UNDER CONSTRUCTION
Guide for Medics
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Hello. As there is no real standardized training for Medics, I thought I would make this guide to help enhance medical RP in the State of Argonath. NOTE: This is NOT a standard first aid course and goes into great detail. I have tried to simplify is as much as possible. If there are more patients than you can handle, request more ambulances. I will add treatment for heart attack, stroke, seizures, diabetic emergencies, and anyphylaxis shortly.
Patient Assessment
The first priorities you need to remember when assessing a patient can be remembered by DRABCE.
Danger
First, it is vital that you make sure that you are safe and the scene is safe. If you get hurt, you become another victim. If there is fire, explosions, or hazardous chemicals, request the fire department. If there is gunfire, violent people, crowds, dangerous traffic, or dangerous animals, request the police. Wear medical gloves to prevent the risk of infection being passed on.
Response
When you arrive to the victim, identify yourself and say that you are a Medic. Ask them what happened and what their name is. If they can answer these questions, they are responsive.
If the patient appears unconscious, tap them and shout "Are you alright!?". If they do not respond, they are unresponsive.
Airway
If the patient is talking to you, you know their airway is open. If the patient is unconscious, open their airway by tilting the head back and lifting up the chin. The tongue is a common cause of airway obstruction. Also, if the patient is unconscious, insert an airway adjunct. This is a piece of plastic that is inserted into the back of the mouth to block the tongue from obstructing the airway. If there is blood, vomit, or debris in the airway, suction it out. If the patient is unconscious, and very sick or severely injured, you want to consider intubating them. This involves sliding a breathing tube directly into the patients windpipe for better control of the airway.
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Opening the Airway
Breathing
Check the patient's breathing. Administer oxygen if needed.
Circulation
Check the patient's pulse. Check for and control any major bleeding.
If there is no pulse, start CPR.
If the patient is complaining of chest pain, or is very sick or severely injured, consider applying a heart monitor. Apply the ECG stickies (leads) to the patient's chest. Turn on the heart monitor and you will be able to look at the patient's heart rythym very thoroughly.
Examination
Examine the patient for other injuries and conditions.
Load the patient onto the ambulance stretcher and strap them in. If the patient has a possible spinal injury, you need to immobilize them to prevent them from making it worse. First apply a cervical collar to the patient's neck. Roll the patient onto a backboard. Place foam blocks next to the patient's head and secure them with tape. Strap the patient onto the backboard. Then lift the backboard onto the stretcher and strap the patient in. Load the stretcher into the ambulance. Once you are in the ambulance, check the patients vital signs. Consider starting an IV for something serious. This involves sticking a needle into someones vein and being able to administer fluids and medicine directly into the patient's blood stream. Radio the nearest hospital with the patient's age and gender, what is wrong with them, if they are stable/unstable, and your expected time of arrival. Transport the patient to the nearest hospital. Make sure you check their vital signs on the way every few minutes. If they are in severe pain, give the patient 0.5 mg Morphine, unless the patient has a head injury. If the patient can talk to you, you may want to ask them if they have any allergies, if they are taking any medications, and to tell you about their past medical history.
Medical Treatment
Bleeding
Treatment
- Apply direct pressure with a sterile dressing
- Secure the dressing with a bandage
- If the wound is in the chest, and you hear a sucking noise, apply an occlusive dressing and tape it on three sides. This is a sign of a sucking chest wound.
- If a body part has been amputated, control the bleeding and put the amputated part on ice
Shock
Signs and Symptoms
â– Pale, cold, clammy skin
â– Weakness
â– Thirst
â– Sweating,
â– Rapid pulse
â– Rapid, shallow breathing
Treatment
- Keep the patient calm.
- Administer high-flow oxygen.
- Elevate their legs.
- Cover them with a blanket.
- Start an IV with Ringers Lactate
Burns
Signs and Symptoms
â– Redness
â– Swelling
â– Pain
Treatment
- Cool the burn with cold water or saline
- Remove any jewelry or clothing, unless it is stuck to the burned skin
- Apply a burn sheet
- Administer high-flow oxygen
- Start an IV with Normal Saline
For chemical burns, remove the victims clothing and brush off the chemicals if they are a dry powder. Next, flush the burn with water or saline.
Broken Bones
Signs and Symptoms
â– Severe Pain
â– Swelling
â– Deformity
Treatment
- Manually stabilize the limb
- Apply a splint; this is a piece of equipment that stabilizes a possible broken bone so the victim cannot move it and cause further pain and injury
- Secure the splint
- Apply an ice pack
Spinal Injury
Signs and Symptoms
â– Neck or back pain
â– The victim was in a car accident
â– The victim was hit by a car
â– The victim fell from a large height
Treatment
- Apply a c-collar (neck brace)
- Roll the patient onto a backboard
- Secure the patient's head on both sides with foam blocks or rolled up blankets
- Strap the patient onto the backboard
- If the patient is in a vehicle, apply a C-Collar and carefully slide them out of the car onto a backboard
Heart Attack
Signs and Symptoms
â– Chest pain
â– Trouble breathing
â– Rapid, weak, or irregular pulse
â– Sweating
â– Nausea
â– Pain that moves to jaw, back, or arm
Treatment
- Help the patient into a position of comfort
- Administer high-flow oxygen
- If chest pain is present, give the patient nitroglycerin spray under their tongue (this will help with the chest pain)
- Start an IV with Normal Saline
- Be prepared to give CPR if the patient loses consciousness and stops breathing
Anaphylaxis
Anaphylaxis (or anaphylactic shock) is a severe allergic reaction that can be caused by an insect sting or certain foods.
Signs and Symptoms
â– Difficulty Breathing
â– Rash (Hives)
â– The face and lips are blue (Hypoxia)
â– Swelling of lips and tongue
Treatment
- Administer high-flow oxygen
- Administer an epinephrine auto-injector; this is a special syringe that has been loaded with a dose of epinephrine; a drug that counters the effects of anyphylactic shock
- Be prepared to give CPR if the victim loses consciousness and stops breathing
Poisoning
Signs and Symptoms
â– Burns or redness around the mouth
â– Vomiting
â– Difficulty Breathing
â– Seizures
â– Abdominal Pain
Treatment
- Remove the patient from the poison
- Place the patient in a position of comfort
- Administer oxygen and be prepared to suction if the patient vomits
- Find out what poison the patient took, how much, and how long ago
- Call the hospital and tell them this information; they may recommend you induce vomiting by using a substance carried aboard ambulances called activated charcoal
- Keep the patient warm
Seizures
Signs and Symptoms
â– Confusion
â– Staring Spell
â– Uncontrollable jerking of arms, legs, and body
Treatment
- Protect the patient, move away any dangerous objects
- DO NOT try to restrain the patient during the seizure
- Administer oxygen; be prepared to suction if the patient vomits or drools
- Treat injuries sustained during the seizure
- Transport immediately
Stroke
Stroke is when there is a blood clot or bleeding in the brain. This stops blood flow to the brain which is vital. The only way a stroke victim can be treated can only be done in a hospital so it is important to get them to the hospital as fast as possible.
Signs and Symptoms
â– Confusion
â– Slurred Speech
â– Numbness on arm, face, leg or one side of the body
â– Dizziness
â– Headache
Treatment
- Administer high flow oxygen; be prepared to suction if the victim vomits
- Cover the patient with a blanket
- Protect paralyzed body parts
- Transport IMMEDIATELY
- Start an IV with Normal Saline
NOTE: Environmental emergencies including heat exhaustion, heat stroke, hypothermia, and frostbite will be discussed in another addition.
Cardiopulmonary Resuscitation (CPR)
Compressions - Perform 30 Chest Compressions
Airway - Open the Airway
Breathing - Ventilate 2 times with a Bag-Valve-Mask (BVM)
While someone is doing CPR and using the AED, have someone intubate the patient and start an IV. Then administer 0.5 mg Epinephrine every 3-5 minutes. This will help
Automated External Defibrillator (AED)
An automated external defibrillator (AED) is a portable device that checks the heart rhythm and can send an electric shock to the heart to try to restore a normal rhythm.
- Turn on the AED
- Apply the pads to the patient's bare chest
- Make sure no one is touching the patient while the AED analyzes the rhythm
- If a shock is advised; make sure no one is touching the patient and hit SHOCK; if a shock is not advised, immediately start 5 cycles of CPR, re-analyzing every 2 minutes
- After defibrillation, immediately start 5 cycles of CPR without checking for a pulse
- After 5 cycles of CPR, the AED will re-analyze the rhythm
- After three rounds of CPR and defrbrillation, start transporting the patient
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Automated External Defibrillator