detected in the primary examination. Use common
sense: do not remove wound dressings, pull off
clothing attached to the wound, or probe the wound.
During the examination:
Look for discolorations, wounds, unusual chest
movements, deformities, penetrations, vomit,
Listen for changes in breathing patterns,
unusual breathing sounds, and grating noises
made by the ends of broken bones.
Feel for deformities, wounds, swelling,
abnormal hardness or softness, tenderness,
spasms, and skin temperature.
Smell for any unusual odors coming from the
casualtys body, breath, or clothing.
Special Emergency Care Procedures
Special emergency care procedures common to the
emergency treatment of practically all casualties
Intravenous infusion of fluids
Transporting an IV casualty
is the most effective of all available pain-relieving
drugs. When administered properly, it can relieve
severe pain and prevent shock.
As a dental assistant, you will not ordinarily
administer morphine. Experienced medical personnel
make the decision to administer this drug. But
situations do arise, such as mass casualties, when you
may be issued syrettes containing 1/4 grain of
morphine (fig. 13-11).
You may give one syrette of morphine to a casualty
suffering severe pain. You may give a second syrette
only if a casualtys severe pain persists and at least 4
hours have passed since you administered the first
syrette. After this, do not administer any more
morphine unless told to do so by a medical or dental
MORPHINE CANNOT BE GIVEN TO ALL
CASUALTIES WHO SUFFER SEVERE PAIN.
Administer morphine only if the pain is very severe
and only if there is:
No head, neck, or spine injury
No chest injury
Figure 13-11.Morphine syrette.
No airway obstruction or impairment
No wound of the throat, nasal passages, mouth,
or jaws from which blood might flow to obstruct
No evidence of severe or deepening shock
No loss of consciousness
If you administer morphine in a mass casualty
situation, you should:
1. Select an injection site. The best site is the
muscle on the back of the upper arm. If both arms are
injured, you may use a thigh or buttock as an injection
If a tourniquet has been applied to the arm or the
thigh, you must inject the morphine between the
tourniquet and the main part of the body, if no other
extremity is available.
and the materials. Swab the injection site with alcohol
or any skin antiseptic. If no antiseptic is available, wash
the injection site with soap and water, or with plain tap
2. Disinfect the injection site if you have the time
3. Remove the plastic hood from the syrette.