |
|hands? | |
|After applying a |Incorrect Selection: |
|sling, how | |
|elevated should |1 or 2 inches above the heart |
|the patient's | |
|hand be? | |
|Which of the |Incorrect Selection: |
|following is NOT | |
|an appropriate |Bandage a scalp injury |
|use of a cravat? | |
|What type of |Correct |
|bandage can be | |
|used to secure | |
|dressings? | |
|Which of the |Correct |
|following is NOT | |
|true of splints | |
|and slings? | |
|When using an |Correct |
|elastic or roller| |
|gauze bandage, by| |
|how much should | |
|you overlap the | |
|bandage with each| |
|wrap? | |
|Which crutch |Correct |
|gaits require | |
|that the patient | |
|use the shoulders| |
|and arms to move?| |
|When adjusting |Correct |
|crutches for fit,| |
|how many inches | |
|should there be | |
|between the | |
|axillary bars and| |
|the patient's | |
|underarms? | |
|A triangular |Correct |
|bandage is often | |
|used on which | |
|part of the body?| |
|What determines |Correct |
|the type of | |
|bandage used for | |
|an injury? | |
|Which item is |Correct |
|used to stop | |
|bleeding, prevent| |
|infection, absorb| |
|secretions, and | |
|treat pain? | |
|What are splints |Correct |
|used for? | |
|Which of the |Correct |
|following is not | |
|a crutch gait? | |

Shock
Shock often results from physical or emotional trauma. Shock, also called hypoperfusion, is a reduction of blood flow in the body, particularly to the brain and heart. As the body attempts to increase the blood supply to the brain and heart, it reduces blood flow to other organs. Without proper blood flow, the body's organs and tissues are deprived of oxygen. If left untreated, shock can be fatal, even in cases where the initial injury was not fatal. Therefore, it is important to recognize shock and to know how to respond to it as an emergency situation.

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Question # 1
Shock occurs when organs and tissues do not receive enough oxygen and what other substance? • [pic]Water • [pic]Carbon dioxide • [pic]Blood • [pic]Plasma • [pic]All of the above
[pic]
Correct Answer.
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Question # 2
Shock can be fatal. • [pic]True • [pic]False
[pic]
Correct Answer.
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Causes of Shock
Trauma causes shock. Trauma can be physical or emotional in nature. The following list includes several types of trauma that can cause shock. • Hemorrhage • Severe pain • Infection • Heart attack • Stroke • Poison, including drugs, chemicals, and gases • Lack of oxygen • Dehydration caused by burns, vomiting, and diarrhea • Psychological trauma, such as a car accident

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Question # 3
Which of the following can be a cause of shock? • [pic]Excessive pain or excessive blood loss • [pic]Lack of oxygen • [pic]Dehydration • [pic]Extreme emotions • [pic]All of the above
[pic]
Correct Answer.
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Question # 4
A person suffering from a non-fatal injury is in no threat from shock. • [pic]True • [pic]False
[pic]
Correct Answer
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Symptoms of Shock
Just as shock has many causes, it also has many symptoms. Symptoms vary from patient to patient; however, some symptoms are good indicators of shock. These symptoms include: • Pale, blue-gray skin color, especially under the nails and around the mouth • Cool skin • Rapid, weak pulse • Irregular breathing • Low blood pressure • Anxiety or restlessness
Other possible symptoms of shock include: • Nausea • Vomiting • Excessive thirst • Heavy perspiration • Dizziness • Fainting • Clammy skin • Blurry vision • Dilated, or large pupils • Confusion

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Question # 5
Patients with shock usually have hot, flushed skin. • [pic]True • [pic]False
[pic]
Correct Answer.
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Question # 6
Patients with shock usually have a rapid, weak pulse. • [pic]True • [pic]False
[pic]
Correct Answer.
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Types of Shock
Because there are many causes of shock, there are also many types of shock. Types of shock are distinguished by their causes and the specific affects on the body.
Click each term to learn the definition of each type of shock. • Anaphylactic Shock • Cardiogenic Shock • Hemorrhagic Shock • Metabolic Shock • Neurogenic Shock • Psychogenic Shock • Respiratory Shock • Septic Shock

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Anaphylactic shock is caused by a severe ____ • [pic]allergic reaction • [pic]emotional shock • [pic]heart attack
[pic]
Correct Answer.
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Question # 8
A hemorrhaging victim loses a lot of ____.
Correct Answer(s): blood
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Correct Answer.
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Question # 9
Metabolic shock can be caused by severe ___ • [pic]Diarrhea • [pic]Vomiting • [pic]Dehydration • [pic]Heat • [pic]All of the above
[pic]
Correct Answer.
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Question # 10
An injury to the brain and/or spine can cause neurogenic shock. • [pic]True • [pic]False
[pic]
Correct Answer

Treating Shock
Because shock is such a serious condition, the caregiver should begin treatment immediately. There are several aims for treating shock. In order of importance, these aims include: • Eliminating or controlling the cause of shock • Improving blood flow • Providing oxygen • Regulating body temperature

Procedure for Shock
It is important to learn the correct procedure for treating shock. Individual agencies may have specific procedures that their employees must follow. The following process is an example of a shock procedure that might be found at any agency. 1. Perform priority care. o Only if necessary for safety, move the patient. o Check if the patient is breathing and conscious. o Call emergency medical services, EMS. o Provide care. o Control bleeding. 1. Check the patient for shock symptoms. 1. Eliminate or control the cause of shock.

1. Position the patient according to injuries. o A patient with a spine or neck injury or a broken bone should not be moved. When in doubt, play it safe and do not move the patient.[pic] o If a patient with no major injuries is in an uncomfortable or unsafe position, place the patient on the back, with the legs raised slightly. However, if raising the legs causes pain, lay the patient out flat.[pic] o If the patient is having trouble with breathing, place a pillow, or folded towel or cloth, under the head or shoulders.[pic] o A vomiting patient should be placed on the side.[pic] o A head injury patient should lie flat, or lie with the head slightly elevated. Raise the head or shoulders by placing a pillow, or folded towel or cloth, under the head or shoulders.[pic] 1. Attempt to regulate body temperature. If the patient is cold, cover the patient with blankets or clothing. If the patient is on the ground and can be moved without injury, place fabric between the patient and the ground. If the skin becomes flushed and the patient perspires heavily, the patient is overheated. Remove blankets and clothing, if practical.[pic] 1. Do not give the patient food or fluids. If the patient is very thirsty, wet a cloth and moisten the patient's lips and tongue.[pic] 1. Keep the patient calm through reassurance and your own calm demeanor. 1. Continue to monitor and care for the patient until help arrives.[pic]
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Question # 11
Remove a patient from a dangerous environment before calling for help. • [pic]True • [pic]False
[pic]
Correct Answer.
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Question # 12
A person with a spinal injury should not be moved. • [pic]True • [pic]False
[pic]
Correct Answer.
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Question # 13
An overheated patient has cool, clammy skin. • [pic]True • [pic]False
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Correct Answer.

Bone and Joint Injuries
Bone and joint injuries are very common. They include fractures and breaks, dislocations, sprains, and strains. Common causes for these injuries are falls and other accidents, working muscles too hard, and sports injuries.

Question # 1
Which of the following is a bone or joint injury? • [pic]Fractures and breaks • [pic]Dislocations • [pic]Sprains • [pic]Strains • [pic]All of the above
[pic]
Correct

Fractures
Fractures are breaks or cracks in a bone. Fractures can be compound, which involves a break and an open wound. A simple fracture has no accompanying open wound. Fractures can be extremely painful until the bone can be properly set. For this reason, a fracture or break patient should be monitored for shock. This is especially true if the injury is compound and the patient has lost a lot of blood. When a fracture is suspected, it is critical that the injured area is not moved until it is immobilized by a splint or a cast.
Symptoms of a fracture include: • Deformity • Limited or loss of motion • Pain • Swelling • Discoloration • Protrusion of bone through the skin • Hearing the bone break • Grating sensation inside the body at the site
Dislocations
A dislocation occurs when a bone separates from a joint or is moved out of place in the joint. Like a fracture, dislocations are extremely painful until the bone can be moved back into its proper position. For this reason, a dislocation patient should be monitored for shock. When a dislocation is suspected, it is critical that the injured area is not moved until it is immobilized by a splint or sling. When medical help arrives, a professional can put the bone back into position. Repositioning the bone should only be done by a professional.
Symptoms of a dislocation include: • Deformity • Limited or abnormal movement • Swelling • Discoloration • Pain • Shortening or lengthening of the limb

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Question # 2
Which type of bone or joint injury occurs when a bone separates from a joint or is moved out of place in the joint? • [pic]Fractures and breaks • [pic]Dislocations • [pic]Sprains • [pic]Strains • [pic]All of the above
[pic]
Correct Answer.
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Question # 3
Neither fractures nor dislocations are painful. • [pic]True • [pic]False
[pic]
Correct Answer.
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Sprains
A sprain is a stretch or tear in the tissues around a joint. These tissues include ligaments and tendons. Sprains make the joints painful to use. Ankles and wrists are common areas for sprains. Sprains are treated by supporting the injured joint with elastic bandages or splints. Before an x-ray is taken, a sprain may be confused as a fracture. In such cases, the injury should be treated as though it is a fracture, until the specific injury can be confirmed through x-ray.
Symptoms of a sprain include: • Swelling • Discoloration • Pain • Possibly limited motion

Strains
A strain occurs when a muscle is overused or overstretched. Common causes for strains are performing difficult physical tasks that the body is not accustomed to, such as lifting heavy objects, or stretching a muscle improperly during a fall. Strain injuries are common in the back.
Symptoms of a strain include: • Sudden pain • Swelling • Bruising

Top of Form uestion # 4
Which type of bone or joint injury occurs when a muscle is overused or overstretched? • [pic]Fractures and breaks • [pic]Dislocations • [pic]Sprains • [pic]Strains • [pic]All of the above
[pic]
Correct Answer.
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Question # 5
Which type of bone or joint injury occurs when there is a stretch or tear in the tissues around a joint? • [pic]Fractures and breaks • [pic]Dislocations • [pic]Sprains • [pic]Strains • [pic]All of the above
[pic]
Correct Answer.
Procedure for Bone and Joint Injuries
It is important to learn the correct procedure for treating bone and joint injuries. Individual agencies may have specific procedures that their employees must follow. The following process is an example of a procedure for a bone or joint injury that might be found at any agency.[pic] 1. Perform priority care. o Only if necessary for safety, move the patient. o Check if the patient is breathing and conscious. o If needed, call emergency medical services, EMS. o Provide care. o Control bleeding. Wear gloves or avoid contact between the patient's blood and your skin. 1. Observe the patient for symptoms of the injury to try to determine if it a fracture, dislocation, sprain, or strain. 1. Do not attempt to straighten or align the injury in any way

1. If you have even the slightest suspicion of a fracture, apply a splint.[pic] 1. If the injury involves an arm, apply a sling.[pic] 1. If you are certain that the injury is only a sprain, apply a bandage using the proper wrapping technique for the affected area.[pic] 1. Watch for signs of shock. Treat shock as needed. 1. If immediate professional medical help will be unavailable for an extended amount of time, apply a cold compress or ice. Be sure to protect the skin from ice by wrapping the ice in a towel or other cloth. 1. Get the patient into a comfortable position without moving the injured area.[pic] 1. Keep the patient calm. 1. Get medical help.[pic]

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Question # 6
Attempt to straighten or align bone and joint injuries. • [pic]True • [pic]False
[pic]
Correct Answer.
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Question # 7
What should be applied to a bone or joint injury if immediate professional medical help will be unavailable for an extended amount of time? • [pic]Heating pad • [pic]Dressing • [pic]Cold compress • [pic]All of the above
[pic]
Correct Answer.
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|Question |Your Answer |
|What is a fracture? |Incorrect Selection: |
| | |
| |Joint that comes out of a socket |
|What type of blood |Incorrect Selection: |
|pressure reading is | |
|common if a patient |High |
|is experiencing | |
|shock? | |
|What should be |Incorrect Selection: |
|applied to a bone or | |
|joint injury if |Heating pad |
|immediate | |
|professional medical | |
|help will be | |
|unavailable for an | |
|extended amount of | |
|time? | |
|What is the priority |Incorrect Selection: |
|in treating shock? | |
| |Improving blood flow |
|Which of the |Incorrect Selection: |
|following is true? | |
| |Dislocations must be put back into correct position before immobilizing the joint. |
|Which of the |Incorrect Selection: |
|following is true of | |
|shock? |Patients with shock usually have hot, flushed skin. |
|What causes |Correct |
|anaphylactic shock? | |
|Shock occurs when |Correct |
|organs and tissues do| |
|not receive enough | |
|oxygen and what other| |
|substance? | |
|Which of the |Correct |
|following is NOT true| |
|of fractures? | |
|What causes |Correct |
|neurogenic shock? | |
|Which type of bone or|Correct |
|joint injury occurs | |
|when there is a | |
|stretch or tear in | |
|the tissues around a | |
|joint? | |
|Which type of bone or|Correct |
|joint injury occurs | |
|when a muscle is | |
|overused or | |
|overstretched? | |
|Which type of bone or|Correct |
|joint injury occurs | |
|when a bone separates| |
|from a joint or is | |
|moved out of place in| |
|the joint? | |
|What causes |Correct |
|hemorrhagic shock? | |

Wounds
A wound is an injury that damages the body's tissues. The two greatest concerns in regards to wounds include excessive bleeding and infection. So it is important for a health care worker to know both how to stop or slow bleeding and how to treat a wound properly to prevent infection.

Signs of Infection
Infections can be very serious. Some infections, like tetanus, can cause death if they are not treated. It is important that health care workers be able to recognize the signs of infection so that it can be treated immediately. Signs of infection include: • Redness • Swelling • Pain • Heat • Fever • Pus • Red streaks coming from the wound

Closed Wounds
A closed wound is an injury that causes damage to the tissue under the skin. Closed wounds are caused when the body hits against a blunt object, such as in a bump or fall. Contusions, or bruises, and black eyes are examples of closed wounds. A closed wound will usually heal on its own in a few weeks. Because skin is not broken, there is no external bleeding. Closed wounds are also unlikely to be threatened by infection. Therefore, the treatment for a closed wound is much different than the treatment for an open wound.

Check Your Understanding
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Question # 1
What is another name for a contusion? • [pic]Bruise • [pic]Cut • [pic]Concussion • [pic]Open wound • [pic]Abrasion
[pic]
Correct Answer.
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Question # 2
A closed wound should heal in a few weeks. • [pic]True • [pic]False
[pic]
Correct Answer

Procedure for a Closed Wound
It is important to learn the correct procedure for treating a closed wound. Even though closed wounds will typically heal themselves, there are some things a health care worker can do to make the patient more comfortable. Individual agencies may have specific procedures that their employees must follow. The following process is an example of a closed wound procedure that might be found at any agency.[pic] 1. Place a cold pack on the bruised area to reduce pain and swelling.[pic] If possible, elevate the bruised area. Place pillows or folded blankets or a cloth under the affected area. The area should be higher than the heart. Elevating the injury can reduce or eliminate swelling

Open Wounds
An open wound is an injury where the skin or mucous membrane is broken. Open wounds can be caused by a fall or when the body comes in contact with a sharp object. There are several types of open wounds. Click on each term to learn about wounds. • Incisions • Lacerations • Abrasions • Punctures • Avulsions • Amputations

qTop of Form uestion # 5
Which of the following are open wounds? • [pic]Abrasions, punctures • [pic]Abrasions, contusions • [pic]Contusions, concussions • [pic]All of the above
[pic]
Correct Answer.
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Question # 6
Incisions are rough, irregular wounds caused when blunt objects rip the skin. • [pic]True • [pic]False
Question # 7
What kind of open wound occurs when tissue is torn from the body? • [pic]Incision • [pic]Laceration • [pic]Avulsion • [pic]Puncture wound
[pic]
Correct Answer.
Minor Open Wounds
Some open wounds are classified as minor wounds. They are shallow and produce very little blood. They are not life-threatening and can be treated at home. However, they must be treated with care. Untreated, or improperly treated, minor wounds can become infected or can cause tetanus.
Question # 8
Minor wounds can be left untreated without risk of infection. • [pic]True • [pic]False
[pic]
Correct Answer.

Procedure for Minor Wounds
It is important to learn the correct procedure for treating a minor open wound. Individual agencies may have specific procedures that their employees must follow. The following process is an example of a minor open wound procedure that might be found at any agency.[pic] 1. Cleanse your hands.[pic] 1. Put on gloves. If gloves are not available, create a barrier between the blood and your skin with plastic wrap, plastic bags, or layers of dressings.[pic] 1. Clean the wound with soap, water, and gauze, moving the gauze in a circular motion from the center of the wound out to the outer edge. Repeat this process until the wound is thoroughly clean. Throw gauze away after each pass.[pic] 1. When the wound is clean, rinse all of the soap with cool water.[pic] 1. Apply a dressing to the wound.[pic] 1. Instruct the patient how to recognize symptoms of infection and to get medical attention if any symptoms occur. 1. If the patient has a puncture wound, instruct the patient to see a doctor to get a tetanus shot. 1. If the wound contains foreign bodies, instruct the patient to get professional medical help to remove them.[pic] 1. Remove gloves.[pic] 1. Cleanse your hands.[pic]

When cleaning a minor wound with gauze, which method should be used? • [pic]A back-and-forth motion from the outer edge to the center of the wound • [pic]A back-and-forth motion from the center of the wound to the outer edge • [pic]A circular motion from the center of the wound out to the outer edge • [pic]A circular motion from the outer edge to the center of the wound • [pic]All of the above
[pic]
Correct Answer

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Question # 10
If there are foreign bodies stuck in the wound, you should keep picking at the wound until you get them out. • [pic]True • [pic]False
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Major Open Wounds
Some open wounds are classified as major or severe wounds. It is important to act quickly when treating a patient with a major wound. A patient can bleed to death in a short period of time. Care for a major wound includes stopping the bleeding and then cleaning and covering. However, because a major open wound causes a lot of bleeding and pain, the health care worker should also check the patient's vital signs, and watch for signs of shock.

Question # 11
Which of the following is a step in treating an open major wound? • [pic]Stopping the bleeding • [pic]Cleaning • [pic]Covering • [pic]All of the above
[pic]
Correct Answer.

Procedure for Major Wounds
It is important to learn the correct procedure for treating a major open wound. Individual agencies may have specific procedures that their employees must follow. The following process is an example of a major open wound procedure that might be found at any agency.[pic] 1. Perform priority care. o Only if necessary for safety, move the patient. o Check if the patient is breathing and conscious. o Call emergency medical services, EMS. o Provide care.[pic] 1. Cleanse your hands.[pic] 1. Put on gloves. If there are no gloves available, use plastic wrap or thick layers of dressings. Do what you can to avoid any contact between the patient's blood and your skin.[pic] 1. Control bleeding by applying direct pressure to the wound using a thick sterile dressing. If a dressing is not available, use your hand or a clean cloth. If there is an object in the wound, apply pressure around object, not on top of it. 1. Continue to press firmly on the dressing for 5-10 minutes. Do not check to see if the bleeding has stopped. 1. If blood seeps through the dressing, place a second layer of dressing on top of it and continue to press. Do not lift the first layer of dressing. Removing the first layer will disturb any blood clots that have formed.[pic]

1. While applying pressure, elevate the injured body part above the patient's heart to help control bleeding. Do not raise a broken bone, or fracture, or a suspected break or fracture, which could cause greater injury.[pic] 1. Apply a circular bandage, which will provide direct pressure on the wound.[pic] 1. If bleeding continues after applying a bandage, apply pressure to the pressure point.
If the wound is on the arm or hand, the brachial artery is the pressure point. Do the following: • Find the brachial pressure point location. It is found on the inside of the patient's upper arm halfway between the elbow and axilla.[pic] • Using the flat pads of your fingers and with your thumb on the outside of the arm, press your fingers against the patient's arm to slow the blood flow to the injury.[pic]
If the wound is on the leg, the femoral artery is the pressure point. Do the following: • Find the femoral pressure point location. It is found on the front middle part of the patient's thigh where the leg joins the body. Specifically, find where the artery lies over the pelvic bone.[pic] • Using the flat pads of your fingers or the heel of your hand, press against the femoral artery to slow the blood flow to the injury 1. As bleeding stops, slowly release pressure on the pressure point. If bleeding resumes, reapply pressure immediately. 1. Continue pressure as needed until EMS arrives. 1. Monitor the patient for signs of shock. Treat shock, if needed. 1. Keep the patient calm. 1. If the injury involves an amputation, prepare the amputated part for transport. o Wet a dressing or clean cloth with saline or clean water.[pic] o Wrap the body part in the dressing or cloth.[pic] o Place the part in a clean plastic bag.[pic] o Put ice or cold water in a cooler or any clean container. Make sure you add enough ice or cold water to cover the body part. o Put the body part in the cooler or container. o Send the amputated part to the hospital with the patient. When help arrives, give the body part to the EMS. If you are driving the patient to the hospital, take the amputated part with you.[pic] 1. As soon as possible, remove gloves.[pic] 1. As soon as possible, cleanse your hands thoroughly

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Question # 12
What actions can be taken to try to control or stop bleeding? • [pic]Apply pressure to the wound • [pic]Elevate the injured body part • [pic]Apply pressure to a pressure point • [pic]All of the above
[pic]
Correct Answer
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Question # 13
Treating a major open wound may require skills in applying both a dressing and a bandage. • [pic]True • [pic]False

Burns
A burn is an injury caused by fire, heat, chemicals, radiation, or electricity. Burns are traumatic in that they can cause extreme pain, permanent disfigurement, psychological problems, and even death. The three types of burns are thermal, chemical, and electrical. And there are three classifications of burns. They are first-degree, second-degree, and third-degree. In addition to type and classification, burns can also be described by extent and severity of the injury

Types of Burns
Types of burns include thermal, chemical, and electrical.
Thermal burns are perhaps the most common. They are caused by house fires and car accidents. They can also be caused by playing with matches and firecrackers. Other thermal burns are caused by scalding water, irons, stoves, and sunburn.
Chemical burns are caused by contact with acids or alkaline. Contact includes ingesting, inhalation, and injection. People who work with harmful chemicals must take precautions to avoid contact with the skin or inhalation of dangerous fumes.
Electrical burns are caused by faulty electrical wiring, chewing on electrical cords, high-voltage power lines, and the rare occurrence of lightning strikes. Electrical burns can pose a unique problem for health care workers. Treatment depends on whether or not the patient needs to be separated from the electrical source. A person who touches a live wire is often unable to let it go. In this case, the patient needs to be carefully separated from the electrical source using a nonconductive material, such as plastic, wood, or cardboard. Conductive material such as a person's hands or metal should never be used. Using conductive material will result in the caregiver becoming electrocuted as well.

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Question # 1
Burns can be caused by which of the following? • [pic]Fire, sun, and chemicals • [pic]Heated objects and fluids • [pic]Electricity • [pic]All of the above
[pic]
Correct Answer.
First-Degree Burns
First-degree burns are also called superficial burns. The first-degree burn is the most mild of classifications. It is a shallow burn that damages only the first layer of skin, called the epidermis.
Symptoms of first-degree burns include hot, red, dry skin, mild swelling, and some pain. Causes of first-degree burns are sunburn and brief contact with hot objects, steam, or weak acids.
Usually, a first-degree burn on a small area of the body is not serious and will heal in 5-6 days without leaving permanent scars.

Second-Degree Burns
Second-degree burns are also called partial-thickness burns. This type of burn affects both layers of skin, the epidermis and the dermis.
Symptoms of a second-degree burn include a blister or vesicle. Skin may appear wet and mottled. Swelling, or edema, likely occurs. Causes of second-degree burns include exposure to boiling liquid, fire, extreme sunburn, and artificial radiation.
Second-degree burns are very painful and may take 3 to 4 weeks to heal.
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Third-Degree Burns
Third-degree burns are also called full-thickness burns. This type is called a full-thickness burn because it is the deepest, or thickest, kind of burn. It affects both layers of skin and the tissues beneath the skin, known as subcutaneous tissue. The muscles and bones beneath the tissue might also be affected.
Symptoms of a third-degree burn include skin that appears either white or charred. Charred skin has a black, brown, or red color. Causes of third-degree burns include fire and flames, extended contact with a hot object, exposure to electricity, and immersion in a boiling substance.
A third-degree burn is a very serious injury that can be fatal. These injuries range from extremely painful to almost painless if nerve endings are destroyed. The patient's skin is too badly damaged to heal and may require skin grafts. This type of burn may also cause other health complications. Patients may have breathing or heart problems, or they may go into shock. Any patient with a third-degree burn should receive professional medical care.
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Question # 2
First-degree burns usually heal within 5-6 days, with no permanent scars. • [pic]True • [pic]False
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Correct Answer.
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Question # 3
Which type of burn is also called a partial-thickness burn? • [pic]First-degree • [pic]Second-degree • [pic]Third-degree • [pic]All of the above
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Question # 4
A patient with which type of burn should always get professional medical help? • [pic]First-degree • [pic]Second-degree • [pic]Third-degree • [pic]All of the above
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Correct Answer.
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Question # 5
Why might a third-degree burn patient not need a pain reliever? • [pic]The bones might be destroyed. • [pic]The capillaries might be destroyed. • [pic]The muscles might be destroyed. • [pic]The nerve endings might be destroyed. • [pic]The epidermis and dermis might be destroyed.
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Correct Answer.
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Extent and Severity of Burns
Burns are also categorized based on the extent and severity of the injury. The Rule of Nines and the Lund and Browder chart are methods that estimate the percentage of the body surface area, called BSA, that has been affected by the burn.
With the Rule of Nines, an adult patient should get professional medical care if burns cover more than 15% of the body; children, if burns cover more than 10%. The percentage is determined by comparing the burn pattern on the patient to the Rule of Nines chart model and then adding the percentages to get a total. For example, an adult with a burn on the front of one leg and the front and back of one arm would have a burn percentage of 18%. This patient should see a medical professional.
Another method for categorizing burns is a combination of the burn's depth and its size. Depth refers to first-, second-, or third-degree. Size refers to BSA. This method classifies burns as minor, moderate, or major.

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According to the Rule of Nines, what is the burn percentage of a patient with burns to the back of both legs? • [pic]18 percent • [pic]36 percent • [pic]9 percent • [pic]19 percent
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Correct Answer.
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Procedure for Burns
It is important to learn the correct procedure for treating burns. Individual agencies may have specific procedures that their employees must follow. The following process is an example of a burn procedure that might be found at any agency. 1. In all burn cases, perform priority care. o Only if necessary for safety, move the patient. o Check if the patient is breathing and conscious. o If needed, call emergency medical services, EMS. o Provide care. o Control bleeding. Wear gloves or avoid contact between the patient's blood and your skin. 1. Inspect the burned area to determine if it is a first-, second-, or third-degree burn. Patients may have more than one type of burn. Treat the patient according to the most severely burned area.

Procedure for Burns (continued)
If the patient has a first-degree or mild second-degree burn, do the following: 1. Run cool water over the burned area. If large amounts of cool water are not available, apply a clean cloth that has been wet with cool water[pic] 1. Continue to apply cool water until the pain stops. 1. Blot the area dry.[pic] 1. Apply a non-adhesive, or non-stick, sterile dressing that will not stick to the burned area.[pic] 1. If there are blisters on the burn, do not open them. 1. Elevate the burned area to reduce swelling.[pic] 1. Call EMS if any of the following have occurred: o Burns are on the face. o Burns cover more that 15% of an adult's body or 10% of a child's body. o Patient has trouble breathing. o Patient shows signs of shock 1. Immediately call EMS. 1. Cover the burned area with thick, sterile dressings.[pic] 1. Do not remove any clothing that has become attached to the burned area. 1. Elevate the burned areas, if possible. If the face is burned or the patient has trouble breathing, elevate the head. 1. Watch the patient for symptoms of shock. Treat for shock, if needed. 1. Keep the patient calm until help arrives 1. Immediately call EMS. 1. Pour water on the burned area for 15 or 30 minutes, or until EMS arrives.[pic] 1. If possible, remove clothing or jewelry that has the chemical on it. 1. Keep the patient calm until help arrives.[pic]
If the patient has a chemical or gas burn in the eyes, do the following: 1. Immediately call EMS. 1. Ask patient to quickly remove glasses or contact lenses, if they are wearing them. 1. Turn the patient's head toward the injured side.[pic] 1. Pour cool water on the eye so that it flows from the side closest to the nose to the side closest to the ear. Continue rinsing the eye for 15 to 30 minutes, or until EMS arrives. Be careful to avoid rinsing the chemicals into the uninjured eye. 1. Watch the patient for symptoms of shock. Treat for shock, if needed. 1. Keep the patient calm until help arrives

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Question # 7
Which type of burn should you flush with cool water? • [pic]Severe second-degree or third-degree • [pic]First-degree or mild second-degree • [pic]All of the above
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Correct Answer.
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Question # 8
Before covering the burn, cool it with ice. • [pic]True • [pic]False
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Correct Answer.
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Question # 9
You should not remove clothing stuck to a burn. • [pic]True • [pic]False
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Correct Answer.
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Question # 10
Always get help for a patient with severe burns. • [pic]True • [pic]False
|Question |Your Answer |
|A patient has a |Incorrect Selection: |
|major wound to the| |
|wrist. What |Femoral artery |
|pressure point | |
|should be used to | |
|stop bleeding? | |
|With a bruise, |Incorrect Selection: |
|elevate the | |
|injured area above|Head |
|what body part? | |
|Which type of burn|Incorrect Selection: |
|is also called a | |
|partial-thickness |Third-degree |
|burn? | |
|According to the |Incorrect Selection: |
|Rule of Nines, | |
|what is the burn |18 percent |
|percentage of a | |
|patient with burns| |
|to the front of | |
|the torso and the | |
|front side of both| |
|arms? | |
|A patient with |Incorrect Selection: |
|which type of burn| |
|should always get |All of the above |
|professional | |
|medical help? | |
|Which type of burn|Incorrect Selection: |
|should you flush | |
|with cool water? |All burns should be flushed with cool water |
|Which of the |Incorrect Selection: |
|following is true?| |
| |Incisions are rough, irregular wounds caused when blunt objects rip the skin. |
|Which of the |Correct |
|following are open| |
|wounds? | |
|What is another |Correct |
|name for a | |
|contusion? | |
|What kind of open |Correct |
|wound occurs when | |
|tissue is torn | |
|from the body? | |
|What is the most |Correct |
|critical step in | |
|treating an open | |
|major wound? | |
|Which of the |Correct |
|following is NOT | |
|true of burns? | |
|Why might a |Correct |
|third-degree burn | |
|patient not need a| |
|pain reliever? | |
|When cleaning a |Correct |
|minor wound with | |
|gauze, which | |
|method should be | |
|used? | |
|What should you do|Correct |
|if there are | |
|foreign bodies in | |
|a wound? | |
|What actions can |Correct |
|be taken to try to| |
|control or stop | |
|bleeding? | |
|Redness, oozing |Correct |
|pus and a fever | |
|can indicate what?| |

Foreign Bodies
Foreign bodies are objects or substances that have entered the body and do not belong there. Foreign bodies range in seriousness from a simple splinter in a foot or finger to the life-threatening situation of an object blocking a person's airway. The treatment for foreign bodies always involves removing the object. However, the similarity ends there. The location of the foreign body determines the specific type of care that should be provided.

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Question # 1
The type of care that should be provided to a patient with a foreign body injury is always the same. • [pic]True • [pic]False
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Correct Answer.
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Question # 2
Foreign bodies are objects or substances that have entered the body and do not belong there. • [pic]True • [pic]False
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Correct Answer

Foreign Bodies in the Eye
Mild cases of foreign bodies in the eye are not unusual. Common objects that can get into the eye include soap, beauty products, dirt, eyelashes, and insects. These incidents are usually minor. However, foreign bodies in the eye can be very serious. Sharp objects, such as glass shards, can puncture the eye. Even a small object can cause scratches if the affected eye is rubbed. Sharp objects that are lodged in the eye should be removed by a doctor
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Question # 3
Only large, sharp objects can cause scratches in the eye. • [pic]True • [pic]False
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Correct Answer.
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Question # 4
Sharp objects that are lodged in the eye should be removed by a doctor. • [pic]True • [pic]False
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Correct Answer
Procedure for Objects in the Eye
It is important to learn the correct procedure for treating a foreign body in the eye. Individual agencies may have specific procedures that their employees must follow. The following process is an example of a foreign body procedure that might be found at any agency.[pic] 1. Cleanse your hands. 1. In all cases, perform priority care. o Only if necessary for safety, move the patient. o Check if the patient is breathing and conscious. o If needed, call emergency medical services, EMS. o Provide care. o Control bleeding. Wear gloves or avoid contact between the patient's blood and your skin

1. Instruct the patient Not to rub the eye. 1. Carefully grasp the upper eyelid and pull it down over the lower eyelid. The object may dislodge. 1. If the object does not dislodge, gently grasp the eyelashes of the upper eyelid and raise it. 1. Ask the patient to look down and tilt the head toward the injured side. 1. Flush the eye with water or use a folded piece of sterile gauze or clean cloth to remove the object. The object may dislodge. 1. Do not make any attempt to dislodge an embedded object from the eye. 1. Cover the eye with a sterile dressing.[pic] 1. Get medical help.[pic]
If the patient has protruding object in the eye, do the following: 1. Do not make any attempt to dislodge a protruding object from the eye. 1. Immobilize the object and the eye as much as possible by applying dressings around the object to cover the eye. A paper cup with the bottom cut out can also be used to stabilize the object.[pic] 1. Cover the unaffected eye with a sterile dressing. Covering both eyes helps to eliminate movement of the injured eye.[pic] 1. Get medical help
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Question # 5
To avoid scratches, instruct the patient not to __ the injured eye.
Correct Answer(s): rub, move
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Correct Answer.
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Question # 6
What should be done first when trying to remove a floating object in the eye? • [pic]Flush the eye with water • [pic]Cover eye with dressing. • [pic]Pulling the upper eyelid down over the lower eyelid
Foreign Bodies in the Ear
Foreign bodies in the ear can range from mild to serious. Common objects that can get into the ear include insects, small objects, and chemicals. Generally, objects in the outer part of the ear do not cause significant damage, and they often fall out when the head is gently shaken. More stubborn objects can usually be removed with blunt tweezers or forceps. Serious cases occur when a foreign body causes the eardrum to rupture or perforate
Procedure for Objects in the Ear
It is important to learn the correct procedure for treating a foreign body in the ear. Individual agencies may have specific procedures that their employees must follow. The following process is an example of a foreign body procedure that might be found at any agency.[pic]
First, try gently shaking out the object: 1. Tilt the head to the side, toward the affected ear. For example, if there is an object in the right ear, tilt the head to the right.[pic] 1. Gently pull the ear up and back. Pulling the ear will straighten the ear canal, making it easier to remove the object. 1. Gently shake the head. The object may fall out.[pic]
If the object does not fall out and the object is in the outer part of the ear, do the following: 1. Use blunt-edged tweezers to remove the object. Never use sharp-edged tweezers in the ear. 1. Be very careful not to push the object further into the ear canal. 1. Be sure not to touch the eardrum
Flushing Objects from the Ear
If an object cannot be removed from the ear using tweezers, the ear can be flushed with a few drops of warm oil or water. The head is tilted away from the affected ear. Then the ear is pulled up and back, to straighten the canal. The water or warm oil is placed in the ear using an eyedropper. Then the head is tilted so that the oil or water and the object will pour out. If flushing the ear does not remove the object, then the patient should seek medical help
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Question # 7
When a foreign object is in the ear, the first method to try is flushing the ear. • [pic]True • [pic]False
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Correct Answer.
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Question # 8
Which of the following is a method for removing a foreign object from the ear? • [pic]Flushing with warm oil • [pic]Blunt tweezers • [pic]Gently shaking the head • [pic]Flushing with water • [pic]All of the above

Foreign Bodies in the Nose
Most cases of foreign bodies in the nose are minor. Common objects that can get into the nostrils include insects and chemicals that are accidentally inhaled. Children are also famous for placing objects such as coins, buttons, pebbles, marbles and other small toys in their noses. In most cases, the foreign body can be safely removed. However, if an item is stuck, get medical help.

Procedure for Objects in the Nose
It is important to learn the correct procedure for treating a foreign body in the nose. Individual agencies may have specific procedures that their employees must follow. The following process is an example of a foreign body procedure that might be found at any agency. 1. First try to have the patient to blow forcefully through the nose.[pic] 1. If the object does not come out, then gather blunt tweezers or forceps. 1. Tilt the head back.[pic] 1. Shine a flashlight into the nostril to find the object.[pic] 1. Carefully remove the object with the tweezers or forceps. Do not scrape the sides of the nasal passage. Be careful not to push the object further into the nose. If the object cannot be removed or if it is removed and pain or irritation continues, call EMS
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Question # 9
If an item is stuck in the nose and not removable with tweezers, seek medical help. • [pic]True • [pic]False
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Correct Answer.
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Question # 10
Which method should be attempted first when trying to remove a foreign object from the nose? • [pic]Blunt tweezers • [pic]Blowing the nose
[pic]
Correct Answer.
Foreign Bodies in the Skin
Most cases of foreign bodies in the skin are minor. Common objects that can get into the skin include splinters, insect stingers, and fish hooks. In most cases, the foreign body can be safely removed without professional medical help. However, if an item is stuck, be sure to get help.

Procedure for Removing Splinters
It is important to learn the correct procedure for treating a splinter. Individual agencies may have specific procedures that their employees must follow. The following process is an example of a splinter procedure that might be found at any agency.[pic] 1. Cleanse your hands.[pic] 1. Wash the area with soap and water.[pic] 1. Hold a needle over a flame until it is heated, which sterilizes the needle. 1. Allow the needle to cool. Do not blow on the needle to cool it. 1. Using the needle, make a slit in the skin over the splinter. 1. With the needle, lift the end of the splinter.[pic] 1. Use tweezers to grasp the end of the splinter and remove it from the skin.[pic] 1. Wash the area again with soap and water. 1. Cover the area with an adhesive bandage. 1. If the object is located under a fingernail or if it cannot be removed, get medical help. 1. Cleanse your hands
Procedure for Removing Fish Hooks
It is important to learn the correct procedure for treating a fish hook in the skin. Individual agencies may have specific procedures that their employees must follow. The following process is an example of a procedure that might be found at any agency for a fish hook in the skin.[pic] 1. Cleanse your hands.[pic] 1. If possible, seek medical help to get a local anesthetic and for removal of the hook. 1. If medical help is not available, push the barb end of the hook through the skin. The barb has a small hook on it, so never pull the barb end back out of the skin.[pic] 1. Cut off the barb with nipper pliers. 1. Back the rest of the hook out from the skin. 1. Wash the area with soap and water.[pic] 1. Apply a sterile dressing. 1. Seek medical help for a tetanus toxoid booster or tetanus antiserum, and possibly antibiotics. 1. Cleanse your hands

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Question # 11
Needles used to remove splinters should be sterilized before use. • [pic]True • [pic]False
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Correct Answer.
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Question # 12
Never pull the barb end of a fish hook back out of the skin. • [pic]True • [pic]False

Poisons
Poison is any substance that causes injury, illness, or death when it enters or comes in contact with the body. Most poisonings occur in the home from household cleaners, beauty products, or other substances. They may be swallowed, injected, inhaled, or absorbed through the skin. Another method of poisoning is abusing alcohol or prescribed or illegal drugs. Poisoning can also be caused by plants and insect and snakebites.
Exact treatment for poisoning varies according to the substance, the amount, and the way it enters the body. Also, treatment for a conscious patient differs from that for an unconscious patient. Some poisons can be fatal, so it is critical to treat poisoning quickly and correctly.

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Question # 1
Poisoning treatment varies, depending on the type of poison, and the way it entered the body. • [pic]True • [pic]False
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Correct Answer.
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Question # 2
Which of the following are ways that poison can enter the body? • [pic]Swallowing • [pic]Inhaling • [pic]Injecting • [pic]Absorption through the skin • [pic]All of the above

The Poison Control Center
All poisoning requires quick action. In most cases, poison does not enter the bloodstream right away, so fast action can prevent injury or death. If a patient has swallowed or inhaled poison, the health care worker should call EMS or the local Poison Control Center, or PCC, immediately. The Poison Control Center is prepared to help treat poison cases by giving specific instructions over the phone.
The national Poison Control Center hotline is 1-800-222-1222. Health care workers should also be aware of the phone number for their local Poison Control Centers

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Question # 3
The Poison Control Center is prepared to help treat poison cases by giving specific instructions over the phone. • [pic]True • [pic]False

Signs of Poisoning
An ill or unconscious patient combined with an open or empty container of a poisonous substance can indicate poisoning.
In addition, people who have been poisoned can experience any of the following symptoms: • Burns or redness around mouth and lips • Breath that smells like chemicals • Vomiting • Difficulty breathing • Sleepiness or confusion • Dramatic changes in appearance or behavior

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Question # 4
Signs of poisoning include which of the following? • [pic]Burning and redness around the mouth and lips • [pic]Breath that smells like fruit • [pic]Torn clothing • [pic]All of the above
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Correct Answer.
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Question # 5
Breath that smells like chemicals is a sign of poisoning. • [pic]True • [pic]False
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Correct Answer.
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Question # 6
A poison victim may experience vomiting and difficulty breathing. • [pic]True • [pic]False

Gather Information
When treating a patient for poisoning, quickly gather as much information as possible. Treatment may depend on the answers to four important questions: • What is the poisonous agent? • How did the poison enter the body? • How much poison entered the body? • What time did the poison enter the body?
If possible, ask the patient and any witnesses for information. Look for clues, such as an open or empty bottle or chemical stains on clothes. If the poison is a commercial product in a container, read the label for instructions about treatment, and save the container or label for EMS. If the patient vomits, gather a sample of the vomit. The sample can help medical professionals see how much poison is in the patient's system

Question # 7
Which of the following is a question to be asked in a poison case? • [pic]How much poison entered the body? • [pic]How did the poison enter the body? • [pic]What is the poisonous agent? • [pic]What time did the poison enter the body? • [pic]All of the above
Procedure for Poisoning
It is important to learn the correct procedure for treating poisoning. Individual agencies may have specific procedures that their employees must follow. The following process is an example of a poisoning procedure that might be found at any agency.[pic] 1. In all poison cases, perform priority care. o Only if necessary for safety, move the patient. o Check if the patient is breathing and conscious. o Call emergency medical services, EMS. o Provide care. o Control bleeding. Wear gloves or avoid contact between the patient's blood and your skin o
2. Try to find out the type of poison, how much was taken, and how long ago it was taken. 1. Immediately call the Poison Control Center or EMS. 1. Follow PCC or EMS instructions. If PCC or EMS instructs you to induce vomiting, give the patient syrup of ipecac, warm salt water, or tickle the back of the patient's throat. Never induce vomiting if the patient has ingested acid, alkali, or petroleum; has burns on the lips or mouth; is unconscious; or is having convulsions. 1. If the patient vomits, save a sample.[pic]
If the patient has swallowed poison and is unconscious, do the following: 1. Check for breathing. If the patient has stopped breathing, give artificial respiration. 1. If the patient is breathing, turn him on his side so that fluids can run out of the mouth. 1. Call PCC or EMS. 1. If it is available, save the poison container. 1. If the patient vomits, save a sample. 1. If there are any witnesses, try to find out the type of poison, how much was taken, and how long ago it was taken 1. Wash the area thoroughly with water. If a large area of the body has been covered, use a shower, tub, or hose to rinse the patient thoroughly. 1. If poison is on clothing or jewelry, remove it from the patient. 1. Check the patient for burns or injuries from the poison. If the patient has serious burns or injuries, call EMS. 1. Check the patient for rash or weeping sores. For small areas of rash or sores, treat with Calamine lotion, Caladryl, or a paste made from baking soda and water. If large areas of the body are affected, call EMS immediately. 1. Take a deep breath of fresh air, then enter the poisonous area and remove the patient. 1. Once in a safe area, check for breathing. If the patient has stopped breathing, give artificial respiration. 1. Call EMS immediately. 1. Position the affected body part below the heart. 1. If the injection is from an insect sting, get out the stinger. Scrape it out using a flat object, such as a credit card. Wash the affected area with soap and water and apply a cold pack dressing to prevent swelling. 1. If the injection is a tick, use tweezers to pull it out gently. Be very careful to extract the tick slowly and gently so that the tick's head does not remain embedded in the patient's skin. Wash the site with soap and water and use an antiseptic. 1. If the injection is from a snakebite, wash the wound immediately. Position the affected area below the heart and then do not move it. Check for breathing. If the patient has stopped breathing, give artificial respiration. Call EMS. 1. In all patients who have been poisoned, watch for symptoms of allergic reactions, including redness, swelling, itching, hives, pain, throat swelling, difficulty breathing, dizziness, or change in consciousness. If an allergic reaction occurs, monitor and maintain breathing and call EMS. 1. Watch for signs of anaphylactic shock. If needed, treat shock. 1. Keep calm and reassure the patient. 1. Always get medical help for a patient that has been poisoned. Some poisons may cause delayed reactions.
Question # 8
If a poison patient seems okay, there is no need to get medical help. • [pic]True • [pic]False
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Correct Answer

Exposure to Heat
The body works hard to keep itself cool. If body temperature rises just a few degrees, the heart must pump harder to get blood to the muscles and to the skin. Blood at the skin's surface helps the body perspire. Perspiration moistens and cools the surface of the skin. Usually this cooling system works.
However, if too much water and salt are lost from the body through excessive perspiration, there can be serious consequences. Overexposure to heat can cause a chemical imbalance inside the body. If the situation is not properly addressed, the effects can be fatal.
Some causes of overexposure to heat include being in extreme heat for too long, working or exercising on a hot day, and illnesses, such as heart conditions, diabetes, and high blood pressure. All of these occurrences can affect the body's ability to cool itself.
When the body is unable to cool itself, a heat-induced condition occurs. These conditions include heat cramps, heat exhaustion, and heat stroke.

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Question # 1
What is the body's method for cooling itself down? • [pic]Shivering • [pic]Perspiration • [pic]Fainting • [pic]All of the above
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Correct Answer.
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Question # 2
When the body is unable to cool itself, which of the following heat-induced conditions can occur? • [pic]Heat cramps • [pic]Heat exhaustion • [pic]Heat stroke • [pic]All of the above
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Heat Cramps
Heat cramps occur when a person perspires a lot, usually through working or exercising on a hot day. This causes the body to lose water and salt. If the person does not drink fluids to replace the water and salt, heat cramps may result.
A heat cramp is essentially a muscle cramp. Often, the cramps affect the calves, back, abdomen, or arm muscles. However, any muscle can be affected.
Symptoms of a heat cramp include muscle pain or spasm.

Question # 3
Give a heat cramp patient large amounts of ice cold water to drink. • [pic]True • [pic]False
[pic]
Correct

Procedure for Heat Cramps
It is important to learn the correct procedure for treating heat cramps. Individual agencies may have specific procedures that their employees must follow. The following process is an example of a heat cramp procedure that might be found at any agency.[pic] 1. With your hand, apply firm pressure to the affected area.[pic] 1. Get the patient to relax in a cool area. 1. Give the patient small sips of cool water, about four ounces every 15 minutes.[pic] 1. If the cramps do not stop, or if they get worse, get medical help
Heat Exhaustion
Similar to heat cramps, heat exhaustion also occurs when the body loses too much water and salt through perspiration. A patient with heat exhaustion must be monitored carefully because heat exhaustion can quickly lead to a life-threatening condition called heat stroke.
Symptoms of heat exhaustion include pale and clammy skin, excessive perspiration, weakness, tiredness, headache, heat cramps, nausea and dizziness, or even vomiting or fainting. People with heat exhaustion may also have a low-grade fever, usually 104ºF or less.

Procedure for Heat Exhaustion
It is important to learn the correct procedure for treating heat exhaustion. Individual agencies may have specific procedures that their employees must follow. The following process is an example of a heat exhaustion procedure that might be found at any agency.[pic] 1. Move the patient to a cooler area. Get the patient out of the sun and into air conditioning, if possible. 1. Help the patient lie on the back.[pic] 1. Elevate the patient's feet and legs approximately 12 inches.[pic] 1. If possible, remove unnecessary layers of clothing. Loosen remaining clothing.[pic] 1. Moisten the face with a cool, moist cloth.[pic] 1. If the patient is conscious and not nauseated, supply about 4 ounces of cool water every 15 minutes.[pic] 1. If the patient is unconscious, nauseated, or vomiting, get medical help. Do not give such a patient any water or other fluids

Question # 4
Heat exhaustion patients may have a low-grade fever, 104ºF or below. • [pic]True • [pic]False
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Heat Stroke
The most serious condition caused by heat exposure is the heat stroke. Heat stroke can be fatal. A heat stroke occurs when heat causes high blood pressure and very high body temperature. In fact, during a heat stroke, body temperature can rise to 105ºF or higher. If left untreated, this high fever can cause brain damage.
Symptoms of heat stroke include red, dry, flushed skin; rapid, shallow breathing; a high temperature; and a fast, strong pulse. Other symptoms include seizure, irritability, confusion, or unconsciousness.

Question # 5
The most serious condition caused by heat exposure is the heat stroke. • [pic]True • [pic]False

Correct Answer
Procedure for Heat Stroke
It is important to learn the correct procedure for treating heat stroke. Individual agencies may have specific procedures that their employees must follow. The following process is an example of a heat stroke procedure that might be found at any agency.[pic] 1. Immediately move the patient to a cool place. 1. Remove as much clothing as possible. 1. If possible, get the patient into a tub filled with cool water. If a tub is not available, sponge bare skin with cool water and place ice or cold packs on the wrists, ankles, axillary, and groin areas.[pic] 1. If vomiting occurs, turn the patient to the side.[pic] 1. Watch the patient for breathing problems, and treat, if needed. 1. Check vital signs, and treat, if needed.[pic] 1. Get medical help. 1. Keep the patient calm
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Question # 6
Which heat-induced condition can cause body temperatures in excess of 105ºF? • [pic]Heat cramps • [pic]Heat exhaustion • [pic]Heat stroke • [pic]All of the above
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Question # 7
Which heat-induced condition is treated by applying firm pressure to the affected area? • [pic]Heat cramps • [pic]Heat exhaustion • [pic]Heat stroke • [pic]All of the above
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Correct Answer.

Exposure to Cold
Cold temperatures cause the body to shiver, which helps to keep it warm. However, even shivering is unable to keep the body warm in some conditions. Exposure to cold as a result of improper dress, immersion in very cold water, or as an affect of illnesses, can lower body temperature below the normal 98.6ºF. Prolonged exposure to cold can cause hypothermia and frostbite

Question # 1
What is the body's method for warming itself up? • [pic]Shivering • [pic]Perspiration • [pic]Fainting • [pic]All of the above
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Correct Answer.

Hypothermia
A patient with hypothermia will have a temperature reading below 95°F. Hypothermia can lead to death if a patient's temperature falls below 93°F for a period of time.
Hypothermia can be caused by submersion in extremely cold water. It can also result from spending too much time in cool, damp environments or in temperatures that are below freezing. Both the very young and the very old of age are at the greatest risk of hypothermia. Their bodies have the most difficulties regulating body temperature.
Symptoms of hypothermia include any of the following. • Shivering • Numbness • Drowsiness • Confusion • Poor coordination • Unconsciousness

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Question # 2
A patient with hypothermia will have a temperature below what reading? • [pic]90°F • [pic]95°F • [pic]32°F • [pic]All of the above
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Question # 3
Healthy young adults are at the greatest risk of hypothermia. • [pic]True • [pic]False
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Correct Answer.

Frostbite
Frostbite occurs when skin and the tissues and fluids beneath it freeze from exposure to extremely cold temperatures. Frostbite usually affects fingers, toes, ears, and the nose. The longer a person is exposed to cold, the more serious the damage. In time, the tissue cells in the affected area can die. In this case, frostbitten areas need to be amputated.
The initial symptoms of frostbite are redness and tingling in a certain area after exposure to cold. These symptoms are followed by numbness and white or gray/yellow, glossy skin. Blisters may appear as well. The area may be numb, or it may be painful. If exposure continues, symptoms may include confusion, tiredness and weakness, and even unconsciousness

Question # 4
With severe frostbite, if the tissue cells in the injured area die, they can be brought back to life without any permanent damage. • [pic]True • [pic]False
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Procedure for Cold Exposure 1. If needed, perform priority care. o Only if necessary for safety, move the patient. o Check if the patient is breathing and conscious. o Call emergency medical services, EMS. o Provide care. o Control bleeding. Wear gloves or avoid contact between the patient's blood and your skin. 1. Assess the patient's symptoms of cold exposure. Check for shivering, numbness, weakness, confusion, and low body temperature. 1. Look for signs of frostbite. Check hands, feet, nose and ears for white or gray/yellow glossy, cold skin. Ask the patient if there is any numbness or painlessness.[pic] 1. As soon as possible, move the patient somewhere warm. 1. Quickly remove cold, wet clothing. Loosen tight clothing 1. Warm the patient slowly with dry, warm clothing and blankets. Do not warm the patient too fast. If it is done too quickly, it can cause heart problems or it can warm the skin, but draw even more blood away from the vital organs. Never use heat lamps, ovens, stoves, or hot water over 104º F. These high heats can easily burn a patient who is numb.[pic] 1. If you are far from a medical facility and suspect frostbite, place the affected area in warm water, between 100ºF and 104ºF, but no warmer. Do not rewarm frostbite if a medical facility is close by or there is a chance that it might refreeze.[pic] 1. When rewarming a frostbite, remove it from the warm water as soon as it is thawed. Gently dry the area by blotting with a clean cloth. Do not rub the area, which can cause gangrene.[pic] 1. Wrap the frostbitten area in sterile or clean cloth. For frostbitten hands and feet, gently separate fingers and toes with gauze before wrapping them.[pic] 1. Get the patient to lie down. If the toes, feet, or legs are injured, do not allow the patient to walk.[pic] 1. Watch for signs of shock, and treat it if necessary. 1. For conscious patients who have no feelings of nausea, give them something warm to drink. Do not give the patient any alcohol or caffeine.[pic] 1. Keep the patient calm. 1. Get medical help.[pic]

Check Your Understanding
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Question # 5
Which of the following is a key location on the body to check for frostbite? • [pic]Ears • [pic]Hands • [pic]Feet • [pic]Nose • [pic]All of the above
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Correct Answer.
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Question # 6
Give something warm to drink only to conscious cold exposure patients that have no feelings of nausea. • [pic]True • [pic]False
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Question # 7
It is important to try to get a cold exposure patient warm. • [pic]True • [pic]False
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Correct Answer.
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