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AFTER FIRST AID, TREAT SECONDARY INJURIES, SHOCK

FIRST-AID TRAINING: Part II

Last week's column featured information on initial first-aid treatment for an injured person. Today's column covers what to do next.Secondary survey

After treating all injuries found, obtain additional information by performing a secondary survey to look for conditions that have a lower priority, such as fractures and soft-tissue injuries. They are unlikely to cause serious immediate harm, but they can cause significant pain and later complications. Basically, their treatment consists of the well-known first-aid procedures - putting on dressings and splints.

When putting on a bandage, put it on tight enough to stop the bleeding, but be sure that the circulation in the extremity is good by checking the capillary refill test described last week. Whenever possible, leave the tips of the fingers exposed so you can see from their color that they have proper circulation.

Shock

Most severely injured victims should be placed in a position with the legs elevated to use gravity to move the blood into the body's core circulation. When a person also has a head injury and the neck is not injured, raise the head and neck at about a 45-degree angle, keep the abdomen flat, and then elevate the legs from the hips.

Treat all severely injured victims for shock. Since 60 percent or more of the blood volume is in the venous system, raise the legs above the trunk.

Victims of shock often complain of being chilled, and first-aid manuals always advise keeping them warm. If you overheat the skin, however, you may cause vasodilation and divert blood from the core body circulation. Obviously, if you're treating a person outside in cold weather, you're going to have to keep him warm or hypothermia may develop.

Another thing first-aid manuals tend to recommend is giving liquids to shock victims. Do not give any liquids by mouth because their swallowing and gag reflexes may not be working, and if the victim has to go to surgery later on, intubation will be more dangerous. On the other hand, if you are many hours from medical care and the situation indicates that the victim is suffering from dehydration, you should give fluids.

Call the Utah Safety Council (533-5851 or toll-free 1 (800) 933-5943) about taking the new National Safety Council's first-aid course or becoming an instructor using state-of-the-art teaching materials.