1, trauma:
The body is torn or damaged by external forces. There are many causes of trauma, depending on whether there are wounds or not, they can be divided into open and closed categories.
1-1, closed trauma: caused by blunt force, no skin, body surface mucosa rupture, common bruises and sprains.
1-1-a, contusion: blunt force caused by the skin and subcutaneous soft tissue damage, skin without cracks, bruising injury, subcutaneous bleeding, swelling, tenderness. Light wounds can be used outside the injury area. For thoracoabdominal contusion and head contusion, consider whether there is a deep hematoma or visceral injury bleeding, it should be to the hospital for observation and diagnosis.
1-1-b. Sprains: Sprains often occur in the ankle, waist, neck, and wrists. The general treatment principle of sprain is to allow the patient to stabilize emotions, fix the injured area, and cover the affected area with a cold damp cloth. Sprained hands and feet can raise the affected area. Neck and waist sprained people cannot move the affected part while carrying. Sprains often accompanied by dislocation or fracture related to the joint, should immediately go to the hospital for treatment. In addition, regardless of the severity of the sprains, they should not be bathed and massaged indiscriminately and must be sent to the hospital for treatment. The commonly used treatments for sprains are partial closure (using 0.25% to 0.5% procaine), external application of drugs, physical therapy and so on.
1-2. Open trauma: Most of them are caused by sharp instruments and firearms. A few can be caused by blunt force. Frequently, skin and body surface mucosa break down.
1-2-a, cuts: shallow wounds are rinsed with warm water or normal saline, dried, sterilized with iodine or alcohol, stopped bleeding, or sprayed on the wound with a “quickly fast†spray, and then are usually dressed. Faster recovery. Use a band-aid on a small wound. For deeper wounds, hemostasis should be immediately oppressed, and hospital debridement should be performed at a rapid rate, depending on the condition of the injury. Scald wounds should not be coated with drugs such as ointment, otherwise the wound will be difficult to heal.
1-2-b, stab wound: should first clean the wound, use the sterilized needle and tweezers, remove the foreign body, and then disinfect the wound after dressing. Foreign body stays in the body to facilitate pyogenic infection. For those with small wounds and less bleeding, it is better to squeeze out some blood from the wound. The fingernail's puncture injury is not easy to handle. You can first cut the nail into a V-shaped mouth and pull out the thorn. Or to the hospital. If it is left in the body by a needle, metal sheet, etc., it should be taken to the hospital under X-ray. Deep wounds may have deep tissue damage, often with concurrent infections, and may be treated with anti-inflammatory drugs. Defective stab wounds should prevent tetanus and should be given intramuscular injection of tetanus antitoxin.
1-3 general treatment principles of trauma:
For patients with massive bleeding, it is advisable to take hemostasis first; for small wounds such as cutting wounds or stab wounds, if small amounts of blood can be squeezed out, bacteria and dust can be excreted; the wound should be cleaned with clean water, and it cannot be thoroughly cleaned. Wounds must be covered with a clean cloth and not covered directly with cotton or toilet paper.
2, burns:
Burns can be divided into two types of burns and water burns. In addition to boiling water, flames, steam and other high-temperature burns that are common in daily life, there are chemical burns such as strong acids and alkalis in the industry, and physical burns such as current, radiation, and nuclear energy. The larger the area, the deeper the depth, and the greater and more severe the impact on the whole body and the area.
2-1. The degree of burns: scalding can be divided into
Once burned (erythema, skin red, and burning tingling);
Second-degree scald (bubble, blisters in the affected area);
Third-degree scald (necrotic, skin peeling), for a small area of ​​minor burns, can be treated at home, after cleaning the wound, can be coated with Jing Wanhong, MEBO moisturizing burn cream and so on. For large areas of burns, it is advisable to go to the hospital as soon as possible.
2-2. Treatment of burns:
The principle of scalding treatment is to first remove the heat source, quickly leave the scene, use a variety of fire extinguishing methods, such as flooding, water shower, lying on the ground, etc., immediately take off the wet clothes or cut clothes to cold water, limbs soaked in cold water Until the pain disappears. You can also use a wet towel or sheets to cover the wound and spray cold water on. Do not break the blisters.
The treatment of burn wounds is of utmost importance. First, the hair in the wounded area and its vicinity must be shaved, and long nails must be cut off. The healthy skin around the wound was washed with soap and water and then disinfected with 0.1% benzalkonium bromide or 75% alcohol scrub. The wound was washed with isotonic saline to remove foreign matter, dirt, etc. from the wound. Protect the small blisters from damage. Large blisters can be used to empty the blisters with an injection needle, or to release the blisters at a low level. Those with severed blisters or heavier pollution should remove the foamed skin and gently crush the wound with gauze. Cover it with a layer of liquid paraffin gauze or a thin layer of Vaseline gauze, plus a multi-layered absorbent gauze and cotton pad, and add evenly with a bandage. Pressure dressing. Burns can also use bandaging therapy, exposure therapy and so on.
Burns are often complicated by infections, so antibiotics should be added, and tetanus antitoxin can be injected.
The treatment of large area scalds requires a lot of human, material and financial resources. And often leave extensive scars, causing serious deformities and dysfunction. Therefore, we must pay attention to prevention, in daily life we ​​must strengthen the fire safety education for residents and children, in industrial and mining enterprises to strengthen the safety of production workers, education, and develop a strict fire management system.
3, frostbite:
It is the damage caused by the body being exposed to cold for too long. Frostbite can be divided into two types: local and whole body: Local frostbite occurs in the exposed parts of the fingers, toes, nose, ears, cheeks, etc., and it is easy to relapse in the same site.
3-1. The degree of frostbite:
First degree (erythema): The skin of the frostbite changes from pale to plaque-like purple-blue and later turns red, swollen, and congested. And itching, pain, numbness and other phenomena. About 5 to 7 days, the symptoms disappeared, leaving no scars.
Second degree (bubble): In addition to redness in the frostbite, there may be blisters of varying sizes, local pain, and insensitivity to cold, heat, and acupuncture sensations. After 2 to 3 weeks, blisters dry to form a dry crust. When the crust peels off, a thin new skin covers the wound.
Third degree: Light is confined to the skin, the skin turns from pale to purple and black, the skin around the wound is swollen and blisters, mostly with severe pain. The healing of wounds after necrotic tissue shedding requires more than two months and scar formation.
3-2. Whole body frostbite: When the whole body suffers from frostbite, in addition to the vasoconstriction of the body surface and the skin pale, the wounded suffers chills to increase body heat and maintain body temperature. But when the body temperature continues to fall, the wounded feel tired and drowsy. Still further dullness of consciousness, often hallucinating. If not treated, it will endanger life.
3-3. Treatment of frostbite:
After frostbite occurs, the wounded part must be quickly rewarmed. The wounded part can be soaked in clean warm water and warmed to about 37-42°C within 5-7 minutes. Frostbite limbs should be slightly elevated to eliminate edema. The first and second frostbite were warmly bandaged. The third degree frostbite should be disinfected, bandaged, prevented by infection, and treated by the medical unit. After rewarming of systemic frostbite, hypovolemic shock and cardiac and renal dysfunction may occur due to damage to the entire body tissues and organs, so hospitalization should be performed.
After the occurrence of frostbite, treatment is more difficult, so it should be prevention. Persons working under severe cold should be careful to keep them cold and wet and wear tights and keep them dry. The exposed part should be coated with ointment to reduce heat dissipation. Wear masks, gloves, earmuffs, etc. Proper activities should be performed when working outdoors to promote blood circulation. In addition, have enough sleep, avoid excessive fatigue, and pay attention to nutrition. There should be an alarm device in the cold room to prevent accidents.
4, snake bites:
Vipers have poisonous glands that can secrete toxins. When a poisonous snake bites, the venom glands are compressed and the venom is injected into the wound through fangs.
Viper venom can be roughly divided into two categories:
1 Neurotoxicity, can make the medulla oblongata and muscles rapidly lick;
2 blood poisoning, can make the blood does not coagulate, cause bleeding and hemolysis, but also make the vasoconstriction and diastolic function loss. Failure to save in time can result in death.
4-1. The type of viper:
The snakes of the genus Cobra, Vipera, Vipera, and Serpentidae of our country have different venom properties. Therefore, the pathological changes and symptoms of biting are different.
The venom of snakes and snakes (including snakes, five-step snakes, iron heads, bamboo leaves, etc.) belongs to the blood, poisoning, bites, pain, swelling, and continuous bleeding from the wound. The person who was bitten suffered from cold sweat, nausea, fainting, bleeding from multiple places such as epistaxis, conjunctival hemorrhage, subcutaneous hemorrhage, hematemesis, hemoptysis, and hematuria. He eventually died of external failure. Biting to death varies from 2 to 7 days.
The venom of Cobra snakes (including cobras, golden snakes, and silver rings snakes) is a neurotoxicity. It was burned from the beginning of the bite, and later it felt numbness. Later, there was sagging of the upper eyelids, unstable walking, weakness of the extremities, and heads. Severe sagging, runny nose, nausea, vomiting, difficulty in swallowing, unclear speech; followed by quadriplegia, weak breathing, conscious suffocation, and finally death due to respiratory center paralysis and heart failure. Between half an hour and 30 hours from bite to death.
Identifying the type of venom-induced symptoms is important in therapy.
4-2. Treatment of Viper Snake Bites:
The first-aid principle for poisonous snake bites is to prevent the diffusion and absorption of toxins as early as possible and to reduce local damage as much as possible. Snake venom is absorbed in 3 to 5 minutes, so the sooner the emergency is, the better.
4-2-a. Banding injured limbs: Brace with a tourniquet or rubber band on the proximal side of the bite to prevent backflow of venous blood and lymph, then squeeze around the mouth or mouth (Oral mucous membrane rupturers avoid suction), the venom out of the body.
4-2-b, wash the wound: first wash the surrounding skin with soap and water, and then wash the wound with saline, 0.1% potassium permanganate or clean water.
4-2-c, local cooling: first immersed the injured limb in 4 ~ 7 °C cold water for 3 to 4 hours, and then use ice packs, can reduce the absorption rate of toxins and reduce the enzyme activity of toxins.
4-2-d, detoxification: bite wounds within 24 hours, with the teeth as the center cut the wound into a "ten" or "sputum" shape, so that the venom outflow, can also be sucked with a breast pump or cupping venom. But the mouth should not be too deep so as not to damage blood vessels. If snake tooth residue should be removed immediately. Cutting or sucking should be done as soon as possible, otherwise the effect is not obvious.
4-2-e, drug treatment: commonly used detoxification anti-toxic drugs are Shanghai snake medicine (oral, the first 20 ml, later changed to 10 ml every 6 hours), Nantong snake medicine (the first 20 tablets with 30 ml of shochu warming Under boiled water suit, after every 6 hours l0) and so on, can also be used 60 grams of Scutellaria barbata, 60 grams of Hedyotis diffusa, 9 leaves a flower 9 grams, 60 grams of Viola decoction orally external application. Anti-venom serum is given every 10 ml of intravenous injection with saline 20 ml, or 7.5 ml of intramuscular injection near the wound. The domestic snake antoxin specifically treats abdominal snake bites and has a certain effect on bamboo leaves and green bites. Hormones, diuretics, and supportive therapies can also be used to aid the treatment of this disease.
4-3. Prevention of Viper Snake Bites:
The prevention of snake bites is mainly due to the enhanced protection of field workers. From the bite at the bite, it can be determined whether the biting snake has fangs or not, which is helpful in diagnosing whether it is a snake bite. After the poisonous snake bites, it leaves a neat array of tooth marks. After the poisonous snake bites, it leaves a common tooth mark. In addition, the teeth of the two fangs are slightly larger and deeper than the ordinary non-venomous snake teeth. . If there is no poisonous snake nick on the bite, or if there is no swelling or pain after 15 minutes, it may be a non-venomous snake bite. No treatment is needed. If it is not easy to discriminate between poisonous or non-venomous snake bites, they should be treated as poisonous snake bites to avoid losing the opportunity to rescue them.
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