突发事件应对之战地救护.ppt

Penetrating trauma 穿透伤 Tension pneumothorax气胸 Air leak through lung or chest wall 空气渗进胸腔或肺里 “One-way” valve ? lung collapse ”单向阀“----肺衰竭 Mediastinum shifts to opposite side纵隔膜转到反向 Inferior vena cava “kinks” on diaphragm ?decreased venous return ? cardiovascular collapse 降低静脉回流 心血管瓦解 Tension pneumothorax气胸 ..\Movies\Pneomothorax.wmv Open pneumothorax打开气胸 Initial treatment: seal defect and secure on three sides (total occlusion may lead to tension pneumothorax 初治: 封闭伤口, 按住3个角留一个（完全封闭会造成张力性气胸） Definitive repair of defect in O.R. 只有在手术室才能最终封闭 Movie sucking Chest wound Open pneumothorax打开气胸 ..\Movies\First Aid Phnemutorax A.wmv Needle Thoracentesis胸腔穿刺术 Emergently decompress affected hemithorax with 14-gauge needle inserted over 3rd rib in 2nd inter-costal space at mid-clavicular line 紧急情况下为半胸减压, 使用14-gauge针从2、3肋骨间, 正对锁骨中间位刺入 THE TARGET: PREVENTABLE COMBAT DEATH目标: 避免战斗死亡  Main points关键点 Try to keep yourself from getting shot?首先要确保自己不要被击中 Try to keep the casualty from sustaining any additional wounds?要确保伤员不要再受伤 Airway management is generally best deferred until the Tactical Field Care phase?气道处理要等战术抢救开始时再实施 Stop any life-threatening hemorrhage with a tourniquet?对任何威胁生命出血用止血带进行止血 Reassure the casualty?为伤员打气 evacuation撤离 Cause of injury? Fall involved? 受伤原因？跌落？ Type of evacuation? Under fire? 撤离种类？火力下撤离？ Reassure the casualty给伤员打气 ..\Movies\Very Intense Injury Transport From Korengal Valley, Afghanistan.wmv Evacuation撤离 Cause of injury? Fall involved? 受伤原因？跌落？ Type of evacuation? Under fire? 撤离种类？火力下撤离？ Reassure the casualty给伤员打气 Movie “very intense” First stage第一步 One person carry 单人搬运 Blanket drag 毯子拖拽 Vehicle车辆 Release the legs from debris将腿从车辆残骸中退出 Casualty head lean on your shoulder伤员头靠在你肩上 Your arm under armpit你手穿到她腋下 Firm footing, rigid neck and drag踩实, 挺直脖子, 然后拖拽 Second stage第二步 Air Ambulance available (Helicopter)假如有抢救直升机 Sufficient space must be provided for hovering and maneuvering必需为直升机提供足够悬停和机动空间 select approach zones that permit the helicopter to lan