with subdural hematoma will experience facial
TREATMENTEnsure that the patient has
a patent airway. If oxygen is to be administered,
a nasal catheter is the preferred method of
administration. Manipulation such as suturing or
setting fractures should be held to a minimum,
if possible, until the patients condition is stable.
If the patient demonstrates extreme restlessness
that may further complicate his or her condition,
sedate quickly; otherwise avoid sedation. DO
NOT attempt to stem bleeding or the escape of
fluids from the ears or nose. Tell the patient to
try to avoid sneezing, coughing, or blowing the
nose. Evacuate the patient immediately.
In most cases, herniation or rupture of an
intervertebral disk is the result of trauma. It may
occur with sudden straining of the back in an odd
position or while lifting in the trunk flex position.
Herniation may occur immediately or may take
years to occur. Most herniation occurs in the
lumbosacral area but may also occur in the
cervical or thoracic regions.
SYMPTOMSOver 90 percent of all
herniated disks occur at the fourth or fifth
lumbar interspace. There is pain upon palpation,
and the patient will have a limited range of
motion. The posture of the spine will be
abnormal due to the loss of curvature of the spine.
The patient may exhibit mild weakness of the foot
or extensor areas of the great toe. There may be
impaired sensations of pain or touch, and
coughing or sneezing may cause radiation of the
pain to the calf.
TREATMENTPlace the patient on bed rest
with a backboard and administer analgesics for
pain. If possible, apply traction and prevent the
patient from using any severe physical effort.
Applications of heat to the area of tenderness is
beneficial. Definitive treatment of herniated disks
will normally require surgery. Therefore, evacuate
the patient as soon as possible.
Psychiatric disorders are more commonly
encountered now than at anytime in the past. This
is due in part to improved diagnostic techniques,
changing technology, and many other factors.
Psychiatric disorders run the gamut from
anxiety reactions to schizophrenia. The
independent duty hospital corpsman is not
properly trained to treat acute psychiatric
disorders. He should, however, be familiar with
the signs and symptoms of psychiatric disorders
and be able to manage those individuals who may
be a threat to themselves or to other personnel.
Classification of Psychiatric Disorders
The major classifications of psychiatric
disorders are neuroses, psychoses, and personality
. NeurosesEmotional maladjustments
that may impair thinking and judgment, but cause
minimal loss of contact with reality. Neuroses
often manifest themselves in the form of
anxiety reactions, phobias, and obsessive
depressive states. (Suicide is a definite possibility
in depressive states.) The management of
individuals with neuroses includes removing them
from stressful environments, listening, and the
presentation of alternatives versus being given
. PsychosesMental disorders in which
mental functioning is so impaired that it interferes
with the capacity of the individuals to meet the
ordinary demands of life. These disorders
manifest themselves in the form of schizophrenia,
psychotic depression, and paranoid reactions.
Tranquilizers and antipsychotic medications may
be necessary to protect the patient if immediate
evacuation is not possible.
l Personality DisordersCharacterized by
relatively fixed and inflexible lifelong reactions
to stress. Common personality disorders include
hysterias and antisocial, paranoid, obsessive
compulsive, passive aggressive, and inadequate
personalities. The processing of personality
disorders is administrative in nature and medical
department responsibilities in managing them may
be limited to confirmation and counseling.
The following are some of the more commonly
encountered disorders of the endocrine system.
This is a hereditary disease characterized by
an inadequate secretion and production of insulin