general, this is accomplished by keeping the
patient at bed rest with the injured part
elevated, on surgically clean sheets, and
with sterile pieces of cotton separating the
toes or fingers. Expose all lesions to the air
at normal room temperature. Weight bear-
ing on injured tissue must be avoided.
Whirlpool baths, twice daily at 98.6°F
(37°C) with surgical soap added, assist in
superficial debridement, reduce superficial
bacterial contamination, and make range
of motion exercises more tolerable.
Analgesics may be required in the early
post-thaw days but will soon become un-
necessary in uncomplicated cases.
Encourage the patient to take a nutritious
diet with adequate fluid intake to maintain
Perform superficial debridement of rup-
tured blebs, and remove suppurative scabs
and partially detached nails.
COMMON MEDICAL EMERGENCIES
This section of the chapter deals with some
other relatively common medical problems a
corpsman may face in a first aid situation.
Generally speaking, these particular problems are
the result of previously diagnosed medical con-
ditions, so at least for the victim they do not come
as a complete surprise. Many of these victims will
be wearing a MEDIC ALERT necklace or
bracelet, or carrying a MEDIC ALERT identifica-
tion card that specifies the nature of the medical
condition or the type of medications being taken.
In all cases of sudden illness, search the victim
for a MEDIC ALERT symbol. It may help you
diagnose the victims problem and start ap-
propriate first aid procedures immediately.
After checking the vital signs, you must
carefully assess all the signs and symptoms before
making a preliminary diagnosis.
Determine the victims level of con-
sciousness, including orientation to sur-
roundings and reaction to pain stimulus.
Check the limbs for weakness or paralysis.
Check pupil size and reaction to light for
signs of brain injury.
Continuously monitor respiration depth
. Log all observations
tion by a physician.
carefully for evalua-
is the result of blood
pooling in dilated veins, which reduces the amount
of blood being pumped to the brain. Causes in-
clude getting up too quickly, standing for long
periods with little movement, and stressful situa-
tions. Signs and symptoms that may be present
are dizziness, nausea, visual disturbance from
pupillary dilation, sweating, pallor, and a weak,
rapid pulse. As the body collapses, blood returns
to the head and consciousness is quickly regained.
Revival can be promoted by carefully placing the
victim in the shock position or in a sitting posi-
tion with the head between the knees. Placing a
cool wet cloth on the face and loosening the
clothing can also help.
Syncope may also result from an underlying
medical problem such as diabetes, cerebrovascular
accident (stroke), heart condition, or epilepsy.
Diabetes mellitus is an inherited condition in
which the pancreas secretes an insufficient amount
of the protein hormone insulin. Insulin regulates
carbohydrate metabolism by enabling glucose to
enter cells for use as an energy source. Diabetics
almost always wear a MEDIC ALERT identifica-
Diabetics may suffer from rising levels of
glucose in the blood stream (hyperglycemia). The
rising levels of glucose result in osmotic diuresis,
and increase renal excretion of urine. A serious
dehydration (hypovolemia) may result. Concur-
rently, lack of glucose in the cells leads to an in-
crease in metabolic acids in the blood (acidosis)
as other substances, such as fats, are metabolized
as energy sources. The result is gradual central
nervous system depression, starting with symp-
toms of confusion and disorientation and leading
to stupor and coma. Blood pressure falls and the
pulse rate becomes rapid and weak. Respirations
are deep, and a sickly sweet acetone odor is pres-
ent on the breath. The skin is warm and dry.
(NOTE: Too often a diabetic victim is treated as
if intoxicated; the signs and symptoms presented
are similar to those of alcohol intoxication.)