记者 杨蔚然 通讯员 黄配

记者 杨蔚然 通讯员 黄配

　　指导专家 长沙市第一医院

指导专家 长沙市The first医院

　　蒋　　林 脊柱外科主任、主任医师

蒋林 脊柱外科主任/Chief physician

　　郦　　俊 急诊科主任、主任医师

郦俊 急诊科主任/Chief physician

　　意外伤后首先要考虑止血 意外伤后首先要考虑止血

　　【急救常识】发生地震伤亡，主要是挤压伤和碰撞伤，四肢及头面部易受到创伤，一旦有创伤，就难免流血，如果失血过多，就会发生生命危险，此时止血很关键。如何自救止血呢？

[Emergency rescue]The earthquake casualties,Main is crush injury and impact injuries,Limbs and head facial vulnerable to trauma,Once you have trauma,Is hard to avoid bloodshed,If there is excessive loss of blood,Life happens,Hemostasis is critical at this time.How to rescue yourself stop bleeding?

　　止血方法有多种，应根据出血的具体情况选用。任何人如果意外受伤，首先要就地采取止血措施，然后尽快去就近医疗机构急诊，或立即向120呼救。

止血方法有多种,Should be based on specific situation to choose bleeding.If injury to anybody,First of all, on the hemostatic measures,And then go to the medical institutions to the nearest emergency as soon as possible,Or to 120 immediately for help.

　　外伤出血的现场急救，主要是指压止血法，适用于动脉损伤出血。方法是以手指压迫伤口近心侧的动脉干，使动脉血流受阻而达到止血的效果。止血时应行动快、止血彻底，自己无法止血时，可呼救请他人给予帮助。

外伤出血的现场急救,Is mainly refers to pressure hemostasis,Is suitable for the bleeding artery injury.Methods based on finger pressing the wound near the side of the heart artery,Make the blood flow to blocked arteries and hemostatic effect.Bleeding should action quickly/The bleeding altogether,When they can't stop bleeding,Can call please to help others.

　　举例说明，如皮下出血多发生在跌倒、挤压、挫伤的情况下，皮肤没有破损，仅仅是皮下软组织发生出血，形成血肿、淤斑。这种出血，一般外用活血化淤、消肿止痛药稍加处理，随后可痊愈。

举例说明,More such as subcutaneous hemorrhage happened in the fall/squeeze/Under the condition of contusion,Skin is not damaged,Is simply the subcutaneous soft tissue bleeding,To form the hematoma/blotchy.The bleeding,For external use commonly huoxue huayu/Slightly swelling pain processing,Can then be recovered.

　　皮肤表面的毛细血管出血，表现为慢慢渗出、出血量小，会自动停止，没有危险性。身边若有“创可贴”，一贴就好。

皮肤表面的毛细血管出血,Performance is slowly seeping/The bleeding little,Will automatically stop,No risk.If there is around"band-aid",A stick is good.

　

　切勿用香灰、煤油、石灰、泥土等污物撒到伤口里止血。 Do not use incense ashes/kerosene/lime/Soil, in the dirt and to stop the bleeding.

　　【心理指导】地震造成的损失要比大火、洪水大得多，一旦发生了强烈地震，很难立刻得到救援。面对重大的突发事件，首先应保持镇静，这是人类战胜各种天灾人祸、完美生存下来的必要条件。其次，自己设法（或者寻求他人帮助或帮助他人）脱离危险。再次，对外求救，一定请记住这三个电话号：110（匪警）、119（火警）、120（医院急救）。

[Psychological guidance]The loss caused by earthquake than fire/The flood is much bigger,Once the earthquake happened,It is difficult to get aid immediately.In the face of major emergencies,First of all should keep calm,This is man's triumph over all kinds of natural disasters/Perfect the necessary condition to survive.The second,His own(Or to seek help or help others)Out of danger.Once again,,For help,Must remember this three telephone number:110(nature)/119(The fire alarm)/120(hospital).

　

　昏迷及胸脑外伤的救护法 Coma and rescue method of thoracic traumatic brain injuries

　　【急救常识】第一，昏迷救护法：若找到突发事件的昏迷者，要立即让病人侧卧，清除其鼻咽部分泌物或异物，保持呼吸道通畅，防止痰液吸入。对躁动者应加强防护，防止坠地，并急送医疗点救治。

[Emergency rescue]The first,Coma rescue method:If find emergency coma,To let the patient side immediately,Remove the nasopharyngeal secretions or foreign bodies,Keep the airway open,To prevent the sputum suction.Should strengthen the protection of agitation,Prevent fell to the ground,And rushed to the clinic treatment.

　　第二，脑外伤救护法：在突发事件死亡者中，头部外伤占半数以上，绝大多数死于伤后24小时以内。发现脑外伤者，千万不要随便移动患者，注意固定其头、颈部，向后微仰，以保证呼吸道畅通。若受伤者呼吸停止，可进行人工呼吸。若脉搏消失，可进行心脏按压。若头皮出血，可用干净纱布等直接压迫止血。如果有血液和脑脊液从鼻、耳流出，一定要让受伤者向患侧侧卧，即左侧耳、鼻流出脑脊液时要向左侧卧，反之则右侧卧。

第二,Brain trauma care method:The men who were killed in emergencies,Head trauma accounted for more than half,Most died within 24 hours after injury.Found the injured brain,Don't literally move patients,Pay attention to fixed its head/The neck,Micro back up,In order to ensure smooth respiratory tract.If the victim stops breathing,Can be carried out artificial respiration.If the pulse disappear,Can be heart pressure.If scalp bleeding,Available clean gauze and other direct pressure to stop the bleeding.If you have blood and cerebrospinal fluid from the nose/Ear out,Make the victim to suffer from side to side,Namely, the left ear/Nose outflow of cerebrospinal fluid left side as you,The opposite of right side.

　　第三，胸外伤救护法：轻度胸外伤，只是胸壁被擦、受挫等，主要表现为胸壁疼痛，经过止痛、热敷、服用舒筋活血药物等治疗后，几天即可康复。重度胸外伤则为肋骨骨折。　　

第三,Chest trauma care method:Mild chest trauma,Just be wipe of chest wall/Frustrated, etc.,Mainly for pain in chest wall,After the pain/Hot compress/Relaxing tendons drugs such as after treatment,A few days to recover.Severe chest trauma is fractured ribs.

　　胸部发生骨折会出现各种各样的情形，如相连的几根肋骨同时骨折（浮动骨折，也叫连枷胸），这时也要尽快密封伤口，并让受伤者取患部向下的卧位。

胸部发生骨折会出现各种各样的情形,如相连的几根肋骨At the same time骨折(Floating fractures,Also called flail chest),At this time also need to seal the wound as soon as possible,And let the injured taken down decubitus affected part.

　 　【心理指导】

[Psychological guidance]

　　以上患者在康复过程中，其心理康状况将贯穿整个病程和护理的始终。提醒医护人员及家属，需掌握好患者不同时期的心理状态，训练强度以患者能接受为原则，使患者由被动运动逐渐过渡到主动运动，由替代护理逐渐过渡到自我护理，最大限度地发挥患者身体的残存功能。

以上患者在康复过程中,The mental health status will be throughout the entire course of the disease and care always.Remind staff and their families,需掌握好患者不At the same time期的心理状态,Training intensity to patients can accept for the principle,Make patients by passive movement gradually transition to the active movement,By alternative care gradually transition to self care,Maximize patient survival function of the body.

　　此外，还应注意观察病人的认知功能和感情方面的变化，发现异常要及时处理，这对于患者能否获得全面康复是个重要前提。

此外,Also should pay attention to observe the patient's cognitive function and emotional changes,Found abnormalities should be handled in a timely manner,This access to comprehensive rehabilitation is an important premise for the patient.

　

　扭伤及对截肢者的救护法 Sprain and rescue method for amputees

　　【急救常识】在突发事件中，如果遭遇肢体或关节扭伤，首先是冷敷30分钟左右。最好用冰，也可用冷水代替。冷敷后，用纱布把肢体或关节固定在舒服体位，抬高患肢。腰部扭伤后，最好采取感觉比较舒服的体位，将下肢垫高。

[Emergency rescue]In emergencies,If a body or joint sprain,First is the cold for 30 minutes.It is better to ice,Also can use cold water instead.After the cold,The members, or joint fixed in a comfortable position with gauze,Raise the limb.After lumbar sprain,Best to feel more comfortable position,The lower extremity pad high.

　　如果是重伤患者，如肢体残端可用弹力绷带包扎，给予经常的、均匀的压迫和按摩，以减轻残端疼痛，促进软组织恢复，并防止肌肉萎缩。

如果是重伤患者,Such as limb stump available in elastic bandage,To often/Uniform pressure and massage,In order to reduce residual pain,Promote tissue recovery,And to prevent muscle atrophy.

　　常用手轻轻拍打残端，可减轻其敏感性。应尽量保持肢体残端于伸直位，以防止残肢屈曲畸形。

常用手轻轻拍打残端,Can reduce the sensitivity.Should try to maintain limb stumps in straight position,In order to prevent the residual limb flexion deformity.

　　指导其早日开始功能锻炼，对防止患肢痛有重要作用。小腿以下截肢者，拆线后即可装配临时义肢练习负重。

指导其早日开始功能锻炼,Play an important role to prevent limb pain.Below leg amputees,After remove the temporary prosthesis assembly exercise load.

　　功能锻炼应循序渐进，上肢肩胛带离断者，下地活动时易失去重心平衡，身边应有人扶助。初次下地活动时很不习惯，易影响情绪，家属及医护人员均要鼓力和帮助患者，积极进行适应性锻炼，指导其正确使用拐杖，以防跌倒和摔伤。

功能锻炼应循序渐进,Upper limb pectoral girdle is broken,Activities on fields easily lose the center of gravity balance,Should have people around to help.Engaged in activities for the first time is not used,Easy to affect mood,Family members and medical personnel have to drum force and help patients,Adaptability of exercise actively,Guide them to use them correctly,In case of fall down and hurt.

　　【心理指导】当年唐山大地震导致16万人伤残，其中高位截瘫者达3817人。汶川大地震，造成的截肢病人也多达数千人。

[Psychological guidance]The tangshan earthquake left 160000 people disabled,With high paraplegia is 3817 people.The wenchuan earthquake,Amputation patients caused by as many as thousands of people.

　　在截肢成为他们保存性命的唯一希望下，每一个幸存者几乎都最终选择截肢。有腿，没腿，是两种生活。截肢的疼痛会在半个月后过去，但适应没腿或没手的生活，必将是一辈子的心理压力。因此，加强对患者针对性的心理呵护，非常有必要。

在截肢成为他们保存性命的唯一希望下,Every one survivor almost amputation was finally chosen.Have a leg,No legs,Are two kinds of life.Amputation pain will be in after half month past,But to adapt to life in hand no legs or no,Will is a lifetime of psychological pressure.so,To strengthen the psychological care of patients targeted,It is important.