Dressings and Bandages

It is important to treat wounds with the appropriate bandages and dressing.  Some bandages may be improvised at the emergency scene, if other options are not available.  Be sure to apply your PPE BEFORE providing care where you may come into contact with bodily fluids.  

When using bandages and dressings check for signs that the bandage may be too tight by observing any of  the following:
  • Bluish or pale skin color
  • Coldness of extremity below or above the bandage
  • Inability to move fingers and/or toes
  • Bluish tinge in fingernails and/or toenails
***If bandage is too tight, correct and continue to provide care.  If bleeding is not controlled, continue to apply direct pressure and do NOT remove dressings

Dressings

    Functions
  • Control bleeding
  • Prevent infection
  • Absorb blood
  • Protect the wound
    Types
  • Gauze pads
  • Adhesive strips
  • Trauma dressings
  • Improvised dressings
Bandages

    Functions
  • Hold dressing in place
  • Apply pressure 
  • Control bleeding
  • Prevent or reduce swelling
  • Support and stabilize extremity or joint
  • Hold splint in place
    Types
  • Gauze roller
  • Self-adhering bandages 
  • Conforming bandages
  • Adhesive tape

Head, Neck and Spine Injuries

Signs and Symptoms of a Head Injury

  • Victim does not respond or only moans or moves
  • Acts sleepy or confused
  • Vomits
  • Complains of a headache
  • Difficulty seeing
  • Difficulty walking or moving around any part of the body
  • Seizure

Signs and Symptoms of a Neck and Spine Injury

  • Victim fell from a height
  • Is 65 or older
  • Was in a car or bicycle crash
  • Tingling or weakness in the victim’s extremities
  • Pain or tenderness in the neck or back
  • Victim appears to be intoxicate or not fully alert
  • Victim has other painful injuries of the head and neck

Caring for a Head, Neck or Spine Injury Victim

  • Assess the scene for safety
  • Call or direct bystander to call EMS
  • Apply PPE, if available
  • Minimize movement
    • Encourage victim to remain as still as possible
    • Do not apply a cervical collar or move the victim
    • Stabilize the head and neck with your hands, if possible
  • Advise victim to remain calm and still
  • Evaluation by a healthcare provider should occur as soon as possible

Ongoing Care until EMS arrives
  • Check the victim using ABC assessment:
    • Airway – use head tilt-chin lift method
    • Breathing – look, listen and feel for breathing
    • Circulation – check for severe bleeding
  • Care for shock, if necessary
    • Victim lies on back
    • Cover and keep warm
    • Do not give anything to eat or drink
  • Record any changes in victim
  • Report findings to EMS when they arrive
  • If victim becomes unresponsive or has agonal breathing (irregular, shallow or gasping) or is not breathing at all – begin CPR
    • Continue CPR cycle until EMS arrives, a second rescuer takes over or you are too tired to continue
    • If you do not know CPR begin “Hands Only” compressions at a rate of 100-120 per minute

Broken Bones and Sprains

Broken bones and sprains occur when a victim’s body moves in directions it’s not supposed to go.  Without an x-ray it is not possible to determine if a bone is broken.  Rescuers will perform the same action, regardless of the condition of the bone. 

Signs and Symptoms of a Broken Bone or Sprain

  • Swelling at the joint
  • Swelling under the skin
  • Bruising at injury site
  • Large open wound
  • An abnormally bent limb or other part of the body

Caring for a Victim with a Broken Bone or Sprain

  • Asses the scene for safety
  • Call or direct bystander to call EMS
  • Advise the victim to remain still and avoid using or moving the injured body part
  • Apply a cold pack to the injured area
  • Do NOT try to straighten a bent or deformed body part
  • Do NOT try to move a broken bone that has come through the skin
  • Make a splint if you are unable to access EMS support immediately (example hiking in the woods)
    • Use something to support the arm or leg from moving (magazine, stick, rolled up towels)
    • Place the splint so that it goes beyond the injured area and supports the joints above and below the injury
    • Tie the splint to the injured body part for support
    • Use tape, gauze or cloth to secure it
    • Check to make sure the splint is not too tight
      • You should be able to put a few fingers between the splint and the injured body part
  • If the injured part is bleeding, apply direct pressure to stop the bleeding and apply dressing to the wound BEFORE applying the splint
  • If there are no materials to make a splint, have the victim self-splint by using his/her arm to hold the injured arm in place
  • Do NOT try to straighten body parts when applying a splint
Ongoing Care until EMS arrives
  • Check the victim using ABC method:
    • Airway – use head tilt-chin lift method
    • Breathing – look, listen and feel for breathing
    • Circulation – check for severe bleeding
  • Care for shock, if necessary
    • Victim lies on back
    • Cover and keep warm
    • Do not give anything to eat or drink
  • Record any changes in victim
  • Report findings to EMS when they arrive
  • If victim becomes unresponsive or has agonal breathing (irregular, shallow or gasping) or is not breathing at all – begin CPR
    • Continue CPR cycle until EMS arrives, a second rescuer takes over or you are too tired to continue
    • If you do not know CPR begin “Hands Only” compressions at a rate of 100-120 per minute

Burns and Electrical Injuries

Victims who come into contact with heat, electricity or certain chemicals can experience burns and injuries. Heat burns can be caused by fire, hot surfaces, hot liquids or steam.  It is important to use cool water on burns, as ice can damage burned areas.  Hypothermia (low body temperature) can occur when a burn victim gets too cold.  

Types of Burns

  • Thermal (Heat related) burns
  • Chemical burns
  • Electrical burns

Caring for Thermal Burns

  • Assess the scene for safety
  • Call or direct bystander to call EMS if
  • There is a fire
    • If the victim is on fire
      • Direct the victim to stop, drop and roll
        • Cover the person with a wet blanket to put the fire out
        • Remove the blanket after the fire is out
        • The victim has a large second degree or third degree burn
    • You are unsure of what to do
    • Apply PPE
  • Determine the type and severity of burn
    • Depth (Degree)
      • First degree (superficial)
      • Second degree (partial thickness)
      • Third degree (full thickness)
    • Extent
      • Rule of palm - use the size of palm to measure size of burn (palm area=1% of the body)
  • Stop the burning process
  • Open airway and check breathing
  • Seek medical attention if
    • Victim is younger than 5 and older than 55
    • Victim has difficulty breathing
    • Victim has other injuries or electrical injuries
    • Face, feet, hands and/or genitals are burned
    • Child abuse is suspected
    • Second degree burn is larger than 20% BSA
    • Burn is third degree

First Degree Burns (superficial)

  • Signs and Symptoms
    • Redness
    • Mild swelling
    • Tenderness 
    • Pain
  • Caring for First Degree Burns
    • Cool burn with cold water – no ice
    • Apply moisturizer, such as aloe vera gel
    • Adult: administer ibuprofen for pain relief
    • Child: administer acetaminophen for pain relief

Second Degree Burns (partial thickness)

  • Signs and Symptoms
    • Redness
    • Blisters
    • Swelling
    • Weeping fluids
    • Intense pain
  • Caring for Second Degree Burns
    • Cool burn with cold water – no ice
    • Apply antibiotic ointment
    • Cover burn with dry, nonstick, sterile dressing
    • Adult: administer ibuprofen for pain relief
    • Child: administer acetaminophen for pain relief
    • For larger Second Degree Burns – see caring for third degree burns

Third Degree Burns (full thickness)

  • Signs and Symptoms
    • Redness
    • Dead nerve endings
    • Leathery, waxy appearing skin
    • Pearly gray or charred skin
  • Caring for Third Degree Burns
    • Seek medical attention immediately
    • If the person is on fire, put the fire out
    • Remove jewelry and clothing that is not stuck to the skin
    • Cover the person with a blanket
    • Open airway and check for breathing
    • Monitor breathing
    • Care for shock – see shock section
    • Remain with the victim until EMS arrives
  • If victim becomes unresponsive or has agonal breathing (irregular, shallow or gasping) or is not breathing at all – begin CPR
    • Continue CPR cycle until EMS arrives, a second rescuer takes over or you are too tired to continue
    • If you do not know CPR begin “Hands Only” compressions at a rate of 100-120 per minute

Chemical Burns

  • Signs and Symptoms
    • Occur when a victim comes into contact with a caustic or corrosive substance
      • Acids, alkalis and/or organic compounds
    • Continue to burn as long as they in contact with the skin
  • Caring for Chemical Burns
    • Flush skin
    • Remove contaminated clothing
    • Cover burn
    • Seek medical care
    • Monitor breathing
    • Care for shock – see shock section
    • Remain with the victim until EMS arrives
  • If victim becomes unresponsive or has agonal breathing (irregular, shallow or gasping) or is not breathing at all – begin CPR
    • Continue CPR cycle until EMS arrives, a second rescuer takes over or you are too tired to continue
    • If you do not know CPR begin “Hands Only” compressions at a rate of 100-120 per minute

Electrical Burns

  • Signs and Symptoms 
    • Victim may have burns on the inside and outside of the body
    • Victim may stop breathing or have an irregular heart rhythm
  • Caring for Electrical Burns
    • Assess the scene for safety – do not touch a victim if still in contact with electrical source
    • Call or direct a bystander to call EMS
    • Ask if you can help
    • Turn off the main power source, if possible
    • Cover burns
    • Check for spinal injuries
    • Assess the victim, once safe
  • Check the victim using ABC assessment:
    • Airway – use head tilt-chin lift method
    • Breathing – look, listen and feel for breathing
    • Circulation – check for severe bleeding
  • Care for shock, if necessary
    • Victim lies on back
    • Cover and keep warm
    • Do not give anything to eat or drink
  • Record any changes in the victim’s condition
  • Report your findings and care to EMS when they arrive
  • If victim becomes unresponsive or has agonal breathing (irregular, shallow or gasping) or is not breathing at all – begin CPR
    • Continue CPR cycle until EMS arrives, a second rescuer takes over or you are too tired to continue
    • If you do not know CPR begin “Hands Only” compressions at a rate of 100-120 per minute