...-Number of shots heart; type of gun used; position of pt when shot; distance of the pt from the gun. History should be gathered from the pt, available eye-witnesses, and emergency medical service providers Does the patient have intra or extraperitoneal bleeding that requires surgical intervention? Does the patient have peritoneal contamination requiring washout and repair of a hollow viscus? Penetrating injuries with any hemodynamic instability and/or signs of intraperitoneal injury are treated operatively at the outset of management -GSWs most often injure the small bowel followed by the colon and liver Clinical thinking Does the patient have an adequate airway, and ability to protect it? Is the patient breathing? Is oxygenation and ventilation adequate? A GSW in the abdomen may penetrate the diaphragm and cause a significant thoracic injury -Does that patient have adequate blood volume and perfusion? How does the patient respond to resuscitation, does the pt take beta blockers that may mask an appropriate tachycardia? -evaluate the pts ability to follow commands and respond appropriately. Is neurological disability a central phenomenon from shock, or is there a direct spinal cord injury? The patient must always be adequately exposed to evaluate all injuries, don’t over look the axial, back, gluteal cleft, and perineum. Patients with penetrating abdominal injuries are best served by antibiotic therapy prior to operative intervention. Initial therapy should be broad...
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...Ancient Science of Life Vol : XXV (3 & 4) January, February, March & April, May, June 2006 BURN WOUND HEALING ACTIVITY OF Euphorbia hirta Jaiprakash.B1, Chandramohan2, D.Narasimha Reddy1 CMR College of Pharmacy, C.A.No.5, Bhuvanagiri, OMBR Layout, Bangalore-560 043. 2 Bharathi College of Pharmacy, Bharathi Nagar, Mandya (Dt), Karnataka Received : 19-10-2005 Accepted : 12-12-2005 ABSTRACT The Ethanolic extract of whole plant of Euphorbia hirta was screened for burn wound healing activity in rats as 2% W/W cream. The study was carried out based on the assessment of percentage reduction in original wound. It showed significant burn wound healing activity. INTRODUCTION: Tissue damage from excessive heat, electricity, radioactivity or corrosive chemicals that destroy (denature) protein in the exposed cells is called a burn. Burns disrupt haemostasis because they destroy the protection afforded by the skin. They permit microbial invasion and infection, loss of body fluid and loss of thermoregulation.1 Several indigenous drugs have been described in Ayurveda (an ancient Indian system of Medicine) for the management of wounds and burns. Hence, in an attempt to study the wound healing activity of several locally available indigenous herbs, we studied and reported the wound healing activity of the ethonalic extract of the whole plant of Euphorbia hirta in various models like excision, incision and dead space wounds.2 In this communication we report the bourn wound healing activity of...
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...An automated external defibrillator (AED) is a lightweight portable device that delivers an electric shock to the heart after sudden cardiac arrest (SCA). The shock is needed to reset the heart after SCA. Cardiac arrest is a condition wherein the heart produces irregular rhythm and then stops beating. This is a medical emergency as the blood flow to the brain and internal organs will cease. If no immediate care is done for individuals having sudden cardiac arrest, the chances of survival will decrease since the condition may result in death within minutes. Automated external defibrillators make it possible for people to respond immediately to individuals that are having sudden cardiac arrest. This is one of the tools used by emergency medical responders and is used to provide electrical shock to “shockable” heart rhythms. What are “shockable” heart rhythms? The heart has its own electrical system that triggers the contraction of the heart muscles. It is responsible for the control of all of the events that occur in the heart during pumping out of blood to the circulation. When there are problems within the heart, blood vessels and electrolytes may cause a disruption of the electrical system and may result in arrhythmia. Arrhythmias are problems with the conduction of electricity in the heart that causes abnormal heart rhythms. There are a number of arrhythmias but not all of them are treated with defibrillation. The only “shockable” arrhythmias are pulseless ventricular...
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...SHOCK, SURGICAL INFECTIONS & TRAUMA Choose the best answer: 1) More commonly, wound infections following surgery become evident on: A. Between third and fifth day B. Between eight and eleventh day C. Between first and third day D. Between fourth and seventh day E. Between twelfth and sixteenth day 2) The following is an example of Class III surgical wound: A. Urinary bladder surgery B. Herniorrhaphy C. Gastrectomy D. Resection of obstructed bowel E. Surgical drainage of pelvic abscess 3) A 70 yr old victim of an auto-pedestrian accident develops manifestation of severe sepsis 14 days after a Splenectomy. The organism most likely to be involved is: A. Staph. aureus B. Strep. Pyogenes C. Hemophilus influenza D. E. coli E. Klebsiella sp. 4) The most reliable protection for the surgeon against Hepatitis B infection is by: A. adherence to universal precautions B. administration of gamma globulins C. active immunization D. double gloving E. administration of interferons 5) Pro-inflammatory mediators in shock, EXCEPT: A. IL-4 B. IL-2 C. TNF D. IL-6 E. IL-8 6) Hypotension occurs in healthy patients if blood volume is decreased by: A. 15-30% B. More than 40% C. Up to 15 % ...
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...1. A person having a heart attack may have an uncomfortable feeling, such as pain or pressure in the chest or other areas of the upper body. true 2. What sudden illness is usually caused by a blockage of blood flow to the brain? stroke 3. If someone faints, the first thing you should do is: Drink cool water on face 4. What is the best way of opening the airway to check for breathing? Head tilt chin lift 5. Which statement best outlines the steps of proper use of an epinephrine pen? (1 point) fist 6. If a known diabetic appears has missed their lunch and appears confused and vague, you should do what immediately? Sugary drink 7. If an adult is eating and suddenly coughs and cannot breathe, talk, or make any sounds, you should ask the adult if she is choking. If she nods "yes", tell her you are going to help and give abdominal thrusts. true 8. How should you care for a person with a possible head, neck or back injury? minimize 9. What are the signs of shock? Cold and moist skin - all the above 10. A flail chest is where Several ribs 11. In stroke recognition, F.A.S.T. means: Face arm speech time 12. Which of the following sequences is correct for using an AED? Turn on, pads, analyze, shock 13. If a victim falls from a height and then becomes sleepy or confused, vomits or complains of a headache, the victim may have a head injury. false 14. Which form of hyperthermia (high body temperature) is more severe? Heat...
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...laparotomy is a large incision made into the abdomen. Exploratory laparotomy is used to visualize and examine the structures inside of the abdominal cavity. Exploratory laparotomy is a method of abdominal exploration, a diagnostic tool that allows physicians to examine the abdominal organs. The procedure may be recommended for a patient who has abdominal pain of unknown origin or who has sustained an injury to the abdomen. Injuries may occur as a result of blunt trauma (e.g., road traffic accident) or penetrating trauma (e.g., stab or gunshot wound). Because of the nature of the abdominal organs, there is a high risk of infection if organs rupture or are perforated. In addition, bleeding into the abdominal cavity is considered a medical emergency. Exploratory laparotomy is used to determine the source of pain or the extent of injury and perform repairs if needed. Laparotomy may be performed to determine the cause of a patient's symptoms or to establish the extent of a disease. For example, endometriosis is a disorder in which cells from the inner lining of the uterus grow elsewhere in the body, most commonly on the pelvic and abdominal organs. Endometrial growths, however, are difficult to visualize using standard imaging techniques such as x ray, ultrasound technology, or computed tomography (CT) scanning. Exploratory laparotomy may be used to examine the abdominal and pelvic organs (such as the ovaries, fallopian tubes, bladder, and rectum) for evidence of endometriosis...
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...Signs of Shock As a veterinary technician, it’s important to be able to recognize when a patient enters the animal hospital in distress. Prompt action following the hospital’s procedures can save a pet’s life. Shock is a medical term meaning a loss of circulation. If a pet is in shock, their blood pressure is very low. This can be critical if the pet’s vital organs and brain is not getting enough blood flow. There are many reasons why a pet may go into shock. Often it is due to a trauma to the body and or loss of blood. A pet that has been hit by a car can present to the hospital in shock, or a dog fight. Severe allergic reactions, heart failure, or excessive vomiting and diarrhea...
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...Community Emergency Preparedness and Response Paper Kelly M. White NUR/408 August 10, 2015 Amy Reagan Community Emergency Preparedness and Response The terms “preparedness” and“readiness” can be used interchangeably. Preparedness is defined as the existence of plans, procedures, policies, training, and equipment necessary at the Local, State, and Federal level to maximize the ability to prevent, respond to, and recover from major events (Katz, 2013). Emergency preparedness is essential in assisting with disasters and emergent issues that happen around the world. Media coverage of disasters across the globe occur in real time with an intensity level that makes one believe that natural or manmade disasters happen more frequently. Disasters, in all forms, is a part of life and how we deal with these events depends on how well we are prepared. It is of the utmost importance that all of the population be aware of what to do and who to contact when an event is about to happen or while it is unfolding. A community’s ability to recover and be self-reliant after a disaster also depends on how well the community prepares for and responds to these emergencies. This paper will discuss and examine how the resources and people of the chosen neighborhood responded to the emergency at hand, a forest fire ravaging for more than 5 days (Neighborhood 2.0-News). The Neighborhood There is an uncontained forest fire that has been burning for more than 5 days in a forest west of the Neighborhood...
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...Community Preparedness and Response NUR/408 Community Preparedness and Response This paper discusses The Neighborhood - Pearson Health Science season two, episode five at the University of Phoenix student website. The examination of the actions of health care workers in response to the health concerns of key characters will be highlighted including the community hospital, senior center, school, and the Bley household. The role of the preparedness of the public health agencies, who initially responded to the community emergency, and who should monitor the effects on the community health will be assessed. Identification of how public health care teams can enhance the citizens’ preparedness for emergencies will be explored as well as suggestions to improve personal preparedness in a similar community emergent event. The Neighborhood The Neighborhood has a population of 64,200 including all ages from zero to over 90 years-old. An uncontrolled forest fire has been burning for over five days. As firefighters battle the fire, city officials state the community is not in any danger. However, the thick smoke is covering the town. The healthcare workers are working hard to treat people of the community with chronic lung problems (Pearson Health Science, 2009). Hospital The local hospital is a 362 inpatient bed facility (Pearson Health Science, 2009). The raging fire has the emergency room and local offices seeing an increase of patients suffering breathing problems...
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...CAPABILITY OF EMERGENCY SERVICES TO REACT TO DISATERS Devon Clemons American Military University 12 February 2015 Abstract Every day throughout United States, thousands of emergency personnel respond to various types emergencies both natural and man-made. Such disasters pose significant problems for emergency managers and emergency response personnel as well as the medical facilities that treat them. At a moment’s notice, medical facilities can become overwhelmed after a disaster from people seeking medical attention. The key to success is information sharing and management among these responding organizations during and after a disaster. The idea of sharing information does not occur overnight, the plan should be implemented before any disaster occurs. Many of the issues responders face range from a lack of preparedness and training of emergency responders to a lack of communication. Disaster readiness remains uneven across the United States especially in small cities or rural areas and without significant disaster preparedness many emergency responders or emergency facilities such as hospitals or clinics remain unprepared for natural disasters. As a result, many facilities may be unprepared to accept and care for an influx of patients as a result of a terrorist attacks, chemical spills, and natural disasters. This paper will explore problems emergency responders may face during disasters due to a lack readiness and preparedness. In addition, this paper...
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...Jonathan Peragine Professor McMillan English 101 June 9, 2015 Emergency Decision-Making Unfortunately, people are confronted with medical emergencies all the time. Such emergencies can be very scary and the people involved must make crucial decisions without much time to deliberate. Because emergencies happen so frequently, I usually already have a detailed plan of how to act when I encounter them. However, I know from personal experience that even if a person has a plan for how to navigate an emergency, his plan will go out the window the minute his emergency becomes a reality. He will have to make the best decisions that he can in hopes of them not coming back to rest on his conscience. In my experience, driving my girlfriend to the emergency room with a suspended driver’s license was not what I would have planned, but ultimately satisfied my conscience. A few years ago, my girlfriend decided that she wanted to play college softball. This meant that I had to spend every weekend going to watch her softball games. One weekend, as my girlfriend was up to bat, she tried to bunt the ball and the ball hit her finger, crushing it between the extreme force of the fast ball and the titanium bat in her hands. Because of the strange thud noise that this created, I knew pretty quickly that something had gone wrong. I became immediately nervous and as she turned to me with a pale and distressed face, my stomach dropped into my shoes. As we made eye contact, I began to hear a slight...
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...HAT 1 March 4, 2014 A disaster of any time cause chaos among those affected and loss of valuable time trying to coordinate efforts. In 1968 at a fire chief meeting in Phoenix Arizona and incident command system was established to organize our responses to a disaster large, small, natural or man-made ("Incident command system," ). This system was designed to help lessen the communication errors by establishing common terminology which identifies...who's in charge, what is needed and who is expected to follow up. Along with establishing a common terminology the ICS has established a common hierarchy, which will decrease management deficiencies because the composition of this team is usually diverse and covers many organizations. These members are usually volunteers and come in a number of field expertise. The roles in ICS usually include a single incident commander who commands the response effort and is the final decision-making. The command staff which reports to the incident commander includes a Safety officer - monitors safety conditions and develop measures for assuring the safety of all personnel and persons affected. Public information officer is the information source for all involved. This officer also serves as a liaison to the media. Answering questions, addressing rumors helping to keep the public aware of what is being done. Liaison officer is the contact person for all supporting agencies assisting in the incident. Operations chief directs all actions to meet...
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...Purpose The purpose of the Health and Medical section is to provide information which identifies the methods used in mobilizing and managing health and medical services in response to emergencies at Glover International Airport. These areas include treatment, transport and evocation of the injured, removal of deceased, disease control and prevention of contamination during emergencies. • Situation and Assumptions Glover International Airport provides basic emergency medical care response for the Airport and will request assistance from the city of Seattle and City or Tukwila Fire Departments as necessary. The Airport provides emergency medical services through ARFF personnel and on/off-site mutual aid emergency medical technicians. If mutual aid is not available, the use of triage will be utilized to ensure an efficient use of existing resources. The Airport strives to ensure its response is adequate to protect life and health for the first 12 to 24 hours without outside assistance. Large-scale incident will require outside agency support. The surrounding communities have a large contingent of Health and Medical resources to bring to bear. Many medical professionals will volunteer their services and Glover International Airport must be prepared to ensure their legitimacy. It should be noted that these resource might they be adversely affected by the emergency. All requests for additional health and medical support will be made though the on-site Law Enforcement and will...
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...challenged our medical infrastructures. The emergency medical preparedness programs evolved a lot in response to medical surge in these disasters. In our system, several characteristics should be clarified in the beginning: 1. In our multiple casualty incident plans require to send hospital doctors to the incidents immediately to save lives, disregarding what they can do or if the scene is under control. The emergency medical services system of Taiwan was established in 1995, and the fire fighters were trained to be emergency medical technicians (EMT) to provide pre-hospital medical care, people still believe that physicians at the scene can provide better medical care than the fire fighters/EMT. An experienced physician at the rescue scene may do a better job in triage and arranging definite medical care site, but not every hospital physician has street sense and proficiency in trauma care skills. When the personnel in emergency room of a smaller hospital were deployed to the scene, it jeopardized the capacity of hospitals for receiving patients. 2. The plans tend to call back all the personnel immediately. The first step of a response plan of an organization is usually to call back all the off duty personnel by all means. This procedure is self-depicted because it guarantee there will be adequate human resources for the following several hours. It may sometimes prematurely deplete the resources, for example the manpower for the next shift if the emergency extends for a while...
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...Head: Emergency Preparedness and Response Emergency Preparedness and Response Michelle Gage NURS408 Epidemiology: Global and Public Health Emergency Preparedness and Response Emergency preparedness is a key factor in helping with disasters and emergent issues that happen around the world. Emergency preparedness requires attention not just to specific types of hazards but also to steps that increase preparedness for any type of hazard (Centers for Disease Control and Prevention, 2010). It is important that all the population be aware of what to do in an event or who to contact if they notice a particular event about to happen or happening. In the pre-event preparation stage, much training, information, and safety are critical to minimizing deaths and injuries that occur from emergencies. One type of situation that could occur and cause chaos is a neighborhood forest fire. Numerous people could respond to this event to aid in the public’s needs and to help prevent further complications or exacerbations of medical problems. In the Neighborhood News it was a focus on the forest fire that was still occurring near this town. Kate, RN was discussing how she is overwhelmed with the amount of admissions that they have on the medical unit. This was caused from the exacerbation of emphysema and asthma because of the neighborhood forest fires. The entire unit of staff were feeling tired and morale was decreased lately. Pat, nurse manager for the medical unit also...
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