A vehicular accident (VA) can lead to suspected broken bones that needs stabilization such as a hand injury that will require a SAM Splint Soft Shell (NAR). There are many things that will happen during such accident and it’s important that you respond appropriately should there be delays in health care delivery.
The Accident Scene
The first you have to do if you respond to a VA is to survey the scene and assess the safety. Here’s a small checklist.
- Is it safe for you to approach?
- Is it safe to perform emergency health care on the site?
- Is it safe to keep the patient on the scene until ready for transport?
The important thing is to remember you have to be uninjured if you’re going to help. In some departments, patients are moved immediately away from the wreckage in case of explosions which can happen if the gas tanks are punctured.
Stabilizing the Patient
There are several pressing injuries or suspected injuries that you need to address. The mnemonics ABC is still useful in keeping the patient safe until transportation.
- A – Airway
- B – Breathing
- C – Circulation
In a vehicular accident, airway can be obstructed or compromised by the following:
- Spine damage – especially the cervical vertebrae.
- Mechanical obstruction – Anything that can block the mouth, nose and throat. The tongue in particular can roll back to cause obstruction.
- Head posture – the posture of the neck and head can deviate and cause obstruction to the airway.
Rather than waiting to determine which can obstruct the airway, most emergency response personnel will apply a Cervical Collar Soft, TOPCARE which helps solve or at least reduce any of the mentioned obstructions to airway and solve breathing problems.
Circulation is another problem with especially when bleeding occurs. Most superficial wounds can be closed with Silk sutures, but deep ones might require institutional care like in a minor operating room. Sutures such as Vicryl 3/0, Plain 2/0 strand Softcat, B-BRAUN (12’s) and even Chromic 3/0s and 2/0s will be needed to close any wounds.
Dealing with Fractures and Sprains
Vehicular accidents will sometimes cause fractures and sprains. They are usually immobilized with splints or for bigger fractures, with orthopedic casts such as a circular mold which covers the whole extremity or a partial mold that’s either anterior or post mold. They are immobilized to help the bones and sprain heal. After a set amount of time, circular molds need to be cut away with a tool such as a Plaster Cutter 10” and the patient can proceed to rehabilitation to improve strength on the injured part.
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After Childbirth – Proper Newborn care and biophysical Data recording with Infant Weighing Scale Mechanical, INMED
Put your nurse cap white on and let’s refresh ourselves with proper newborn care. The birth of a baby is certainly a miracle. Just imagine it came from inside a mother from a tiny clump of cells to a bawling baby boy or girl. Proper care must be taken to ensure the survival of the baby within the first 24 to 48 hours.
The First Cry
As the baby is delivered from the womb, amazing changes start to happen. The first cry signals the baby’s functioning lungs. Inside the womb, the lungs are not yet functioning and thus doesn’t a lot blood supply. The amazing process somehow times the baby’s birth so that the lungs are activated after delivery. Just imagine if the baby started breathing inside the womb. Depending on the hospital protocol, you can rest the baby for a while with the mother, or just allow the mother to see the baby before being wheeled to the newborn care station.
Dealing with the Cord
The umbilical cord is sealed with a cord clamp that’s near to the navel before it’s cut. There are a lot of literature out there that says to wait for the pulsations of the cord to stop before clamping and cutting. Others perform a milking technique to squeeze the blood into the baby. Everything depends on the protocol of the hospital you’re in.
The Importance of Warmth
Inside the womb, the baby is kept at a very nice and toasty body temperature of the mother. Once out of the womb, the differences in room temp and body temp might trigger shivering of the baby as he or she tries to maintain body temperature. The shivering requires a lot of oxygen and could put the baby into respiratory distress. Don’t underestimate warmth, it could mean a lot of difference in the survival of the baby. Always maintain warmth when transporting to the newborn care station, when cleaning off the baby or putting the baby on an infant weighing scale mechanical, INMED. Determine if the baby is small for gestational age (SGA) or full term.
Baby’s first Physical Check-up
Most nurses do their physical check-up of the baby while it’s on a weighing scale for convenience. The size of the head, body length and abdominal circumference are recorded for baseline statistics. Should there be abnormal increases or decreases will alert the Pediatric doctor of any problems. Other areas of the body are also checked. Using a digital thermometer, the anal temp is measured for a proper body temp reading as well as to check for anal imperforation. Eyes are not usually checked because they take some time developing but the ears can be checked with an Otoscope Pocket (LED), WELCH ALLYN 22880.
Cleaning Up and Rooming In
The baby will likely be covered in vernix caseosa. It’s a white, jelly-like substance that functions as lubricant to make childbirth easy. There will also be some blood, mucus and other secretions on the body of the baby. Proper newborn care must include the gentle cleaning of the baby and swaddling them and giving the baby to the mother for their first proper bonding and initiation of breastfeeding.
Dealing with Infant Jaundice
Unfortunately, there will be times when the baby has some problems that need to be taken cared of. The most common problem is infant jaundice. Sometimes the immature liver of the infant can’t handle the breakdown of fetal blood cells and their skin sometimes turns to yellow. An Infant Phototherapy Bilirubin, TRP100 might be needed to expose the baby to gentle UV light to facilitate the breakdown of bilirubin and turning the baby back to normal.
Be prepared for newborn care. Philippine Medical Supplies has all the equipment and medical supplies you need. Order online and get it delivered to your lying-in clinic or hospital.
Emergency kits like the Warrior Aid and Litter Kid (WALK) – NAR could mean a difference to a fatal wound. Emergency care for wounds like lacerations, avulsions, excisions and more need immediate care. It doesn’t have to be reparative surgery. Quick thinking and immediate response at the scene of the health incident can save the life of your patient.
How to Prepare yourself to Respond to Emergencies
Being prepared is a number one requirement. If you’re near the area, be ready with the necessary equipment. That’s why you should have your emergency kit at the ready. It should have the following basic supplies as well as supplies for advanced wound care if needed. But before that, you must learn some of the basics when dealing with emergencies.
- Survey the scene – The first step is to survey the area for any immediate danger. You can move the patient to a safer place before you can start any lifesaving procedures.
- Identify the patient – Tap the patient firmly enough to elicit- a response. You need proper ID to report to EMS. It also serves to check if your patient is conscious or not.
- Activate EMS – If you are just a passerby, call the EMS. You may be given instructions on what to do. An ambulance may be dispatched to your location.
- Stabilize the patient – This includes procedures like basic life support and wound stabilization.
Readying Equipment for Emergency Response
Before you can respond to any emergencies, you must prep your kit first. It should have the basic supplies to help with managing a patient with wounds. Commercial kits already have a set, but you could always make one of your own.
Basic Supplies in an Emergency Kit for Wound Care
- Sterile Water and Sterile Plain NSS – Very helpful in the washing of any debris. At least 500 ml should be in your bag which is enough for most emergencies.
- Bandages and Sterile Gauzes – Needed for putting pressure on wounds and covering them to prevent more contamination.
- Scissors – These are needed to help cut bandages, gauzes, and sutures. You should have bandage scissors, a Metzenbaum scissor (straight) or Mayo scissors.
- Antiseptics – Your kit should also have a skin cleanser and an antiseptic. Skin cleansers are strong cleaning agents that can help remove dirt and bacteria. Antiseptics, on the other hand, are formulated to keep bacteria from growing on a cleaned wound. These can be Betadine and 70% Ethyl alcohol.
- Sutures – In the case when pressure dressing does not work, you might need to at least close the wound or suture bleeders. You need the following in your bag. Silk 2/0 or 3/0 (6’s), Chromic Softcat B-Braun (12’s) and Vicryl 1 and 3/0 (2’s). These will provide you the basic sutures for any type of wounds
- O2 Sat device – Very helpful in determining tissue perfusion. You can check if the extremity involved has enough oxygen reaching them with a Pulse Oximeter, ROSSMAX. You can also monitor the pulse rate of the client.
- Plaster – A very useful equipment. Plasters or medical adhesives are like sticky tapes. They can be used to reinforce elastic bandages or hold gauzes in place. If you can’t suture wounds, plaster can be utilized to approximate the wounds close.
There are many more equipment and supplies that you can put in your emergency bag. For a list of medical supplies, Philippine Medical Supplies has it all. Just visit their website and get your order delivered to your home or clinic ASAP.