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Delaware Health Alert Network #48

September 19, 2003 2:00 pm

Health Advisory

Hurricanes and other major storms can leave destruction, flooding, and dangerous situations in their wake. Delaware's Division of Public Health (DPH) reminds Delawareans to allow officials to first declare an area safe before entering, and to observe safety precautions. Disaster clean-up crews will encounter hazards including floodwaters, falling or floating building debris, fires, and chemicals such as poisonous gases. They should be alert to the potential for bloodborne pathogens such as hepatitis from sewage or HIV from blood or other bodily fluids.

Broken Limbs

If a person suffers pain in a joint or limb, cannot bear weight or use it, or if there is an obvious deformity, the limb should be splinted if possible and iced. Seek medical attention. Persons with broken limbs should call 911.

If someone suffering a limb injury is unsure if it is broken, elevate the limb above the heart, wrap with an elastic bandage and ice. If the limb causes extensive pain for more than 30 minutes seek medical attention.


Emotional and physical stress from a disaster may cause persons with pre-existing heart conditions to experience health problems. Emergency response workers and homeowners who are cleaning up after a hurricane should not work to the level where they feel over-tired. Instead work in short intervals with frequent rest periods. Workers with heart problems should not lift exceptionally heavy objects. If workers experience chest discomfort or tightness, shortness of breath, a fluttering sensation in the chest, sweating, or pain or numbness in the arms, neck or jaw, they should immediately stop working, rest and call 911. Such symptoms could indicate a heart attack.

Cuts and Minor Wounds

If there is a large amount of bleeding, apply direct pressure to the wound. If the bleeding does not stop after 5-10 minutes of direct pressure, seek medical attention. If the patient becomes lightheaded or weak due to a large amount of blood loss, call 911.

For minor wounds, after bleeding is controlled, wash the area with soap and water, apply an antibiotic ointment and cover. Keep the wound clean and dry for at least 24 hours.

If the wound is over a joint, clean it thoroughly with soap and water, apply an antibiotic ointment as directed, bandage, keep the area clean and then splint the joint. This will help prevent the wound from reopening. Depending on the wound location and severity, a health care provider's opinion should be sought on the need for stitches. Sutures are used to close wounds to improve healing and wound appearance after healing. If blood is spurting from the wound or it does not stop bleeding, seek medical care.

A tetanus boost may be required if the injured person has not had a tetanus shot within the last ten years, or within the last five years if the wound is obviously contaminated with flood water, feces, soil or saliva.


To treat diarrhea, drink plenty of fluids to replace the fluids lost. If diarrhea or weakness persists longer than 24 hours, consult a physician. If nausea and vomiting accompanies the diarrhea, consult a physician immediately.


People responding to hurricane and flood cleanup often work long, grueling hours under dangerous and stressful circumstances. To reduce the risk of injury and illness, responders should:

  • Set priorities for cleanup tasks and pace the work. Avoid physical exhaustion.
  • Resume a normal sleep schedule as quickly as possible.
  • Be alert to emotional exhaustion or strain. Consult family members, friends or professionals for emotional support.

Eye Care

Emergency responders should wear their issued protective gear, taking special care to protect their eyes from injury. Welders, chain saw operators and rescue personnel, including volunteers, should know how to use tools properly and wear protective eye gear. Clean-up crews and emergency responders should have eyewash or sterile eye solutions on site, preferably in a first aid kit.

If there is a foreign object in the eye, do not rub it. Use eyewash and flush the eye. See a doctor if the object does not wash out or if it causes pain or redness. If the eye is cut or punctured, do not wash out the eye and do not try to remove the foreign object. Stabilize the eye with a rigid shield without pressure such as the bottom half of a paper cup, and seek emergency care.

Chemical eye burns require the eye to be immediately flushed with water or any drinkable liquid, whether or not there is a contact lens in the eye. Open the eye as wide as possible. Continue flushing for at least 15 minutes. For caustic or basic solutions, continue flushing while en route to emergency care.

Head Injuries

The most severe head injuries involve loss of consciousness and a change in mental status, such as the patient becoming disoriented and unable to talk sensibly. For these types of head injuries call 911.

If children become sleepy after a head injury and vomit two to three times, parents or caregivers should call 911.


For an isolated rash wash the area thoroughly with soap and water. Apply antihistamine cream as directed. Keep out of the sun and as cool as possible. If itching continues, apply calamine lotion as directed.

If a fever accompanies a rash, this may be an indication of measles or a similar contagious viral disease. In the event of a fever with a rash take non-aspirin pain tablets, rest, keep cool, and stay away from other people. If the fever does not subside in 48 hours, see a physician.

Cellulitis, or infection of the skin can occurs after a small wound. Symptoms of Cellulitis include the area around the wound becoming warm, tender and red, and possibly developing red streaks toward the body. Elevate the area, apply warm compresses and seek medical attention. The treating health professional will likely prescribe an antibiotic and will review the patient's need for a tetanus shot. Diabetics and patients with circulation problems or immune system diseases with cellulites should seek medical attention immediately.

Sprains and Strains, Including Back Strain

Follow the R-I-C-E acronym:

R: Rest - Stop what you are doing as soon as it is safe to do so.

I: Ice - Apply an ice or cold pack to the area. If using ice, wrap in a towel; do not apply ice directly to the skin. Once the swelling has gone down you my use heat for pain relief.

C: Compression - Wrap affected area in an elastic bandage to immobilize the injury. Do not wrap so tightly that circulation becomes impaired.

E: Elevation - Keep the affected limb elevated.

For back strain, stop the activity that hurts and rest. Ice the injured back for 24-48 hours. Take over-the-counter pain medication as directed. On the third day, apply moist heat for 15-30 minutes four to five times per day. If symptoms persist, seek medical attention.

For more information or other public health concerns, contact the Division of Public Health at 1-888-459-2943.

Categories of Health Alert messages:

  • Health Alert: Conveys the highest level of importance; warrants immediate action or attention.
  • Health Advisory: Provides important information for a specific incident or situation; may not require immediate action.
  • Health Update: Provides updated information regarding an incident or situation; unlikely to require immediate action.
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