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АНГЛИЙСКИЙ ЯЗЫК

АНГЛИЙСКИЙ ЯЗЫК - раздел Философия, Министерство Аграрной Политики Украины Керченский Государственный Мо...

Министерство аграрной политики Украины

Керченский государственный морской технологический университет

Кафедра иностранных языков

 

АНГЛИЙСКИЙ ЯЗЫК

Методические указания

к практическим занятиям и самостоятельной работе

по теме: «Основы судовой медицины»

для студентов направления 6.070104

специальности «Судовождение»,

«Судовождение и промышленное рыболовство»

дневной и заочной формы обучения

 

 

Керчь, 2009

 

Составитель: Чарова Ирина Витальевна, преподаватель кафедры иностранных языков Керченского Государственного морского технологического университета (КГМТУ)

 

 

Рецензенты: Маркевич Т.А. старший преподаватель кафедры иностранных языков КГМТУ;

Коробко Т.Н., старший преподаватель УТЦ КГМТУ, врач-терапевт высшей категории.

 

 

Методические указания рассмотрены и рекомендованы к утверждению на заседании кафедры иностранных языков КГМТУ,

протокол № 11 от 24.06.2009 г.

 

 

Методические указания рассмотрены и рекомендованы к утверждению на заседании методической комиссии МФ (ТФ) КГМТУ,

протокол № от

 

Методические указания утверждены на заседании Методического совета КГМТУ,

протокол № от

 

Ó Керченский государственный морской технологический университет

Содержание

 

Предисловие……………………………………………………………………… 4

Unit 1. ANATOMY AND PHYSIOLOGY…………………………………….…. 5

Unit 2. FIRST AID….……………………………………………………………...11

Unit 3. BASIC LIFE SUPPORT: ARTIFICIAL RESPIRATION AND HEART COMPRESSION…………………………………………………………………...14

Unit 4. SHOCK……………………………………………………….……………17

Unit 5. HISTORY - TAKING………………………………………………………19

Unit 6. BURNS AND SCALDS…………………………………………………...24

Unit 7. ABDOMINAL PAIN……………………………………………...……….27

Unit 8. INFECTIOUS DISEASES……………………………………...………… 32

Unit 9. FRACTURES………………………………………………………..……. 35

Unit 10. TOXIC HAZARDS OF CHEMICALS………………………………….. 38

ADDITIONAL TEXTS (HOME READING)………………………..……………41

Список использованной литературы…………………………………………….60

 

 

Предисловие

 

Данные методические указания представляют собой тексты по судовой медицине для изучения студентами старших курсов морских специальностей. Тематика объединяет различные аспекты медицинских знаний, адаптированные для судовых условий. Пособие интегрирует основные темы различных разделов («Анатомия и физиология», «Оказание первой помощи», «Инфекционные заболевания» и т.д.).

Методические указания направлены на развитие и совершенствование навыков прямого и обратного перевода, активных коммуникативных навыков для общения по заданной тематике. Материал изложен в соответствии с требованиями ИМО и ВОЗ, предъявляемых к судовой медицине и с учетом международной одобренной терминологии.


Unit 1

 

1. Read and translate the text

Anatomy and physiology

Treatment of illness on board ship requires some understanding of the anatomy and physiology of the human body.

The skeletal system

The skull forms a case that contains and protects the brain. It consists of many bones, firmly joined to one another except for the lower jaw, which moves at joints just in front of the ears. The skull rests on the upper end of the backbone, which is made up of a series of small bones placed on top of each other. These bones are called vertebrae and collectively compose the spinal column, within which is housed the spinal cord; nerves emerge from the cord at the level of each vertebra.

At the lower end of the backbone is the pelvis, formed by the hipbones, one on each side, which together form a basin to support the contents of the abdomen. On the outer side of either hip is a cup-shaped socket into which the rounded head of the femur (or thigh bone) fits, forming a ball-and-socket joint. The femur ends at the knee, where it forms a hinge-like joint with a strong tibia (shin bone), which can easily be felt under the skin. On the outer side of the shinbone is attached the slender fibula. In front of the knee-joint lies the patella (knee-cap), the shape of which can be easily felt. At the ankle the foot is joined to the lower ends of both the tibia and fibula by another hinged joint. The foot is made up of many small bones of different shapes. There are two bones in the great toe and three in each of the other toes.

Twelve ribs are attached to the backbone on either side. Each rib, with the exception of the two lowermost on each side, curves round the chest from the backbone to the sternum (breastbone) in front. The lowermost ribs have no attachment to the sternum in front. The ribs form the chest and protect the lungs, heart, and other internal organs. When you take a deep breath, your ribs move slightly upwards and outwards so as to expand your chest. The sternum, flat and danger-shaped, lies just under the skin of the front of the chest, and to its upper end is attached the clavicle (collar-bone). On the either side this bone goes out horizontally to the point of the shoulder and acts like an outrigger in keeping the shoulder in position. The outer end of the collar-bone joins with the scapula (shoulder-blade), which is triangular bone lying at the upper and outer part of the back on either side. Each scapula has a shallow socket into which fits the rounded upper end of the humerus (arm bone). At the elbow the arm bone forms another hinge-like joint with the radius and ulna (the forearm bones), and these join with the hand at the wrist. The wrist and hand, like the foot, are made up of many small bones. There are two bones in the thumb and three in each finger.

 

The muscular system

Voluntary muscles are found in the head, neck, limbs, back, and walls of the abdomen. They are attached to the bones by fibrous tissue, which is frequently in the form of a cord and is then called a tendon or leader. When a muscle contracts in response to an impulse sent to it through a nerve, it becomes shorter and thicker and draws the bones to which it is attached nearer to one another. The brain controls such movements.

Involuntary muscles are found in the stomach and intestines, heart, blood vessels, and other internal organs of the body. As the name indicates, they are not under the influence of the will, but function on their own, day and night.

 

The circulatory system (heart and blood vessels)

The body contains about five litres of blood, which circulates to all the tissues of the body. It is kept moving round the body by the heart, a muscular pump about the size of a clenched fist situated in the chest behind the breastbone, lying between the lungs, rather more on the left than on the right. The heart has two sides; the right side receives the venous blood coming back to it from the body in general and pumps it through the lungs, where it passes through minute tubes, gives up carbon dioxide, and takes up a supply of oxygen. The oxygenated blood now passes to the left side of the heart, which pumps it to all parts of the body through the arteries. This blood carries oxygen, food, water and salts to the tissues; it is bright red in colour. It also conveys heat to all parts of the body and contains various substances to counteract infections in the tissues. The arteries are like thick-walled tubes and decrease in diameter away from the heart. In the tissues the smallest blood vessels are very minute and are called capillaries. The blood, having supplied the tissues with oxygen and other substances and removed the carbon dioxide that has accumulated, becomes darker in colour. The capillaries take it into the veins, thin-walled tubes that carry the blood back to the right side of the heart.

Some of the blood passes to the stomach and intestines and, having taken up food products, carries them away to be stored in the liver. Blood is also taken by arteries to the kidneys and there gets rid of waste products, which are passed in the urine.

The digestive system and abdomen

Food in the mouth is broken up by chewing and tongue movements and mixed with saliva (spittle), which lubricates it and starts the digestive processes. When it is in a suitable state, it passes to the back of the throat, where muscular action forces it down the esophagus, or gullet, a muscular tube in the neck behind the windpipe. The gullet runs down the back of the chest between the two lungs, then passes through the diaphragm into the stomach.

The stomach lies mainly in the left upper part of the abdominal cavity, partly behind the lower left rib cartilages and just under the heart. When food enters stomach, various digestive juices act upon it, and the stomach muscles contract and relax, mixing it thoroughly. The capacity of the adult stomach is about one litre.

Still only partly digested, the food passes into the small intestine, where more digestive juices, especially those from the liver and pancreas, mix with it. Nourishment and fluids are absorbed from this coiled-up tube, which is about six metres long, and the residue of the food passes into the large intestine, or colon, at a point in the lower part of the right side of the abdomen, close to where the appendix is situated. In the large intestine more moisture is extracted from the food residue. At its far end, the large intestine joins the rectum, and here the unwanted food residue collects and is passed out of the body by the back passage or anus.

The liver secretes the important digestive juice called bile (a greenish/brownish fluid) and, on its surface, has a small reservoir called the gall-bladder, where a supply of bile is kept available. The liver also deals with, and stores, digested food materials.

The spleen is a solid oval-shaped organ in the upper part of the left side of the abdominal cavity at the back of the stomach, just above the kidney. Its functions are largely connected with the blood and it may be enlarged in certain diseases.

The urinary system

The kidneys are at the back of the upper part of the abdominal cavity, one on either side of the spine. They remove water and certain waste products from the blood and produce urine. Urine leaves each kidney by a small tube called the ureter, the two ureters entering the back of the bladder, which is a muscular bag situated in the front part of the cavity of the pelvis. Urine collects in the bladder and is expelled from it through a tube leaving its under-surface. This tube is called the urethra and in the male is contained in the penis.

The nervous system

The nervous system consists of the brain, the spinal cord, and nerves that issue from them. The brain, in the cavity of the skull, is a mass of nervous tissue. The coordinating center of the body, it acts like a computer, receiving messages through the incoming (sensory) nerves and the special nerves connected with sight, smell, hearing, etc., deciding on the action necessary, then sending out orders to the various parts of the body by the outgoing (motor) nerves.

The spinal cord is composed of similar tissue; it leaves the under-surface of the brain through an opening in the base of the skull and passes down a canal in the vertebral column. To pursue the analogy with the computer, it contains the trunk lines running between the brain and the various parts of the body and also a number of local nerve centers. At intervals down the spinal column, nerve trunks issue from the spinal cord containing both motor and sensory fibres; these nerves make contact with the muscles, which they cause to contract, and with the skin and other organs, where the sensory messages to the brain and spinal column start.

Autonomic nervous system

This is a fine network of nerve, which helps control the functions of various organs in the body. It too has local nerve centers, such as the solar plexus, which is situated in the upper part of the abdomen, behind the stomach. Although connected with certain parts of the brain, it is not controlled by the will but functions automatically day and night. It regulates the rate at which the heart pumps, in accordance with the demands of the various bodily systems at any particular time. It also helps control the muscles of the stomach and intestine and the rate and depth of breathing.

Skin

The skin covers and protects the body. It consists of two layers. The outer layer is hard, contains no blood vessels or nerves, and protects the inner layer, where the very sensitive nerve-endings lie. The skin contains numerous sweat glands, the roots of the hair, and special glands that lubricate the skin and the hair.

Sweat consists of water, salt, and other substances. Sweating cools the body and helps to regulate its temperature.

 

2. Answer the following questions

1. What are the main parts of the skeletal system?

2. What does the skull form?

3. Where is the skull situated?

4. What bones are called vertebrae?

5. Where is the pelvis located?

6. What types of muscles are found in the body?

7. How much blood does the body contain?

8. What is the heart?

9. What are the arteries (veins, capillaries)?

10. What are their functions?

11. What are the main parts of the digestive system?

12. Where is the stomach located?

13. How does the liver function?

14. Where are the kidneys located and what is their function?

15. What does the skin do in the body?

 

3. Find Russian equivalents of the following words

Skull, brain, jaw, joint, backbone, vertebrae, spinal column, pelvis, hipbone, femur, tibia (shin bone), fibula, patella, ankle, sternum, clavicle, scapula, humerus, ulna, cranium, carpals, ilium, coccyx, sacrum.

 

4. Fill in the blanks with the given below words

Kidneys, brain, stomach, spleen, abdomen

1. The skull forms a case that contains and protects the….

2. The solar plexus is situated in the upper part of the …, behind the stomach.

3. The … are at the back of the upper part of the abdominal cavity, one on either side of the spine.

4. The … lies mainly in the left upper part of the abdominal cavity.

5. The … is a solid oval-shaped organ in the upper part of the left side of the abdominal cavity.

 

5. Translate the following sentences from Russian into English

1. Организм человека состоит из множества клеток, тканей, органов.

2. Скелет - основа опорно-двигательного аппарата.

3. Скелет состоит из костей черепа, костей туловища, костей верхних и нижних конечностей.

4. Сердечно-сосудистая система образована из центрального органа – сердца и кровеносных сосудов разной величины – артерий, вен, капилляров.

5. Сердце – мышечный орган размером с кулак.

6. По кровеносным сосудам человека циркулирует около 5 литров крови.

7. Систему органов дыхания образуют носовая полость, горло, гортань, бронхи, легкие.

8. Пищеварительная система состоит из ротовой полости, глотки, пищевода, желудка, тонкого и толстого кишечника, а также желез пищеварительного тракта (печени, поджелудочной железы)

9. Мочевая система включает почки, мочеточники, мочевой пузырь и мочеиспускательный канал.

10. Кожа играет роль наружной оболочки и выполняет защитную функцию

 

6. Match the synonyms

1. Skull a. Vertebrae
2. Backbone b. Shoulder-blade
3. Femur c. Arm-bone
4. Tibia d. Cranium
5. Patella e. Fore-arm bones
6. Sternum f. Gullet
7. Clavicle g. Breastbone
8. Scapula h. Knee-cap
9. Humerus i. Thigh-bone
10. Radius & ulna j. Collar-bone
11. Esophagus k. Shin-bone
12. Pharynx  

7. Give English equivalents of the following words and expressions

Череп, челюсть, сустав, позвонок, позвоночник, таз, бедро, колено, лодыжка, ребро, грудная клетка, грудина, ключица, лопатка, локоть, брюшная полость, ткань, кишечник, сердце, кровеносный сосуд, пищевод, горло (гортань), дыхательное горло, желудок, поджелудочная железа, печень, селезенка, желчный пузырь, почка, мышца, кожа, железа, легкое.


Lexical Minimum I

Regions of the Body – Части тела

Front - Спереди

Back - Сзади

  Unit 2 1. Read and translate the text

Priorities

On finding a casualty:

· Look to your own safety: do not become the next casualty;

· If necessary, remove the casualty from danger or remove danger from the casualty. If there is only one unconscious or bleeding casualty (irrespective of the total number of casualties), give immediate treatment to that casualty only, and then send for help.

If there more than one unconscious or bleeding casualty:

· Send for help;

· Then start giving appropriate treatment to the worst casualty in the following order of priority: severe bleeding; stopped breathing/heart; unconsciousness.

 

General principles of first aid aboard ship

A rapid, emergency evaluation of the patient should be made immediately at the scene of the injury to determine the type and extent of the trauma.… In the case of an injured limb, get the sound limb out of the clothing first,… Keep workers from crowding round.

Unconscious casualties

The causes of unconsciousness are many and are often difficult to determine. Treatment varies with the cause, but in first aid it is usually not possible to make a diagnosis of the cause, let alone undertake treatment. The immediate threat to life may be: breathing obstructed by the tongue falling back and blocking the throat; stopped heart.

 

  1. Give a summary of the general principles applied when rendering the first aid.

 

  1. Read the following text. Retell this text in English

При несчастном случае необходимо внимательно осмотреть пострадавшего, перед тем как оказывать помощь. Обратите внимание на: 1) его реакцию; 2) его дыхание; 3) имеется ли кровотечение (где?) 4) находится ли он в состоянии шока или нет.

Если пострадавший в сознании

· Удобно разместите его, не оставляйте одного, разговаривайте с ним, пока не прибудет помощь, говорите ему, что сейчас ему помогут: страх ухудшает состояние пострадавшего; - укройте, защитите пострадавшего от вредного воздействия (дождь, снег, холод и т.д.); - ни в коем случае не давайте ему спиртного; - проверьте, удобно ли ему; наблюдайте за его самочувствием, настроением.

Если пострадавший в бессознательном состоянии

· Опустите челюсть пострадавшего так, чтобы рот был открыт; · Убедитесь, что дыхательные пути пострадавшего открыты; · Широко откройте свой рот и плотно прижмите его ко рту пострадавшего, при этом зажмите ему нос (ноздри);

UNIT 3

1. Read and translate the text

 

 

Basic life support:
artificial respiration and heart compression

Basic life support is an emergency life-saving procedure that consists of recognizing and correcting failure of the respiratory or cardiovascular systems.

Oxygen, which is present in the atmosphere in a concentration of about 21%, is essential for the life of all cells. The brain, the principal organ for conscious life, starts to die if deprived of oxygen for as little as four minutes. In the delivery of oxygen from the atmosphere to the brain cells, there are two necessary actions: breathing (taking in oxygen through the body's air pas sages) and the circulation of oxygen-enriched blood. Any profound disturbance of the airway, the breathing, or the circulation can promptly produce brain death.

Basic life support comprises the "ABC" steps, which concern the airway, breathing, and circulation respectively.

Its prompt application is indicated for:

A. Airway obstruction

B. Breathing (respiratory) arrest

C. Circulatory or Cardiac (heart) arrest.

Basic life support requires no instruments or supplies, and the correct application of the steps for dealing with the above three problems can maintain life until the patient recovers sufficiently to be transported to a hospital, where he can be provided with advanced life support. The latter consists of the use of certain equipment, cardiac monitoring, defibrillation, the maintenance of an intravenous lifeline, and the infusion of appropriate drugs.

Basic life support must be undertaken with the maximum sense of urgency.

Ideally, only seconds should intervene between recognizing the need and starting the treatment. Any inadequacy or absence of breathing or circulation must be determined immediately.

If breathing alone is inadequate or absent, all that is necessary is either to open the AIRWAY or to apply ARTIFICIAL RESPIRATION.

If circulation is also absent, artificial circulation must be instituted through HEART COMPRESSION, in combination with artificial respiration.

If breathing stops before the heart stops, enough oxygen will be available in the lungs to maintain life for several minutes. However, if heart arrest occurs first, delivery of oxygen to the brain ceases immediately. Brain damage is possible if the brain is deprived of oxygen for 4-6 minutes. Beyond 6 minutes without oxygen, brain damage is very likely.

It is thus clear why speed is essential in determining the need for basic life support and instituting the necessary measures.

Once you have started basic life support, do not interrupt it for more than 5 seconds for any reason, except when it is necessary to move the patient; even in that case, interruptions should not exceed 15 seconds each.

 

2. Remember the following information, make the short review of the points

Summary of points to be remembered when applying artificial respiration and heart compression

Don't delay - Place victim on his back on a hard surface. Step A. Airway - If patient is unconscious, open the airway; thereafter make…  

UNIT 4

1. Read and translate the text

 

 

SHOCK

  1. Fainting

Fainting is the emotional response of some individuals to trivial injuries so that they feel week and nauseated and may faint. This reaction is not serious and will disappear quickly if the casualty lies down.

 

Symptoms and signs include:

· Pale, waxy skin which is cold and clammy to the touch

· Pulse is usually slow at first and then becomes rapid during recovery

· Unconsciousness lasts only a few minutes, and the casualty recovers rapidly after he lies down

 

  1. Circulatory collapse and shock

Circulatory collapse is a disturbed distribution of blood within the body. Severe circulatory disturbances are called shock and result in serious impairment of vital organ functions due to an unsufficient supply of blood.

Burns, bleeding from the gut, fractures and other traumas may cause circulatory collapse and shock. Severe shock may threaten the life of the casualty.

Symptoms and signs include:

· Pale, waxy skin which is cold and clammy to the touch. Later the skin may develop a bluish, ashen colour

· Rapid and shallow or irregular and deep breathing

· Rapid, weak but false pulse

· Agitation at first but later the casualty becomes apathetic. Unconsciousness may follow this

· Large pupils, which do not react to light. LIFE IS IN DANGER.

· A reduction in the amount of urine passed, if this condition persists for more than one or two hours.

 

Further advice:

1. The casualty should be placed in a horizontal position. His legs should be elevated approximately 30 cm unless there is injury to the head, pelvis, spine or chest, or difficulty in breathing.

2. Loosen clothing around the neck

3. Check for a pulse. The best pulse to feel in an emergency is the carotid. Feel for five seconds before deciding it is absent. If it cannot be felt or is feeble, there is insufficient circulation and CPR (cardio-pulmonary resuscitation) may be necessary

4. Measure and record pulse and blood pressure every 15 minutes

5. Give oxygen at a flow rate of 8 litres per minute until symptoms resolve.

6. Keep the casualty warm.

 

2. Answer the following questions

  1. What is the difference between fainting and circulatory collapse?
  2. What should be done in case of fainting?
  3. What is the circulatory collapse, its signs and symptoms?
  4. What should one do in case of circulatory collapse?
  5. Why is circulatory collapse dangerous for life?

 

  1. Translate from Russian into English

Шок нельзя смешивать с обмороком (потерей сознания). Это обычно последствия несчастного случая, особенно мучительного в связи с потерей крови. Пострадавший бледен, поверхность кожи холодная, дыхание учащенное, пульс становится учащенным и слабым. Следует уложить пострадавшего на ровную поверхность, но так, чтобы ноги были выше головы (исключая случаи с ранением головы). Укрыть одеялом, к ногам приложить грелки. Если пострадавший в сознании, дать ему теплое питье (горячий чай, кофе и т.д.). Для поддержания сердечной деятельности дайте кордиамин (30-35 капель на рюмку воды) или 1-2 таблетки кофеина. Помните, что длительное пребывание в шоке может быть смертельным, поэтому всеми средствами пытайтесь остановить кровотечение и облегчить боль.

 


UNIT 5

 

1. Read and translate the text

History –taking

 

Taking the history is an important part of the examination and often a diagnosis may be made from the history alone. All possible information should be obtained and organized logically to tell the story of the patient’s illness.

The recorded history should begin with the time the patient first noted any symptoms of sickness, body changes, or a departure from good health. Symptoms and events up to the present time should be included. The dates or times at which various symptoms appeared should be noted as precisely as possible. The patient should be encouraged to talk freely, without interruption. Specific leading questions should be asked.

Some questions that will help the patient to give the history are:

- How did your illness start?

- What was the first symptom you noticed?

- How long have you had this?

- How and where does it affect you?

- What followed?

It is important to be specific about the main symptom or symptoms, such as pain in the abdomen or severe headache. Time should not be wasted on vague symptoms such as tiredness, weakness, and loss of appetite. These non-specific symptoms are a part of almost every illness. The patient should be asked if he has experienced similar symptoms or had the condition or problem before. He should be asked for the diagnosis of any similar situation in the past, the treatment that was prescribed and the medicaments he had taken. Also, any medicaments that the patient is currently taking should be noted, because his present illness might be a reaction to medication (for instance, allergy to penicillin or another drug.

 

Remember the following expressions

Запись в истории болезни – record in a case report Заполнение истории болезни – filling in a patient’s card Жалобы больного- patient’s complaints

In case of illness

Routine particulars about the ship

1.2. Call sign 1.3. Date and time (GMT/UTC) 1.4. Course, speed, position

Other comments

9. Comments by the radio doctor

 

In case of injury

Routine particulars about the ship

1.6. Call sign 1.7. Date and time (GMT/UTC) 1.8. Course, speed, position

Other comments

Make the following radio message Моторист, Н., 45 лет. Приступ сжимающей боли за грудиной, иррадиация в левое… Совет: симптомы указывают на стенокардию. Нитроглицерин под язык немедленно на месте возникновения приступа. Если в…

UNIT 6

1. Read and translate the text

Burns and Scalds

Clothing on fire

If someone’s clothing is on fire, by far the best way to put the fire out is to use a dry-powder extinguisher at once. If a dry-powder extinguisher is not available, then lay the person down and smother the flames by wrapping him in any available material, or throw bucketfuls of water over him, or use a hose, if available. Make sure that all smouldering clothing is extinguished.

Note: The powder from a fire extinguisher will not cause much, if any, eye damage. Most people shut their eyes tightly if sprayed with powder. Any powder in the eye should be washed out immediately after the fire has been extinguished and while burns are being cooled.

Heat burns and scalds

All heat burns should be cooled as quickly as possible with running cold water (sea or fresh), applied for at least ten minutes, or by immersion in basins of cold water. If it is not possible to cool a burn on the spot, the casualty should be taken to a place where cooling can be carried out. Try to remove clothing gently but do not tear off any that adheres to the skin. Then cover the burned areas with a dry, non-fluffy dressing larger than the burns, and bandage in place.

In cases of severe burns followed by shock, obtain RADIO MEDICAL ADVICE as soon as possible.

Electrical burns

Electrical lines may be removed from the casualty with a wooden pole, a chair, an insulated cord, or other non-metal object. Then check casualty immediately for breathing and heartbeat. If casualty is not breathing, give artificial respiration.

Chemical Splashes

Remove contaminated clothing. Drench casualty with water to wash the chemical from the eyes and skin. Give priority to washing the eyes, which are particularly vulnerable to chemical splashes. If only one eye is affected, incline the head to the side of the affected eye to prevent the chemical from running across into the other eye. Wash the chemical out of the eye with copious amounts of water as for long as is necessary to ensure that none remains (usually at least 10 minutes).

Care of burns and scalds

The treatment of burns and scalds is the same, whether they are caused by dry or wet heat.

Classification

Skin has an outer layer (epidermis) and a deep layer (dermis). The latter contains the sweat glands, hair follicles, and nerves relaying sensation and pain to the skin.

First-degree burns affect only the outer skin layer, causing redness, mild swelling, tenderness, and pain.

Second-degree burns extend into the deeper skin layer (dermis):

Superficial second-degree burns cause deep reddening, blister formation, considerable swelling and weeping of fluid.

Deep second-degree burns may not be easy to distinguish from third-degree burns immediately after the injury. Pain may be severe because of damage to the nerve endings.

Third-degree burns involve the whole thickness of skin, and may extend to the underlying fat, muscle, and bone. The skin may be charred, black or dark brown, leathery or white, according to the cause of the burn. Pain may be absent owing to destruction of the nerve endings.

Treatment

Pending his removal to hospital, put the patient to bed and seek to restore the fluid balance by encouraging him to drink as much as possible. Give… Leave blister intact, but clip off all the dead skin if blisters have burst.… Next cover the burn with neomycin ointment. Now apply a covering of absorbent material to absorb any fluid leaking…

Translate the following sentences from Russian into English

2. Ожоги первой степени затрагивают только наружный слой кожи, вызывая покраснение, умеренный отек, болезненность при прикосновении и боль. 3. При поверхностных ожогах второй степени возникает сильное покраснение,… 4. Ожоги третьей степени поражают кожу на всю ее глубину и могут захватывать подкожную жировую ткань, мышцы и…

UNIT 7

1. Read and translate the text

ABDOMINAL PAIN

This group of conditions includes indigestion, “wind”, flatulence, mild abdominal colic (spasmodic abdominal pain without vomiting or diarrhea and… Guard against total acceptance of the patient’s explanation of the causes of… General treatment

Appendicitis

The illness usually begins with a combination of colicky abdominal pain, nausea, and perhaps mild vomiting. The pain is usually felt in the midline… Examine the patient. If he complains of sharp stabbing pain when you press… Treatment

Закрытая травма живота

Боль в животе соответственно месту приложения травмирующего агента. При повреждении полого органа - признаки перитонита, газ в брюшной полости. При внутрибрюшном кровотечении – клиническая картина анемии, наличие свободной жидкости в брюшной полости, тахикардия, снижение артериального давления.

Помощь – оперативное лечение при наличии операционной и обученного медицинского персонала. При отсутствии одного из условий необходимо внутривенное введение кровезаменителей, плазмы, донорской крови 250-300 мл, противошоковых жидкостей, обезболивающих, в том числе наркотических анальгетиков, сердечно-сосудистых средств, витаминных препаратов. Антибиотики широкого спектра действия. Транспортировка в береговое лечебное учреждение.

 

  1. Retell the following texts briefly

Indigestion

The symptoms may include discomfort after eating, fullness in the upper stomach, bloating, belching, wind, heartburn, pain beneath the breastbone,… The causes of occasional attacks of acute indigestion are: · overeating, excessive drinking or smoking, and eating irritating foods; going to bed just after having a heavy…

Intestinal colic

Intestinal colic causes a griping pain, which comes and goes over the whole abdomen. The pain is due to strong contractions of the muscle round the bowel.

Intestinal colic is not a diagnosis; it is a symptom of many abdominal conditions, but commonly it is associated with food poisoning, the early stages of appendicitis, and any illness that causes diarrhea. However, the most serious condition associated with severe intestinal colic is intestinal obstruction.

Intestinal obstruction

In the early stages, the patient may often complain of an attack of wind and constipation. Later on he can pass neither wind nor faeces downwards. The patient's abdomen… General treatment

UNIT 8

1. Read and translate the text

INFECTIOUS DISEASES

The occurrence and spread of disease are determined by interplay of factors specific to the causative agent, the environment, and the individuals or… Infectious agents Organisms that produce disease in man range in size from the submicroscopic viruses to the tapeworm, which may attain…

Dysentery

Symptoms. – There may be slight attacks of diarrhea for several days and possibly chills and fever. Then stools increase in number and consist… Treatment. – Rest is essential even in mild cases and the patient should be… Prevention. – The early indication of the disease, strict control over the galley, health and hygiene by all the…

UNIT 9

1. Read and translate the text

Fractures

Careless handling of a patient may change a simple fracture into a compound one, by forcing jagged bone-ends through intact overlaying skin.… The following are indications that a bone is very probably broken: - The fact that a very heavy blow or other force has been applied to the body or limbs.

General treatment

RADIO MEDICAL ADVICE should be sought early in the case of a compound fracture or a severe type of fracture (skull, femur, pelvis, spine) because it might be necessary to evacuate the patient from the ship.

Unless there is an immediate danger of further injury, the patient should not be moved until bleeding is controlled and all fractures are immobilized by splinting.

 

Remember the following expressions

Types of fractures

Combined fracture – сочетанный перелом Comminuted fracture – оскольчатый перелом Сompound fracture - открытый перелом

Предполагаемый перелом

Если при несчастном случае возникает подозрение на перелом, крайне важно, чтобы пострадавший лежал неподвижно до прибытия квалифицированной помощи, не двигайте его. Если же он, в конце концов, должен быть передвинут – это необходимо делать с большой осторожностью и вниманием.

Переломы костей конечностей можно обнаружить по изменению их формы, хрусту (crunch), и резкой болезненности в месте перелома при движении. При переломах костей конечностей необходимо наложить шины поверх одежды, используя для этой цели стандартные металлические шины из аптечки или любой другой подручный материал. Применяйте шину такой длины, чтобы были неподвижными два сустава: выше и ниже перелома. При переломе ключицы или лопатки подвесьте руку на косынке, завязанной на шее. Для уменьшения болей давайте пострадавшему с переломом 3-4 таблетки анальгина (болеутоляющее) в сутки.

 

4. Read and translate the text

Internal Bleeding

Internal bleeding can be concealed or visible. Bleeding round a broken limb may be concealed but may be detectable because it causes a swelling, the… The casualty will be shocked. At first he will be pale, giddy, faint, and… The most important indication of continuing bleeding is a rising pulse and falling blood pressure. Anyone in whom…

UNIT 10

1. Read and translate the text

Toxic hazards of chemicals

Toxic substances can affect the body in various ways: · through the lungs by inhalation of toxic gases and fumes; · through the mouth and digestive system, if swallowed;

Diagnosis of poisoning

The diagnosis of poisoning may be simplified if one of the following factors point to the probable cause: · the circumstances of the incident, e.g. a leakage of chemicals; · the nature of the illness, and its relationship in time to recent exposure to chemicals;

Prevention of poisoning

Knowledge of the basic safety precautions and strict adherence to them by people working with dangerous goods, and also knowledge of the… For the handling of some dangerous goods, protective clothing (e.g. rubber or… In the event of leakage or spillage involving dangerous gas or fumes, the use of a gas detector is advised before a…

Food-borne diseases (food poisoning)

The term applies to: · diseases caused by microorganisms that multiply in the intestine, with or… · diseases caused by bacteria that produce enterotoxins (toxins that affect tissues of the intestinal mucosa) during…

Treatment

In severe cases, rest in bed for at least 24 hours, without solid foods, is indicated. Mild cases need only rehydration and a restricted diet.

Fluid should be given in as large a quantity as the dehydrated and thirsty patient demands and can tolerate. A solution of oral rehydration salts flavored with fruit juice should be used for this purpose.

When the diarrhea appears to have settled, a slow return to the normal diet can be made.

Prevention

Perishable food should be kept hot (over 60 °C) or cold (0-4 °C) and covered; it should not be kept at room temperature for longer than necessary. The temperature in the galley and mess refrigerators should be monitored daily and always kept in the "safe" range (0°C-4°C).

To prevent food-borne diseases, strict adherence to the principles of food hygiene is essential.

Botulism

Botulism is a food-borne disease of special significance, which may occur after consuming improperly processed foods; these may include canned foods, sausages, smoked or processed meats, and others.

Symptoms usually appear 1-2 days after eating contaminated food. They start with dry mouth, visual difficulty (blurred or double vision), and drooping of upper lids, followed by paralysis; sometimes vomiting and diarrhea also occur. The fatality rate is high.

In a suspected case of botulism, immediately obtain RADIO MEDICAL ADVICE on treatment.

Prevention

Never consume food from cans with bulging lids, or food that smells off

'.

4. Translate from Russian into English

Отравления

Следует как можно быстрее распознать, чем вызвано отравление (яд) и стремиться удалить яд (или его остатки) из организма. Для этого необходимо вызвать рвоту путем щекотания глотки, промыть кишечник сильнодействующими слабительным и клизмами. Использовать обильное питье для вывода яда через почки. Если больной пить не может внутривенно ввести физиологический раствор, а также 4,5% раствор глюкозы. Источники пищевых отравлений: бактериальные, ядовитая рыба, грибы. Признаки пищевых отравлений: недомогание, тошнота, рвота, понос, озноб, одышка, головокружение, боли в желудке и кишечнике.

Первая помощь: промывание желудка водой, водной взвесью активированного угля или слабый раствор марганцево-кислого калия. Внутрь активированный уголь по 2-3 таблетки в день, солевое слабительное.


Additional texts (Home Reading)

Headache

A headache is a symptom of an illness and not a disease in itself. Some of the more common causes of headache are listed below.

Common causes

· Onset of an acute illness, when headache is almost always associated with fever and feeling ill. Examples are influenza and infectious diseases such as measles, typhoid, etc.

· Common cold with associated sinusitis

· Over-indulgence in alcohol.

· Tension caused by worry, work, or family difficulties. Headaches of this kind are not associated with fever or feeling ill; they are sometimes associated with eye-strain.

Less common causes

· Brain disease; acute as with meningitis and less acute as with raised blood pressure (by no means a common symptom) and stroke. Treatment Always take the patient's temperature and if it is raised, put him to bed and watch for the possible development of…

Angina pectoris (pain in the chest)

When the attack ends (and never during it), the patient will describe a crushing or constricting pain or sensation felt behind the breastbone. The… Once the disease is established, attacks usually occur with gradually… General treatment

Specific treatment

If the patient is emotional or tense and anxious, give him 5 mg of diazepam at equal intervals, three times daily during waking hours, and, if he is… Warning. Sometimes angina pectoris appears abruptly and without exertion or… Frequent easily provoked attacks often precede a myocardial infarction. RADIO MEDICAL ADVICE should always be obtained…

Coronary thrombosis (myocardial infarction)

A heart attack happens suddenly and while the patient is at rest more frequently than during activity. The four main features are pain of similar distribution to that in angina, shortness of breath, vomiting, and a degree of collapse that may be severe. Sweating, nausea, and a sense of impending death are often associated features.

The pain varies in degree from mild to agonizing, but it is usually severe. The patient is often very restless and tries unsuccessfully to find a position that might ease the pain. Shortness of breath may be severe, and the skin is often grey with a blue tinge, cold, and covered in sweat. Vomiting is common in the early stage and may increase the state of collapse.

In mild attacks, the only symptom may be a continuing anginal type of pain with perhaps slight nausea. It is not unusual for the patient to believe mistakenly that he is suffering from a sudden attack of severe indigestion.

General treatment

The patient must rest at once, preferably in bed, in whatever position is most comfortable until he can be taken to hospital. Exertion of any kind must be forbidden and the nursing attention for complete bed rest provided. Restlessness, often a prominent feature, is usually manageable if adequate pain relief is given. Most patients prefer to lie back propped up by pillows, but some prefer to lean forward in a sitting position to assist breathing. An hourly record of temperature, pulse, and respiration should be kept. Smoking and alcohol should be forbidden.

Specific treatment

Whatever the severity of the attack, it is best to give all cases an initial dose of morphine, 15 mg intramuscularly, at once. If the patient is anxious or tense, give diazepam, 5 mg three times a day, until he can be placed under medical supervision. In serious or moderate attacks, give a further 15 mg of morphine, intramuscularly, 3-4 hours after the initial injection. The injection may be repeated every 4-6 hours as required for pain relief. Get RADIO MEDICAL ADVICE.

Specific problems in heart attacks

If the pulse rate is less than 60 per minute, give the patient atropine 1 mg intramuscularly, and raise the legs. The dose should be repeated after 4 hours, if the pulse rate remains less than 60 per minute. However, should a repeat dose become necessary, get RADIO MEDICAL ADVICE.

If the heart stops beating, get the patient on to a hard flat surface and give heart compression and artificial respiration at once.

If there is obvious breathlessness the patient should sit up. If this problem is associated with noisy, wet breathing and coughing give one 40-mg furosemide tablet, restrict fluids, start a fluid balance chart, and get RADIO MEDICAL ADVICE.

 

I. Read and translate the text.

II. Discuss the reasons of myocardial infarction


Heat exposure

 

Excessive heat may affect the body in a variety of ways, resulting in several conditions: heat stroke, heat cramps, and heat exhaustion.

Heat-stroke (sunstroke)

On physical examination, the skin is hot, flushed, and dry. In severe cases, tiny rounded haemorrhage spots may appear. Deep body temperature is… Because of the extreme seriousness of heatstroke, all members of the vessel's…

Treatment

  I. Read and translate the text. II. Remember how to prevent heat stroke

Hernia (rupture)

When a hernia is suspected, the patient must always be examined while standing. In the groin (inguinal hernia), the swelling of a rupture must not… It is sometimes possible to see and to feel an impulse transmitted to the…

Treatment

A person who knows he is ruptured has often learned to push the swelling back for himself. He should be removed from heavy work. An operation to cure the weakness is necessary. If the hernia is painful, the patient should be put to bed. Often the swelling can be replaced into the abdomen by gentle pressure when the patient is lying on his back with his knees drawn up. He should be kept in bed until he can be seen by a doctor at the next port.

Strangulated hernia

An injection of morphine sulfate, 15 mg intramuscularly (1 ½ ampoules), should be given at once. The patient should then lie in bed with his…   I. Read and translate the text

High blood pressure (hypertension)

As blood is pumped by the heart, it exerts a pressure on the walls of the arteries. This pressure -blood pressure - varies within normal limits.… The blood pressure is temporarily raised when a person is exposed to anxiety,… The onset of high blood pressure is usually slow. The early symptoms may include headaches, tiredness, vague ill…

High temperature (hyper pyrexia)

Treatment Any person who has a temperature of 40 С or more MUST be cooled rapidly until… If the brain centre that controls body temperature is damaged (in head injuries, with compression of the brain), heat…

Sore throat

Most sore throats are associated with the winter ailments of coughs and colds. Some are caused by the inhalation of irritants or the consumption of… Tonsillitis This is the inflammation of the tonsils, the fleshy lumps on either side of the back of the throat. The symptoms are…

General treatment for sore throats

Patients with sore throats should not smoke. For simple tonsillitis or sore throat, gargling with warm salt water (a… Give patients with only a mild sore throat, and no general symptoms of illness and fever, acetylsalicylic acid or…

Peritonsillar abscess (quinsy)

General treatment The patient should be put to bed and his temperature, pulse, and respiration… Specific treatment

Stroke and paralysis (cerebrovascular accident)

Stroke

A stroke occurs when the blood supply to some part of the brain is interrupted. This is generally caused by:

· a blood clot forming in the blood vessel (cerebral thrombosis)

· a rupture of the blood vessel wall (cerebral haemorrhage)

· obstruction of a cerebral blood vessel by a clot or other material from another part of the vascular system (cerebral embolism)

· pressure on a blood vessel, e.g., by a tumour.

A stroke can be a complication of high blood pressure.

A stroke generally occurs suddenly, usually in middle-aged or old people, without warning signs. In more severe cases, there is a rapidly developing loss of consciousness and a flabby, relaxed paralysis of the affected side of the body. Headache, nausea, vomiting, and convulsions may be present. The face is usually flushed, but may become pale or ashen. The pupils of the eyes are often unequal in size. The pulse is usually full and rapid, and breathing is laboured and irregular. The mouth may be drawn to one side and often there is difficulty in speaking and swallowing.

The specific symptoms will vary with the site of the lesion and the extent of brain damage. In mild cases, there may be no loss of consciousness and paralysis may be limited to weakness on one side of the body.

In a severe stroke there is loss of consciousness, the breathing is heavy and laboured, and the patient may lapse into a coma and die.

The outcome of a stroke will depend upon the degree of brain compression or damage. When it is fatal, death usually occurs in 2-14 days and seldom at the time of the attack. Most patients with first or second attacks recover, but recurrent attacks are likely. The extent of permanent paralysis will not be determined for at least 6 months.

Treatment

Good nursing care is essential after a stroke. The patient should be undressed as gently as possible and placed in bed with the trunk of the body, shoulders, and head elevated slightly on pillows. An attendant should be assigned to stay with the patient. Extra care should be taken to prevent the patient from choking on saliva or vomit. The patient's head should be turned to one side so that fluids can flow out of the mouth. Mucus and food debris should be removed from the mouth with a piece of cloth wrapped round a finger. If there is fever, cold compresses should be applied to the forehead. If the patient is conscious and able to swallow, liquid and soft foods may be given. To prevent bedsores the patient should be kept clean and turned to a different position in bed every 3-4 hours. Bowel regularity should be maintained.

RADIO MEDICAL ADVICE must be obtained, and early evacuation to hospital should be anticipated.

 

I. Read and translate the text

II. Speak on your actions if someone on board has a cerebrovascular accident.


 

Medical care of castaways and rescued persons

Abandonment of vessel

Forced immersion is the primary hazard to life after surviving the initial impact of hitting the water. It should be kept in mind that no ocean or… The loss of body heat is one of the greatest hazards to the survival of a… The extent to which generalized hypothermia threatens life is determined by the water temperature and the length of…

Survivor pick-up by survival craft (lifeboat or raft)

When injury to a survivor is suspected, the methods used in transferring him to the survival craft should be the same as those outlined in the… The captain of the survival craft must be the one to decide how long…

Immediate medical problems aboard survival craft

Injuries should be handled as outlined in Chap­ter 4. However, a prepared medical survival kit might not be available, so the rescuers will have to… The first objective in caring for any injured per­son is to provide… · controlling haemorrhage with direct pressure;

Other medical problems aboard survival craft

Seasickness (motion sickness) is an acute illness characterized by loss of appetite, nausea, dizziness, and vomiting. Preventive measures are often… Sunburn Sunburn is one of the principal medical hazards of survival on the open sea, regardless of latitude. It may vary from…

Medical problems of the rescued castaway on board the rescue vessel

Personnel on the rescue vessel should rapidly sort all survivors, according to their physical condition, into: a. those with minor injuries whose condition will not be worsened by delay in… b. those who are sick or injured but potentially treatable with the facilities at hand.

Generalized immersion hypothermia aboard the rescue vessel

Seawater freezes at -2°C. It may be assumed that most polar water with ice is as cold as this. In polar water, the body temperature falls very… The rectal temperature should be taken in people rescued from cold water. This… When the rectal temperature is below 35 °C, hypothermia progressively lowers the basal metabolic rate, heart rate,…

Contamination with oil

Dehydration and malnutrition

  I. Read and translate the text II. Give a summary of aspects to be paid attention in the process of medical care of castaways and rescued persons …

Список использованной литературы

 

1. Англо-русский медицинский словарь.

2. Кролик Н.И. пособие по английскому языку для старших курсов лечебных факультетов медицинских вузов: Учебн. пособие. – М.: Высш. шк., 1983-128 с.

3. Русско-английский медицинский словарь-разговорник. - М: Рус.яз., 1987.

4. Справочник судового врача. / под ред. Лобенко А.А. – Киев: Здоров´я, 1983.

5. International Medical Guide for Ships. WHO, Geneva, 1988

 

 

Ó Ирина Витальевна Чарова

 

Методические указания

к практическим занятиям и самостоятельной работе

по теме: «Основы судовой медицины»

для студентов направления 6.070104

специальности «Судовождение»,

«Судовождение и промышленное рыболовство»

дневной и заочной формы обучения

 

 

Тираж_____экз. Подписано к печати_____________.

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98309 г. Керчь, Орджоникидзе, 82.

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