Sunday, December 18, 2011

About first aid,, pls. help?

As an EMT-B, the first thing besides scene safety and BSI (body substance isolation) is your ABC's ( Airway, Breathing, Circulation). Here is what I would do in this scenario. If I was able to safey get to the patient and treat her (if the rescuer gets hurt than there are now two patients, the rescuer and the original patient. That is NOT a good thing to have happen) First, I would check her airway. Obviuosly in this case the MOI (Mechanism of injury would most likely be smoke inhalation). Does she have a clear airway? While I am checking for that I am also checking for breathing by looking for rise and fall of the chest. Do I feel a breath on my cheek? Can I hear air movement? I would also do a brief look over of the face. This will give me a good indicator of a burned airway which could leading to swelling and losing a good airway. Is there soot or burned hair in the nose? Soot in the mouth? What about the eyelashes and eyebrows, were they burnt? Are her lips pale and bluish? With all those in mind, what is her breathing rate? IS she breathing at least 12 per min? Is there wheezing? If she isn't breathing than I need to use a BVM(Bag valve mask ) on high flow O2. If she is breathing a NRB (Non-rebreather mask with O2) would be fine. When I check my ABC's and there is no pulse, I would start CPR and bagging her with the BVM. If the hospital is far away than I would have my partner go ahead and call for ALS to intercept. Either way she needs to be moved quickly to get her to definitive care (hospital). That summary serves as a immediate care summary for this patient on the first treatment she should receive. Depending on your certification ( Intermediate EMT etc) in your state you may or may not be able to intubate her which is what she needs to maintain her airway before swelling sets in and you are screwed in getting a good airway then if any at all. I hope this helps to explain the first first few mins. of treatment on scene.

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