ms emergency
TRANSCRIPT
MEDICAL – SURGICAL MEDICAL – SURGICAL EMERGENCIESEMERGENCIES
Michelle Theresa C Jimenez, RN, MDMichelle Theresa C Jimenez, RN, MD
EMERGENCYEMERGENCY
Any situation that Any situation that warrants immediate warrants immediate medical attention.medical attention.
ContusionContusion – blood trapped under the – blood trapped under the skin surface; results from a blunt forceskin surface; results from a blunt force
Hematoma Hematoma – tumor – like mass of – tumor – like mass of blood trapped under the skinblood trapped under the skin
StabStab – incision with well – defined edges, – incision with well – defined edges, caused by a sharp, pointed instrumentcaused by a sharp, pointed instrument
CutCut – incision with well – defined margins, – incision with well – defined margins, usually long than deepusually long than deep
MANAGEMENTMANAGEMENT
Wound cleansingWound cleansing Use Normal Saline solution if availableUse Normal Saline solution if available Avoid Betadine & Hydrogen PeroxideAvoid Betadine & Hydrogen Peroxide SuturingSuturing
FRACTURESFRACTURES
Break in the Break in the continuity of a bonecontinuity of a bone
Usually occurs Usually occurs when the bone is when the bone is subjected to a subjected to a much greater force much greater force than it usually than it usually carries carries
MANAGEMENTMANAGEMENT
Check for open woundsCheck for open wounds SplintingSplinting ImmobilizationImmobilization ReductionReduction
CRUSH INJURIESCRUSH INJURIES
When a person is When a person is caught between caught between objects, run over by objects, run over by a moving vehicle, or a moving vehicle, or compressed by compressed by machinerymachinery
HEMORRHAGEHEMORRHAGE
Excessive bleedingExcessive bleeding Usually arterialUsually arterial May lead to May lead to
hypovolemic shockhypovolemic shock
Manifestation of Manifestation of Hypovolemic ShockHypovolemic Shock
HypotensionHypotension TachycardiaTachycardia TachypneaTachypnea Cold, clammy skinCold, clammy skin Delayed CRTDelayed CRT PallorPallor
ThirstThirst DiaphoresisDiaphoresis OliguriaOliguria Metabolic AcidosisMetabolic Acidosis Changes in Changes in
SensoriumSensorium
Goals of TreatmentGoals of Treatment
Control bleedingControl bleeding Maintain adequate circulating blood Maintain adequate circulating blood
volumevolume Prevent shockPrevent shock
ManagementManagement
Control of External HemorrhageControl of External Hemorrhage Identify area/s of injuryIdentify area/s of injury Apply direct pressureApply direct pressure Elevate injured partElevate injured part
Tourniquet should be a lost resort when Tourniquet should be a lost resort when hemorrhage cannot be controlledhemorrhage cannot be controlled
ManagementManagement
Fluid ReplacementFluid Replacement Double line with NSS or Lactated Double line with NSS or Lactated
Ringer’s SolutionRinger’s Solution Blood Transfusion ASAPBlood Transfusion ASAP
POISONINGPOISONING
Ingestion, inhalation, or absorption of Ingestion, inhalation, or absorption of any substance or material that may any substance or material that may injure the body because of its chemical injure the body because of its chemical reactionsreactions
May be intentional or May be intentional or unintentionalunintentional
SIGNS & SYMPTOMSSIGNS & SYMPTOMS
– Cardiovascular : Bradycardia, hypotension– Respiratory: Rhinorrhea, bronchorrhea,
bronchospasm, cough, severe respiratory distress
– Gastrointestinal: Hypersalivation, nausea and vomiting, abdominal pain, diarrhea, fecal incontinence
– Genitourinary: Incontinence– Ocular: Blurred vision, miosis– Glands: Increased lacrimation,
diaphoresis
Goals of TreatmentGoals of Treatment
Remove or inactivate poison before it Remove or inactivate poison before it is absorbedis absorbed
Provide supportive care in maintaining Provide supportive care in maintaining vital organ system functionvital organ system function
Administer a specific antidote to Administer a specific antidote to neutralize a specific poisonneutralize a specific poison
MANAGEMENTMANAGEMENT
AirwayAirway OxygenationOxygenation DecontaminateDecontaminate Eye irrigationEye irrigation Atropine & Atropine &
DiazepamDiazepam
MYOCARDIAL INFARCTIONMYOCARDIAL INFARCTION
Inadequate Inadequate oxygenation of the oxygenation of the myocardium caused myocardium caused by blockage in the by blockage in the coronary arteriescoronary arteries
SIGNS & SYMPTOMSSIGNS & SYMPTOMS
Chest painChest pain Radiating pain to Radiating pain to
neck, arms, jaw neck, arms, jaw and backand back
DyspneaDyspnea LightheadednessLightheadedness AnxietyAnxiety
MANAGEMENTMANAGEMENT
AssessmentAssessment Activate EMSActivate EMS OxygenationOxygenation IV accessIV access NitroglycerinNitroglycerin