Alpine First Aid Handbook on Chinese Alps-type Climbing Ambulance (2)
III. First Aid Measures for Common Injuries in Climbing
(1) Basic inspection procedures and first-aid measures for rockfall and gliding team members
Rescue workers should first approach the injured player in a safe manner. After approaching the injured team, the visually injured person's injury and terrain should decide whether to move the injured person. A preliminary examination was then performed on the wounded to see if the injured were conscious, check the injured for obvious injuries and fractures, and inspect the injured for significant head injury. Next, check the wounded in the following order:
Breathing: The normal person breathes 16-18 times per minute, checks whether the injured player can maintain normal spontaneous breathing, and whether the injured player causes vomiting to cause airway obstruction.
Heartbeat: Check that the injured player has normal heartbeat and pulse. If conditions permit, use a wrist sphygmomanometer to check if the injured player can maintain normal blood pressure.
Bleeding: Observe that the injured person has enough bleeding that causes life-threatening.
If there is a problem in any of the inspection links, the injured can respond to the following actions:
Breathing: If the victim has vomiting and the vomit obstructs the airway, clean up the victim's vomit. If the injured cannot maintain normal spontaneous breathing, artificial respiration is performed immediately.
Heartbeat: Do not hesitate to perform CPR if the victim has no pulse
The CPR procedure should be performed in the order of ABC: First, the injured player should be placed supine on the ground before performing cardiopulmonary resuscitation. If the injured player is in a prone position, it should be turned into a supine position.
A:airway, smooth airway. Check the respiratory tract of the injured player and clean up the foreign body in the respiratory tract. Remove dentures, one hand index finger, middle finger placed under the chin, lift the chin, so that the head backwards, a hand caress the neck, the degree of head thrown back jaw and ear lobe vertical line with the ground is appropriate, not too backward .
B: Breath, for artificial respiration. With the thumb and forefinger, tighten the nostrils and wrap the mouth around the patient's mouth. Take a deep breath and then blow 2 times. Don't use too much force when blowing. After insufflation, the patient's chest undulations indicated that artificial respiration was effective.
C:Circulation, artificial circulation. Perform chest cardiac compression. In the lower 1/3 of the sternum, the palm is parallel to the sternum, and the other hand is overlaid on the back of the hand. The two fingers are lifted up and separated from the chest wall. The shoulders are straight. The shoulders are perpendicular to the upper part of the sternum. The strength of the shoulders and arms is downward. Press. Press at a frequency of about 100 times per minute, preferably about 3 to 5 cm. Artificial respiration, and chest compressions and fit. It is usually 15:2 (pressing 15 times, blowing 2 times) for a single person to do cardiopulmonary resuscitation. If it is done by two people, it will be conducted in a ratio of 5 to 1. That is, one person breathes a breath and one person presses out of the heart five times. When you blow, stop pressing. Do not blow on chest compressions.
note:
1. Thoracic cardiac compression can only be performed when the injured player has no heartbeat or pulse.
2. The location of chest cardiac compression must be accurate. Inaccurate damage to other organs. Pressing force should be appropriate, too large and too easy to make the sternum fracture, resulting in pneumothorax hemothorax; press force is too light, small chest pressure, not enough to promote blood circulation. Chest compressions must be performed continuously.
3. When pressing, press down vertically and do not shake left or right.
4. Press down and relax evenly. Keep your hands away from the chest wall when you relax. 5. When performing CPR, remove the technical equipment worn by the injured player and untie his belt and buckle to avoid injury to the viscera.
Bleeding: More than 30% of traumatic acute bleeding can be life-threatening. Therefore, if the injured person has a bleeding phenomenon, the rescue team should determine the type of bleeding.
If the wounded is bright red, blood flow is acute. Bleeding is jetting, and the amount of bleeding is usually arterial bleeding. If blood red, blood flow is slow, continuous bleeding, it is venous bleeding. If the red blood color, can not find a large bleeding, bleeding from the wound surface, it can be judged as capillary bleeding.
Different hemostasis should be taken for different bleeding
Tourniquet Hemostasis: Can only be used for bleeding of the arteries of the extremities resulting from climbing injuries. Hemostasis is solid and reliable. During operation, add padding at the site where the tourniquet is to be ligature (the pad can be replaced with a BUF scarf or a cloth stripped from a fleece, etc.), and use the left thumb and the middle and middle fingers to hold the end of the tourniquet. Hold the blood band tightly around the limb and wrap it around the pad for one week, press the end of the tourniquet, then wrap it around for the second week, clamp the end of the tourniquet with the left hand and the middle finger, and pull it down to fix it. It is also possible to insert the end of the tourniquet into the knot and tighten the other end of the tourniquet to make it more secure.
Finger pressure hemostasis: For moderate or large arterial bleeding, the pulsed superficial artery is touched at the proximal end of the bleeding site of the injured person. With your finger or fist, press the blood vessels against the deep bones to block the blood flow. To achieve the purpose of temporary hemostasis.
Stuffing and hemostasis: Suitable for large and deep wounds on the neck and buttocks; first insert sterile gauze into the wound, such as a piece of gauze can not stop the bleeding, can be added gauze, and finally with a bandage or triangle around the neck to the right Side arm hated and fixed.
Pressure bandaging and hemostasis: Suitable for arterioles, veins, and capillary bleeding. Fill the gauze near the wound and then apply it with bandages or tourniquets. The blood is usually stopped within 20 minutes. In alpine climbing, climbers are less likely to have major arterial bleeding due to injury, so that pressure bandaging and hemostasis can handle most of the bleeding in the climb.
Note: When using a tourniquet to stop bleeding, care should be taken that excessive ligation of the tourniquet may result in limb ischemic necrosis! In order to prevent ischemic necrosis of the limbs, the use of the tourniquet should be as short as possible in principle. Every 40 minutes, the tourniquet should be released for 2 minutes to temporarily restore limb blood supply. The acupressure hemostasis can be used to stop the bleeding temporarily. If there is still a major bleeding during the release, or if it is confirmed that the injured limb may have no reservation, it may not be necessary to release the tourniquet during the withdrawal. If the rescue team cannot follow the wounded person's descent, a mark must be added on the obvious site of the tourniquet to mark the time for the tourniquet to be ligated, and to remind the team member to pay attention.
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