DISASTER NURSING (PATIENT AND CASUALTY HANDLING)

TRANSFERRING AND BANDAGING

GUIDELINES IN GIVING EMERGENCY CARE
GETTING STARTED
1. Planning for Intervention
2. Gathering of all necessary materials
3. Remember the initial response as follows:
A - Ask for help
I - Intervene
D - Do no harm
4. Instruction to co-rescuer
EMERGENCY ACTION PRINCIPLES
1. Scene survey
Check if the scene is safe?
Total injured?
Are there bystanders who can help?
Identify yourself as a trained CPR Provider.
Get consent to give care.
2. Activate for medical assistance
Depending on the situation:
- Call first and care first
- A bystander should make the telephone call for help (if available)
- Somebody will be asked to arrange for transfer facility
Information to be remembered in activating medical assistance:
- Scenario
-Exact location
- Total injured?
- Extent of injury and first aid given
- Available contact number
- Person must identify him/herself and drop the phone last
3. Primary survey
Check Airway
Check Breathing
Check Circulation
4. Secondary survey
* Interview the victim
Ask the victims name
Ask what happened
Assess the SAMPLE history
* Check vital signs
Determine radial or carotid pulse (pulse rate)
Determine breathing (respiration
rate)
Adult 60-90/min
Adult 12-20/min
Child 80-100/min
Child 18-25/min
Infant 100-120/min
Infant 25-35/min
*Determine skin appearance
Look at the victims face and lips
Record skin appearance, temperature, moisture, and color
* Perform head-to-toe examination looking for DCAP-BTLS(deformity, contusion,
abrasion, puncture, burn, tenderness, laceration, swelling)
- Check and compare pupils of both eyes
- Check for fluid or blood in ears, nose and mouth
- Gently feel the sides of the neck for signs of injury
- Check and compare both collar bones and shoulder
- Check the chest and rib cage
- Check the patients abdomen for tenderness by pressing lightly with flat part of your fingers
- Cheek the hipbone by pressing slowly downward and inward for possible fracture

- Check one leg at a time

- Check one arm at a time
- Check spinal column by placing the victim into side lying down position and press gently from
the cervical region down to the lumbar for possible injury
- Record all the assessments including the time
- Keep the patient lying down, his/her head level with his / her feet
- Keep the patient warm and guard against chilling
PATIENT / CASUALTY HANDLING
Rescue is rapid movement of patient from unsafe place to a place of safety
Indication for emergency rescue
1. Danger of fire or explosion
2. Danger of toxic gases or asphyxia due to lack of oxygen
3. Serious traffic hazards
4. Risk of drowning
5. Danger of electrocution
6. Danger of collapsing walls
Methods of rescue
1. For immediate rescue without any assistance, drag or pull the victim.
2. Most of the one-man drags/ carries and other transfer method can be used as methods of
rescue
Transfer is moving a patient from one place to another after giving first aid
Factors to be considered in the selection of choosing the transfer method:
1. Nature and severity of the injury
2. Size of the victim
3. Physical capabilities of the first aider
4. Number of personnel and equipment available
5. Nature of evacuation route
6. Distance to be covered
7. Gender of the victims (last consideration)
Pointers to be observed during transfer
1. Victims airway must be maintained in the correct position
2. Hemorrhage is controlled
3. Victim is safely maintained in the correct position
4. Regular cheek of the victims condition is made
5. Supporting bandages and dressing remain effectively applied
6. The method of transfer is safe, comfortable and as speedy as circumstances permit
7. The patients body is moved as one unit
8. The taller first aiders stay at the head side of the victims
9. First aiders/bearers must observed ergonomics in lifting and moving of patient
Methods of transfer
1. One-man assist/carries / drags
Assist to walk
Carry in arms (cradle)
Pack
strap carry
Firemans carry
Firemans drag
Blanket drag
Armpit/shoulder drag
Cloth drag
Feet drag
Inclined drag (head first passing a stairway)
2. Two-man assist/carries
Assist to walk
Four-hand seat
Hands
as a litter
Carry by extremities
Firemans carry with assistance
3. Three-man carries
Bearers alongside (for narrow alleys)
Hammock carry
4. Four/six / eight man carry
5. Blanket (demonstrate the insertion , testing and lifting of blanket)
6. Improvised stretcher using poles with:
Blanket , Empty sacks, Shirts or coats, Triangular bandages

7. Commercial stretchers
8. Spine board
9. Ambulance or rescue van
10. Other vehicles
Soft Tissue Injury
_______________ is a break in the continuity of a tissue of the body either internal or external
Two classification of wound:
1. Closed wound
Blunt object result in contusion or bruises
Application of external forces
Sign and symptoms
Pain and tenderness
Swelling
Discoloration
Hematoma
Uncontrolled restlessness
Thirst
Symptoms of shock
Vomiting or
Coughing-up blood
Passage of blood in the urine or feces
Sign of blood along mouth , nose and ear canal
2. Open wound
Classification of open wound
Cause
Punctured
Penetrating pointed instruments such as
nails , ice picks , daggers , etc
Abrasion
Scrapping or rubbing against rough surface
Lacerated
Avulsion
Incised

Blunt instruments such as shrapnel ,

rocks , broken glasses etc.
Explosion animal bites , mishandling of
tools , etc.
Sharp bladed instruments such as blades ,
razors , etc,

Characteristics
Deep and narrow , serious or
slight bleeding
Shallow , wide , oozing of blood ,
dirty
Torn with irregular edges ,
serious or slight bleeding
Tissue forcefully separated from
the body
Clean cut , deep , severe
bleeding , wound is clean

Dangers
Hemorrhage
Infection
Shock
Kinds of bleeding
Arterial bleeding
Venous bleeding
Capillary bleeding
First aid management
Wound with severe bleeding (4Cs)
Wound with bleeding not severe (home care)
Clean the wound with soap and water
Apply mild antiseptics or antibiotic ointment/cream
Cover wound with dressing and bandage
____________________ is an injury involving the skin , including muscle , bones , nerves and blood
vessels , the result from heat , chemicals , electricity solar or other forms of radiation
Common causes
1. Carelessness with match and cigarette smoking

2. Scald from hot liquid

3. Defective heating , cooking and electrical equipment
4. Immersion in overheated bath water
5. Immersion in overheated bath water
6. Use of such chemicals as lye , strong acids and strong detergents
Factors to determine the seriousness of thermal burns:
1. The Depth.
2. The Extent to the affected body surface area.
3. Location of the burns.
4. Victims age and medical condition.
Bandage technique
Open phase
1. Head(topside)
2. Face ; back of the head
3. Chest ; back of chest
4. Hand ; foot
Cravat phase
1. Forehead ; eye
2. Ear; cheek ; jaw
3. Shoulder ; hip
4. Arm ; leg
5. Elbow ; knee ( straight ; bent )
6. Palm pressure bandage
7. Palm bandage of open hand
Use of roller bandage
1. Spiral
Open
Closed
Spiral reverse
2. Figure of eight
3. Recurrent with spiral turns
Guidelines in using dressing and bandage
1. Use a dressing that is large enough to extend at least 1 inch beyond the edge of the
wound
2. If body tissue or organs are exposed , cover the wound with a dressing that will not stick ,
such as plastic wrap or moistened gauze , then secure the dressing with a bandage or
adhesive tapes
3. If the bandage is over a joint , splint and make a bulky dressing so the joint remains
immobilized , if there is no movement of a wound over the joint , there should be
improved healing and reduced scarring
4. A bandage should fit snugly but should not cut of circulations or cause the victim
discomfort. if there are beyond the wound changes color , begins to tingle or fell cold , or if
the wound starts to sell the bandage is too tight and should be loosened
5. Bandaging techniques depend upon

size and location of the wound

Your first aid skills
Material hands