WPCG #!UN %5 0(; w@c 4   m 0@ 0@ E_ a Ni ^ k 1w 1m 0ck 0w 0E 0 0o 0# 1 1q 1 1 1 1 0 1 1v 1 1 1  1 1 1 B' 0ND 0L B* 1 1 1 1 1$ 1 12 1 1@ 1 1N 1 1\ 1 1j 1 1x 1 1! 1 " 1" 1# 0@# 0@# 0%L"$ 0Ln$ 0J$ 0T% 0^X% 0h% 0r& 0|& 0 ' 0' 1u"( 0d( 0(( 0(#)U >K)) AIO*o*@++, 0GP&- 0GPv- 0GP- 0GP. 0GPf. 0GP. 0GP/ 0GPV/ 1w/ 1w0 1w0 1w 1 1w1 1w1 1wp2 1w2 1m^3 1m3 1m84 1o4 1o5 1m5 1w5 1wg6 1w6 1wU7 1w7 1wC8 1w8 1w19 1w9 1w: 1w: 1w ; 1w; 1w; 1gr< 1m< 1wF= 1w= 1m4> 1w> 1w?>?v~?vKACANON BJC-6000M/,,/M0x9 Z6Times New Roman RegularX($  e   D  D D D D D)~3|x  U2c0Quick ""0 2b0Quick 0  Ky) fCEKQW]cioAutoList1I.I.1.a.I.I.I.I.# e37=CIQYag1.a.i.(1)(a)(i)1)a)(;$2 e  0  .3  0  (O$0  2 e  a  .3  0` (#(#(bd$0  0` (#(#2 e   .3  0 ` (#` (#(xj$0  0` (#(#0 ` (#` (#2 e(  0  )3  0 (# (#($0  0` (#(#0 ` (#` (#0 (# (#2 e(  a  )3  0h(#(#($0  0` (#(#0 ` (#` (#0 (# (#0h(#(#2 e(   )3  0h(#h(#(EhCEKQW]cioAutoList2a.a.a.a.a.a.a.a. YhCEKQW]cioAutoList31.1.1.A.1.1.1.1. ehCEKQW]cioAutoList4a.a.a.a.a.a.a.a. ҼCEKQW]cioAutoList5A.A.1.a.A.A.A.A. ڼCEKQW]cioAutoList6A.A.1.A.A.A.A.A. CEKQW]cioAutoList7A.A.1.a.1)A.A.A.(t$0  0` (#(#0 ` (#` (#0 (# (#0h(#(#0h(#h(#2 e  0  )3  0(#(# {CEKQW]cioAutoList8IIA.1.a.IIIIIIII(hCEKQW]cioAutoList9IIIIIIIIIIIIIIII EGMSY_ekqAutoList10IIA.1.a.1)IIIIII /EGMSY_ekqAutoList11IVA.1.a.IVIVIVIV(JEGMSY_ekqAutoList121)1)1)1)1)1)1)1) rEGMSY_ekqAutoList13a.a.a.a.1)a.a.a. rEGMSY_ekqAutoList14a.a.a.a.1)a.a.a.(%EGMSY_ekqAutoList15a.a.a.a.a.a.a.a. d>$"Small Circle"0  >b$Large Circle0 &0 d d REGMSY_ekqAutoList16A.A.1.a.1)A.A.A. iEGMSY_ekqAutoList17I.A.1.a.1)I.I.I. aEGMSY_ekqAutoList181.1.1.a.1.1.1.1. qEGMSY_ekqAutoList191.1.1.a.1.1.1.1. !EGMSY_ekqAutoList201.1.1.a.1.1.1.1.(%EGMSY_ekqAutoList21a.a.a.a.a.a.a.a. AEGMSY_ekqAutoList221.1.1.a.1.1.1.1. QEGMSY_ekqAutoList231.1.1.a.1.1.1.1. aEGMSY_ekqAutoList241.1.1.a.1.1.1.1. qEGMSY_ekqAutoList251.1.1.a.1.1.1.1. AEGMSY_ekqAutoList261.1.1.a.1)1.1.1.(EGMSY_ekqAutoList27IIIIIIIIIIIIIIII(EGMSY_ekqAutoList28IIIIIIIIIIIIIIII(EGMSY_ekqAutoList29IIIIIIIIIIIIIIII mEGMSY_ekqAutoList30IIA.1.a.IIIIIIII EGMSY_ekqAutoList31A.A.1.A.A.A.A.A. EGMSY_ekqAutoList32A.A.1.a.A.A.A.A. EGMSY_ekqAutoList33IIA.1.a.IIIIIIII EGMSY_ekqAutoList34A.A.1.A.A.A.A.A. EGMSY_ekqAutoList35A.A.1.a.A.A.A.A.(EGMSY_ekqAutoList361.1.1.1.1.1.1.1.(ŤEGMSY_ekqAutoList371.1.1.1.1.1.1.1.2 0Quick 0 2 0Quick 0 > $Small Circle0 > $Large Circle0 2 0Indent123  2" 0Indent20 23  2, 0Indent30 0 23  26 0Indent40 0 0 23  2@ 0Indent50 0 0 0 23  2J 0Indent60 0 0 0 0 23  2T 0Indent70 0 0 0 0 0 23  2^ 0Indent80 0 0 0 0 0 0 23  FGHIJKLM ?AGMSYaioIndent0I.A.1.a.(1)(a)i)a)P 8Mac DefaultMac Default ` X("$("$<  9p`(&Times New Roman 1 2 3 4 5YC << GWPC'HH=FJ=FJ  *  !5!.&(2 4,4?HH[ !X  P)   ` 'CZ\4$ ` \! `!CQ Page    www.mfri.org !X  Q'   ` !Q InstructorGuideQ InstructorNotes8 6No Indent123  8 6No Indent223  8 6No Indent323  8 6No Indent423  8 6No Indent523  8 6No Indent623  8 6No Indent723  8 6No Indent823  _`abcdef@EGMSY_ekqNo Indent1I.I.1.a.I.I.I.I._`abcdef@EGMSY_ekqNo Indent21.1.1.1.1.1.1.1._`abcdef@EGMSY_ekqNo Indent3a.a.a.a.a.a.a.a._`abcdef@EGMSY_ekqNo Indent41.1.1.1.1.1.1.1._`abcdef@EGMSY_ekqNo Indent5a.a.a.a.a.a.a.a._`abcdef@EGMSY_ekqNo Indent6A.A.1.a.A.A.A.A._`abcdef@EGMSY_ekqNo Indent7A.A.1.A.A.A.A.A._`abcdef@EGMSY_ekqNo Indent8A.A.1.a.1)A.A.A._`abcdef@EGKQW]aeiNo Indent91A.1.a.1111_`abcdef@EGKQW]aeiNo Indent:1A.1.a.1111_`abcdef@EGKQW]aeiNo Indent;1A.1.a.1111_`abcdef@EGKQW]cgkNo Indent<1A.1.a.1)111_`abcdef@EGKQW]cgkNo Indent=1A.1.a.1)111_`abcdef@EGKQW]aeiNo Indent>1A.1.a.1111_`abcdef@EGMSY_ekqNo Indent?1)1)1)1)1)1)1)1)_`abcdef@EGMSY_ekqNo Indent@a.a.a.a.1)a.a.a._`abcdef@EGMSY_ekqNo IndentAa.a.a.a.a.a.a.a._`abcdef@EGMSY_ekqNo IndentBA.A.1.a.1)A.A.A._`abcdef@EGMSY_ekqNo IndentCA.A.1.a.1)A.A.A._`abcdef@EGMSY_ekqNo IndentDI.A.1.a.1)I.I.I._`abcdef@EGMSY_ekqNo IndentE1.1.1.a.1.1.1.1._`abcdef@EGMSY_ekqNo IndentF1.1.1.a.1.1.1.1._`abcdef@EGMSY_ekqNo IndentG1.1.1.a.1.1.1.1._`abcdef@EGMSY_ekqNo IndentH1.1.1.a.1.1.1.1._`abcdef@EGMSY_ekqNo IndentI1.1.1.a.1.1.1.1._`abcdef@EGMSY_ekqNo IndentJ1.1.1.a.1.1.1.1._`abcdef@EGMSY_ekqNo IndentK1.1.1.a.1)1.1.1._`abcdef@EGMSY_ekqNo IndentL1.1.1.a.1)1.1.1._`abcdef@EGKOSW[_cNo IndentM11111111_`abcdef@EGKQW]aeiNo IndentN1A.1.a.1111_`abcdef@EGMSY_ekqNo IndentOA.A.1.A.A.A.A.A._`abcdef@EGMSY_ekqNo IndentPA.A.1.a.A.A.A.A._`abcdef@EGKQW]aeiNo IndentQ1A.1.a.1111_`abcdef@EGMSY_ekqNo IndentRA.A.1.A.A.A.A.A._`abcdef@EGMSY_ekqNo IndentSA.A.1.a.A.A.A.A. 4 !  Q'  PtPtHH(FG(HH(d'A  Q !Styl{WP}01  HH  2$HH  Geneva  <Px443!#4$*$$*$ KK  Geneva  Geneva .,6 Geneva   D3:De Geneva  D3:De Geneva ! . X      X  X Xԛ_   EMTBSoftTissueInjuriesDrill]XXInstructorGuide  SessionReference: 1 Topic: SoftTissueInjuries LevelofInstruction: 3 TimeRequired: 3hours Materials: ` X X0 A0   VarioussizesteriledressingsA  0 A0   VarioussizebandagematerialsA  0 A0   MultitraumapadsA  0 A0   Triangularbandages/cravatsA  0 A0   OcclusivedressingsA  0 A0   BlanketsA  0 A0   3"tapeA  0 A0   BoardsplintsA   ` XӀ References: ` X X0 A0   EmergencyCare,8thEdition,BradyA   ` X==================================================================A* ) xdEX0xA XPREPARATION:XX Motivation: Softtissueinjuriesareamongthemostcommoninjuriesencounteredinthefield.Anunderstandingoftheunderlyinganatomyandphysiology,quickrecognitionandrapid,efficienttreatmentareimportanttothesuccessfulrecoveryfromtheseinjuries. Objective(SPO): 11Thestudentwillbeabletolist,frommemoryandwithoutassistance,theprinciplesofwoundmanagementanddemonstratetheappropriatetreatmentofsofttissueinjuriesandshock. Overview: 0 SoftTissueInjuries` X X0 C0   PrinciplesofBandagesandDressingsC  0 C0   TreatmentofShockC  0 C0   ExternalBleedingControlC  0 C0   SoftTissueInjuriesoftheHeadandNeckC  0 C0   PenetratingChestWoundsC  0 C0   TreatmentofImpaledObjectsC  0 C0   TreatmentofEviscerationsC  0 C0   TreatmentofAmputationsC  0 C0   TreatmentofAvulsionsC  `  XA* ) xdE0xASession1Q SoftTissueInjuriesXX` X X ` X XӢSPO110 Thestudentwillbeabletolist,frommemoryandwithoutassistance,theprinciplesofwoundmanagementanddemonstratetheappropriatetreatmentofsofttissueinjuriesandshock.110 Describe/demonstratetheprinciplesofbandageanddressinguse.120 Describe/demonstratethetreatmentofshock(hypoperfusion).130 Describe/demonstratetheprinciplesofexternalbleedingcontrol.140 Describe/demonstratethetreatmentofsofttissueinjuriesoftheheadandneck.150 Describe/demonstratethetreatmentofpenetratingchestwounds.160 Describe/demonstratethetreatmentofimpaledobjects.170 Describe/demonstratethetreatmentofeviscerations.180 Describe/demonstratethetreatmentofamputations.190 Describe/demonstratethetreatmentofavulsions.,Ha^( g_`abcdef @(&` X  z ,X& 23  0 PrinciplesofBandagingandDressing(11)  A.0 Dressing  1. 0 Preferablysterile( h_`abcdef @(  2. 0 Usedtocoverwoundsto0 0 0 a. controlbleeding0 0 0 b.0 preventadditionalcontamination 򀀀   3. 0 Generallyindividuallywrappedmaterialofvarioussizes( i_`abcdef @(   23  0 2"x2",4"x4",5"x9"( j_`abcdef @( 0 4. 0 Occlusive( k_`abcdef @(0 0 0 23  0 usedwhenanairtightsealisneeded( l_`abcdef @( B.0 Bandages0 0 23  0 Anymaterialusedtoholddressingsinplace0 0 23  0 Neednotbesterile0 0 23  0 Varietyoftypes0 0 0 23  0 selfadherent,formfittingrollerbandage0 0 0 23  0 triangular0 0 0 23  0 tape0 0 0 23  0 anymaterialthatcanbeusedtoapplypressuretoawound( m_`abcdef @( C.0 DressingOpenWounds0 0 23  0 Takebodysubstanceisolationprecautions0 0 23  0 Exposethewound0 0 23  0 Usesterileorverycleanmaterial0 0 23  0 Covertheentirewound0 0 23  0 Controlbleeding0 0 23  0 Donotremovedressingsonceapplied.( n_`abcdef @( D.0 BandagingOpenWounds0 0 23  0 Donotbandagetootightly0 0 23  0 Donotbandagetooloosely0 0 23  0 Donotleavelooseends0 0 23  0 Donotcoverthetipsoffingersandtoes0 0 23  0 Coveralledgesofthedressing0 0 23  0 Specialproblemswhenbandagingextremities0 0 0 23  0 pressurepointifyoubandageasmallarea0 0 0 0 i. 0 coverlargearea0 0 0 0 ii.0 applysmalltolarge(distaltoproximal)0 0 0 23  0 donotbendajointafteritisbandaged0 0 0 0 i.0 mayrestrictcirculation( o_`abcdef @( II.0 TreatmentofShock(Hypoperfusion)(12) 0 23  0 TypesofShock0 0 23  0 Hypovolemic0 0 0 23  0 bloodlosshemorrhagic0 0 0 23  0 plasmaloss0 0 23  0 Cardiogenic0 0 0 23  0 inadequatepumpingofbloodbytheheart&  0 0 23  0 Neurogenic0 0 0 23  0 uncontrolleddilationofbloodvessels'  0 23  0 SignsandSymptoms0 0 23  0 Alteredmentalstatus0 0 0 23  0 anxiety0 0 0 23  0 restlessness0 0 0 23  0 combativeness0 0 23  0 Pale,coolclammyskin0 0 23  0 Nauseaandvomiting0 0 23  0 Pulseincreasestocompensateforbloodloss0 0 0 23  0 latesign0 0 0 23  0 maybecomeweakandthready0 0 23  0 Respirationsincreasetocompensate0 0 0 23  0 latesign0 0 0 23  0 morerapid,labored,shalloworirregular( p_`abcdef @(0 0 23  0 Bloodpressuredrops0 0 0 23  0 latesign0 0 0 23  0 lifethreatening0 0 23  0 Thirst0 0 23  0 Dilatedpupils0 0 23  0 Cyanosisatlipsandnailbeds0 C.0 Treatment0 0 1.0 Takebodysubstanceisolationprecautions0 0 2.0 Maintainanopenairway0 0 0 23  0 highconcentrationoxygen0 0 0 23  0 assistventilationsoradministerCPRifindicated( q_`abcdef @(0 0 23  0 Controlexternalbleeding0 0 23  0 Pneumaticantishockgarments(PASG)asindicated0 0 23  0 Elevatelegs8"12"ifnolowerbodyorspinalinjuries0 0 0 23  0 contraindicatedwithPASG0 0 23  0 Splintfractures0 0 23  0 Preventlossofbodyheat0 0 23  0 Transportimmediately0 0 23  0 Speakcalmlyandreassurethepatient( r_`abcdef @( III.0 ExternalBleedingControl(13) 0 23  0 DirectPressure0 0 23  0 Applypressuretothewound0 0 0 23  0 steriledressingiflightbleeding0 0 0 23  0 glovedhandifprofuseorspurting0 0 23  0 Applypressureuntilbleedingstops0 23  0 PressureDressing0 0 23  0 Bandagedressinginplaceoncebleedingiscontrolled0 0 23  0 Applyadditionalpressuredressingsasneeded0 0 0 23  0 NEVERremoveadressingonceitisinplace0 23  0 Elevation0 0 23  0 Raiseextremityaboveleveloftheheart0 0 0 23  0 beawareof0 0 0 0 i.0 musculoskeletalinjuries0 0 0 0 ii.0 spinalinjuries0 0 0 0 iii.0 impaledobjects0 23  0 PressurePoint0 0 23  0 Locatedwherealargearteryliesclosetotheskinsurfaceanddirectlyoverabone0 0 23  0 Brachialartery0 0 0 23  0 controlbleedingfromupperextremities0 0 0 23  0 locatedontheinneraspectoftheupperarmmidwaybetweenthearmpitandelbow0 0 0 23  0 applypressurewithfingertips( s_`abcdef @(0 0 23  0 Femoralartery0 0 0 23  0 controlbleedingfromthelowerextremities0 0 0 23  0 locatedonthemedialsideoftheanteriorthighwhereitjoinsthetrunk0 0 0 23  0 applypressurewiththeheelofyourhand0 E.0 Tourniquet0 0 1.0 Lastresorttocontrollifethreateningbleeding0 0 2.0 Usemaycausepermanentdamagetotheextremity0 0 3.0 Application0 0 0 a.0 nofurtherthan2"fromthewound0 0 0 b.0 applyabovejointifwoundisonjoint0 0 0 c.0 alwaysapplybetweenwoundandheart0 0 0 d.0 placepadovermainartery0 0 0 e.0 wrapcravataroundextremityandtieknotoverpad0 0 0 f.0 placestickintoknotandtightentocontrolbleeding0 0 0 g.0 secureinplace0 0 0 h.0 DONOTREMOVE0 0 0 i.0 notetimeonpatientthattourniquetwasapplied( t_`abcdef @( IV.0 TreatmentofSofttissueInjuriesoftheHead andNeck(14) 0 23  0 Scalp0 0 23  0 Veryvascularsoitbleedsfreely0 0 23  0 Controlwithdirectpressure0 0 23  0 Beawareofskullfractures0 0 0 23  0 nopressureifinjuryshowsbonefragmentsordepression0 0 0 23  0 useloosesteriledressing&  0 23  0 Eye0 0 23  0 Impaledobjectorpuncturewound0 0 0 23  0 stabilizetheobject( u_`abcdef @(0    i.0 3"rollerbandage0    ii.0 folded4"x4"s0    iii.0 placeonbothsidesalongverticalaxisofthehead( v_`abcdef @('     b.0 fitpapercuporconeoverobject0 0 0 0 i.0 restonthestabilizingrolls0 0 0 0 ii.0 donotallowittotouchobject   c.0 secondrescuerstabilizescupanddressing0 0 0 0 i.0 securewithselfadherentrollerbandage( w_`abcdef @(   d.0 dressuninjuredeyetoreducesympatheticeyemovement   e.0 administeroxygen   f.0 careforshock   g.0 speakcalmlyandreassurethepatient( x_`abcdef @(0 0 23  0 Laceration/bleedingaroundeye0 0 0 23  0 applypressuredressingusingsametechniquesasforimpaledobjects C.0 Neck( y_`abcdef @(0 0 23  0 Arteriesandveinsclosetothesurface0 0 23  0 Lowpressureinveinsincreasesthepossibilityofanairembolus0 0 23  0 Treatmentstrategyincludes0 0 0 23  0 stopbleeding0 0 0 23  0 preventanembolusfromenteringthesystem0 0 23  0 Procedures0 0 0 23  0 maintainanopenairway0 0 0 23  0 placeglovedhandoverwound0 0 0 23  0 applyocclusivedressing0 0 0 0 i.0 atleast2"pastedgesofwound0 0 0 23  0 placeadressingovertheocclusivedressing0 0 0 23  0 applypressuretocontrolbleeding0 0 0 0 i.0 donotcompressbothcarotidarteries0 0 0 23  0 bandageinplacewhenbleedingstops0 0 0 23  0 immobilizethespinepermechanism/protocol( z_`abcdef @( V.0 TreatmentofPenetratingChestWounds(15)  0 23  0 Signsandsymptoms0 0 23  0 Woundtothechest0 0 23  0 Mayormaynothavesuckingsound0 0 23  0 Patientmaygaspforair0 0 23  0 Considerallopenchestwoundstobelifethreatening  &  0 23  0 Treatment0 0 23  0 Maintainanopenairway0 0 0 23  0 provideBasicLifeSupportasneeded'  0 0 23  0 Sealthewoundasquicklyaspossible0 0 0 23  0 useaglovedhandifnecessary0 0 23  0 Applyanocclusivedressing0 0 0 23  0 atleast2"pastedgesofwound0 0 0 23  0 sealallfoursidesonexhalationOR0 0 0 23  0 sealthreesidestocreateafluttervalve0 0 23  0 Administerhighconcentrationoxygen0 0 23  0 Careforshock0 0 23  0 Transportimmediately0 0 0 23  0 transportoninjuredsideifnotcontraindicated0 0 0 23  0 considerAdvancedLifeSupport 0 23  0 ChestInjuryComplications0 0 23  0 Pneumothoraxandtensionpneumothorax0 0 0 23  0 lungcollapsesarearesultofairinthechestcavity  2.0 Tensionpneumothorax 0 0 a.0 airpressureincreases0 0 0 0 i.0 noplacetoescape0 0 0 0 ii.0 putspressureonheart,greatvesselsandunaffectedlung0 0 0 0 iii.0 reducescardiacoutput/bloodoxygenation( {_`abcdef @(  3.0 SignsofpneumothoraxandtensionϢpneumothorax0 0 0 23  0 increasingrespiratorydifficulty0 0 0 23  0 indicationsofdevelopingshock0 0 0 23  0 distendedneckveins0 0 0 23  0 trachealdeviationtouninjuredside0 0 0 23  0 unevenchestwallmovement0 0 0 23  0 reductionofbreathsoundsonaffectedside( |_`abcdef @(  4.0 Hemothoraxandhemopneumothorax0 0 0 23  0 chestcavityfillswithblood0 0 0 23  0 chestcavityfillswithbloodandair( }_`abcdef @(  5.0 SignsofhemothoraxandϢhemopneumothorax0 0 0 23  0 signsofpneumothorax0 0 0 23  0 coughedupredfrothyblood( ~_`abcdef @(  6.0 Traumaticasphyxia0 0 0 23  0 suddencompressionofthechest0 0 0 23  0 rapidbuildupofpressurewithinthechest( _`abcdef @(  7.0 Signsoftraumaticasphyxia0 0 0 23  0 distendedneckveins0 0 0 23  0 head,neckandshouldersappeardarkblueorpurple0 0 0 23  0 eyesmaybebloodshotandbulging0 0 0 23  0 tongueandlipsmaybeswollenandblue0 0 0 23  0 chestdeformitymaybepresent( _`abcdef @(  &  8.0 Cardiactamponade0 0 0 23  0 heartinjury0 0 0 23  0 pericardialsacfillswithblood( _`abcdef @( '   9.0 Signsofcardiactamponade0 0 0 23  0 distendedneckveins0 0 0 23  0 veryweakpulse0 0 0 23  0 lowbloodpressure0 0 0 23  0 steadilydecreasingpulsepressure0 0 0 0 i.0 differencebetweensystolicanddiastolicpressure( _`abcdef @(( _`abcdef @(( _`abcdef @( VI.TreatmentofImpaledObjects(16) 0 23  0 GeneralPrinciples0 0 23  0 Donotremovetheimpaledobject0 0 23  0 Exposethewoundarea0 0 23  0 Usedirectpressuretocontrolprofusebleeding0 0 23  0 Manuallystabilizetheimpaledobject0 0 23  0 Stabilizetheobjectwithbulkydressings0 0 23  0 Securethedressinginplace0 0 23  0 Administerhighconcentrationoxygen0 0 23  0 Careforshock0 0 23  0 Keeppatientatrest0 0 23  0 Provideemotionalsupport0 0 23  0 Carefullytransportassoonaspossible0 0 0 23  0 ifabdominalinjury,leavelegsinpositionfound0 0 23  0 Reassurethepatient0 23  0 ObjectintheCheek0 0 23  0 Beawareofpotentialairwayobstruction0 0 0 23  0 theobject0 0 0 23  0 bloodifthecheekisperforated0 0 0 23  0 vomitus0 0 23  0 Examineexternalcheekandinsidethemouth0 0 23  0 Ifcheekisperforatedandyoucanseebothendsoftheobject,removeitbypullingitoutinthedirectionitentered0 0 23  0 Ifcheekisperforatedandthetipoftheobjectisimpaleddeeper,stabilizeinplace0 0 23  0 Positionheadtoallowfordrainage0 0 23  0 Monitorairway;bepreparedtosuction0 0 23  0 Dresstheoutsideofthewound0 0 23  0 Administeroxygen0 0 23  0 Careforshock VII.TreatmentofEviscerations(17) ( _`abcdef @( 23  0 GeneralPrinciplesOpenandClosedAbdominalInjuries0 0 23  0 Maintainanopenairway0 0 23  0 Placepatientonback,flexthelegsattheknees0 0 23  0 Administerhighconcentrationoxygen0 0 23  0 Careforshock0 0 23  0 Givethepatientnothingbymouth0 0 23  0 Monitorvitalsigns0 0 23  0 Transportassoonaspossible( _`abcdef @( B.0 OpenAbdominalInjuries0 0 23  0 Controlexternalbleeding0 0 23  0 Dressallopenwounds0 0 23  0 Donottouchortrytoreplaceanyexposedorgans0 0 23  0 Coverviscerawithheavy,sterileplastic0 0 0 23  0 donotusealuminumfoil0 0 23  0 Tapeallfoursidesoftheocclusivedressing0 0 23  0 Covervisceralandocclusivedressingwithbulkydressingsandlooselysecureinplace( _`abcdef @( VIII. TreatmentofAmputations(18) 0 23  0 GeneralPrinciples0 0 23  0 Placeapressuredressingoverthestump0 0 23  0 Controlbleeding0 0 0 23  0 pressurepointtechniques0 0 0 23  0 tourniquetaslastresortonly0 0 23  0 Nevercompleteapartialamputation0 0 23  0 Wraptheamputatedpartinadrysteriledressing0 0 23  0 Sealtheamputatedpartinaplasticbagandkeepcool0 0 0 23  0 donotfreeze 0 0 23  0 Transporttheamputatedpartwiththepatient IX.TreatmentofAvulsions(19) ( _`abcdef @( 23  0 FlapTornLoose0 0 23  0 Cleanthewoundsurface0 0 23  0 Foldtissueintonormalposition0 0 23  0 Controlbleeding0 0 23  0 Dressthewound( _`abcdef @( B.0 FlapTornOff0 0 23  0 Controlbleeding0 0 23  0 Dressthewound0 0 23  0 Wraptheavulsedpartinadrysteriledressing0 0 23  0 Sealtheavulsedpartinaplasticbagandkeepcool0 0 0 23  0 donotfreeze 0 0 23  0 Transporttheavulsedpartwiththepatient ` XA* ) xdE0xAX SUMMARY: XXA' ) xdAExA Review: 0 SoftTissueInjuries` X X0 C0   PrinciplesofBandagesandDressingsC  0 C0   TreatmentofShockC  0 C0   ExternalBleedingControlC  0 C0   SoftTissueInjuriesoftheHeadandNeckC  0 C0   PenetratingChestWoundsC  0 C0   TreatmentofImpaledObjectsC  0 C0   TreatmentofEviscerationsC  0 C0   TreatmentofAmputationsC  0 C0   TreatmentofAvulsionsC   ` X̢ Remotivation: Assignment: A' ) xdAE(xA================================================================== XEVALUATION: