Medical problems of the rescued castaway on board the rescue vessel
Medical problems of the rescued castaway on board the rescue vessel - раздел Философия, АНГЛИЙСКИЙ ЯЗЫК The Treatment Of Survivors Will Depend On The Nature Of The Rescue Facility A...
The treatment of survivors will depend on the nature of the rescue facility and the number and medical condition of the survivors.
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 treatment (to be treated last or as time permits);
b. those who are sick or injured but potentially treatable with the facilities at hand.
The latter group includes those who urgently require medical attention. Some persons in this group may be given first aid and relegated to group (a). For example, a broken arm could be splinted quickly and set later, after other more critical problems have been taken care of.
Victims rescued from drowning must receive immediate treatment.
Every submersion victim, even one requiring minimal treatment, should preferably be evacuated to a hospital for follow-up care.
Cold exposure injuries (local)
Cold injuries to parts of the body (face, extremities) are caused by exposure of tissues and small surface blood vessels to abnormally low temperatures. The extent of the injury depends upon such factors as temperature, duration ofexposure, wind velocity, humidity, lack of protective clothing, or presence of wet clothing. Also, the harmful effects of exposure to cold are intensified by fatigue, individual susceptibility, existing injuries, emotional stress, smoking, and drinking alcohol.
Cold injuries to parts of the body fall into three main categories: chilblains, immersion foot, and frost-bite.
Chilblains
This relatively mild form of cold injury occurs in moderately cold climates with high humidity and temperatures above freezing (0-16 °C). Chilblains usually affect ears, fingers, and the back of the hand; but they may affect the lower extremities, especially the anterior tibial surface of the legs.
They are characterized .by the skin burning a bluish red and by a mild swelling often associated with an itching, burning sensation, which may be aggravated by warmth. If exposure is brief, these manifestations may disappear completely with no remaining signs. However, intermittent exposure results in the development of chronic manifestations, such as increased swelling, further discoloration of the skin (which becomes a deep reddish purple), blisters, and bleeding ulcers which heal slowly to leave numerous pigmented scars.
Treatment. For skin discomfort, apply a bland soothing ointment such as petrolatum. People susceptible to chilblains should avoid the cold or wear woolen socks and gloves.
Immersion foot
This form of cold injury is caused by exposure of the lower extremities to water at above-freezing temperatures, usually below 10CC, for more than 12 hours. It characteristically occurs among shipwrecked sailors existing on lifeboats or rafts in enforced inactivity, with a poor diet, with wet and constricting clothing, and in adverse weather conditions. Clinical manifestations include swelling of the feet and lower portions of the legs, numbness, tingling, itching, pain, cramps, and skin discoloration. In cases of immersion foot uncomplicated by trauma, there is usually no tissue destruction.
Treatment. After rescue every effort should be made to avoid rapid rewarming of the affected limbs. Care should be taken to avoid damaging the skin or breaking blisters. Do not massage affected limbs.
Prevention. Every effort should be made by survivors to keep their feet warm and dry. Shoelaces should be loosened; the feet should be raised and toe and ankle exercises encouraged several times a day. When possible, shoes should be removed and unwanted spare clothing may be wrapped round the feet to keep them warm. Smoking should be discouraged.
Frost-bite
This is the term applied to cold injuries where there is destruction of tissue by freezing. It is the most serious form of localized cold injury. Although the area of frozen tissue is usually small, frostbite may cover, a considerable area. The fingers, toes, cheeks, ears, and nose are the most commonly affected parts of the body. If exposure is prolonged, the freezing may extend up the arms and legs. Ice crystals in the skin and other tissues cause the area to appear white or greyish-yellow in color. Pain may occur early and subside. Often, the affected part will feel only very cold and numb, and there may be a tingling, stinging, or aching sensation. The patient may not be aware of frostbite until someone mentions it. When the damage is superficial, the surface will feel hard and the underlying tissue soft when depressed gently and firmly. In a deep, unthawed frostbite, the area will feel hard and solid and cannot be depressed. It will be cold and numb, and blisters will appear on the surface and in the underlying tissues in 12-36 hours. The area will become red and swollen when it thaws, gangrene will occur later, and there will be a loss of tissue (necrosis). Time alone will reveal the kind of frostbite that has been present. It is fortunate therefore that the treatment for various degrees of frostbite is identical except for superficial frostbite. A frostbite of the superficial, dry, freezing type should be thawed immediately to prevent a deep-freezing injury of the part involved. However, never thaw a frozen extremity before arriving at a facility with water, heat, and equipment where the extremity can be rewarmed rapidly.
Treatment. All freezing injuries follow the same sequence in treatment: first aid, rapid rewarming, and care after first aid.
{a) First aid. The principles of first aid in localized cold injury are relatively few. The two most important things are to get the patient to a place of permanent treatment as soon as possible and then to rewarm him. It is important to note that a patient can walk for great distances on frostbitten feet with little danger. Once rewarming has started, it must be maintained. All patients with local cold injuries to the lower extremities become litter cases. Refreezing or walking on a partially thawed part can be very harmful. During transportation and initial treatment, the use of alcoholic drinks should not be permitted, because they affect capillary circulation and cause a loss of body heat. Ointments or creams should not be applied.
(b) Rapid rewarming. The technique of rewarming has two phases: (1) treatment of exposure; and (2) treatment of the local cold injury. Treatment of exposure consists of actively rewarming the patient. This is done in principle by the removal of cold and the addition of warmth. Removal of cold is accomplished by removal of all cold and wet clothing and constricting items such as shoes and socks. Addition of warmth is provided from external and internal source External warmth is added by providing the patient with prewarmed clothes and blankets. Giving a patient a cold change of clothes, a cold blanket, or a cold sleeping-bag will cause a rapid dissipation of his residual heat. If necessary, it would be better to have someone give the clothing he is wearing to the patient. Someone should warm the patient's sleeping bag before he gets into it. A good source of warmth is the body heat of other people. In general, internal warmth is provided by hot liquids and an adequate diet.
(c) Care after first aid. After the rewarming of a cold injury to a lower extremity, the patient is treated as a litter case. All constricting clothing items should be removed, total body warmth should be maintained, and sleep should be encouraged.
After rewarming, the affected part should be cleansed carefully with water, or soap and water, taking care to leave the blisters intact. A soft sterile dressing should be applied. Dry, sterile gauze should be placed between toes and fingers to keep them separated. The patient should be placed in bed with the affected part elevated and protected from contact with the bedding.
If available, a bed cradle can be used, or one can be improvised from boxes to keep sheets and blankets from touching the affected area. Additional heat should not be applied.
Morphine sulfate, 10 mg,may be given intramuscularly for pain and repeated every 4 hours as needed, but only if RADIO MEDICAL ADVICE recommends it.
Front - Спереди
Frontal region of the head – Лобная часть головы Side of head – Височная часть головы Top of head - Макушка Face – Лицо Cheek - Щека Jaw - Челюсть
Back - Сзади
Back of head - затылок Back of neck – Шея (сзади) Back of shoulder - Плечо Scapula region - Лопатка Elbow - локоть Back upper arm – Верхняя часть
General principles of first aid aboard ship
First aid must be administered immediately to: restore breathing and heart-beat, control bleeding, remove poisons, prevent further injury to the patient (for instance, his removal from a room conta
Если пострадавший в бессознательном состоянии
· Положите пострадавшего на спину и расположите голову так, чтобы подбородок был приподнят;
· Опустите челюсть пострадавшего так, чтобы рот был открыт;
· Убедитесь, что дыхательны
Remember the following expressions
Тщательно составленная история болезни – careful history
Запись в истории болезни – record in a case report
Заполнение истории болезни – filling in a patient’s card
Жалоб
Routine particulars about the ship
1.1. Name of ship
1.2. Call sign
1.3. Date and time (GMT/UTC)
1.4. Course, speed, position
1.5.1. Port of destination is … and is … hours/days away
1.5.
Routine particulars about the ship
1.5. Name of ship
1.6. Call sign
1.7. Date and time (GMT/UTC)
1.8. Course, speed, position
1.5.1. Port of destination is … and is … hours/days away
1.5.
Other comments
Comments by the radio doctor
Make the following radio message Моторист, Н., 45 лет. Приступ сжимающей боли за грудиной, иррадиация в левое плечо
Electrical burns
Make sure you do not become the next casualty when approaching any person who is in contact with electricity. If possible, switch off the current. Otherwise, insulate yourself before approaching an
Treatment
Try to remove patient to hospital within 6 hours, otherwise seek RADIO MEDICAL ADVICE in the case of:
third-degree burns; babies; burns of face and genitalia, and l
Translate the following sentences from Russian into English
1. Ожоги, вызванные сухим и влажным жаром, лечат одинаково.
2. Ожоги первой степени затрагивают только наружный слой кожи, вызывая покраснение, умеренный отек, болезненность при прикоснове
ABDOMINAL PAIN
Minor Abdominal Conditions
This group of conditions includes indigestion, “wind”, flatulence, mild abdominal colic (spasmodic abdominal pain without vomiting or diarrhea and fever),
Appendicitis
Appendicitis is the commonest abdominal emergency, occurring mostly in people under 30 years old, though it can appear in people of any age. When considering appendicitis as a diagnosis, always ask
Indigestion
Indigestion occurs when food fails to undergo the normal changes of digestion in the alimentary canal. It is a symptom and not a disease. Occasional indigestion may be of no consequence, but chroni
Intestinal obstruction
Intestinal obstruction may come on either slowly or suddenly; a common cause is a strangulated hernia. The bowel will always try to push intestinal contents past any obstruction, and as it does so
INFECTIOUS DISEASES
Communicable diseases are those that can be transmitted from one person (or animal) to another. There may be direct or indirect transmission to a well person from an infected person or animal – at
Dysentery
This disease is due to bacteria taken into the system through water or food and usually occurs in tropical and semitropical countries. This bacteria cause severe inflammation of the mucous membrane
Fractures
A fracture is a broken bone. The bone may be broken into two or more pieces or it may have a linear crack. Fractures are described as closed if the skin remains unbroken. If there is a wound at or
Internal Bleeding
Internal bleeding may result from a direct blow to the body, from strains, and from diseases such as peptic ulcer.
Internal bleeding can be concealed or visible. Bleeding round a broken li
Toxic hazards of chemicals
Ships carry a number of substances in addition to cargo that are potentially toxic. For instance, medicines are not generally poisonous but can become so if taken other than prescribed. Then there
Diagnosis of poisoning
General Principles
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 lea
Prevention of poisoning
Remember: Prevention is better than cure
Knowledge of the basic safety precautions and strict adherence to them by people working with dangerous goods, and also knowledge
Food-borne diseases (food poisoning)
Food-borne diseases - some forms of which are sometimes also referred to as food poisoning - are illnesses of an infectious or toxic nature caused, or thought to be caused, by the consumption of fo
Less common causes
· Migraine, which usually occurs only on one side of the head and is associated with vomiting and visual disturbances such as flashing lights.
· Brain disease; acute as with meningitis and
Angina pectoris (pain in the chest)
Angina usually affects those of middle age and upwards. The pain varies from patient to patient in frequency of occurrence, type, and severity. It is most often brought on by physical exertion (ang
Specific treatment
Pain can be relieved by sucking (not swallowing) a tablet of glyceryl trinitrate (0.5 mg). The tablet should be allowed to dissolve slowly under the tongue. These tablets can be used as often as ne
Heat-stroke (sunstroke)
Heat-stroke is a medical emergency that is associated with a potentially high mortality rate. It occurs when the body's main mechanism of heat loss (evaporation of sweat) is blocked. There m
Treatment
Immediate treatment must be given to reduce the body temperature, or brain damage and death may occur. The patient should be undressed and placed in a tub of cold (around 20 °C) water; or co
Hernia (rupture)
The abdominal cavity is a large enclosed space lined by a sheet of tissue. The muscles of the abdominal wall resist the varying changes of pressure within the cavity. Increased pressure may force t
Strangulated hernia
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 pouc
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. During activity it tends to be highe
High temperature (hyper pyrexia)
Hyper pyrexia is the word used to describe too high a body temperature, i.e., one of 40 °C or higher. Such temperatures can be dangerous to the survival of the individual and require careful manage
Sore throat
A common complaint, sore throat may be local or it may be part of a serious illness. Tonsillitis (inflammation of the tonsils) and abscesses in the tissues of the tonsillar area are examples of loc
General treatment for sore throats
Take the patient's temperature, and feel for tender enlarged glands in the neck.
Patients with sore throats should not smoke.
For simple tonsillitis or sore throat, gargling with
Peritonsillar abscess (quinsy)
This is an abscess that can follow tonsillitis. It forms normally round one tonsil, and the swelling pushes the tonsil downwards into the mouth. The patient may find it so difficult and painful to
Abandonment of vessel
Lifeboat drills must be conducted to prepare for possible disaster. Both crew and passengers must be instructed in the procedures to be followed. Reasons for such instruction should be given to all
Survivor pick-up by survival craft (lifeboat or raft)
Surviving in a lifeboat or life-craft (hereafter referred to as "the survival craft") is one of the most strenuous ordeals an individual can face. It involves combat against all the eleme
Immediate medical problems aboard survival craft
Trauma
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 improvise. The following m
Other medical problems aboard survival craft
Seasickness
Seasickness (motion sickness) is an acute illness characterized by loss of appetite, nausea, dizziness, and vomiting. Preventive measures are often effective.
Generalized immersion hypothermia aboard the rescue vessel
At environmental temperatures of less than 20-21 °C, man's survival depends upon insulation (body fat, clothing), the ratio of body surface to volume, the basal metabolic rate, and the w
Contamination with oil
Do not clean oil off the skin (except round the mouth and eyes) until the person is warm and comfortable. Survivors who have recovered from hypothermia can taken to a warm shower or bathroom and sh
Dehydration and malnutrition
Survivors who have been adrift for several days may be suffering from dehydration. If they have been adrift for several weeks, malnutrition may also be a problem. Caution should be exercised in try
Хотите получать на электронную почту самые свежие новости?
Подпишитесь на Нашу рассылку
Наша политика приватности обеспечивает 100% безопасность и анонимность Ваших E-Mail
Новости и инфо для студентов