CHAPTER 2

LIKELY MEDICAL ISSUES YOU WILL FACE

T ailoring your education and training to the probable medical issues you will have to treat is important. By looking at the experience of caregivers in remote settings, you can determine what medical supplies will be needed and prepare yourself for the most likely medical issues.

It wouldn’t be unusual to see the following:

   Trauma

       Minor musculoskeletal injuries (sprains and strains)

       Minor trauma (cuts, scrapes)

       Major traumatic injury (fractures, occasional knife or gunshot wounds)

       Burn injuries (all degrees)

   Infections

       Respiratory infections (pneumonia, bronchitis, influenza, common colds)

       Diarrheal disease (sometimes in epidemic proportions)

       Infected wounds

       Minor infections (urinary infections, “pinkeye”)

       Sexually transmitted diseases

       Lice, ticks, mosquitoes, and the diseases they carry

   Allergic reactions

       Minor (for example, bites or stings from insects)

       Major (anaphylactic shock)

   Dental

       Toothaches

       Broken or knocked-out teeth

       Loss of fillings

       Loose crowns or other dental work

   Women’s issues

       Pregnancy

       Miscarriage

       Birth control

Pregnancy is generally considered safe, but the pregnancy news was welcomed with delight and concern not so long ago. Women were affected by complications, including miscarriage, bleeding, and infection, so you should make significant plans to avoid getting pregnant, at least until things get back to normal.

 

MEDICAL SKILLS YOU WILL WANT TO LEARN

 

What will I need to know is a legitimate inquiry for a future medical professional to pose. "As much as you're willing to learn," is the response. You can get a fair idea of the abilities you'll need by using the list of potential medical problems from earlier. Numerous ankle sprains, colds, wounds, rashes, and other common medical conditions that strike you today are expected. But you should be prepared to handle more serious issues, like a broken limb or another severe accident. Additionally, you'll need to be aware of the medical items you'll need and how to use them. The knowledgeable medic will know the following:

       How to measure blood pressure, respiration, and other vital indicators.

       How to apply bandages and wraps to wounds.

       How to take care of and watch over an open wound.

       How to handle burns of various intensities.

       The dosages, frequency of administration, side effects of various medications, and indications for their usage. You will need resources like the Physicians' Desk Reference to complete this; you cannot do it alone. This substantial volume, released once a year, contains all the information you'll need to use for prescription and over-the-counter medications.

       How to do a typical baby and placenta delivery.

       How to bandage, cushion, and splint a fracture, dislocation, or sprain.

       How to recognize infectious bacterial infections (such as strep throat).

       How to recognize infectious viral infections (such as influenza).

       How to recognize infectious disorders caused by parasites and protozoa (such as giardiasis).

       How to recognize and take care of insect bites and stings as well as head, pubic, and body lice.

       How to recognize poisonous snakes and handle snake bites and other animal attacks.

       How to recognize and treat the different types of abdominal, pelvic, and chest pain.

       How to handle anaphylactic shock and allergic reactions.

       The recognition and treatment of sexually transmitted illnesses.

       Diagnosing and treating dental diseases (such as replacing fillings, treating abscesses, and performing extractions).

       How to recognize and handle rashes and skin conditions.

       How to care for a bedridden patient (such as treating bedsores and transport considerations).

       Standard hygienic, dietary, and sanitary procedures. (This is incredibly crucial.)

       Advice for treating patients who are nervous or depressed (common in times of trouble).

       The proper way to implant an IV line. (This is covered in EMT classes.)

       How to treat a cut.

Understanding when to close a wound is more crucial than knowing how to do it. Most injuries sustained outside will be unclean; by covering an injury, germs may become trapped in the tissues and spread infection.

The ability to prevent illnesses and injuries may be crucial to master. Keep an eye out for small details, like if your workers are dressed suitably for the weather. Ensure that hand and eye protection are used at all times while working. You will prevent many injuries and diseases if you learn to identify circumstances that put the people you are medically responsible for in danger.

Do not think that knowing all this knowledge is difficult or that you cannot be useful if you simply understand some of the information above. It's crucial to gain the knowledge necessary to handle some more typical medical conditions.

 

THE PHYSICAL EXAM

 

By choosing to read this book, you have chosen to assume responsibility for your family's medical care after a calamity. Consequently, it will be required to accumulate knowledge on how to assess a patient and arrive at a diagnosis.

You'll need to put your (gloved) hands on them and be able to systematically assess any wounds or seek physical indications of sickness. Sometimes the issue is immediately apparent, while you must thoroughly examine the body to find the issue. Always explain to the patient who you are, what you are doing, and why during an examination. Maintain your composure and exercise extreme caution when attempting to move or act in a way that is above your capacity.

Checking the vital signs provides the simplest information. The following is included in this:

Pulse rate. Two fingers can be used to press on the inside of the wrist or the side of the neck to take this (by the base of the thumb). At rest, a healthy pulse should be 60 to 100 beats per minute. If you want to know the beats per minute, you can select to feel the pulse for, say, 15 seconds and multiply the result by 4. But it would be more accurate to say a full minute. Most people who are agitated after suffering an injury will have a high pulse rate; you'll notice (tachycardia).

Breathing rate. For the most accurate reading, analyze this for a full minute. At repose, an adult typically takes 12–18 breaths per minute; children typically take slightly more. Take note of any oddities, such as wheezing or gurgling sounds. Tachypnea, which is defined as breathing more than 20 times per minute, is an indication of discomfort.

Arterial pressure. The amount of effort the heart must expend to pump blood throughout the body is measured by blood pressure. At rest, you want your blood pressure to be less than 140/90. After intense exercise, blood pressure may be high, but it quickly returns to normal. Some people deal with chronic high blood pressure. A person who has hemorrhaged or is in shock may have very low blood pressure. The book's chapter on high blood pressure includes instructions on how to take a blood pressure reading.

Mental condition. You want to be sure that your patient is awake and can respond to your directions. Inform your patient of what occurred. Ask straightforward inquiries like their name, where they are, or the year if they appear lost. Keep track of if the patient seems agitated or lethargic. Some individuals may seem unresponsive but react upon a spoken instruction, like "Hey! Get your eyes open! If there is no response, try applying little pressure to the patient's breastbone to see if they respond to the stimuli. If they don't, there is a very big problem.

Temp. of the body To ensure the patient doesn't have a fever, take their temperature. The range of a normal temperature is 97.5 to 99.0 degrees. (Note: This book only uses Fahrenheit to express temperature degrees. Use the following equation to convert to Celsius: multiply by 1.8 and add 32.) A temperature greater than 100.4 degrees is considered a severe fever. Hypothermia, commonly known as a cold-related sickness, may be indicated by extremely low temperatures (below 95 degrees). On the other hand, hyperthermia is a condition where the body's temperature rises above 105 degrees.

After taking the vital signs and confirming that there are no evident injuries, conduct a general systematic checkup from head to toe. Feel the skin of the patient. Is it humid or dry, hot or cold? Is the patient pale, or is there redness? As you descend, examine the head region. Are there any bumps on the head, and are the ears, mouth, or nose bleeding? Check the eyes to check if they have a reddish appearance. Using a light source to test whether the pupils react to light evenly.

With a light source and a tongue depressor, ask the patient to open their mouth so that you may look inside for any redness, sores, or dental problems. Feel the back of the head and neck, especially the neck bones, for any signs of injury (vertebrae).

Auscultation, or listening to the chest with a stethoscope, is a medical term. Can you hear the patient breathing as you move the instrument over various parts of each lung? Do you hear any sounds that shouldn't be there? To gain a firm understanding of what sound clear lungs should make, practice listening to healthy people. The noises of wheezing, gurgling, and crackling would be abnormal.

Listening to the listening to check if the heartbeat is normal or erratic. Look for rough spots along the ribs that can indicate a fracture. Look for lumps in the axilla, often the area under the arms. Perform a breast exam by circling the breast tissue with your fingers, beginning at the axilla's edge and finishing at the nipple.

Palpate, which means to press with an open palm, the abdomen. Is pain present? Is the stomach soft, or is it firm and bloated? Feel any masses there? To hear the rumbling of the bowels, use a stethoscope. Intestinal motility may be lacking if there are no bowel movements, and some diarrheal diseases may cause excessive bowel movements. Tap the middle finger of your open hand with the various abdominal quadrants. "Percussion" is the term for this. Normally, the abdomen will sound hollow but dull, where a mass might be present. To check if the liver is enlarged, press down on the right side just below the rib cage (if the liver isn't enlarged, you won't feel anything). On the left side, under the bottom of the rib cage, there will be a mass that is the size of an enlarged spleen.

For signs of pain or damage, look along the patient's spine. If the patient has been injured or has an infection, lightly pound with a closed palm on each side of the back, below the final rib, where the kidneys are located.

Feel the muscle groups in each extremity to check for pain or reduced range of motion. Examining the color of the patient's finger and toe tips can determine whether or not their circulation is strong. These areas will appear white or blue due to poor circulation. By lightly tapping with a safety pin, you can check for sensation. Ask the patient to lift their legs to assess for normal strength and tone by placing your hands on their thighs. With both hands, ask them to hold your fingers while you try to yank their hands away. It's okay if you are unable to.

Each side of the human body is roughly the same if a vertical line is drawn through it (with a few internal exceptions). This means you can compare a limb to the other side if you are unsure whether it is damaged or malformed. Each side should be roughly equal in strength.

These are only a few fundamentals. There is much more to a physical exam than we've just discussed, but getting practice on others can help. As time goes on, you'll gain a sense of what is typical and what isn't.

 

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