Bleeding & Wounds in Emergency Nursing

Bleeding & Wounds Management

• Types of bleeding: arterial, venous, and capillary.
• Direct pressure can control 95% of external hemorrhages.
• Elevating the wound can help with 97% effectiveness in venous bleeding management.
• Pressure points can be used to control bleeding 99% of the time.
• Use of tourniquets is rare and considered a last resort.
• Most types of hemorrhage can be controlled within four to six minutes with direct pressure.
• Elevate extremities to reduce venous bleeding, supplementing direct pressure.
• Effective arterial compression requires the artery to be above the injury site and against a bony structure.

Managing Shallow and High-Risk Wounds

• Clean shallow wounds with soap and water, irrigate with pressurized water, apply antibiotic ointment, and cover with a sterile dressing.
• High-risk wounds necessitate urgency and appropriate medical care.

RICE Protocol for Bone, Joint, and Muscle Injuries

• R = Rest to minimize further injury.
• I = Ice applied for 20-30 minutes every 2-3 hours.
• C = Compression using elastic bandages for swelling control.
• E = Elevation helps reduce swelling.

Specific Injuries and Treatments

• Clavicle fractures are common; the scapula is well-protected.
• Use a sling and swathe for clavicle and scapula injuries; splint shoulder dislocations with a pillow or towel.
• Humerus fractures can occur proximally, midshaft, or distally; traction may be applied for severe angulation.
• Elbow injuries may have associated nerve and blood vessel damage; assess neurovascular function.
• Forearm fractures typically involve both radius and ulna; use padded board splints.
• Wrist and hand injuries require wound coverage and a padded board splint, ensuring the hand is in a functional position.
• Pelvis fractures may result in life-threatening bleeding; immobile stable patients on long backboards for isolation.

Fainting and Diabetes Emergencies

• Fainting may originate from carotid artery dilation leading to bradycardia and hypotension.
• For conscious victims, lay them down with elevated feet; assess for diabetic history.
• Insulin shock leads to hypoglycemia, while diabetic coma results from ketoacidosis, both requiring distinct emergency responses.

Rabies and Animal Bites

• Rabies is deadly once symptomatic; treat bites by rinsing, cleaning, and seeking medical attention.
• Rattlesnake and copperhead bites require limiting activity and immediate medical care.
• Never use the "cut and suck method" for venom extraction.

Seizures and Emergency Procedures

• During seizures, protect the victim from hazards; check breathing and have a clear airway.
• For transporting a victim, use two-person carries; seek medical care for cleaning wounds.

Cold and Heat-Related Emergencies

• Hypothermia treatment includes removing wet clothing, warming with blankets, and providing warm liquids if swallowing is possible.
• Heat stroke is a medical emergency characterized by cognitive symptoms and extreme body temperature; immediate cooling measures include immersion, wet sheets, and compresses.

Fractures and Sprains

• Fractures classified by cause (direct/indirect) and type (open/closed).
• Open fractures expose bone to contamination; must be covered and immobilized.
• Signs of fractures include pain, swelling, and possible deformation; sprains may also present similar symptoms.