Blood, clear fluid, or blood-tinged fluid draining from the ear may indicate skull fracture or severe head trauma
Never probe the ear
Never pack the ear to stop bleeding; check for clear fluid (cerebrospinal fluid, or CSF) which may indicate a skull fracture from the ear canal.
Place a loose clean dressing across the opening to absorb the fluids.
Do not apply pressure.
A nosebleed is an emergency that can be serious and should not be neglected. The loss of blood can be great and lead to shock. If the patient has a suspected skull fracture or spinal injury, do not try to
(This topic will be discussed in more detail in the lesson on skull injuries.)
Pre-hospital treatment for nosebleeds
Use universal precautions and secure the scene.
Maintain an open airway.
Pinch nostrils together or place a dressing between the upper lip and the gum and apply pressure.
Keep the patient seated and still.
Do not pack the nose, check for clear fluid (CSF) which may indicate a skull fracture
Do not remove any object you may find inside the nose.
For avulsions, apply a compressive dressing
5.5 Injuries to the Mouth
Pre-hospital treatment for injuries to the mouth
Use universal precautions and secure the scene
1. Maintain an open airway. For cut lips, use a rolled or folded dressing. Place the dressing between the patient’s lip and gum. Ensure the dressing does not come loose and enter the airway; this dressing should not be swallowed.
2. For avulsed lips, apply a pressure bandage to the site of injury.
For cut to the internal cheek, position a dressing between the patient’s cheek and gum. Hold the dressing in place with a gloved hand and do not pack the mouth with dressing. Leave 3-4 inches of dressing material outside the patient’s mouth for quick removal. If possible, position the patient’s head to allow drainage
5.6 Injuries to the Neck
Visible lacerations or other wounds can produce massive bleeding or air embolism.
Difficulty speaking, loss of voice.
Airway obstructions without foreign bodies in mouth, nose, or airway. Often caused by inflammatory
process (subcutaneous emphysema)
Deformities or depressions.
Immobilize the patient if you suspect a spinal injury.
Pre-hospital treatment for injuries to the neck
Use universal precautions and secure the scene.
If there is bleeding from a neck wound, do not delay treatment, cover injury with a gloved hand and apply direct pressure if necessary,
Apply slight to moderate pressure with an occlusive dressing.
Tape down all edges of the dressing to form an airtight seal, to avoid air embolism.
Add a bulky dressing over the occlusive one
2. For a patient without spinal injury, place the patient on the left side with a 15-degree incline (head lower), if possible
3.If an object is impaled in the neck, stabilize it in place with bulky dressings Do not remove it
4. Treat for shock.
What not to do:
Never apply pressure to both sides of the neck at the same time.
Never apply a pressure dressing completely around the neck.
IMPORTANT: With any head. face, scalp, eye, ear, nose or neck injury, the MFR should also suspect a possible spinal injury.
5.7 Injuries to the Abdomen
The abdomen contains solid and hollow organs. The rupture of _______organs (stomach, large and small intestine) can cause the contents (acids, digestive enzymes, bacteria) to spill into the peritoneal cavity, causing an inflammatory reaction Rupture of
the _______ organs (liver, spleen, etc ) can cause severe hemorrhage
A contusion may indicate injury to the abdomen or pelvis.
Signs and symptoms of abdominal injury
Pain or cramps in the abdominal area, local or diffuse
Guarding the abdomen or lying down in foetal position
Tenderness of the abdomen
Signs of shock
Rigid, tense or distended abdomen
Mild discomfort progressing to intolerable pain
Deep, penetrating pain in the pelvis or lower back
Pain radiating to a shoulder or both shoulders
Vomiting blood bright red or like coffee grounds
Blood in the stool, bright red or tarry black.
Pre-hospital treatment for abdominal injuries
Use universal precautions and secure the scene. Be alert for patient vomiting.
Cover all open wounds.
Do not replace exposed internal organs – cover them with thick, moist sterile dressing Then loosely cover the moist dressing with an occlusive dressing. Keep the exposed area warm by placing a dressing or towel over the occlusive dressing.
Do not remove impaled objects – stabilize them with bulky dressings.
Constantly monitor vital signs.
Place the patient supine with legs in the most comfortable position.
Treat for shock.
5.8 Injuries to the Genitals
Pre-hospital treatment for wounds to genitalia
Wounds to the genitals should be treated the same as any other wound. However, special care and attention should be given to protect the patient’s privacy.
(to be used in Station 2. Applying Tourniquet)
Blunt trauma: An ice pack, if available, can help.
Cuts: Bleeding should be controlled by direct pressure A sterile dressing or a sanitary pad should be used. If either is not available, then use any clean, bulky dressing.