|
|||||||
|
|
|
|||||
|
|
|||||||
Disclaimer: The following texts are
provided for role playing purposes only and are not meant as
guides for situations found in real life.
The following scrolls are provided as reference tools and are not required reading.
Human Anatomy | | CPR Chart
Evaluation of Injuries | Infection
Cycles | Healer Hall Home Page
Healer Hall Home Page Scroll Section
By Gavroche
This scroll is provided as a reference tool and not required
reading.
SKIN: Anatomy. The skin consists of two layers. The outer layer
is thin, and mostly there for protection. The inner, thicker part
contains all the blood, water, and other stuff. (like sweat
glands and hair roots)
Physiology. Skins serves several important functions, listed
here.
1. Regulation of body temperature. In response to external
temperature or excersize, skin releases sweat, which helps cool
the surface as it evaporates. If the outside temperature is low,
the skin slows down sweat productions, thereby preserving heat.
2. Protection. The skin covers the body and provides a physical
barrier that proctects underlying tissues from physical abrasion,
infection, and dehydration. Hair and nails also have protective
functions.
3. Sensation. The skin contains abundant nerve endings that
detect a variety of occurances, such as temperature, pressure,
and pain.
4. Excretion. Besides removing heat and some water, sweat also
removes a small amout of slats and other chemicals.
5. Blood resevoir. The skin contains a large portion of the blood
supply at any given time. This amount varies with external
temperature and excersize.
MUSCLE:Anatomy: Muscles are attached primarily to bones. It is
striated (alternating light and dark bands), and it is voluntary
because it can be made to work by conscious control. Cardiac
muscle, or the heart, is involuntary.
Physiology:
1. Motion. Motion is obious in movements such as walking and
running, and in localized movements, such as grasping a mug of
klah or nodding the head. Less noticable kinds of motion are
produced by smooth and cardiac muscle, such as the beating of the
heart, or the churning of the stomach.
2. Stabilizing body positions and regulating organ size. Muscle
contractions maintain the body in stable positions, such as
standing or sitting. For example, partially contracted muscles
hold the neck upright (which is often the source of a
neck-ache!). Temporary storage of "stuff" is possible
due to contraction of smooth muscle... ie, urine in the bladder,
extra food in the stomach...
3. Thermogenesis. Muscles contract to do work, this causes heat
Muscle contractions many generate as much as 85% of all body
heat.
BONE: Anatomy. The skeletal system consists of cartilage, bone
tissue, and bone marrow.
Physiology.
1. Support. Bones provide a framwork for the body by supporting
and providing points of attachment for muscles.
2. Protection. Bones protect many internal organs from injury.
For example, the brain and spine, and the ribcage enclose the
heart and lungs.
3. Movement. Skeletal muscles attach to bones. When they
contract, they pull on bones and together, they produce movement.
4. Site of blood production. We know from the oldest ledgible
scrolls that blood, or some component of blood, is made in the
bone marrow. We no longer have proof of this, however.
5. Storage of energy. Yellow marrow, named for it's colour,
consists primarily of fat, the body's energy reserve.
DIGESTION: The main function of the digestive system is to break
down food, mechanically and chemically, and converted into an
absorpable form.
Mouth - teeth mechanically crush food, saliva help breaks some
food down further. Esophagus - food is delivered from the mouth
to the stomach through peristalsis, the wave-like motion of
smooth muscle. Stomach - This is where most digestion occurs. The
stomach uses an extremely powerful acid to break food down. Small
intestine - this is very long, over 8 feet in length. Digestion
is finished here, and the body absorps what it needs. Large
intestine - This is for waste only, some fluid absorption occurs.
It takes 3-5 days for waste to pass through. If the passage
quickens, this is diarrhea, if the passage slows, constipation.
RESPIRATION: Nose -- pharynx -- esophagus (food) \-- larynx (air)
Upper respiratory: nose, pharynx, larynx common cold, head cold
Lower respiratory: trachea, bronchi, lungs pneumonia, bronchitis
Nose - filters, warms, and moistens air Pharynx - throat Larynx -
voice box
Epiglottis - a valve that works like a trap door covering the
opening of the larynx to prevent food from entering trachea (this
causes choking).
Trachea - windpipe, tube between larynx and bronchi,. Bronchi -
tubes branch of trachea to lungs.
Breathing: diaphragm contracts, increase in volume, decrease in
pressure = lungs expand with air. diaphragm relaxes, decrease in
volume, increase in pressure = air rushes out. The hiccup is
cause by the diaphragm being knocked out of postion. The hiccups
are it's attempts to jerk back into place.
Within the lungs, through methods we really do not know, old air
is exchanged for fresh.
CIRCULATION: The main function of the circulatory system is to
transport needed materials to the body and collect wastes from
it. (The average adult has between 8-10 pints of blood. Loss of 2
pints or 20% is cause for alarm)
Arteries have thick walls, they carry clean blood away from the
heart. Veins are very thin walled. They carry dirty blood back to
the heart. The oldest scrolls speak of a network of very minute
vessels called capillaries that connect arteries to veins.
The heart takes old, dirty blood from the body and pumps it to
the lungs, then takes the clean blood from the lungs and pumps it
back into the body.
Body -> right atrium -> right ventricle -> arteries to
lungs -> lungs -> veins from lungs -> left atrium ->
left ventricle -> body
Blood, when removed from the body and spun vigorously, separates
into two parts. One is a straw coloured liquid that can be used
to immunize people against a sickness. The second is a red/black
clot that contains most of the solids of the blood.
pulmonary arteries --> cappilaries (gas exchange) -->
pulmonary veins --> left atrium --> bicuspid valve -->
left ventricle --> aortic semilunar valve --> aorta -->
body.
Written by Kylandra
*Note the following scroll is provided as a general informational
text to help with RP should you encounter these types of
situations. It is often not neccissary to go into such detail in
the course of RP but it was felt that this information could be
helpful to you. As a PERN healer you would know the rudaments of
these approaches but not neccissarily call them by the names we
know them in RL. Keep this in mind when/if you use these
techniques in RP and also keep in mind the technology level of
the society in which we are playing ( Medieval-ish)
Disclaimer: The following texts are
provided for role playing purposes only and are not meant as
guides for situations found in real life.
A proper approach to the unconscious victim may make the
difference between life and death. Always assume that an
unconscious person maybe seriously hurt.
I.Open and maintain the airway. Check for adequacy of pulse. One
of the leading causes of death in victims of head injury is
airway obstruction. Adequacy of the airway and breathing must be
attained rapidly in every patient. If oxygen is not supplied to
the brain then death will follow
Symptoms of airway obstruction
-sudden inablitity to speak
-blue skin coloration
-choking gestures
-harsh raspy noises that come from the neck during breathing
B. Treatment
Under no circumstances should the neck be manipulated if there is
a possibility of an injury to the back.
1.If there is a possibility of such an injury keep the airway
open by gently but firmly lifting the jaw by grasping the lower
teeth and pulling directly forward.
2. If there is NO chance of neck injury tilt the head backward
while gently lifting under the neck.
3. Keep the airway clear of blood, vomit and debris. This can be
accomplished by sweeping the mouth with 2 fingers. Take care not
to force objects deeper into the throat If the tongue appears to
be the problem, wrap the end of the tongue in a cloth or gauze
bandage, grasp firmly and pull till the tongue no longer blocks
the throat.
4. If the victim is unconscious and there is no chance of a
broken neck, do not leave him lying flat on his back. Turn him on
his side so that if vomiting occurs the fluid can drain from the
mouth and the victim won't drown.
5. Choking is a life-threatening condition in which the upper
airway is blocked by a foreign object (tongue, broken teeth,
food).The choking person is profoundly agitated (before he
becomes unconscious from lack of oxygen), frequently grasps at
his throat in a 'choking' gesture, cannot breathe, and is unable
to speak. Sweep the mouth with one or two fingers to remove any
foreign material. Take care not to force material farther into
the throat Using an open hand, give the victim two to four rapid
sharp blows on the back between the shoulder blades. Remove the
obstruction by positioning yourself behind the victim and
encircle him with your arms,clasping hands in a fist in the upper
abdomen just below the ribs.Squeeze the victim suddenly and
firmly (bear hug) two or three times, in an attempt to produce a
violent exhalation and ejection of the foreign body.
1b. Check for adequacy of blood pressure. Assess the need for
cardiopulmonary resuscitation (CPR). Check for pulses at the neck
(carotid artery) or groin (femoral artery). If no pulse is
detected and the victim is unconscious and not breathing, begin
cardiopulmonary resuscitation.
A. Procedure for CPR
1. Place the patient on his back on a firm surface and position
the heel of one hand over the center of the breastbone. The heel
of the second hand is placed over the bottom hand. Interlock the
fingers.
2. The healer's shoulders should line up directly over the
victim's breastbone, with the arms straightened at the elbows.
3. Using a stiff-arm technique, the breastbone is compressed 1
1/2 to 2 inches. Using a smooth motion, the compression phase
should equal the relaxation phase, with a rate of 60 compressions
per minute.
4. With two healers working together, a breath should be forced
into the patient with every 5 chest compressions. If a single
healer is performing the procedure, he should alternate 10 chest
compressions with 2 breaths.
II. Protect the bones in the neck.
To protect the patient from spinal cord damage, the healer must
strive to protect the spine. Immediately immobilize the head and
neck. This may be done by taping the head to a backboard or
stretcher, by applying a rigid collar, or by placing sandbags or
their equivalent on either side of the head.
III. Carefully examine the patient for evidence of an obvious
injury and treat accordingly.
A. If the patient is conscious and able to talk, ask the person
what happened and where the pain is located. First, recognize the
victim's problems as real, next, work within your limitations and
abilities in offering advice and/or providing treatment. Examine
the patient working from head to foot. Usually the injuries at
the top of the body are more serious, and the injuries located
farther downward, toward the feet, are comparatively less
serious.
1. Head check for bruises and any area sensitive to touch.
Examine the eyes for pupils which are uneven, enlarged, or
unresponsive to a glow stick. Headaches, disorientation,
confusion,or memory problems, coupled with uneven pupil size, may
indicate serious head injury. Disorientation may be a part of a
variety of illnesses and injuries, especially if fever is
present. If watery fluid or blood is flowing from the nose or
ears, it indicates the possibility of a skull fracture.
2. Neck Check for any pain, stiffness, or soreness in this area.
Numbness and tingling sensation in extremities may be present.
Without moving the patient, gently run your fingers over the
vertebrae to feel for any irregularities. These signs indicate
the possibility of neck or cervical spinal injuries and the
person should NOT be moved.
3. Chest Gently feel the chest walls for any irregularities.
Soreness may indicate bruised or fractured ribs. The coughing up
of bright, frothy blood indicates probable injuries to the lungs.
Pain or discomfort may be present in breathing. Problems
associated with breathing and the heart rate often follow
accidents and should be recognized.
4. Abdomen If the conscious person complains of pain in the
abdomen or if there is tenderness upon palpation, suspect an
injury to the liver, spleen, kidneys, or intestine. Firmness of
the muscles of the abdomen on the left side may indicate injury
to the spleen. An individual passing blood in urine may well have
kidney injury.
5. Arm, Shoulder, Pelvis, and Legs Pain, tenderness, or
deformities in these areas indicate possibilities of bruises,
sprains, strains, fractures and/or dislocation.
By Gavroche
This chart gives rates and cycle information for CPR. Recall,
always start with two breaths after opening the airway. Continue
until further help arrives or victim starts to breathe on their
own.
Hand Position Compressions Breaths Cycles
(pulse/beathing check)
1. Adults Heels, both | 15 | 2 | 4
2.Child Heel, one | 5 | 1 | 10
3.Baby Two fingers | 5 | 1 | 10
by Krilin
At every point in someones lifetime they suffer an injury. For
this reason, it is a good idea to know how to evaluate an injury
when it occurs. There are several types or injuries and certain
techniques on how to asess them.
-Listen to what the patient tells you. For example, the patient
tells you that they hurt their leg when they fell down a flight
of stairs; this is subjective because they are telling you this.
-Observe the patient and their injury.
- Assess what you think or know is wrong with the patient.
-Decide the best treatment for the patient
Aside from this there is also good to use a technique calls HOPS,
which helps during the actual evaluation of the patient.
H- This stands for History. In this part, you have just been
presented with the patient, and you need to find out what is
wrong, and what happened. The goals of using the History is to
find out several things: 1) Any previous injury the patient has
had to that area; any minor or major.
2) What happened
3) How did it happen
4) Did they hear a pop, or any unusual type of noise.
5) Location of the pain
6) A description of symptoms
7) And general medical health
O- Observation. This is where you compare the patients uninjured
limb or body part to the injured one. As with the history, there
are several things to look for:
1) Gross Deformity- This could be from a dislocated patella or
just an unusual sweeling to the particular area.
2) Discoloration, such as bruising, inflammation.
3) Infection, looking for the obvious signs of infection
(redness, swelling,pus, etc.)
4) Bleeding (this one pretty much explains itself)
5) And as noted before, the overall appearance compared to the
uninjured limb or body part.
P- Palpation. This is where you use your fingers to feel, where
your eyes cannot see. When palpating, it is wise to look at the
patients face for signs of pain, for that is one of the best
indicators. You should also palpate by beginning at the point of
least pain, slowly moving towards the damaged area. Their are
three types of palpation, and they are done in the following
order:
1) Bony palpation: This is palpating the bony structures in the
body. This must be done first to rule out the possibility of a
fracture.
2) Soft tissue: This is palpating the muscle tissues, looking for
any pain or point tenderness.
3) Ligamentous Tissues: Palpate the ligamentous tissues, looking
for pain as in the soft tissue.
While doing the different types of palpations, you should also be
paying attention for several types of situations you may find.
These are: 1)Increases in Skin Temperature at the site of the
injury- This could signify inflammation, or possible infection to
the area.
2) Crunching or grinding- This is a crunching like feeling-almost
like a snowball- which is a grinding of the tissues. It can
indicate a fracture ir inflammation when felt over the tendon,
bursa or joint capsule.
3) Point Tenderness- This is the point of the most pain. A
patient is point
tender in a certain area when you can pinpoint it with your
finger and then
move it, finding pain only in that spot.
S- The last, but not least part of the HOPS. It stands for
special or
functional testing. This is done by moving the injured part ( if
applicable). As with the others, there are
several parts to this.
1) Active- This is done by having the patient move the limb or
body part by themself, testing both the injured and non-injured
part.
2) Passive You take the limb and move it .
3) Resistive Motion -This is when you have them resist a certain
motion. For example, you would push down onto a persons foot as
they try to keep it up, therefore resisting you. This tests their
overall strength.
4) SensationTesting- This is where you test the sensory and motor
functions of the patient. Sensory testing would be simply
touching the person; if they feel you touching them, then it is a
positive test. A normal motor function would have them move the
body part.
by Gavroche
The following is provided as a guide and its contents may nor be
fully understood by Pern Healers but the basic concepts of
infection etc are probably well understood from records and as
seen in Moreta.. by A. McCafferty
Infection
The cycle starts with what is called the "resevoir
host". The host may be animal or human. It either naturally
harbors the disease, or was previously infected with it.
Basically, the resevoir host is where the infection comes from.
An infection doesn't simply bounce merrily from person to person.
It must exit the host, to begin with. The means are various and
many. Any opening from the body can serve as an exit portal, be
it your mouth, nose, ears, eyes, genital regions, and of course
open wounds. Other parts of your body, those that harbor bugs,
are also responisble, such as your throat, intestinal tract and
urinary tract.
So now, the infection has exited our resevoir host. Now, we need
a means of transmission, that is, how the infection spreads from
the resevoir host to everyone else. Direct contact with an
infected person or discharge is the most obvious way. Indirect
transfer includes water vapor from the lungs, as when a person
coughs or sneezes*; contaminated hands (ah-hah!) or equipment;
contaminated food and water; and insects.
* Droplet infection is very interesting. Every time a person
coughs or sneezes, they expel between 4 and 5 thousand droplet
nuclei (a small mass of mucus and water) at the rate of 150 feet
per second. The droplets have a hangtime (time spent in air) of
about 30 minutes, and hold, in total, about 30 million germs.
A germ not only needs a means of exit, it needs a means of
entry... generally, any way a germ can get out, it can get in as
well. Mouth, nose, throat, ears, eyes, intestinal tract, urinary
tract, reproductive tract, open wounds and any breaks in the
skin.
A susceptible host is the fancy term for the person at risk of
catching the infection. Their resistance, or ability to fight off
disease is low. Factors that contribute to low resistance include
such things as poor health, poor hygiene, and poor nutrition.
The cycle continues... as the suseptible host's condition
improves, this person becomes the new resevoir host.
Of course, there are many things that affect, change and
otherwise alter this cycle. The disease itself makes a
difference. Some diseases are so virulent that the merest contact
ensures you've caught it, while other diseases might require a
prolonged contact before infection.
Acute infections are characterized by swift, sudden onsets and
are of short duration. If there is a fever, it is high.
Chronic infections are characterized by slow onsets and are of
long duration. The fever, if any, is low.
Localized infections are those occuring in one area on the body,
for example, a boil.
Systemic infections are those occuring throughout the body. Note
that a localized infection can spread, becoming systemic.
Secondary infection is caused by a person being exposed to a
disease while their resistance is low due to fighting off a
different infection. An example of this would be a person down
with the flu, who is exposed to bronchitis and catches it.
Secondary infection is extremely dangerous, especially since 99
times out of 100, it worsens the patient's condition.
Plagues do occur on occasion. A plague disease is generally
extremely virulent, with a short incubation period. There are
some handy terms for plague diseases, determined by the number
and frequency of infected cases.
A sporadic infection refers to isolated cases occuring rarely. An
example of this would be a young lady in a small hold coming down
with an ancient illness that no-one has seen in many Turns....
nor will we see it again for at least as many Turns... if we're
lucky.
Endemic infection is where there are numerous cases confined to
one region. An example... a cold rampage in a large hold during
the winter.
Epidemic infection is where we have the beginnings of a real
problem. Numerous cases no longer confined to a region. Example,
our holders with the colds infect every one in the three large
holds nearest them.
Pandemic infection is simple. Numerous cases world-wide. The
plague that swept the Holds, Halls and Weyrs in Moreta's time was
pandemic.
Fighting Infection
The means for fighting infections are many. Some of them are more
effective than others.
The first rule in the event of a contagious infection is
isolation. Isolate the sick from the healthy, and keep contact to
a minimum. This protects the sick as well as those who aren't
sick.
Your first, and often, best defense against infection is
handwashing. Do it often, and thoroughly. Handwashing cannot be
stressed enough. It is also a good idea, in the case of a
virulent disease, to cover your mouth and nose while tending the
patient. We would recommend a clean cloth, or gauze. This
protects the patient as well as yourself.
Limit contact. This may seem difficult, maybe even senseless, but
it can save lives, your included. Do not handle anything the
patient may have contaminated without a barrier. Use a cloth to
pick something up, for example... and never touch the
"dirty" side of the cloth. And most especially, *never*
come into physical contact with the patient's bodily fluids if it
can be at all avoided. Yes, accidents can happen. Try to limit
the chances for an accident. Always, use a barrier, wash your
hands frequently, and if you do come into contact with anything
such as blood, urine, or vomit, clean it off yourself
immediately. This also cannot be stressed enough.
In the event that physical contact with bodily fluids is
unavoidable, there are certain things you must do. First of all,
don't panic. Remove any garments that have been contaminated,
there is no room for modesty. Immediately scrub the area of skin
with hot water and soap and then redwort. If the fluid (or
whatever) is on your hands, touch *nothing* with them until you
are certain they are clean again. This includes yourself, do not
rub your eyes, wipe your mouth, or even scratch your ears. If the
contaminated substance gets you in the eye, flush the surface
with water for several minutes. If it splashes into your mouth,
spit, then flush your mouth with water, not swallowing at all. Of
course, a cloth covering your nose and mouth tends to prevent
that from occuring. Once you have cleaned yourself to the best of
your ability, leave the room. Find more clothes, if necessary,
relax. When you are calm again, report back to duty, but be
careful. If you know the incubation period of the illness, it may
be wise to wait long enough to know whether or not you've caught
the infection.
There are herbal remedies for infections, this scroll doesn't
deal with those, since those properly belong in the Herbalism
class. However, if you have a patient who is not responding to
any treatment you can devise, try having them eat a bit of moldy
bread and cheese. It seems to have beneficial effects on some
diseases.