Basic Medical Care and First Aid in "Yangye Medical" - Medical Care
Chapter 2: Basic Medical Care and First Aid
Most people who are injured or suffering from wilderness usually receive ambulances within a few hours to a day or two. However, special circumstances may sometimes prevent the injured from being evacuated in time. Some wounded patients may be able to self-recover to a walking level in a relatively short period of time without being evacuated.
Section 1: Nursing Care
All the injured who need to stay in bed (or place in sleeping bags) have a certain degree of care needs. This kind of nursing care is collectively referred to as medical care. Its basic purpose is simple: Let the injured person recover his own body.
Comfort and understanding of the injured
Regardless of the severity or type of medical condition, understanding and comforting the injured are the basics of medical care. Some victims have higher psychological comfort than others; others reject or hide themselves, especially young men. But no matter what kind of situation, it means that it is necessary to understand and comfort the injured.
rest
Rest has many benefits for rehabilitation. Physical and psychological stress is relieved; further damage is avoided. Rest can improve the body's nutrition, and the rest of the body's nutrition will be mainly used for rehabilitation. Injuries that have heart, lungs, and severe wounds, especially fractures, may require recovery from rehab, but in most cases there is no need for restricted activity. Usually, the injured can stay in the camp instead of continuing to hike or climb to speed up recovery.
Sedation
Injured patients below 3,000 meters above sea level can take sedatives to help sleep if there is no brain trauma or illness. However, at higher altitudes, sedative drugs should not be used. Such drugs inhibit the oxygen-carrying efficiency of sleep-related injuries and aggravate the symptoms of altitude sickness. Insomnia caused by altitude sickness and irregular nighttime breathing can be safely eliminated by taking Acetazolamide [drug] acetazolamide, acetazolamide (diuretics). (Chapter 21, "High Altitude-induced Disorders")
Analgesia
You can use analgesics safely in the outdoors, but it is also wise. There have been no cases of addiction due to the use of painkillers due to injuries, especially when such drugs are used only occasionally (used continuously for a week or week).
However, the risk of taking large doses of analgesics is that these drugs will further inhibit the brain activity of the injured, especially brain injury or illness, and their central nervous system has been weakened due to injury. The impaired respiratory function will further exacerbate the suppressed brain function - the symptoms are that breathing becomes more sluggish and shallow. However, at high altitudes, further suppression of respiratory function by anesthetics and sedatives may result in hypoxia. If there is severe brain trauma, the victim may stop breathing completely and cause disastrous consequences.
Don't: Don't take painkillers at high altitude for injuries with severe brain trauma!
However, for people who have no brain trauma, analgesics can comfortably relieve the discomfort and frustration caused by the pain. In many traumatic patients, the inhibition of pain can reduce the emotional impact of accidents. Analgesics can speed up recovery by promoting sleep in the affected person. Many wounded people are tortured at night because there is no other thing that distracts them. In cases where severe trauma occurs 3 to 4 days, sometimes longer, it is necessary to take large doses of analgesics.
Most analgesics have a significant sedative effect, and those who take painkillers do not need to take extra sedatives. Taking both drugs at the same time can be dangerous.
Avoid: Can not take painkillers and sedatives at the same time!
Keep warm
Must pay attention to the warmth of the injured! At low temperatures, the injured cannot rely on their own power to generate enough heat to maintain body temperature, even if placed in a sleeping bag. For example, a person who has lost temperature may need an additional source of heat, such as drinking plenty of hot water, passing more heat through the body of the companion, and so on. (Chapter 23, "Cold Damage")
Lower to lower altitude
Lowering from a height of more than 4,600 meters above sea level can help the recovery of the injured. Persons with cardiopulmonary disorders should be evacuated to the lowest possible altitude, preferably below 2,400 meters, and assisted with oxygen.
cough
Persons with limited mobility due to severe injuries often do not breathe heavily, especially when breathing causes pain. The consequence of impaired respiration is that the injured lung's lobe does not fully relax, causing the fluid to pool in areas that have failed to relax. These deposited fluids are ideal bed bases for the multiplication of pathogens that eventually lead to pneumonia! (These infections are the most common cause of death in elderly people with bed fractures).
The injured must actively or passively take a deep breath and cough, which can eliminate these effusions. Cough is particularly difficult for people with serious illnesses or severe trauma to the chest and abdomen. However, the probability of lung infection in such injuries is the greatest. The timely removal of effusions from the lungs is even more important! In hospitals, the usual way of doing this is to get the injured sitting up, grasping both sides of the body and allowing the victim to cough more deeply – not just cleaning up the shallow cough in the throat. This operation must be performed at least every 2 hours. In the open air, especially at high altitudes, similar operations should also be used. Lung function damage is particularly terrible at high altitudes!
Tip: Pulmonary effusions may develop bacteria that cause pneumonia but can be cleared by deep breathing and deep cough.
By adjusting the body posture, the removal of pulmonary effusions from injured patients can be promoted. If the head and chest are lower than the rest of the body, gravity can help clear the effusion. In the tent, this effect can be achieved by raising the abdomen and the following areas. When the injury recovers to the point where it can stand and walk, it is no longer necessary to remove the fluid from the lungs through forced cough or posture adjustment.
mobile
All those who need to stay in bed should be encouraged to get up and take action several times a day. Such exercise can promote blood circulation in the legs and avoid thrombophlebitis (see Chapter 10, Respiratory Dysfunction). The only exception to this principle is that the injured cannot act or have already developed thrombophlebitis. Such personnel should be absolutely recumbent until these problems are resolved.
Diet control
During illness, fluid supplements are more important than food intake. Unless the patient needs particularly mild food because of gastrointestinal ulcers, the injured diet should not be restricted. During the rehabilitation phase, more nutrients such as protein intake can be added.
Intestinal Care
Intestinal care for bed-wounded patients is also often required. The excretion of the injured person is suppressed, and food intake is reduced, often leading to dehydration and constipation. (See Chapter 12, "Gastrointestinal Disorders.") Even if the intake of solid foods reduces stool excretion, intestinal movement should occur every 3 or 4 days. The best way is to ensure adequate fluid intake. Adding coarse grains or fiber to food can increase the amount of bowel movements, which is helpful in cleaning up the intestinal tract. Try to avoid the use of enema and laxatives for patients who are bedridden.
Rehabilitation
Although moderate exercise should be encouraged, carrying out heavy-duty exercises too early may slow recovery, especially at high altitudes. In addition, people during rehabilitation are more prone to other sports injuries. In order to ensure complete recovery, it is necessary to postpone the full recovery of physical activity two or three days later.
Basic Medical Care and First Aid in "Yangye Medical"--Balance of Liquidity
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