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 bearing on injured tissue must be avoided.
2. 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.
3. Analgesics may be required in the early post-thaw days but will soon become unnecessary in uncomplicated cases.
4. Encourage the patient to take a nutritious diet with adequate fluid intake to maintain hydration.
5. Perform superficial debridement of ruptured 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 conditions, 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 identification 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 victim’s problem and start appropriate first aid procedures immediately. After checking the vital signs, you must carefully assess all the signs and symptoms before making a preliminary diagnosis.
FAINTING (SYNCOPE)
Uncomplicated fainting is the result of blood pooling in dilated veins, which reduces the amount of blood being pumped to the brain. Causes include getting up too quickly, standing for long periods with little movement, and stressful situations. 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 position 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.
DIABETIC CONDITIONS
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 identification symbol.
Diabetic Ketoacidosis
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. Concurrently, lack of glucose in the cells leads to an increase 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 symptoms 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 present 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.)