Injuries

Information
The human has around five to six liters of blood. Blood performs a variety of important tasks, including transporting oxygen and nutrients to cells. Injuries result in the opening of blood vessels and the leakage of blood. Large blood loss poses the greatest danger and can become life-threatening. In addition, open injuries pose a risk of infection.

Recognition

• visible bleeding
• visible injury and open wound
• possibly foreign body in wound
• possibly leaking blood on the floor

Action

• Self-protection (consider cause of accident)
• Put on protective gloves.
• Support the patient in his or her position, sitting or lying position are preferable.
• In the event of serious injuries and major blood loss, alert EMS.
• Apply wound dressing: place sterile compress on wound and secure with bandage or triangular cloth.
• Do not apply ointments or powders.
• Do not clean the wound.

Heavily bleeding wound

• Self-protection (consider cause of accident).
• Put on protective gloves.
• Apply direct pressure to the wound, use sterile dressing if possible.
• Apply wound pressure if bleeding cannot be stopped: sterile compress on the wound, one or two dressing packs over it and then apply a tight dressing.
• If necessary, apply local cold therapy with or without pressure to wound.
• If bleeding cannot be stopped, apply tourniquet if learned to do so.

Foreign body in wound

• Leave foreign body in the wound.
• Cover wound as well as possible.
• Stabilize foreign body with "cushion" (e.g. dressing pack).
• If bleeding cannot be stopped, apply tourniquet if learned to do so.

Information
Bleeding from the nose that is not related to a head injury can have various causes, for example an injury caused by manipulation or inflammation or the result of excessive blood pressure. Such bleeding becomes dangerous if it persists and affects the patient's airway or if the blood loss is significant.

Recognition

• Blood dripping or running from the nose.
• Affected person feels very disturbed and unsettled.
• Often clothes are already stained with blood or handkerchiefs are soaked with blood.
• Possibly dizziness or general feeling of weakness.

Action

• Patient shall sit down.
• Hold head forward so that blood can drain off.
• Hold cloth in front of nose to catch the blood.
• Pinch upper part of nose to try to stop bleeding.
• Spit out blood, do not allow it to be swallowed.
• Place cold cloth on back of neck to decrease blood flow.
• If bleeding is severe and unstoppable: alert EMS.
   

Information
An amputation involves the severing of one or more body parts. The fingers are most frequently affected. The basic prerequisite for successful replantation is professional care of the severed body part (amputate).

Recognition

• Body part is completely or almost severed.
• Recognizable bleeding.
• Possible pain.
• Possibly malposition of the affected extremity.
• Affected person is restless and frightened.

Action

• Support the patient in his or her position, sitting or lying position are preferred.
• Reassure and calm the patient.
• Cover amputation wound and amputate cleanly (sterile if possible).
• Locate severed body parts and continue care without attempting to clean as follows.

Amputate packing:

• Wrap amputate in sterile wound dressing or clean cloth and place in clean plastic bag.
• Seal the bag and place it in a second bag filled with ice water.
• Seal the second bag as well (see illustration).
• No direct contact between amputate and ice water!
• It is important that the amputate is given to the ambulance staff!
   

Information
If the "amputate" is a tooth, rapid action can make replantation possible.

Recognition
The tooth is broken or completely knocked out.

Action

• If possible, do not touch the root of the tooth.
• Do not clean the tooth.
• Keep the tooth amputate in specific solution, alternatively in coconut water, whole milk or saline solution (order of preference).
• Immediately consult a dentist or dental clinic.

Information
Bones and joints form the support and movement apparatus of the human body. The movement itself is made possible by the musculature. Bones have great stability based on their typical loads, but can break if overloaded.

Recognition
Certain signs of fracture:

•  Malposition of the affected extremity
• Stepped formation, bone gap
• Visible bone fragments (open fracture)
• Abnormal mobility
• Noticeable bone rubbing

Uncertain signs of fracture:

• Swelling
• Pain
• Bruise
• Functional limitation

Action

• Alert EMS.
• Positioning in low-pain position.
• If necessary, temporary splinting.
• Cooling to relieve pain – for a maximum of 20 minutes. 
   

Information
From the brain the nerve fibers in the spinal cord run through the spinal canal. An accident can cause an injury to the bony spine, but also to the spinal cord. The result of spinal cord transection is paraplegia. The accident mechanism should always be considered. In case of doubt, for example if the affected person is unconscious, it should be assumed that there may be a potential injury to the spine.

Recognition

• Pain in the affected region of the back.
• Possibly numbness or insensitivity in the legs, possibly also in the arms.
• Inability to move the legs and at most the arms.
• Loss of temperature and pain sensation in the affected regions of the body.

Action
Responsive patient

• Move only if in immediate danger.
• Avoid head and back movements at all costs.
• If learned, stabilize the head and neck area manually.
• For awake victims, helmet removal by two rescuers, if this has been learned.
• Keep warm.

Unconscious patient

• Stable unconscious positioning on as flat and hard a surface as possible (preservation of vital functions is the first priority and is preferred to avoiding movement of the spine).
• If learned, stabilize the head and neck area manually.
• In case of unconscious motorcyclists, helmet removal also alone to ensure monitoring of breathing to enable correct unconscious positioning.
• Keep warm.
   

Information
Accidents in which the head hits something, is suddenly moved very violently or direct blows to the head often result in a significant damaging concussion to the brain. Since the extent of the brain damage cannot be determined by lay personnel and such an injury can have fatal consequences, the EMS should always be called or a doctor should be consulted immediately.

Recognition

• Mostly headache and dizziness
• Nausea and vomiting
• Memory lapse
• Clouding of consciousness
• Possibly visual disturbance
• Possibly speech impair, unconsciousness and seizure
• Possibly loss of orientation to person, place, time or date
• Possibly visible injuries such as lacerations or abrasions.

Action

• Calm patient.
• Support patient in his or her position, preferably in a sitting or lying position with the upper body slightly elevated.
• If learned, stabilize the head and neck area manually in case of pain in the cervical spine area.
• Place unconscious patient in recovery position on as level and hard a surface as possible and check breathing.
• Refrain from food intake. 
   

Information
Since the eyes have little protection, injuries can occur relatively easy. Most often, an injury caused by the penetration of a foreign object, by direct force, or by a chemical burn caused by an aggressive substance, such as household cleaner. Injuries to the eye are often accompanied by fear and uncertainty on the part of the individual.

Chemical fluid in the eye
Recognition

• Affected person squeezes eye shut, often holds hands to eye
• Noticeable damage and pain
• Visible damage to the eye
• Tear flow
• Sensitivity to light
• Visual disturbance up to (temporary) loss of vision

Action

• Alert EMS.
• Support patient in his or her position, preferably in a sitting or lying position with slightly raised upper body.
• Avoid manipulation of the eye (also do not allow rubbing).
• In case of chemical exposure, use special eye rinsing solution (if available) and call Intoxikation Information Center via telephone number 145.

Procedure eye rinsing

• Hold head of patient sideways, so that rinsing solution does not run into healthy eye.
• Rinse affected eye with plenty of clean water, keeping the eye open at the same time.
• Rinsing solution.
• Cover eye with compress.
• Do not administer ointments or drops.
• Immediately consult eye clinic or ophthalmologist.

Foreign body in eye

• Try to "dab" away superficial foreign bodies in the eye with a fresh handkerchief (only in case of insect, dust or eyelash).
• Do not manipulate the foreign body.
• In case of injuries with penetrated foreign bodies, cover both eyes (affected eye as sterile as possible).
• Calm the patient.
• Immediately consult eye clinic or ophthalmologist.

Information
Electricity accidents are rare but mainly occur at home or at work. A lightning strike is an exceptional situation. An electric shock can often cause multiple, sometimes invisible, serious internal injuries.

Recognition

• In extreme cases, the affected person is still in direct contact with the power source (cannot let go)
• Fear, panic, confusion
• Disturbance of consciousness up to unconsciousness
• Possibly cardiac arrhythmia up to cardiac arrest.
• Possibly abnormal breathing
• Visible current marks visible at the entry and exit points
• Possibly burns
• Possibly bone fractures or other injuries as a result of falling after electrocution

Action

• Self-protection, switch off power source and secure against reconnection (beware of possible residual current), call in specialist if necessary.
• Alert EMS.
• Support the patient in his or her position, preferably in a sitting or lying position with the upper body slightly raised.
• Place unconscious patient in stable unconscious positioning and check breathing.
• Treat secondary injuries, e.g. from a fall.
   

Information
Burns are caused by direct exposure to flames, hot objects, vapors or liquids (scalds). In a burn or scald, the skin and possibly deeper tissues are damaged. To distinguish the severity of a burn, there is a classification into different degrees of burns. Burns are usually extremely painful, except for 3rd and 4th degree burns where the painconducting nerve cells have been destroyed.

Recognition
Grade 1 burns:

• Top layer or skin affected
• Redness 
• Severe pain

Grade 2a burns:

• Top and upper middle layer of skin affected
• Severe pain
• Hair firmly anchored

Grade 2b burns:

• Top and deep middle layer of skin affected
• Severe pain
• Hair easily removed

Grade 3 burns:

• Third skin layer, muscles and possibly bones affected
• Charring of the affected part of the body
• No pain
• In case of burns in the face, soot in the nose or face as well as coughing, an additional inhalation trauma must be considered and EMS must be alerted immediately!

Action

• Alert EMS in case of extensive burns as well as in case of burns in children and/or inhalation trauma.
• Immediately cool the burn with lukewarm water; continue this measure for a maximum of ten minutes (e.g. with tap water).
• Large burns to the trunk of the body and burns in young children are not cooled because of the risk of hypothermia.
• Heat preservation (very important, since cooling measures and lack of heat regulation can lead to hypothermia due to skin damage and this significantly influences the course of the burn)
• After cooling, cover the burn as sterilely as possible and only with suitable materials – do not bind (heat accumulation)
• Do not apply any ointments.
• Do not open blisters.
   

Information
Anyone exposed to intense sunlight for prolonged periods without protection can suffer sunstroke. Children and the elderly are particularly at risk. If you also neglect hydration in the heat, you can expect a heat stroke – a life-threatening emergency!

Recognition
Heat stroke

• Body temperature over 40 degrees
• Rapid heartbeat
• Low blood pressure
• Red dry skin, no sweat

Sunstroke

• Headache
• Head red and hot
• Neck stiffness
• Body often rather cool
• Dizziness, nausea, vomiting

Action

• Immediately bring the affected person in the shade.
• In case of impaired consciousness, alert EMS.
• In case of heat stroke, open patient's clothing.
• Cool head and in case of heat stroke, also cool extremities.
• Support the patient in his or her position, preferably in a sitting or lying position with the upper body slightly elevated.
• Place the unconscious patient in a stable unconscious positioning and control breathing.
   

Information
Just like heat, cold can also cause damage to health. While the danger of frostbite is mainly for the parts of the body furthest away from the trunk and therefore with the weakest blood supply, such as toes or nose, hypothermia affects the entire body and thus also the performance of all important organs. Severe hypothermia can become a life-threatening emergency! Very sick or injured person must be kept warm – even in an environment with a comfortable temperature for healthy people – in order to avoid hypothermia.

Recognition
Hypothermia:

• Affected person is restless, shivering.
• Later, impaired consciousness up to unconsciousness and cardiac arrest.
• Breathing in severe hypothermia often superficial and difficult to perceive

Frostbite:

• Noticeably distinct cold part of the body
• Hard, possibly frozen tissue with unnatural color (from pale to marbled to blue-black)
• Affected person feels tingling, later pain, and finally nothing in the affected body region-

Action

• Alert EMS.
• Keep warm (woolen or rescue blanket, relocate to warm place).
• Cover had if possible.
• Remove wet clothes.
• Support patient in his or her position, preferably in a sitting or lying position with the upper body slightly elevated.
• Offer conscious patient hot, sugary, non-alcoholic drink.
• Place unconscious patient in recovery position and control breathing; if severely hypothermic, move as little as possible.
• Cover frostbitten parts of the body in a sterile manner.

Information
The majority of drowning accidents in Switzerland occur in lakes and rivers.

Recognition

• Patient screaming for help or waving arms in despair
• Patient lying on the bottom of the pool, waters or floating lifeless on the surface
• Disturbance of consciousness to unconsciousness
• Respiratory disturbance to respiratory arrest
• Possibly pale skin, trembling, fear

Action

• Self-protection (drowning in panic can become a danger or causes of the emergency situation potentially threaten rescuers, such as currents).
• Alert lifeguard or call for help.
• Alert EMS.
• Bring patient ashore as quickly as possible.
• Bring unconscious, normally breathing patient to recovery position and control breathing.
• Resuscitate unconscious patient without normal breathing according to BLS-AED-SRC.