Dr. Donald Blake & Thor Odinson (![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png)
ifwebeworthy) wrote in ![[community profile]](https://www.dreamwidth.org/img/silk/identity/community.png)
fandomhigh2024-06-03 08:28 am
ifwebeworthy) wrote in fandomhigh2024-06-03 08:28 am
Entry tags:
First Aid, Monday, Fifth Period
"Let's talk about what to do if somebody's bleeding," Don told his students. "It's probably the first thing you think of when it comes to first aid, right? What is it moms tell their kids? 'Don't bother me unless somebody's bleeding.'" Did moms tell their kids that? It seemed like they did, but Don had never been a kid.
"So, what do you do? First things first, you have to stop the bleeding. Press a cloth to the wound and apply pressure--gentle, if that's appropriate. If you need more pressure you may have a real problem and need to get to a doctor. You can also elevate it, if that applies--like you can raise your hand above your head if you cut your finger. If it won't stop bleeding: doctor. Stitches. Do not pass go, do not collect two hundred dollars. If it's doing anything that could be described as 'gushing' or 'spurting' or any other fun thing like that, congratulations, your patient cut something important and their life is now in danger, so you need to call 911 and, if 911 is not available, get to the ER or equivalent immediately. You may need to use a tourniquet. Do not jump directly to the tourniquet. Improperly used, or even properly used over a long enough period of time, a tourniquet cuts off blood flow, which causes tissue death, which may result in amputation of the limb. Now, obviously, you can live without a leg better than you can all your blood, but still, it's not the ideal outcome. But we'll get back to that.
"Let's say that none of these dire things are happening. It really is just a minor cut and after you applied gentle pressure with a washcloth for a few minutes, it stopped bleeding. Great. Now you're going to wash the wound with clean water. You can use soap around the wound, but don't get it in the wound. Don't get alcohol or hydrogen peroxide in the wound, either. If there's stuff in the wound, like dirt or splinters, you can pick that out with tweezers if the water doesn't wash it out. You want it clean, and then you can put Neosporin on and bandage it up. Change the dressing once a day to keep it clean, and so you can see how the wound is healing. If your patient hasn't had a tetanus shot in five years and there was rust or dirt or whatnot involved, they should probably get one of those. If the wound was caused by an animal bite, they should definitely see a doctor, because animal mouths are nasty and also: rabies. Any signs of infection? Doctor.
"Back to tourniquets. Seriously, I cannot stress enough, they aren't a 'Oh, that's a lot of blood,' tool, they're a, 'We've tried everything else and we can't stop the bleeding and your life is in danger' tool. First try elevating the injury site, or apply direct and heavy pressure for fifteen minutes or so to see if a clot will form. Then you can bust out the tourniquet. If you're gonna use one you need to know how to use one correctly, so let's go over that. Basically, you need two things: a suitable or suitable-ish piece of fabric, and something stick-like that's sturdy enough not to break." Don proceeded to talk the students through how to apply a tourniquet as he demonstrated on the first aid dummy's leg, then encouraged them, "Now you try."
And as an afterthought, he added, "Oh, and yes: you can put a tampon in a bullet wound. It's not really ideal, and I would not recommend it under best circumstances, and especially not if it's a complex or life-threatening wound, but if we're talking like a flesh wound then it will work to control and absorb bleeding until you can get proper medical treatment. Sorry if I just ruined your appetite for the day." He didn't sound that sorry. "Does anybody have any questions?"
"So, what do you do? First things first, you have to stop the bleeding. Press a cloth to the wound and apply pressure--gentle, if that's appropriate. If you need more pressure you may have a real problem and need to get to a doctor. You can also elevate it, if that applies--like you can raise your hand above your head if you cut your finger. If it won't stop bleeding: doctor. Stitches. Do not pass go, do not collect two hundred dollars. If it's doing anything that could be described as 'gushing' or 'spurting' or any other fun thing like that, congratulations, your patient cut something important and their life is now in danger, so you need to call 911 and, if 911 is not available, get to the ER or equivalent immediately. You may need to use a tourniquet. Do not jump directly to the tourniquet. Improperly used, or even properly used over a long enough period of time, a tourniquet cuts off blood flow, which causes tissue death, which may result in amputation of the limb. Now, obviously, you can live without a leg better than you can all your blood, but still, it's not the ideal outcome. But we'll get back to that.
"Let's say that none of these dire things are happening. It really is just a minor cut and after you applied gentle pressure with a washcloth for a few minutes, it stopped bleeding. Great. Now you're going to wash the wound with clean water. You can use soap around the wound, but don't get it in the wound. Don't get alcohol or hydrogen peroxide in the wound, either. If there's stuff in the wound, like dirt or splinters, you can pick that out with tweezers if the water doesn't wash it out. You want it clean, and then you can put Neosporin on and bandage it up. Change the dressing once a day to keep it clean, and so you can see how the wound is healing. If your patient hasn't had a tetanus shot in five years and there was rust or dirt or whatnot involved, they should probably get one of those. If the wound was caused by an animal bite, they should definitely see a doctor, because animal mouths are nasty and also: rabies. Any signs of infection? Doctor.
"Back to tourniquets. Seriously, I cannot stress enough, they aren't a 'Oh, that's a lot of blood,' tool, they're a, 'We've tried everything else and we can't stop the bleeding and your life is in danger' tool. First try elevating the injury site, or apply direct and heavy pressure for fifteen minutes or so to see if a clot will form. Then you can bust out the tourniquet. If you're gonna use one you need to know how to use one correctly, so let's go over that. Basically, you need two things: a suitable or suitable-ish piece of fabric, and something stick-like that's sturdy enough not to break." Don proceeded to talk the students through how to apply a tourniquet as he demonstrated on the first aid dummy's leg, then encouraged them, "Now you try."
And as an afterthought, he added, "Oh, and yes: you can put a tampon in a bullet wound. It's not really ideal, and I would not recommend it under best circumstances, and especially not if it's a complex or life-threatening wound, but if we're talking like a flesh wound then it will work to control and absorb bleeding until you can get proper medical treatment. Sorry if I just ruined your appetite for the day." He didn't sound that sorry. "Does anybody have any questions?"