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, etc.
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 casualty's body, breath, or clothing.
Special Emergency Care Procedures
Special emergency care procedures common to the emergency treatment of practically all casualties include:
Administering morphine
Intravenous infusion of fluids
Transporting an IV casualty
ADMINISTERING MORPHINE.
- Morphine 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 casualty's 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 officer.
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 the airway
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 site.
WARNING
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 water. 2. Disinfect the injection site if you have the time 3. Remove the plastic hood from the syrette. 13-13