Most hernias, whatever their size, manage to pass backwards and forwards through the weakness in the abdominal wall without becoming trapped in the opening. However, the contents of the hernia pouch may occasionally become trapped and compressed by the opening and it may be impossible to push them back into the abdomen. The circulation of blood to the contents may be cut off and if a portion of intestine has been trapped, intestinal obstruction may occur. This is known as strangulated hernia and, unless attempts to return the abdominal contents through the hernia weakness are successful, surgical operation will become urgently necessary.
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 legs raised at an angle of 45° and his buttocks on a pillow. In about 20 minutes, when the morphine has completely relieved the pain, try again by gentle manipulation to coax the hernia back into the abdomen. If you are not successful within 5 minutes, stop. In any event get RADIO MEDICAL ADVICE.
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II. Make a request of radio advice as if one of the crewmembers had a case of strangulated hernia.