Text / Picture 🖊 Wang Zhengyang
Ten minutes for platinum, one hour for gold. In order to thoroughly implement a series of instructions and requirements of the higher authorities on strengthening training and preparing for war, and to focus on improving the front-line treatment capacity of the troops, recently, the Shandong Armed Police Corps organized all personnel of the armed police to carry out front-line combat rescue technical training in response to the "six technologies for self-rescue and mutual rescue of war wounded".
During the training, experts from the hospital of the corps combined the battlefield environment and clinical reality, focusing on the common techniques for the treatment of war wounds, such as ventilation, hemostasis, bandaging, immobilization, transportation, and cardiopulmonary resuscitation, and adopted the methods of theoretical lectures and explanations and demonstrations, and systematically expounded the technical methods and action essentials of combat rescue for the officers and men in simple terms.
Triangular scarf and cap bandaging, roll splinting, cardiopulmonary resuscitation, chest compressions······ During the training, hospital experts and instructors guided the officers and soldiers participating in the training through the whole process, conducted action demonstration drills, and conducted "full-coverage" random tests on the training content.
"The environment is safe, and ······ can be implemented" The wound has been bandaged······" During the assessment, the trainees had a standard of tactical movements, a strong sense of the enemy's situation, tacit understanding of rescue cooperation, rapid response to the exercise, and effective rescue, which further strengthened and consolidated the officers and men's application and mastery of combat rescue skills.
The treatment of war wounds is not only a "professional course" for security personnel, but also a "compulsory course" for ordinary officers and men. Through this training of front-line rescue technology, the level of health training of government personnel and the ability of self-rescue and mutual rescue on the battlefield have been further improved, and strong support has been provided for accelerating the construction of front-line combat rescue capacity of the troops.
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Interpretation of the basic common sense of war wounded ambulance
1. The significance of battlefield ambulance
Battlefield rescue is an important measure that must be taken in wartime in order to reduce casualties, quickly restore combat effectiveness, and maintain war strength. The basic principles for conducting combat rescue are: Strengthen the concept of enemy situation and sterilization, and rescue the wounded quickly, accurately, and in a timely manner. In the ambulance, it is necessary to rush first and then rescue, first heavy and then light, first near and then far. It is necessary not to touch the wound with hands, not to rub the wound with iodine, not to rinse the wound with water (except for chemical burns and phosphorus bullet wounds), not to take out foreign bodies in the wound casually, not to stuff back the protruding organs, and not to give up and stop the rescue opportunity easily.
2. Classification of war wounds
(1) Fei Tong injury: Zidan, shrapnel, and bayonet penetrate and pierce human tissue, and the wound has an entrance and exit.
(2) Blind tube injury: Bullets or shrapnel enter the human body, only the entrance and no exit.
(3) Abrasions: bullets or shrapnel have grazed the surface of the human body, and the wound area is furrow-shaped or only the body surface is abrasive.
(4) Penetrating and non-penetrating injuries: bullets and shrapnel penetrate the body cavity and its protective membranes (meninges, pleura, peritoneum and joint capsule), and those that communicate with the outside world are called penetrating injuries, and non-penetrating injuries are not penetrating injuries. According to the location of injury, it can also be divided into head injury (including facial brain injury and maxillofacial injury), neck injury, chest injury, abdominal injury, pelvic injury, spinal cord injury, upper limb and lower limb injury.
3. Five techniques for the rescue of the war wounded
(1) Ventilation. The nasopharyngeal cavity and trachea of the injured person are blocked by blood clots, mud or vomit, etc., or the tongue falls back after coma, which can cause ventricular breathing, and the following methods should be used immediately to restore airway ventilation
1. Finger to mouth method Use the thumb and index finger of one hand to pull out the tongue, and the other hand index finger to extend into the mouth and pharynx to quickly remove blood clots and foreign bodies.
2. Pat the back method to make the upper body of the casualty lean forward or semi-prone down: support the front of the sternum with one hand, and slam the back between the shoulder blades with the palm of the other hand to promote coughing and coughing out the blockage of the upper respiratory tract.
3. Abdominal pressure method (Heimlich method) Wrap your arms around the upper abdomen of the casualty from the back side, lift the casualty to make its upper body droop, and press the abdomen forcefully to promote the vomiting and coughing out of the upper respiratory tract blockage.
4. Jaw and tongue pulling method The tongue recoil of the unconscious wounded person blocks the glottis, and the hand should be held up from the front side of the mandible to relieve the obstruction of the airway by the tongue fall.
(2) Hemostasis
1. Types and characteristics of bleeding
Blood flowing outward from the wound is called hemorrhage. There is no wound in the epithelium, and the blood flows into the tissues, organs, and body cavities from the broken blood vessels, which is called internal bleeding. Hemorrhage has arterial hemorrhage: it is a spurt, the blood is bright red, and it is life-threatening. Venous bleeding: Slow outflow, dark red blood, little life-threatening. Capillary hemorrhage: flaky oozing, bright red blood, less life-threatening.
2. Methods of hemostasis
The purpose of hemostasis is to prevent shock or death due to excessive bleeding. Capillary and venous bleeding is sufficiently compressed. The following are the main methods of hemostasis for arterial bleeding:
(1) Acupressure hemostasis: suitable for large arterial vascular bleeding. It is a temporary emergency method of hemostasis. Pressure the proximal end of the wound with your hand so that the moving dolphin is pressed against the bone surface to achieve the purpose of rapid hemostasis. The tourniquet is then replaced, and acupressure on the bleeding arteriole can be changed to compression bandaging.
(2) Filling cold and pressurizing bandaging to stop bleeding: larger wounds can be filled with gauze blocks or first-aid kits, and then folded into mats with cotton balls, sand cloth rolls, towels, handkerchiefs, etc., or placed outside the gauze at the bleeding site with stones and small pieces of wood, and then pressurized and bandaged with a triangular towel or bandage. This method is simple and easy to implement, and it is one of the commonly used methods in combat rescue
(3) Padded limb flexion compression hemostasis: suitable for rescue when there are no fractures and joint injuries of the limbs. If the upper arm is bleeding, you can use a cushion of a certain hardness and size to be placed in the armpit, and the upper arm is attached to the side of the chest, and fixed to the chest with a triangular scarf, bandage and belt. If there is bleeding in the lower leg and forearm, it can be fixed in the national fossa (i.e., leg curvature) and elbow fossa with additional flexion limbs.
(4) Tourniquet hemostasis method: suitable for bleeding from large moving dolphins in the limbs. Such as femoral artery and brachial artery hemorrhage. When using, the tightness of the tourniquet should be appropriate, so that the mouth does not bleed. Too tight can easily hurt nerves, and too loose will not achieve the purpose.
(3) Bandaging. Bandaging is done to protect the wound, reduce infection, fix the dressing, and apply pressure to stop bleeding. The requirements for bandaging are accurate, rapid, light and agile, suitable tightness, firm and tight.
1. Bandage bandaging method. There are three main ways to do this:
(1) Bandage ring bandaging method: suitable for the strength, wrist, forehead, etc. The method is to completely overlap the loop for several weeks per lap.
(2) Spiral reverse fold bandaging method: mainly used for forearms and lower legs. The method is: first use the annular method to fix the end of the table for a simple oblique rotation rise, and fold once per turn.
(3) Bandage cap bandaging method: suitable for the head. The method is to start from the right ear, return to the starting point on the right ear through the forehead and the external occipital tuberosity above the right ear, and repeat for one week. When wrapping around the center of the forehead for the second time, fold the bandage backwards, press it with the second finger of the right thumb, the bandage passes through the center of the top of the head and goes below the external occipital tuberosity, the assistant holds down this point, the bandage is reversed on both sides of the scarf, and the front circumference is 1/2 of the cover every week until the head is completely covered, and then it is fixed around the second circumference.
2. Triangle bandaging method. This method is simple to operate, easy to master, fast to bandage, and flexible in application. It can be used to bandage the face, shoulders, armpits, chest and back, groin and other parts.
(1) Head bandaging method: The head bandaging method is to tie a knot at the top corner and low center of the triangular scarf. Shaped like a hood. Place the top knot on the front jaw and the bottom knot on the back of the head to cover the head. Tighten the two corners towards the face, fold outward 3-4 finger widths, wrap around the jaw, and pull to the back of the head to tie a knot to fix.
(2) Double-middle bandaging method on the chest and back: use the beveled edge of the triangle scarf around a circle, knot the top angle and the bottom corner at the waist on one side, and then use the triangle to tie the knot around the bread, and then tie the other bottom corner of the two triangles, and knot each over the shoulder and the opposite bottom edge. The key to the operation is to have the two top corners in opposite positions, and the bottom corners are knotted with the bottom edge of the other triangle scarf.
(3) Triangle middle abdomen bandaging method: the top angle of the triangle scarf is facing down, the bottom edge is placed horizontally on the abdomen, the bottom is tightened to the waist and knotted, the top angle is pulled to the back through the perineum, and the rest of the bottom corner is knotted, or it will be knotted with the top for a week, and the other bottom corner is knotted around the bottom edge.
3. Precautions for bandaging
(1) The wound and the dressing block covering the wound should not be in contact with other dirt to avoid wound infection.
(2) The center of gravity should be at the center of gravity when bandaging.
(3) The tightness of the bandaging should be appropriate, too tight will affect blood circulation, too loose and easy to fall off or move.
(4) The bandaging action should be light to prevent collision wounds, so as not to aggravate the pain and bleeding of the wound.
(4) Fixation. Fractures are one of the most common traumatic injuries in war wounds. If the fracture is not fixed in time and correctly, it will not only cause shock due to severe pain, but also affect the recovery of the function of the injured limb. In severe cases, it can cause massive bleeding and disability due to puncture blood vessels and severed nerves. Therefore, it is very important to do a good job of fracture fixation in the station injury rescue. Fractures can be divided into two types: open fractures and closed fractures. Where the broken end of the fracture punctures the human skin and communicates with the outside world, it is called an open fracture. A fracture that does not pierce the human skin and is not connected to the outside world is called a closed fracture.
Characteristics of fracture: 1. Severe pain, obvious tenderness at the fracture site. 2. Limited function and inability to move. 3. Local swelling. 4. In the case of complete fracture, limb deformity occurs due to the displacement of the broken end (often shortened or elongated, bent, flexed, rotated, dislocated, and overlapped), and the seat fricative can be heard when the broken end moves.
1. The principle of fracture fixation
(1) If the wound is bleeding, the bleeding should be stopped first, and then bandaged and fixed. If there is shock, first or at the same time as hemostasis, anti-shock first aid is given.
(2) Fixation in place. It is necessary to pay attention to the functional position, do not rehabilitate, and do not arbitrarily move the wounded and injured limbs. Clothing can be cut to expose the wound. If the marginal deformity of the limb is not suitable for fixation, it can be slightly adjusted according to the direction of the long axis of the limb, but the action is light.
(3) When fixing, it is necessary to add pads first and then fix, first fix the two ends of the fracture, and then fix the upper and lower joints. The fixation material is appropriate for the length of the injured limb, and the fixation should be moderately tight. When the limbs are immobilized, the tips of the fingers (toes) should be set aside so that the blood circulation can be observed.
(4) After the fracture is fixed, a sign should be set up and evacuated quickly.
2. Methods of fracture fixation
(1) Clavicle fracture fixation method: add pads under the two armpits, fold into a belt with two triangles, wrap one to two circles around the shoulder joint, tie a knot behind the shoulder, leave a residual end, slowly tighten the remaining end, make the shoulder close back open, and then tie the knot, and finally make the elbow joint bent, cross the two wrists in front of the chest, and fix it on the chest with a bandage or triangle.
(2) Forearm fracture fixation method: the forearm is flexed, the forearm is flattened, two splints are placed on both sides of the part, and then fixed, and the neck is hung with a large cantilever belt.
(3) Calf fracture fixation method: use two wooden planks equivalent to 1/3 of the lower thigh to the length of the heel, middle on the outside of the injured limb, and replace the other side with the healthy limb. If there is no splint, it can be replaced with a stick.
(5) Handling
1. Freehand handling: single handling can be carried by supporting, holding and carrying on the back. Double handling can be carried by chair, pull cart and pinto.
2. Stretcher handling: first put the stretcher into the injured side of the wounded, and then two ambulance personnel kneel down on the healthy side of the wounded, untie the collar of the wounded spell, the first person with the right hand to support the shoulders and head of the wounded, hold the lower limbs of the wounded with the left hand, and gently put the wounded on the stretcher. The position of the wounded on the stretcher, except for penetration, should be carried on the stretcher on the healthy side. After the wounded person is lying down, use soft things such as clothing to pad the gap to prevent swaying. When traveling on a stretcher, the casualty's head should be turned back so that the person behind can easily observe the injury at any time. When you know the situation, stop and give first aid. Keep the stretcher as smooth as possible when picking it up. To carry a member with a vertebral fracture, a stretcher must be made of a wooden plank, not an ordinary canvas stretcher. In winter, it is necessary to prevent freezing and keep warm, and in summer, it is necessary to prevent heat and shade.
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(This article is the original article of Shandong Armed Police, please contact for authorization for reprinting)
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