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Textbook on First Aid & Emergency Nursing
I Clement
1:
Introduction to First Aid
INTRODUCTION
Definition
Meaning of First Aid
Aims of First Aid
Objectives of First Aid
Basic Objectives of Psychological First Aid
History of First Aid
Scope of First Aid
Golden Rules of First Aid
Principles of First Aid
Importance of First Aid
FIRST AIDER
Qualities of a First Aider
Responsibilities of a First Aider
Limitations of the First Aider
Skills Required for the First Aider
Safety Measures of the First Aider
Seeking Immunization
Coping with Unpleasantness
Taking Stock after an Emergency
OBSERVATION TECHNIQUE USED IN FIRST AID
Symptoms
Signs
EMERGENCY
Preparing for Emergencies
Goals of Emergency Medical Treatment
Principles Applied in Emergency Management
Obtaining Data from the Patient
Recording of Data
Action at an Emergency
ETHICAL AND LEGAL CONSIDERATION IN FIRST AID
Consent to Treatment
Emergency Doctrine
Right to Privacy and Confidentiality
Mandatory Reporting
Physical Evidence and chain of Custody
Bullets
Specimens
Transfer Laws
FIRST AID KIT
Solutions Used in First Aid
CONCLUSION
2:
First Aid Assessment
INTRODUCTION
Approach
ASSESSING THE SITUATION
By Getting others to Help You
Determine the Priorities of Treatment
Other Needs
Highest Priority
Second Priority
Lowest Priority
METHODS OF VICTIM ASSESSMENT
Calling for Assistance
DIAGNOSING OF VICTIM
History
Symptoms
Signs
VITAL SIGNS IN ASSESSMENT OF VICTIM'S CONDITIONS
Breathing Rate
Procedure for Counting Respiration
Breathing is Increased in
Breathing is Decreased in
Pulse Rate
Sites to Check the Pulse Rate
Procedure for Counting the Pulse
Pulse Increases (Tachycardia) during
Pulse Decreases (Bradycardia) during
Pupil Reaction
Level of Consciousness
Level of Consciousness and Possible Cause
Skin Temperature
Sites Where Temperature is Recorded
Instrument by Which Temperature is Recorded
Recording of Temperature
Procedure for Taking Temperature by Mouth
Procedure for Taking a Temperature in Axilla or Groin
Procedure for Taking Rectal Temperature
Body Temperature
Skin Color
Ability to Move
Reaction to Pain (Table 2.4)
BLOOD PRESSURE (BP)
Systolic Pressure
Diastolic Pressure
Measuring of Blood Pressure
Hypertension
Signs of Death
GENERAL HEAD-TO-TOE EXAMINATION
Secondary Victim Assessment
Rules Followed in General Examination
Examining the Head
Examining the Lips
Examining of Teeth
Examining the Eyes
Examining the Nose
Examining the Face
Examining the Ears
Examining the Skull
Examining the Spine
Examining the Lower Spine
Examining the Trunk
Examining the Arms
Examining the Legs
CONCLUSION
3:
Bandaging
INTRODUCTION
BANDAGING
Definition
Purpose of Bandaging
Functions of Bandages
General Principles
Types of Bandages
Bandaging Materials
Caution
Materials Used for Bandage
Assessing before Applying Bandage
Equipment
Procedure
Special Bandages
Eye Bandage (Monocular)
Bioccular Bandage
Ear Mastoid Bandage
Jaw Barton Bandage
Capeline Bandage (Head Bandage)
Shoulder Spica
Width of the Bandages
General Rules for Applying Bandages
ROLLER BANDAGE
Applying Roller Bandage
General Rules for Applying Roller Bandage
Points to be Observed
Circular Turn
Method
Spiral Turn
Method
Spiral Reverse Turns
Method
Figure-of-Eight Turns
Method
Spica Bandage
Hand Bandage
Wrist and Forearm Bandage
The Upper Arm Bandage
Finger Bandages
Spica of Thumb Bandage
Method for Thumb Spica
Spica of Shoulder Bandage
Bandages for the Foot, Ankle and Leg
Bandage for the Knee
Spica of Hip Bandage
Spica of Groin Bandage
Head and Other Bandage
Breast Bandages
Stump Bandage
Many-Tailed Bandages
Application of an Abdominal Many-Tailed Bandage
‘T’-Bandages
OTHER BANDAGES
Adhesive Bandage
Tubular Gauze Bandage
Triangular Bandage
Application of Triangular Bandage in Bandaging other Parts of the Body
Scalp
Chest
Wrist
Shoulder
Elbow
Hand
Hip and Groin
Knee
Foot
Stump
Eye, Ear, Cheek Forehead and Jaw
CONCLUSION
4:
Slings and Binders
INTRODUCTION
REEF KNOT
SLINGS
Definition
Uses of Slings
Different Types of Slings
Large Arm Sling
Collar and Cuff Sling
Triangular Sling
BINDERS
Purpose of Binder
Types of Binder
T-Binders
Straight Binders
Breast Binder
Abdominal Binders
Equipment
Procedure
Applying Binders, T- and Breast Binders
Equipment
CONCLUSION
5:
Wounds and Hemorrhage
INTRODUCTION
WOUND
Classification of Wounds (Fig. 5.1)
Principles of First Aid in Wounds
Control of Bleeding
First Aid Measures in Minor Wounds
First Aid Measures in Major Wounds
Chest Wounds
Abdominal Wound
Eye Injuries
Amputation
Prevention of Wound Infection
The Signs of Infection will Include
Prevention of Infection can be Obtained by
WOUND CARE
Purpose of Dressing
Types of Dressing
General Instructions
Preliminary Assessment
Equipment
Procedure
Sterile Dressing
How to Use Sterile Dressing?
After Care
HEMORRHAGE
Classification of Hemorrhage
External Hemorrhage
Internal Hemorrhage
First Aid Measures for Bleeding from Special Parts
Skull
Scalp
Nose
Ears
Mouth
Gums
Symptoms and Signs
Treatment
Temple
Face
Neck
Palm
Fingers
Lungs
Stomach
Tongue
Thigh
Varicose Veins
Bleeding from the Mouth
Symptoms and Signs
Aim
Treatment
Bleeding Varicose Veins
Symptoms and Signs
Aim
Treatment
Vaginal Bleeding
Symptoms
Aim
Treatment
Miscarriage
Symptoms and Signs
Aim
Treatment
CONCLUSION
6:
Basic Life Support
INTRODUCTION
Definition
Adult and Child Basic Life Support
Basic Life Support 2011 Guidelines
Steps of Basic Life Support
Check Responsiveness
Activate EMS (Emergency Medical System)
Position the Unresponsive Victim
Open the Airway
Check for Breathing
Perform Rescue Breathing
Mouth-to-Mouth Method
Mouth-to-Nose Method
Mouth-to-Stoma Method
Mouth-to-Barrier Device
Check for a Pulse
Chain of Survival
Perform External Chest Compressions
Follow these Steps to Accomplish Effective Chest Compression
Two-Rescuer CPR
Switching Functions
Complications of CPR
INFANT BASIC LIFE SUPPORT
Infant Rescue Breathing and CPR
Check Responsiveness
Positioning an Unresponsive Infant
Opening the Airway
Check for Breathing
Rescue Breathing
Check for Pulse
Chest Compressions
CONCLUSION
7:
Injuries
INTRODUCTION
Injury Assessment
Types of Injuries
Strain
Sprain
Dislocation
Skeletal Inujries
Movable Joints
Immovable Joints
Chest Injuries
Lung Injuries
Rib Fracture
Flail Chest
Intra-abdominal Injuries
Penetrating Abdominal Injuries
Assessment for Abdominal Injuries
Blunt Abdominal Trauma
Crush Injuries
Emergency Management
Multiple Injuries
Emergency Management
Head Injury
Concussion
Signs and Symptoms (Figs 7.5A and B)
Skull Fracture
Signs and Symptoms
Spinal Cord Injury
Causes of Spinal Cord Injury
Signs and Symptoms of Spinal Injury Include the Following
The Measures of First Aid are as Follows
Road Accidents (Fig. 7.10)
Immediate Action
Moving a Casualty
Removal of Trapped Casualty
Accidents with Dangerous Substances
CONCLUSION
8:
Shock
INTRODUCTION
Definition
Effects of Shock
Causes of Shock
Progress of Shock
Types of Shock
Factors Influencing the Degree of Shock
Signs and Symptoms of Shock (Fig. 8.2)
Signs
Symptoms
Treatment
HYPOVOLEMIA
Effects
Diagnosis
Treatment
First Aid
Hospital Treatment
ANAPHYLAXIS
Sign and Symptoms
Causes
Emergency Treatment
Clinical Care
CARDIOGENIC SHOCK
Signs and Symptoms
Diagnosis
Electrocardiogram
Radiology
Swan-Ganz Catheter
Biopsy
Treatment
NEUROGENIC SHOCK
Signs and Symptoms
First Aid
In case of chest or abdomen injuries
Treatment
CONCLUSION
9:
Unconsciousness
INTRODUCTION
Definition
Causes of Unconsciousness
Types of Unconsciousness
Classification of Coma
Clinical Manifestation of Unconsciousness
Clinical Manifestations of Brief Unconsciousness
Clinical manifestations of coma
Early Symptoms of Supratentorial Coma
Later Symptoms
Manifestations of Infratentorial Coma
Manifestations of Metabolic Coma
Diagnosis of Unconsciousness
Pharmacological Management
Nursing Management
Position
Airway
Observation and Charting
Hygiene
Nutrition
Eliminations
Prevention of Contractures
Care of Pressure Areas and the Prevention of Foot Drop
CONCLUSION
10:
Fracture
INTRODUCTION
Definition
Causes of Fracture
Types of Fracture (Fig. 10.2)
Signs and Symptoms of Fracture
Signs
Symptoms
First Aid Treatment of Fractures
Aims
Rules
Measures
Immobilization of the Fractured Part
Emergency Management
ORTHOPEDIC TRAUMA
Facial Fractures
Cheekbone and Nose Fractures
Collar Bone Fracture
Signs and Symptoms
First Aid Measures
Upper Arm Fracture
Signs and Symptoms
First Aid Measures
Elbow Fracture
Signs and Symptoms
First aid measures
Forearm and Wrist Fracture
First aid measures
Fractures of the Hand and Fingers
First Aid Measures
Fracture of the Ribcage
Flail Chest Injuries
Fracture of Backbone/Spine
First Aid Measures
Fracture of Pelvis
Signs and Symptoms
Hip and Thigh Fracture
Signs and Symptoms
First Aid Measures
Knee Joint Fracture
Signs and Symptoms
First Aid Measures
Lower Leg Fracture
Signs and Symptoms
First Aid Measures
SPLINTS
Definition
Purposes
Materials Used
Types of Splints
Rules for Application of Splints
Technique of Padding Splint
Nursing Care of Patients after Application of Splints
PLASTER CAST AND APPLICATION
Definition
Types of Casts
Circular Casts
Model Casts
Preparation of Plaster Bandages
Purposes of Plaster Casts
Application
Preparation of the Patient
Method of Application
Nursing Care of Patient in Plaster Cast
Care of the Patient after 24 Hours
Removal of the cast
After Care of the Equipment
TRACTION AND EXTENSION
Purposes
Kinds of Traction
Skin Traction
Skeletal Traction
Principles Applied when Maintaining Traction and Extension
Nursing Care and Value in Traction and Extension
Methods of Lifting and Transport of Injured
Blanket Lift
Emergency Lift
CONCLUSION
11:
Burns and First Aid Measures
INTRODUCTION
Burns Classification
Causes of Burns and Scalds
Burns are Caused by the Following
Scalds are Caused by the Following
Characteristics of Burn Injury
Surface Area of the Body Burned
First Aid Measures to Prevent Further Damages
For First and Second-Degree Burns
For Third-Degree Burns
Management of Burns
Burns management includes
Wound Care in Burns
Chemical Burns
Management of Chemical Burns
Acid Burns
Alkali Burns
Chemical Burns of Eye
Thermal Burns
Fires
Electrical Burns
Preventive Measures
Lightening
CONCLUSION
12:
Poisoning
INTRODUCTION
Definition
Causes of Poisoning
Sources of Poisoning
Mechanism of Action of Poison
General Symptoms and Signs of Poisoning
FIRST AID IN POISONING
Treatment
Self-care to be Taken by the Aider
SWALLOWED POISONS
General Rules for Treatment of Swallowed Poisoning
Type of Poisons
The Goals of Emergency Treatment
General Management
Corrosive Poisons
Emergency Management
Non-corrosive Poisons
Emergency Management
INHALED POISONS
General Management
Carbon Monoxide Poisoning
Emergency Management
INJECTED POISONS
Stinging Insects (Bees, Hornets, Yellow Jackets, Wasps)
Emergency Management
HOUSEHOLD POISONS
FOOD POISONING
Emergency Management
Potential
First Aid to be Given
Drug Poisoning
Symptoms and Signs
Narcotics
Depressants
Stimulants
Hallucinogens (Drugs Causing Hallucinations)
Aspirin Overdose
Treatment
ALCOHOL POISONING
Symptoms and Signs
In Early Stages of Unconsciousness
In Later Stages of Unconsciousness
Treatment
Methyl Alcohol Poisoning
Symptoms
Treatment
Ethyl Alcohol Poisoning
Symptoms
Treatment
INDUSTRIAL POISONS
Classification
Acid Poisoning
Symptoms
Treatment
Alkali Poisoning
Symptoms
Treatment
COMMON INDIAN PLANT POISONS
Signs and Symptoms
Aim
General Treatment
Castor Oil Plant
Symptoms
Treatment
Jamal Gota
Symptoms
Treatment
Cannabis Sativa
Symptoms
Treatment
Datura
Symptoms
Treatment
Atropa Belladonna
Cocaine
Symptoms
Treatment
White Oleander (Kaner)
Symptoms
Treatment
Aconite
Symptoms
Treatment
Mushroom Poisoning
Symptoms
Treatment
Tobacco (Tombaku)
Symptoms
Treatment
Opium
Symptoms
Treatment
Metal Poisoning
Lead
Mercury
Copper
Arsenic
Organic Chemical Poisoning
Dichloro Diphenyl Trichloroethane (DDT)
Petroleum Distillates
Insecticides
Organophosphorus Compounds
Naphthalene
Cyanide
Strychnos Nux Vomica (Kuchla)
Poison Absorbed Through Skin
Signs and Symptoms
CONCLUSION
13:
Bites and Stings
INTRODUCTION
DOG BITE (FIGS 13.1A TO C)
Clinical Manifestations
Diagnosis
Management
CAT BITE
RAT BITE
SNAKE BITES (FIGS 13.2A AND B)
Clinical Features
First Aid Management
Hospital Management
INSECT STING (FIG. 13.4)
Management
Bee and Wasp Bites
Tick and Mite Bites
Spider Bite (Figs 13.6A and B)
Leech Bite (Fig. 13.7)
Fish Stings
CONCLUSION
14:
Foreign Bodies
INTRODUCTION
Foreign Bodies in the Respiratory Tract
Diagnosis
Emergency Management
Foreign Bodies in the Alimentary Tract
Foreign Bodies in the Stomach
Foreign Bodies in the Eyes
Signs and Symptoms
Remember the Following Points to Avoid Severe Loss by the Foreign Bodies
Treatment
Foreign Bodies in the Skin
Splinters
Fish Hook in the Skin
Foreign Bodies in the Ear
Do Not
Foreign Bodies in the Nose
Foreign Bodies in the Throat
What Not To Do?
Foreign Body (Needle) in the Foot
What Not To Do?
CONCLUSION
15:
Common Emergencies and Resuscitation Measures
INTRODUCTION
CHOKING
Introduction
Symptoms and Signs
First Aid in Choking
Abdominal Thrusts
In Case of Unconscious Casualty
First Aid for Child
First Aid for Choking Infants (Conscious)
First Aid in Unconscious Infant
ASPHYXIA
The Cause of Asphyxia will be as Follows
Causes Affecting the Respiratory Tract
Causes Affecting the Respiratory Mechanism
Causes Affecting the Respiratory Center
Signs and Symptoms of Asphyxia
Early Stages
Later Stages
General Rules for Treatment of Asphyxia
First Aid in Special Cases
SUFFOCATION
General Symptoms and Signs
Aim
Treatment
HANGING, STRANGLING AND THROTTLING
Symptoms and Signs
Aim
Treatment
DROWNING
Aim
Symptoms and Signs
General Measures
SMOKE INHALATION
Causes
Symptoms and Signs
Aim
Treatment
First Aid in Inhalation of Fumes
FIRES
Treatment
SHOCK
Definition
Causes of Shock
Classification of Shock
Signs and Symptoms of Shock
First Aid in Shock
ANAPHYLACTIC REACTIONS
Clinical Manifestations
Respiratory Signs Include
Skin Manifestations
Cardiovascular Manifestations
Gastrointestinal Discomforts
Emergency Management
Additional Treatment as Indicated
Preventive Measures
CONCLUSION
16:
Environmental Emergencies
INTRODUCTION
HEATSTROKE
Etiology
Clinical Manifestation
Metabolic Consideration
Diagnostic Evaluation
Medical Management
Nursing Management
Emergency Management
HEAT EXHAUSTION
Etiology
Clinical Features
Diagnostic Evaluation
Medical Management
HEAT CRAMPS
Preventive Measures of Extreme Heat
FROSTBITE
Signs and Symptoms of Frostbite Include
Medical Management
Emergency Management
ACCIDENTAL HYPOTHERMIA
Emergency Management
Preventive Measures for Extreme Cold
SUNBURN
It Occurs After
Symptoms and Signs
Treatment
SNOW BLINDNESS AND WELDER'S FLASH
Symptoms and Signs
Treatment (Fig. 16.1)
TRENCH FOOT
Symptoms and Signs
Treatment
CHILBLAIN
Symptoms and Signs
Treatment
CONCLUSION
17:
Minor Ailments
INTRODUCTION
HEADACHE
Types
Tension-type Headache
Migraine Headache
Cluster Headache
Causes
Signs and Symptoms of Migraine Headache
Other Types of Headache
Etiology
Clinical Features
Diagnostic Evaluation
Medical Management
Prophylactic Treatment
Nursing Management
COUGH
Definition
Cough is Induced by the Following
Different Respiratory Disorders Present Different Types of Cough
Therapeutic Measure
Nursing Assessment
Nursing Intervention
DYSPNEA
Therapeutic Measures
Nursing Assessment
Nursing Intervention
HYPOXIA
Types
Hypoxemic Hypoxia
Circulatory Hypoxia
Anemic Hypoxia
Histotoxic Hypoxia
Interventions
Nursing Intervention
CHEYNE-STOKES RESPIRATION
Therapeutic Measure
Nursing Assessment
Nursing Intervention
CYANOSIS
Causes
Therapeutic Measures
Nursing Assessment
Nursing Measures
HYPERCAPNIA
Causes
Therapeutic Measures
Nursing Assessment
Nursing Intervention
HYPOCAPNIA
Causes
It is Manifested by
Therapeutic Measures
Nursing Assessment
Nursing Intervention
RESPIRATORY ACIDOSIS
It is Manifested by
Complications of Respiratory Acidosis are
Therapeutic Measures
Nursing Assessment
Nursing Intervention
RESPIRATORY ALKALOSIS
It is Manifested by
Therapeutic Measures
Nursing Assessment
Nursing Intervention
HYPOGLYCEMIA
Etiology and Risk Factors
Clinical Manifestation
Adrenergic Manifestation
Neuroglycopenic (Decreased Glucose to Brain) Manifestation
Management
SYNCOPE
The Physiologic Causes of Syncope Fall Under Two Categories
The Causes of Syncope are
Vasovagal Syncope
Postural Hypotension (Orthostatic)
Cardiac Syncope
Carotid Sinus Syncope
Cerebral Syncope
Hematologic Causes of Syncope
Pulmonary Disorders
Diagnosis is Made by
Reproducing Syncopal Attacks
Management
Nursing Responsibility
FAINTING
Symptoms and Signs
Aim
Prevention
Treatment
BRUISES
Symptoms and Signs
Aim
Treatment
CONCLUSION
18:
Handling and Transport of Injured
INTRODUCTION
GENERAL PRINCIPLES OF HANDLING AND TRANSPORT OF INJURED
LIFTING THE CASUALTY
MANUAL LIFTS
CARRIES FOR ONE FIRST AIDER
CARRIES FOR TWO FIRST AIDERS
Four-handed Seat
Two-handed Seat
Chair Method
LIFTING A CASUALTY IN A WHEEL CHAIR
STRETCHERS
Testing and Basic Mechanism
Types of Stretcher
PREPARING A STRETCHER OR A TROLLEY BED
LOADING A STRETCHER
Loading a Casualty on to a Pole-and-Canvas Stretcher
Placing a Blanket Under the Casualty
Loading a Casualty in the Recovery Position
Carrying a Stretcher
For Four Bearers
Crossing Uneven Ground
Crossing a Wall
Moving a Stretcher From One Level to Another
LOADING AN AMBULANCE
UNLOADING AN AMBULANCE
CONCLUSION
19:
Sports Injuries
INTRODUCTION
COMMON SYMPTOMS OF SPORTS INJURIES
Parts of the Body do Sports Injuries Affect
Minor Injuries
Sprains and Strains
Cuts
Bruises
Blisters
Minor Head Injuries
Heel Pain
Tennis Elbow
Golfer's Elbow
Tendonitis
Sore Shins
Knee Pain (Runner's Knee)
Stress Fractures
Bursitis
Cartilage Damage
More Serious Injuries
Broken Bones
Severe Head Injuries
Ligament Damage
THE BODY HEALING PROCESS
KNEE INJURIES (FIGS 19.1 AND 19.2)
The History of Injury
On Examination
McMurray's Test
Apley's Grinding Test
Management
Non-operative Management
Operative Management
Jumper's Knee
Management
Osgood-Schlatter Syndrome
Management
Bursitis
Shin Pain
Osteogenic Causes of Shin Pain
Management
INJURIES OF EXTREMITIES
Tennis Leg
Achilles Tendonitis
Retrocalcaneal Pain
Plantar Fasciitis
Blisters
Athlete's Foot
Frozen Shoulder
Tennis Elbow
Wrist Pain in Gymnasts
Finger Tendon Injury
INJURIES OF SKULL/FACE
Eye Injuries
Dental Injuries
Ear Injuries
Under Water Diving Injuries
Maxillofacial Injuries
Nasal Injuries
MANAGEMENT OF SPORTS INJURIES
Treatment of Sports Injuries
Non-steroidal Anti-inflammatory Drugs
Immobilization
Surgery
Treatment Modalities of Sports Injuries
Therapeutic Heating
Infrared Radiation
Conduction Heat
Microwave Diathermy
Short Wave Diathermy
Pulse Short Wave
Ultrasonic
Faradic Stimulation
High Voltage Stimulation
Cold
Rehabilitation
Other Therapies
Electro Stimulation
Cold/Cryotherapy
Heat/Thermotherapy
Ultrasound
Massage
Some Recent Advances in Treating Sports Injuries
Arthroscopy
Tissue Engineering
Targeted Pain Relief
Advances Might we Expect in the Future
MANUAL THERAPY
PREVENTION OF SPORTS INJURIES
Tips for Preventing Injury
Prevention of Sports Injuries
CONCLUSION
20:
Disaster Nursing
INTRODUCTION
Definition
TYPES OF DISASTER
Natural Disaster
Man-made Disaster
STEPS OF SAFETY MEASURES DURING DISASTER
Impact of Disaster on Community
ROLE OF COMMUNITY HEALTH NURSE IN DISASTER MANAGEMENT
Nurse's Role during Disaster
Role of ICN in Disaster Preparedness
Prevention, Mitigation and Preparedness Activities
Disaster Response
Disaster Recovery
Disaster Preparedness
Relief Response
Disaster Management
STAGES OF DISASTER MANAGEMENT
Preparedness
INTERNATIONAL AGENCIES IN DISASTER MANAGEMENT
I. Levels of Disaster and Agency Involvement
II. Disaster Responsibilities by Agency
American Red Cross
Other Voluntary Organizations
Business and Labor Organizations
Disaster Management by Health Sector in India
IMPORTANT AGENCIES IN INDIA
PSYCHOLOGICAL REACTION TO A DISASTER
Disaster Plan
Principles of Disaster Plan
Hospital Disaster Manual
CONCLUSION
21:
Triage and Ambulance Service in Disaster
INTRODUCTION
BASIC CONCEPTS OF TRIAGE
Objectives of Triage Nursing
Principles of Triage
Function of Triage
Goals of Triage
Advantages of Triage
Triage Acuity Determinates
Key Points in Triage in the Emergency Department
Triage Team Members
Triage Set-up
JCAHO Standards for Triage
Before Admission to the Hospital
The Admission Process
Triage is Important
TRIAGE PROCESS
Triage Priorities
Highest Priority
Second Priority
Lowest Priority
Patient Assessment
Pulse
Respiration
Blood Pressure (BP)
Pupils
State of Consciousness
Paralysis
THE AMBULANCE
Information Obtained by Dispatcher
Driving the Ambulance to the Scene
Understanding the Law
The Driver
Facts to be Known by the Driver
During Emergency Operations, the Driver May
Driver Should Realize that
Use of Warning Devices
The Siren
Horn
Visual Warning Signal
Stopping Distance
The Road
Standing Water
Poor Visibility
Steering Failure
Brake Failure
Accelerator Failure
Objects on the Roadway
Animals in the Roadway
People in the Roadway
Night Driving
NURSING IMPLICATIONS OF TRIAGE
Triage Nurse
Function
Effects
Education and Licensing
Requirements
Responsibilities of Triage Nurse
Administrative Duties
Medical Duties
Telephone Triage
CONCLUSION
22:
Emergency Department
INTRODUCTION
The Types of Patients who Attend Casualty Services are
FUNCTIONS OF EMERGENCY CARE/CASUALTY
INFRASTRUCTURE AND DESIGN OF CASUALTY DEPARTMENT (FIG. 22.1)
SITE, AREA AND DESIGN OF EMERGENCY DEPARTMENT
Facilities for Management
STAFF REQUIREMENT IN EMERGENCY DEPARTMENT
COMMON PROBLEMS FACED IN EMERGENCY DEPARTMENT
MANAGERIAL ISSUES IN EMERGENCY DEPARTMENT
Security
Traffic Control
Triage
Communication
Availability of All Medical Supplies
Medicolegal Aspects of Emergency Department
CONCLUSION
23:
Nursing Process
INTRODUCTION
DEFINITION
STEPS INVOLVED IN NURSING PROCESS
Nursing Assignment
Nursing Diagnosis
Planning
Implementation
Evaluation
BENEFITS OF NURSING PROCESS
Benefits for the Client
Benefits for the Nurse
A Framework for Accountability
NURSING ASSESSMENT
Prerequisites to Assessment
Data Collection
Sources of Data
Methods of Data Collection
Guidelines for Data Collection
NURSING DIAGNOSIS
Diagnostic Reasoning
Errors in Diagnosis
Using a Nursing Diagnosis
Writing a Nursing Diagnosis
Ten Rules for Writing a Nursing Diagnosis
Collaborative Problems
NURSING PLANNING
Phases of Planning
Setting Priorities
Establishing Goals for Nursing Action
Team Planning
Formulating the Nursing Care Plan
NURSING IMPLEMENTATION
Characteristics
Providing Self-care
Nursing Roles
Rationale
NURSING EVALUATION
Formal Evaluation Models
CONCLUSION
24:
Physical Examination
INTRODUCTION
DEFINITION AND PURPOSE OF PHYSICAL EXAMINATION
Definition
Purpose
METHODS OF EXAMINATION
Inspection
Palpation
The Following Points are to be Kept in Mind while Doing Palpation
Percussion
Methods of Percussion
Auscultation
Manipulations
Testing of Reflexes
Olfaction
HEAD TO TOE EXAMINATION
General Appearance
Mental Status
Posture
Skin Conditions
Head and Face
Eye
Ears
Nose
Mouth and Pharynx
Neck
Chest
Abdomen
Extremities
Back
Genital and Rectum
Neurological Tests
ROLE OF THE NURSE IN PHYSICAL EXAMINATION
Articles Appropriate for Specific Examination
Preparation of the Environment
Preparation of the Equipment (Fig. 24.2)
Preparation of the Patient
Physical Preparation
Mental Preparation
Principle in Physical Examination
NURSING IMPLICATIONS IN PHYSICAL EXAMINATION
Anthropometric Measurements
To Take Height and Weight
To Measure the Skull Circumference
Examination of the Eyes
Examination of the Ears
Examination of the Nose, Throat and Mouth
Examination of the Neck
Examination of the Chest
Examination of the Abdomen
Examination of Genitalia
Examination of Rectum
Examination of Upper Extremities
Examination of Lower Extremities
Examination of Back
Care after Examination
Nurse's Responsibilities during Physical Examination
POSITIONS USED AND SYSTEMS EXAMINED
Skin
Head
Eyes
Ears
Nose and Sinuses
Mouth and Pharynx
Neck
Back
Breasts and Armpits
Breasts
Front of Chest and Lungs
Heart
Abdomen
Rectum and Anus
Reproductive Organs
Legs
Musculoskeletal System
Blood Vessels
Neurologic Screen
The 12 Nerves in the Head (Cranial)
CONCLUSION
25:
Pharmacological Therapy in Emergencies
INTRODUCTION
BASIC CONCEPTS OF DRUGS
Purpose and General Action of Drugs
Routes of Drug Administration
The Routes can be Broadly Divided into Two Groups
Following are some of the Important Routes, through which Drugs are Administered.
Effects of Drug
Side Effects
Toxic Effects
Additive Effects
Synergism
Potentiation
Cumulative Action
Adverse Effects of Drugs
Important Antidotes
FACTORS INVOLVED IN DRUG THERAPY
Factors Involved in Adverse Effects of Drugs
SCIENTIFIC PRINCIPLES AND MEASUREMENTS
Principles
Weights and Measurement
NURSES RESPONSIBILITIES IN DRUG ADMINISTRATION
Responsibilities of the Nurse
The Nature of Drug
Dose
CLASSIFICATION OF DRUGS AND ACTIONS
Drugs are Classified According to their Action
GENERAL INSTRUCTIONS FOR DRUG ADMINISTRATION
Special Points to be noted during any Injection
PHARMACOLOGICAL MANAGEMENT IN CARDIAC ARREST
Drugs Used in Cardiac Arrest
Drugs Generally Used
Vasodilators
EMERGENCY DRUG MANAGEMENT
Oxygen
Goals of Oxygen Therapy
Indications
Methods
General Instructions
Epinephrine
Mechanism of Action
Cardiovascular Response
Indication
Atropine
Description
Mechanism of Action
Lidocaine
Descriptions
Indications
Precautions
Procainamide
Mechanism of Action
Indications
Precautions
Bretylium
Mechanism of Action
Indications
Precautions
Verapamil
Mechanism of Action
Indications
Precautions
Sodium Bicarbonate (NaHCO3)
Mechanism of Action
Indications
Precautions
Morphine
Mechanism of Action
Indications
Dosage
Precautions
Calcium Chloride
Mechanism of Action
Indications
Precautions
Norepinephrine
Mechanism of Action
Indications
Precautions
Dopamine
Mechanism of Action
Indication
Dosage
Precautions
Dobutamine
Mechanism of Action
Indications
Dosage
Precautions
Isoproterenol
Mechanism of Action
Indications
Dosage
Precautions
Amrinone
Mechanism of Action
Indications
Dosage
Precautions
Digitalis
Mechanism of Action
Indications
Dosage
Precautions
Sodium Nitroprusside
Mechanism of Action
Indications
Dosage
Precautions
Nitroglycerin
Mechanism of Action
Indications
Dosage
Precautions
Furosemide
Mechanism of Action
Dosage
Precautions
CONCLUSION
26:
Medical and Surgical Emergencies
EPISTAXIS (NOSEBLEED)
Medical Management
Nursing Management
ESOPHAGEAL VARICES
Clinical Manifestations
Assessment and Diagnostic Methods
Medical Management
Non-surgical Measures Include
Surgical Management
Nursing Management
STATUS EPILEPTICUS
Causes of Epilepsy
Diagnosis
Differential Diagnosis
Medical Management of Epilepsy
Anticonvulsant Drug Therapy
Surgical Treatment
Nursing Management of Patients with Seizures
Patient Education and Rehabilitation
HYPOGLYCEMIA
Causes
Signs and Symptoms
INCREASED INTRACRANIAL PRESSURE
Etiology
Risk Factor
Pathophysiology
Clinical Manifestation
Management
Complications
Nursing Management
CEREBRAL VENOUS THROMBOSIS (CVT)
Epidemiology
Causes of CVT
Recognized Causes or Predisposing Conditions
I. Infective Causes
Noninfective Causes
Coagulation Disorder
Pathology
Clinical Manifestation
Diagnosis
STROKE
Definition
Incidence
Types of Strokes
Causes of Ischemic Strokes
Cerebral Thrombosis
Cerebral Embolism
Cerebral Ischemia
Causes of Hemorrhagic Stroke
Risk Factors for Stroke
Pathophysiology
Clinical Manifestation
Symptoms According to the Artery Occluded
Internal Carotid Artery
Anterior Cerebral Artery
Middle Cerebral Artery
Posterior Cerebral Artery
Basilar Artery
Manifestation of Hemisphere Involvement
Diagnosis
Treatment of Stroke
I. First Aid in Stroke
II. Medical Management
III. Surgical Treatment
IV. Nursing Management
Psychological Needs
Rehabilitation
Discharge Planning and Continuity of Care
Recovery
Nurses Responsibilities in Prevention of Strokes
HEART ATTACK
How to Recognize Heart Attack
First Aid in Heart Attack
CONCLUSION
27:
Psychiatric Emergencies
INTRODUCTION
OVERACTIVE PATIENTS
Emergency Management
THE VIOLENT PATIENT
Emergency Management
UNDERACTIVE OR DEPRESSED PATIENTS
Emergency Management
SUICIDAL PATIENTS
Emergency Management
Prevention
SEXUAL ASSAULT
Emergency Management
Reducing the Result of Sexual Assault
RAPE
Prevention
Management
DELIRIUM TREMENS (ALCOHOLIC HALLUCINOSIS)
Emergency Management
HYSTERIA
Signs and Symptoms
SUDDEN INFANT DEATH SYNDROME (SIDS)
Definition
Three Ways to Reduce the Risk of SIDS
Signs and Symptoms
CONCLUSION
28:
Emergencies in Reproductive, Maternal and Child Health
INTRODUCTION
MISCARRIAGE
Signs and Symptoms
Measures to be Taken during Such Condition Lie
ECLAMPSIA
Definition
Signs and Symptoms
Premonitory Stage
Tonic Stage
Clonic Stage
Comatose Stage
Epidemiology
Treatment
CHILDBIRTH
The Stages of Childbirth
Prevention of Infection
Vaginal Delivery (Figs 28.1A to C)
Description of the Procedure
Procedure
Immediately after Procedure
The Delivery of the Placenta (Afterbirth)
Controlling Bleeding
If the Bleeding is Still not Under Control
Care of the Baby after Birth
Cutting the Cord
POSTPARTUM HEMORRHAGE
Causes of Postpartum Hemorrhage
Atonic Uterus
Traumatic Hemorrhage in Third Stage
Blood Coagulation Disorders
Management of Primary Postpartum Hemorrhage
Principles
Immediate Measures
Management Steps
Secondary Postpartum Hemorrhage
Causes
Management
Supportive Therapy
Active Management
Nursing Considerations
RUPTURE OF UTERUS
Definition
Classification of Rupture
Scar Rupture and Dehiscence
Complete and Incomplete Rupture
Spontaneous and Traumatic Rupture
Risk Factors
Signs and Symptoms
Management
Nursing Care
Once a Rupture is Diagnosed
THREATENED ABORTION
Definition
Clinical Features
Pelvic Examination
Treatment
General Measures
Advice on Discharge
Prognosis
PRE-LABOR RUPTURE OF MEMBRANES
Definition
Incidence
Causes
Manifestations
Risks of PROM
Management
Term PROM
Preterm PROM
OBSTRUCTED LABOR
Causes
Signs of Obstructed Labor
Late Signs
Effects on Mother
Effects on the Fetus
Management of Obstructed Labor
Measures of Management
Obstetric Management
CONCLUSION
29:
Pediatric Emergencies
INTRODUCTION
CHILD ABUSE
Signs
Causes
Effects
Assessment in Accident and Emergency
Measures to Ameliorate the Problem
INFANTILE CONVULSIONS
Introduction
Symptoms and Signs
Treatment
BURNS
Classifications
Depth of Injury
Percent of Body Surface Area Involved
Location of the Burns
Association with Other Injuries
Causes of Burns
Scalds
The Most Common Cause of Burn are
Pathophysiology
Clinical Features
Diagnostic Evaluation
Nursing Management of Burns
First Aid
Immediate Management
DROWNING
Causes
Clinical Features
Laboratory and Imaging Studies
Nursing Management
Emergency Care
Care in the Hospital
FOREIGN BODIES
Pathophysiology
Composition
Small Objects
Anatomic Location
Degree of Air Passage Obstruction
Clinical Features
Diagnostic Evaluation
Nursing Management
Prevention
Complications
POISONING
Clinical Feature
Diagnostic Evaluations
General Management of Poisoning
Approach to the Child
Termination of Exposure to the Poison
Immediate Removal of the Poison
Non-corrosive Substances
NAPHTHALENE POISONING
Mechanism of Action
Causes
Diagnostic valuation
Management
ASPHYXIA NEONATORUM
Definition
Etiopathology of Prenatal Asphyxia
Clinical Manifestations
Management
Prophylactic
Definitive: Apgar Scoring
Babies with Apgar Score: 7–10
Babies with Apgar Score: 4–6
Babies with Apgar Score Below 4
Prognosis: It Depends Upon
Complications
NEONATAL RESUSCITATION
Resuscitation Equipment and Medications
Resuscitation—Stepwise Approach
Bag and Mask Ventilation
Chest Compression
Endotracheal Intubation
Medications
High-risk Newborns, Screening Methods, and Care of New Born in ICU
High-risk Pregnancies
High-risk Newborns
Screening for High-risk
Special Care Neonatal Units (SCNUs)
CONCLUSION
30:
Community Emergencies
INTRODUCTION
EARTHQUAKES
Before an Earthquake
During an Earthquake
After an Earthquake
FLOODS
Precautions
CYCLONES
Before a Cyclone
When Cyclone Approaches
After a Cyclone
LIGHTNING
Outdoors
Indoors
CIVIL DEFENCE
Principles of First Aid in War
Types of Warfare
NUCLEAR WEAPONS
CHEMICAL WARFARE
BIOLOGICAL WARFARE
Problems of First Aid in War
Radiation Sickness
Injuries from Blast
Labeling of Casualties in War
CONCLUSION
31:
Advanced Life-saving Procedures
INTRODUCTION
ADVANCED CARDIAC LIFE SUPPORT
Airway and Ventilatory Support
Oxygenation
Airway Adjuncts
Masks
Ventilation Circuits
Endotracheal Intubation
Support of Circulation
ECG Monitoring
Defibrillation
Electrical Defibrillation
Correction of Acidosis and Fluid Replacement (Figs 31.3A and B)
Volume replacement
Drugs in Advanced Cardiac Life Support
Termination of Cardiopulmonary Resuscitation (Fig. 31.4)
DEFIBRILLATION AND CARDIOVERSION
Defibrillator
Recent Advances in Defibrillation
Current-based Defibrillator
Cardioversion
Automatic Implantable Cardioverter-Defibrillator
PACEMAKERS (FIG. 31.7)
Pulse Generator (Fig. 31.8)
Mode of Pacing (Figs 31.9A and B and 31.10)
Types of Pacemakers
Depending on the Place of Action
Indications for Artificial Pacemakers
Temporary Pacemakers
Permanent Pacemakers
Patient Teaching
Trouble Shooting
External Transcutaneous Pacemakers
ARTERIAL BLOOD GAS ANALYSIS
Components of Arterial Blood Gas
Obtaining Sample for Arterial Blood Gas Analysis
Obtaining Sample by Direct Puncture
Interpretation of Arterial Blood Gas
Clinical Symptoms
Metabolic Acidosis
Metabolic Alkalosis
Respiratory Acidosis
Respiratory Alkalosis
MECHANICAL VENTILATION
Ventilators are not Respirators
Definition
Indications for Ventilatory Support
Positive-Pressure Ventilation
Types of Positive-Pressure Ventilators
Modes of Mechanical Ventilation
Special Positive-Pressure Ventilation Technique
Newer Modes of Mechanical Ventilation
Indications
Contraindications
Pressure Support Ventilation
Indications
High Frequency Ventilation
VENTILATOR SET UP
Type of Ventilation
Complications of Mechanical Ventilation
Fluid Retention and Hemodynamic Alteration
Ventilator Troubleshooting
Weaning from Ventilator
Respiratory Parameters as Criteria for Weaning (Huba)
Signs of Fatigue
Psychological Readiness
Methods of Weaning
Causes of Failure to Wean
Patient who is Fighting the Ventilator
ARTIFICIAL AIRWAY MANAGEMENT
Definition
Indications
Route of Insertion
Types of Tube
General Instructions
Physical Management
Psychological Care of the Patient
Equipment
Procedure
Complications
Mechanical
Laryngeal and Tracheal
ENDOTRACHEAL INTUBATION
Definition
Purpose
Objective
Assessment Phase
Precautions
Planning Phase
Client/family Teaching
Implementation Phase
SUCTIONING TECHNIQUES
Types
Oropharyngeal and Nasopharyngeal Suctioning
Orotracheal and Nasotracheal Suctioning
Tracheal Suctioning (Figs 31.18A and B)
Equipment
Procedure
ENDOTRACHEAL EXTUBATION
Objective
Assessment Phase
Precautions
Planning Phase
Client/Family Teaching
Implementation Phase
Belated Nursing Care
TRACHEOSTOMY CARE (TABLE 31.3)
Definition
Parts of the Tracheostomy Tube (Fig. 31.19)
Use of Tracheostomy (Figs 31.20 and 31.21A and B)
Indications for Tracheostomy
Complications of Tracheostomy
TRACHEOSTOMY SUCTIONING (FIG. 31.23)
Definition
Purpose
Equipment
Preliminary Assessment
Procedure
CONCLUSION
32:
Terminology
INDEX
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