First aid instructions that are being sent to Libya

[exquisite]

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As the hugely popular blog Boing Boing reports, there's an ongoing effort to send an information package to Libyan fax numbers. The file includes a page on emergency treatment.

Do you guys have ideas for improvement, or feedback? I asked on the chat channel mentioned in the document, and apparently the document is an ad hoc collaborative project - there's no Activist's Guide to Being Machine-Gunned or any other kind of established instruction set. They're open to suggestions.

And in any case, people might find it interesting to see how familiar principles are being adapted to these very particular circumstances.

Me, I'm a bystander: no background in medicine beyond Red Cross activity, no IT skills that would be of use here. I saw the blog post and figured I could do something to help people in danger get good medical info.

Since the authors of the document are explicitly in favor of distribution, and since people are understandably wary of clicking on links on bizarre first posts, I'll quote the relevant portion.

EMERGENCY TREATMENT
Do not move the victim unless you must do so to keep him safe or to access care.
Act quickly. Time is your enemy in treating the victim. Victims who reach medical facilities during the "Golden Hour" have a much better likelihood of surviving.
Assess these five critical factors:
• (Airway) - If the person is unconscious, check to make sure that his airway is not obstructed. The tongue can be a common cause of airway obstruction, and simply turning his head can solve the problem.
• (Breathing) - Is the victim taking regular breaths? Can you see his chest rising and falling? If the patient is not breathing, start rescue breathing immediately
• (Circulation) - Does the victim have a discernible pulse? If the victims does not have a pulse, begin CPR.
• (Disability/Deformity) - Disability refers to damage to the spinal cord or neck. Check to see if the victim can move hands and feet. If not, there may be an injury to the spinal cord. Deformity refers to things such as compound or obvious fractures, dislocations, or anything that looks out of place or unnatural. These injuries can be worsened by moving him.
• (Exposure) - Make sure that you fully expose the patient so that you do not miss wounds to the armpit, buttocks or other difficult-to-see areas.
Control bleeding. Controlling bleeding is most important thing you can do to save a gunshot victim's life.
• Applying direct pressur e is the best way to control most wounds. Use a pad over the wound and apply pressure directly to the wound. If you have nothing available, even your hand or fingers can be used to control bleeding.
• Use pressure points in the arm (between the elbow and armpit), groin (along the bikini line), or behind the knee to control bleeding in the arm, thigh, or lower leg.
• Be prepared to treat the victim for shock. Gunshot wounds frequently lead to shock, a condition caused by trauma or loss of blood that leads to reduced blood flow throughout the body. Expect that a gunshot victim will show signs of shock and treat him accordingly. However, do not elevate the legs if the gunshot wound is to the torso, as this will increase bleeding and make it more difficult for the victim to breathe.
Special instructions for regions of the body
• Head – Gunshot wounds to the head are frequently fatal. Your best option is to keep the head elevated and get the victim to a trauma center as soon as possible.
• Face and neck – These wounds typically bleed severely. Use direct pressure to control bleeding and keep the victim upright. Be careful not to obstruct breathing while controlling bleeding. With injuries to the neck, be careful that blood flow to the carotid arteries isn't disrupted, as this can reduce blood flow to the brain.
• Chest and back – Apply direct pressure to control bleeding; understand that it may be difficult to control chest bleeding because the ribs make it difficult to compress the structures that are bleeding. Gunshots to the chest can cause what is known as a "sucking chest wound". These happen when air travels in and out of the wound with each breath. Treat these as follows:
• Seal wound with hand or airtight material (e.g., plastic film).
• Apply an airtight bandage on three sides of the wound (see image below). Do not close the bandage on the fourth side. This will allow the chest to achieve its usual negative pressure state. Air will escape through the valve during inhalation.
• Abdomen – Use direct pressure to the injury site. As with the chest, controlling bleeding in these cases can be quite difficult.
• Arm or leg – Use direct pressure to control bleeding. Arm and leg injuries from gunshots can be elevated above the heart to help control bleeding. Use pressure points in the arm, groin, or behind the knee if direct pressure does not control bleeding.

 

[gro2001]

Perhaps including a translation in Arabic would be a good idea.

 

[pseudoknot]

I think a lot of the things on that list are really oriented toward care in a well-organized trauma system that includes EMS and rapid access to trauma centers. I don't think it's going to be helpful to someone in an austere environment who likely doesn't have access to definitive care either because it doesn't exist or because they are hiding from the government. I feel for these people, but aside from the advice to use direct pressure for bleeding, I don't see this realistically being useful.

 

[Rendar5]

I echo the above. CPR for instance seems to me especially useless in this situation and a waste of time if there is someone else who can simply be salvaged by holding pressure.

This is a high triage environment with limited resources. This is not a situation for hospital and pre-hospital treatment (we're assuming an active EMS system).