there. Impalement injuries may occur when a per-
son falls into a stationary object such as a fence
rail or tree branch. Nail guns are responsible for
numerous impalement injuries. Such injuries may
penetrate a hand or foot in such a way as to nail it
to a surface. Because nail guns expel nails under
tremendous force, a nail may penetrate the skull
or sternum to cause potentially life threatening
injury. Impalement injuries may also occur when
falling on an object such as a pencil.
Do notattempt to remove an impaled
object from any part of the body.
Immobilize the part as quickly as possi-
ble and summon emergency medical
personnel.Site and situation assessment Generally there
are no risks to others at the site of an impalement
injury. An exception might be in the circumstance
of a nail gun, in which the responder must deter-
mine the nail gun is inactive.
Responder personal protection measures Latex
gloves, which the responder should put on before
approaching the injured person, are essential for
personal protection from bloodborne pathogens as
there is often bleeding from an impalement injury.
First response actions It is crucial to avoid
moving a person who is impaled on an immobile
object and to provide as much information as pos-
sible about the object to the 911 dispatcher. The
responder should stabilize the person to support
the body or impaled body part and attempt to
comfort and calm the person until emergency per-
sonnel arrive.
Follow-through Impalement injuries require a
physician’s assessment and medical treatment.
See also INFECTION; PUNCTURE WOUND;SITE AND SIT-
UATION ASSESSMENT; SYMPTOM ASSESSMENT AND CARE
TRIAGE; TRAUMA TO THE EYE.
inhalation burns Thermal or chemical BURNSof
the upper airway (TRACHEA) that result from
BREATHING extreme heat (as in a fire) or toxic
fumes. There may also be burns to the lips,
tongue, and inside of the MOUTHand NOSE. Inhala-
tion burns may cause rapid swelling of the airway,
blocking the flow of air and presenting a life
threatening situation. As emergency intubation or
tracheotomy (invasive methods to bypass the
upper airway to get air to the LUNGS) may be the
only measures to save the person’s life, the need
for care from appropriate medical personnel is
urgent.
Site and situation assessment The risk for
injury to rescuers and others is high if there is still
a burning or smoldering fire or a chemical expo-
sure remains uncontained. A situation that
requires personal protective equipment is one the
first person to arrive should not enter.
Responder personal protection measures The
responder should use a resuscitation shield if CAR-
DIOPULMONARY RESUSCITATION(CPR) or RESCUE BREATH-
INGis necessary.
First response actions Most inhalation burns
are critical injuries that require advanced life sup-
port care well beyond the scope of untrained med-
ical response. The most effective action on the part
of the first person at the site is to rapidly summon
emergency personnel.
Follow-through Inhalation burns require
urgent medical treatment from physicians and
other personnel trained and experienced in treat-
ing such injuries. Emergency transportation to a
hospital or trauma center is often crucial.
See also ACUTE RESPIRATORY DISTRESS SYNDROME
(ARDS); INHALED TOXINS; SHOCK.lacerations Cuts or tears of the skin and tissues.
Lacerations may be fairly superficial or extend
deep into the body. The risk for damage to nerves
and BLOODvessels is high. A large or deep lacera-
tion may bleed profusely, requiring immediate
BLEEDING CONTROLefforts. A responder providing
first aid for a laceration should put on latex or
latex-type gloves approaching the injured person,
are essential for personal protection from blood-
borne pathogens as well as to prevent BACTERIA
from the responder’s hands from causing INFECTION
in the wound.
To treat a mild laceration (less than^1 ⁄ 2 inch in
length):- Apply a bandage or gauze pad and hold it in
place to stop any bleeding. - When the bleeding stops, remove the bandage
and apply an antibiotic ointment and a clean
bandage.
Burns, Bleeding, Breaks 365