户外医疗专题

心亦远

好明姐

bigsun

猫薄荷

猫薄荷

黑丑白丑牵牛花

<span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-bidi-font-family: 'Times New Roman'; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">
<p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt; TEXT-INDENT: 24pt; mso-char-indent-count: 2.0"><strong><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">四肢的骨折在户外活动中并不罕见，现场处理的正确与否，对伤者今后的治疗及康复有很大的影响。</span><span lang="EN-US" style="FONT-SIZE: 12pt"><o:p></o:p></span></strong></p>
<p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt; TEXT-INDENT: 24pt; mso-char-indent-count: 2.0"><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'"><strong></strong></span></p>
<p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt; TEXT-INDENT: 24pt; mso-char-indent-count: 2.0"><strong><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">骨折的判断：</span><span style="FONT-SIZE: 12pt"><font face="Times New Roman"> <span lang="EN-US"><o:p></o:p></span></font></span></strong></p>
<p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt; TEXT-INDENT: 24pt; mso-char-indent-count: 2.0"><strong><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">骨折往往是有摔倒、撞伤和击伤所致，</span><span style="FONT-SIZE: 12pt"><font face="Times New Roman"> </font></span><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">开放性骨折诊断较易，</span><span style="FONT-SIZE: 12pt"><font face="Times New Roman"> </font></span><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">闭合性骨折、其局部多有肿胀、皮下出血、畸形、压痛及轴心叩击痛是判断有无移位骨折及外观有无畸形骨折的依据，伤处有异常活动及骨擦音是诊断的依据，但不要为了明确诊断而故意活动患肢。如果不能明确，就按照骨折进行处理。</span><span lang="EN-US" style="FONT-SIZE: 12pt"><o:p></o:p></span></strong></p>
<p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt; TEXT-INDENT: 24pt; mso-char-indent-count: 2.0"><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'"><strong></strong></span></p>
<p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt; TEXT-INDENT: 24pt; mso-char-indent-count: 2.0"><strong><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">现场处理：</span><span lang="EN-US" style="FONT-SIZE: 12pt"><o:p></o:p></span></strong></p>
<p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt; TEXT-INDENT: 24pt; mso-char-indent-count: 2.0"><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'"><strong></strong></span></p>
<p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt; TEXT-INDENT: 24pt; mso-char-indent-count: 2.0"><strong><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">冷静处理：还是老话，要保持冷静，切忌七嘴八舌，手忙脚乱。处理由一个人进行，别人进行配合。判断受伤疼痛的部位是一处还是多处</span><span lang="EN-US" style="FONT-SIZE: 12pt"><font face="Times New Roman">,</font></span><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">是否还有颅脑、椎体、胸腹等其它的损伤。如果有其它的损伤，按照前面所述进行现场处理。</span><span lang="EN-US" style="FONT-SIZE: 12pt"><o:p></o:p></span></strong></p>
<p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt; TEXT-INDENT: 24pt; mso-char-indent-count: 2.0"><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'"><strong></strong></span></p>
<p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt; TEXT-INDENT: 24pt; mso-char-indent-count: 2.0"><strong><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">患肢固定：骨折良好的固定可以减少疼痛</span><span lang="EN-US" style="FONT-SIZE: 12pt"><font face="Times New Roman">,</font></span><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">减少休克</span><span lang="EN-US" style="FONT-SIZE: 12pt"><font face="Times New Roman">,</font></span><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">避免骨折移动刺伤血管神经</span><span lang="EN-US" style="FONT-SIZE: 12pt"><font face="Times New Roman">,</font></span><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">减少出血和感染。肢体骨折应迅速用夹板或木棍、竹竿、登山杖等将断骨上、下方固定。若骨折是由于局部有内出血而引起肿胀，</span><span style="FONT-SIZE: 12pt"><font face="Times New Roman"> </font></span><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">固定时不宜过紧，</span><span style="FONT-SIZE: 12pt"><font face="Times New Roman"> </font></span><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">以免压迫血管引起淤血。</span><span lang="EN-US" style="FONT-SIZE: 12pt"><o:p></o:p></span></strong></p>
<p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt; TEXT-INDENT: 24pt; mso-char-indent-count: 2.0"><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'"><strong></strong></span></p>
<p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt; TEXT-INDENT: 24pt; mso-char-indent-count: 2.0"><strong><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">上肢伤的固定比较简单</span><span lang="EN-US" style="FONT-SIZE: 12pt"><font face="Times New Roman">,</font></span><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">在无法找到固定的夹板时</span><span lang="EN-US" style="FONT-SIZE: 12pt"><font face="Times New Roman">,</font></span><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">利用自体固定亦可取得相当好的效果。下肢伤的固定较上肢更为重要</span><span lang="EN-US" style="FONT-SIZE: 12pt"><font face="Times New Roman">,</font></span><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">亦可采取自体固定</span><span lang="EN-US" style="FONT-SIZE: 12pt"><font face="Times New Roman">,</font></span><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">即将伤肢固定于健侧肢体上</span><span lang="EN-US" style="FONT-SIZE: 12pt"><font face="Times New Roman">,</font></span><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">固定时先将伤肢牵拉正直</span><span lang="EN-US" style="FONT-SIZE: 12pt"><font face="Times New Roman">,</font></span><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">用棉花或毛巾等将两膝隔开</span><span lang="EN-US" style="FONT-SIZE: 12pt"><font face="Times New Roman">,</font></span><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">以免相互摩擦挤压</span><span lang="EN-US" style="FONT-SIZE: 12pt"><font face="Times New Roman">,</font></span><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">然后用绷带或三角巾、布带等将两下肢扎在一起即可。简单的夹板固定</span><span lang="EN-US" style="FONT-SIZE: 12pt"><font face="Times New Roman">,</font></span><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">即利用足够长的木板、扁担、竹板等作临时固定</span><span lang="EN-US" style="FONT-SIZE: 12pt"><font face="Times New Roman">,</font></span><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">将伤肢牵拉正直</span><span lang="EN-US" style="FONT-SIZE: 12pt"><font face="Times New Roman">,</font></span><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">在骨突起部用棉花或布块垫好</span><span lang="EN-US" style="FONT-SIZE: 12pt"><font face="Times New Roman">,</font></span><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">固定物放在外侧</span><span lang="EN-US" style="FONT-SIZE: 12pt"><font face="Times New Roman">,</font></span><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">用绷带或布带与伤肢捆扎在一起。</span><span lang="EN-US" style="FONT-SIZE: 12pt"><o:p></o:p></span></strong></p>
<p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt; TEXT-INDENT: 24pt; mso-char-indent-count: 2.0; tab-stops: 318.0pt"><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'"><strong></strong></span></p>
<p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt; TEXT-INDENT: 24pt; mso-char-indent-count: 2.0; tab-stops: 318.0pt"><strong><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">止血包扎：开放性伤口包扎的目的是保护伤口免受再污染，因会对伤处的组织有破坏的作用，且给伤者带来不必要的痛苦，不要用碘酒或酒精冲洗或涂擦伤处。开放性骨折伴有大出血则可用干净布片或卫生巾压迫、覆盖伤口。只有在加压包扎后不能控制出血的情况下</span><span lang="EN-US" style="FONT-SIZE: 12pt"><font face="Times New Roman">,</font></span><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">才暂时使用止血带止血法，并在止血带上标明止血时间。切勿将外露的断骨推入伤口内，若在包扎时骨折端已自行滑回创口内，则送医院后必须向负责医生说明。应用止血带时，压力要适当，并在途中每一个半小时放松</span><span lang="EN-US" style="FONT-SIZE: 12pt"><font face="Times New Roman">5</font></span><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">分钟，使伤肢间断的恢复血循环，同时放松时以手指在出血之处近端压迫主要血管，以免每放松一次丢失大量血液。</span><span lang="EN-US" style="FONT-SIZE: 12pt"><o:p></o:p></span></strong></p>
<p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt; TEXT-INDENT: 18pt; mso-char-indent-count: 1.5"><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'"><strong></strong></span></p>
<p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt; TEXT-INDENT: 18pt; mso-char-indent-count: 1.5"><strong><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">&nbsp;离断肢体的保存：</span><span style="FONT-SIZE: 12pt"><font face="Times New Roman"> </font></span><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">如果有不全离断但已缺血的肢体或离断的肢体，立即给予放置塑料袋中，外置冰块降温，勿使冰块与冰水直接与肢体接触，</span><span style="FONT-SIZE: 12pt"><font face="Times New Roman"> </font></span><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">肢体不要浸泡在其他药液内，如果环境温度低，转运时间不长，可以不用降温保存，若气温炎热，且转运时间较长，应立即实行降温保存。下肢比上肢肌肉组织多，</span><span style="FONT-SIZE: 12pt"><font face="Times New Roman"> </font></span><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">离断缺血后，更应强调降温保存。</span><span lang="EN-US" style="FONT-SIZE: 12pt"><o:p></o:p></span></strong></p>
<p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt"><span lang="EN-US" style="FONT-SIZE: 12pt"><font face="Times New Roman"><strong><span style="mso-spacerun: yes">&nbsp;</span><span style="mso-spacerun: yes">&nbsp;&nbsp; </span></strong></font></span></p>
<p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt"><strong><span lang="EN-US" style="FONT-SIZE: 12pt"><font face="Times New Roman"><span style="mso-spacerun: yes">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></font></span><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">骨与关节损伤后，途中能及时而正确急救观察与救治，不仅能消除和缓解立即致命致残的威胁，而且为进一步治疗创造必要的有利条件，提高抢救成活率，</span><span style="FONT-SIZE: 12pt"><font face="Times New Roman"> </font></span><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">提高急救人员训练有素的应急能力和技术水平，紧张有序的心理因素，</span><span style="FONT-SIZE: 12pt"><font face="Times New Roman"> </font></span><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">以缩短急救半径，</span><span style="FONT-SIZE: 12pt"><font face="Times New Roman"> </font></span><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">降低伤残率、死亡率，</span><span style="FONT-SIZE: 12pt"><font face="Times New Roman"> </font></span><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">挽救更多的生命。</span><span lang="EN-US" style="FONT-SIZE: 12pt"><o:p></o:p></span></strong></p>
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车马炮

娟儿*

无铭小辈

螨虫

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