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Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
Cert unit4 jan2011
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Cert unit4 jan2011

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  • 1. Disaster Medical Operations —Part 2CERT Basic TrainingUnit 4
  • 2. 4-2Unit 3 Review● 3 “Killers” Airway obstruction Excessive bleeding ShockCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 3. 4-31. Gather Facts2. Assess Damage3. Consider Probabilities4. Assess Your Situation5. Establish Priorities6. Make Decisions7. Develop Plan of Action8. Take Action9. Evaluate ProgressREMEMBER:CERT SIZEUP IS ACONTINUALPROCESSCERT SizeupCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 4. 4-4Unit Objectives● Take appropriate sanitation measures tohelp protect public health● Perform head-to-toe patient assessments● Establish a treatment area● Apply splints to suspected fractures andsprains● Employ basic treatments for other injuriesCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 5. 4-5Unit Topics● Public HealthConsiderations● Functions of DisasterMedical Operations● Establishing MedicalTreatment Areas● Conducting Head-to-Toe Assessments● Treating Burns● Wound Care● Treating Fractures,Dislocations, Sprains,and Strains● Nasal Injuries● Treating Cold-RelatedInjuries● Treating Heat-RelatedInjuries● Bites and StingsCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 6. 4-6Public Health Considerations● Maintaining proper hygiene● Maintaining proper sanitation● Purifying water (if necessary)● Preventing spreadof diseaseCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 7. 4-7Maintaining Hygiene● Wash hands frequently Or use alcohol-based hand sanitizer● Wear non-latex exam gloves● Wear N95 mask and goggles● Keep dressings sterile● Avoid contact with body fluids “If it is warm, wet, and not yours,don’t touch it!”CERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 8. 4-8Maintain Sanitation● Control disposal of bacterial sources● Put waste products in plastic bags Tie off bags and mark them as medical waste● Bury human wasteCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 9. 4-9Water Sanitation Methods● Boil water for 1 minute● Water purification tablets● Non-perfumed liquid bleach 8 drops/gal of water 16 drops/gal if water is cloudy Let stand for 30 minutesbefore useCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 10. 4-10Functions of Disaster Medical Operations● Triage● Treatment● Transport● Morgue● SupplyCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 11. 4-11Establish a Medical Treatment Area● Select site and set uptreatment area as soon asinjured victims areconfirmed● When determining bestlocation(s) for treatmentarea, consider: Safety of rescuers andvictims Most effective use ofresourcesCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 12. 4-12Treatment Area Site Selection● The site selectedshould be: In a safe area, free ofhazards and debris Upwind, uphill, andupstream (if possible)from hazard zone(s) Accessible bytransportation vehicles ExpandableCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 13. 4-13Most Effective Use of CERT Resources● To help meet the challenge of limited resources,CERT may need to establish: Decentralized medical treatment location (more thanone location) Centralized medical treatment location (one location)CERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 14. 4-14Treatment Area Layout● Four treatment areas: “I” for Immediate care “D” for Delayed care “M” for Minor injuries/walking wounded “DEAD” for the morgueCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 15. 4-15Treatment Area LayoutCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 16. 4-16Treatment Area Organization● Assign treatment leader to each treatment area● Document thoroughly Available identifying information Description (age, sex, body build, estimated height) Clothing Injuries Treatment Transfer locationCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 17. 4-17Head-to-Toe Assessment● Objectives of head-to-toe assessment: Determine extent ofinjuries Determine type oftreatment needed Document injuriesCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 18. 4-18DCAP-BTLS● Deformities● Contusions● Abrasions● Punctures● Burns● Tenderness● Lacerations● SwellingCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 19. 4-19Where and When● Light damage: assess in place● Moderate damage: move to treatmentarea first● Assess and tag everyone● Both verbal and hands onCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 20. 4-20Conducting Head-to-Toe Assessment● Pay careful attention● Look, listen, and feel● Check own hands for patient bleeding● If you suspect a spinal injury inunconscious victims, treat accordingly● Check PMS in all extremities● Look for medical identificationCERT Basic TrainingUnit 4 Disaster Medical Operations – Part 2
  • 21. 4-21Order of Assessment1. Head2. Neck3. Shoulders4. Chest5. Arms6. Abdomen7. Pelvis8. LegsCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 22. 4-22Closed-Head, Neck, Spinal Injuries● Do no harm Minimize movement of head and neck● Keep spine in straight line● Stabilize headCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 23. 4-23Treating Burns● Conduct thorough sizeup● Treat with first aid Cool burned area Cover with sterile cloth to reduce risk ofinfectionCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 24. 4-24Burn Severity● Factors that affect burn severity: Temperature of burning agent Period of time victim exposed Area of body affected Size of area burned Depth of burnCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 25. 4-25Burn Classifications● Superficial: epidermis● Partial Thickness: dermis and epidermis● Full Thickness: subcutaneous layer and alllayers aboveCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 26. 4-26Burn Treatment: DOs● When treating a burn victim, DO: Cool skin or clothing if they are still hot Cover burn loosely with dry, sterile dressingsto keep air out, reduce pain, and preventinfection Elevate burned extremitiesCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 27. 4-27Burn Treatment: DON’Ts● When treating a burn victim, DO NOT: Use ice Apply antiseptics, ointments, or otherremedies Remove shreds of tissue, break blisters, orremove adhered particles of clothingCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 28. 4-28Treatment for Chemical Burns● Remove cause of burn + affected clothing/jewelry● If irritant is dry, gently brush away as much aspossible Always brush away from eyes, victim, and you● Flush with lots of cool running water● Apply cool, wet compress to relievepain● Cover wound loosely withdry, sterile or clean dressing● Treat for shock if appropriateCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 29. 4-29Inhalation Burns Signs and Symptoms● Sudden loss ofconsciousness● Evidence of respiratorydistress or upper airwayobstruction● Soot around mouth ornose● Singed facial hair● Burns around face orneckCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 30. 4-30Wound Care● Control bleeding● Clean wound● Apply dressing andbandageCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 31. 4-31Cleaning and Bandaging Wounds● Clean by irrigating with clean, roomtemperature water NEVER use hydrogen peroxide Irrigate but do not scrub● Apply dressing and bandage Dressing applied directly to wound Bandage holds dressing in placeCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 32. 4-32Rules of Dressing● If active bleeding: Redress OVER existing dressing● If no active bleeding: Remove bandage and dressing to flushwound Check for infection every 4-6 hoursCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 33. 4-33Signs of Infection● Signs of possibleinfection Swelling aroundwound site Discoloration Discharge from wound Red striations fromwound siteCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 34. 4-34Amputations● Control bleeding; treat shock● If amputated body part is found: Save tissue parts, wrapped in clean materialand placed in plastic bag Keep tissue parts cool, but NOT directly onice Keep severed part with victimCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 35. 4-35Impaled Objects● When foreign object is impaled in patient’sbody: Immobilize affected body part Do not attempt to move or remove Try to control bleeding at entrance wound Clean and dress wound, making sure tostabilize impaled objectCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 36. 4-36Fractures, Dislocations, Sprains, Strains● Immobilize injury and joints immediatelyabove and below injury site● If uncertain of injury type, treat as fractureCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 37. 4-37Types of FracturesCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 38. 4-38Treating Open Fractures● Do not draw exposed bone ends back intotissue● Do not irrigate wound● Cover wound with sterile dressing● Splint fracture without disturbing wound● Place moist dressing over bone endCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 39. 4-39Displaced and Nondisplaced FracturesCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 40. 4-40Dislocations● Dislocation is injury to ligaments aroundjoint So severe that it permits separation of bonefrom its normal position in joint● Treatment Immobilize; do NOT relocate Check PMS before and after splinting/immobilizationCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 41. 4-41Signs of Sprain● Tenderness at site● Swelling and bruising● Restricted useor loss of useCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 42. 4-42SplintingCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 43. 4-43Splinting Guidelines1. Support injured area above and belowinjury2. Assess PMS in extremity3. Splint injury in position that you find it4. Don’t try to realign bones or joints5. Fill voids to stabilize and immobilize6. Immobilize above and below injury7. After splinting, reassess PMSCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 44. 4-44Nasal Injuries● Causes Blunt force to nose Skull fracture Nontrauma conditions, e.g., sinus infections, highblood pressure, and bleeding disorders● Cautions Large blood loss from nosebleed can lead to shock Actual blood loss may not be evident because victimwill swallow some amount of bloodCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 45. 4-45Treatment of Nasal Injuries● Control nasalbleeding: Pinch nostrils or putpressure on upper lipunder nose Have victim sit withhead forward, NOTback● Ensure that airwayremains open● Keep victim calmCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 46. 4-46Cold-Related Injuries● Hypothermia : Occurs when body’s temperature drops belownormal● Frostbite: Occurs when extreme cold shuts down bloodflow to extremities, causing tissue deathCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 47. 4-47Symptoms of Hypothermia● Body temperature of95° F or lower● Redness orblueness of skin● Numbness and shivering● Slurred speech● Unpredictable behavior● ListlessnessCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 48. 4-48Hypothermia Treatment● Remove wet clothing● Wrap victim in blanket● Protect victim from weather● Provide food and drink to conscious victims● Do not attempt to massage to warm body● Place unconscious victim in recovery position● Place victim in warm bathCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 49. 4-49Symptoms of Frostbite● Skin discoloration● Burning or tingling sensation● Partial or complete numbnessCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 50. 4-50Frostbite Treatment● Immerse injured area in warm (NOT hot)water Warm slowly!● Do NOT allow part to re-freeze● Do NOT attempt to usemassage● Wrap affected body partsin dry, sterile dressingCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 51. 4-51Heat-Related Injuries● Heat cramps: Muscle spasms brought on by over-exertion inextreme heat● Heat exhaustion: Occurs when exercising or working in extreme heatresults in loss of body fluids● Heat stroke: Victim’s temperature control system shuts down Body temperature rises so high that brain damageand death may resultCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 52. 4-52Symptoms of Heat Exhaustion● Cool, moist, pale orflushed skin● Heavy sweating● Headache● Nausea or vomiting● Dizziness● ExhaustionCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 53. 4-53Symptoms of Heat Stroke● Hot, red skin● Lack of perspiration● Changes in consciousness● Rapid, weak pulse and rapid, shallowbreathingCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 54. 4-54Treatment of Heat-Related Injuries● Remove from heat to cool environment● Cool body slowly● Have the victim drink water, SLOWLY● No food or drink if victim is experiencingvomiting, cramping, or is losingconsciousnessCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 55. 4-55Treatment for Bites/Stings● If bite or sting is suspected, and situationis non-emergency: Remove stinger if still present by scrapingedge of credit card or other stiff, straight-edged object across stinger Wash site thoroughly with soap and water Place ice on site for 10 minutes on and 10minutes offCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 56. 4-56Anaphylaxis● Check airway and breathing● Calm individual● Remove constrictive clothing and jewelry● Find and help administervictim’s Epi-pen● Watch for signs ofshock and treatappropriatelyCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 57. 4-57Unit Summary● Public health concerns related tosanitation, hygiene, and water purification● Organization of disaster medicaloperations● Establishing treatment areas● Conducting head-to-toe assessments● Treating wounds, fractures, sprains, andother common injuriesCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2
  • 58. 4-58Homework Assignment● Read unit to be covered in next session● Bring necessary supplies for next session● Wear appropriate clothes for next session● Practice completehead-to-toeassessment onfriend or familymemberCERT Basic TrainingUnit 4: Disaster Medical Operations – Part 2

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