- If the injury bleeds through the covering mate-
rial, add more but do not remove the original
covering. - Maintain pressure until emergency medical
personnel arrive.
Use these measures to stop a nosebleed:- Put on latex or latex-type gloves.
- Have the person sit upright, holding the head
tipped slightly toward the chest. - Firmly squeeze both nostrils with the thumb
and forefinger. - Hold pressure in this way for at least 10 min-
utes. - If bleeding starts again after releasing the pres-
sure, repeat the procedure.
Follow-through A health-care provider should
evaluate most bleeding injuries to cleanse them
and determine whether sutures (stitches) or other
treatments are necessary. Nosebleeds require med-
ical attention when they persist or frequently recur.
See alsoGASTROINTESTINAL BLEEDING; IMPALEMENT;
PUNCTURE WOUND; SYMPTOM ASSESSMENT AND CARE
TRIAGE.
burns Injuries resulting from exposure to fire,
intense heat, extremely hot water, electricity
(including lightning), radiation (including ultravi-
olet radiation from sunlight or tanning systems),
or caustic chemicals. The severity of a burn
depends on the depth of penetration into the tis-
sues (first degree, second degree, and third
degree) and the amount of surface area the burn
covers (percentage). SHOCK is a significant risk
with any burn.
Medical personnel often use a method called
the “rule of nines” to assess the body surface area
a burn covers. This method assigns a percentage of
9 or 18 percent to regions of the body. For exam-
ple, each arm is 9 percent, as is the head; the legs,
back, and chest are each 18 percent. The surface
area a burn covers may have more significant
health consequences than the burn’s depth. A
first-degree (superficial) burn that covers an
extensive area is often more serious than a third-
degree burn that covers a very small area.
Heat and explosion burns on the upper body,
face, and head may indicate the person also has
burns to the MOUTH, NOSE, or upper airway
(INHALATION BURNS). Such burns are potentially life
threatening because swelling may close the air-
way, blocking the flow of oxygen to the LUNGSand
compromising the ability to breathe.
Site and situation assessmentRisk for injury to
the first person to respond is very high when the
source of the burn remains. In situations of active
fire, risk for explosion, lightning, downed power
lines, or chemical or radioactive contamination,
the only response that may be safe for the respon-
der is to provide as detailed information as possi-
ble when summoning emergency aid to help
dispatchers send the appropriate equipment and
trained personnel.
Responder personal protection measures Latex
gloves, which the responder should put on beforeBurns, Bleeding, Breaks 363BURN SEVERITYBurn Classification Extent of Burn Symptoms
first degree or superficial burn penetrates only into the epidermis redness, PAIN, slight swelling
thickness (outer layer of SKIN)
second degree or partial burn penetrates into the dermis (middle blisters, pain, moderate swelling
thickness layer of skin)
third degree or full thickness burn penetrates into the subcutaneous open wound or charring, may be no pain
layer (innermost layer of skin) and
possibly into underlying tissues