Post by ReconPWN on Oct 15, 2013 19:40:57 GMT
UNIT: 605
DIVISION: NOVA
CLEARANCE: DvL
New File Opened: TRAINING.OUTLINE
Send To: NOVA
Subject: TRAINING.OUTLINE
<:| Units, this document is to be used for training purposes and a reference for basic guidelines to execute and follow the protocol for the most common medical instances you are to experience. Real world medical situations are dynamic and will have unforeseen medical accidents and conditions, you must be prepared to adapt to the changing environment. If you cannot execute this properly contact your superior.||::>
Introduction to Medical
Basic Medical Treatment
Cardiovascular Training
Patient Care
[/ul][/spoiler]
Intermediate Medical Treatment
Hazard Management 101
Roles and Responsibilities
Chemical Spills
Hazardous Gas
Viral Outbreaks
Surgery Preparation
Surgery Assistance
Advanced Medical Treatment
Abdominal Injuries
Severed Limbs/Appendages
Prosthetic Limb Surgeries
Chest Wounds
Flail Chest
Respiratory Therapy
Respiratory therapy is often prescribed to treat conditions such as asthma, cystic fibrosis, emphysema, and other respiratory diseases. There are several different types of Respiratory Therapy:
Breathing Treatments:
• Used for treating asthma and emphysema
• Administer bronchodilator inhaler aerosol
• Watch for side effects (Increased heart rate and headache)
Chest Physiotherapy:
• Used when mucus builds up in lungs
• Using a cupped hand, pound over the unit’s back over his lungs
• Be careful not to cause a severe coughing fit
Incentive Spirometry
• Used for measuring lung capacity
• Using an incentive spirometer, instruct the unit to inhale slowly
• Measure the unit’s lung capacity
• Do not rush the procedure. Hyperventilation is possible.
Noninvasive Positive Pressure Ventilation
• When unit is undergoing respiratory distress, a tube does not necessarily need to be shoved down his throat.
• Using a CPAP located in the medbay, apply the oxygen mask to the unit’s face
• Set a specific pressure and start pumping oxygen as soon as possible
Tattoo Removal Procedure
[/b]
Standard Surgery
[/b]
[/ul][/spoiler]
Brainwashing
Pharmaceutical Training
Fracture Treatment
DIVISION: NOVA
CLEARANCE: DvL
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New File Opened: TRAINING.OUTLINE
Send To: NOVA
Subject: TRAINING.OUTLINE
<:| Units, this document is to be used for training purposes and a reference for basic guidelines to execute and follow the protocol for the most common medical instances you are to experience. Real world medical situations are dynamic and will have unforeseen medical accidents and conditions, you must be prepared to adapt to the changing environment. If you cannot execute this properly contact your superior.||::>
Introduction to Medical
Safety Procedures
One of the most important, and most commonly used safety procedure in SHIELD is DRABC.
It is a proficient way to assess the environment as well as ensuring you understand the subjects' state, this ensures that the treating unit and others nearby are not exposed to the dangers as well.
D - Danger: assess the danger of the situation.
R - Response: look for a response from the patient.
A - Airways: ensure the subjects' airways are clear.
B - Breathing: identify if the patient is breathing.
C - Circulation: establish if there is a stable circulation.
Aims of First Aid
The aims of first aid are often referred to as the four P's.
General Principles
In all situations there are general principles that should be applied in the management of the casualties.
The treating unit must:
One of the most important, and most commonly used safety procedure in SHIELD is DRABC.
It is a proficient way to assess the environment as well as ensuring you understand the subjects' state, this ensures that the treating unit and others nearby are not exposed to the dangers as well.
D - Danger: assess the danger of the situation.
R - Response: look for a response from the patient.
A - Airways: ensure the subjects' airways are clear.
B - Breathing: identify if the patient is breathing.
C - Circulation: establish if there is a stable circulation.
Aims of First Aid
The aims of first aid are often referred to as the four P's.
- First - to preserve life.
- Second - to protect the unconcious.
- Third - to prevent the condition from worsening.
- Fourth - to promote recovery.
General Principles
In all situations there are general principles that should be applied in the management of the casualties.
The treating unit must:
- Assess the situation quickly.
- Ensure as much safety as possible.
- If possible, remain with the patient.
- Inspect the patient and the wounds encovered.
- Execute appropiate first aid on wounds.
Basic Medical Treatment
Stabbing & Bullet Wounds
Fractures
Reseting the Fracture:
Splint and Final Observations
Casting
[/ul][/spoiler]- Execute the principles of DRABC.
- Apply pressure on the wound with a bandage or gauze patch to slow the bleeding.
- Evacuate to medbay.
- Connect the patient to life monitoring apparatus.
- (OPTIONAL) Administer morphine if the patient is in intense pain.
- Pause the treatment until a trained NOVA unit is ready for surgery (if needed).
Fractures
- Used to reduce the fracture and stop the internal bleeding caused by the fracture.
- Administer the Hematoma Block directly to the Hematoma of the fracture (Bleeding/ Blood build up from fracture)
- The Hematoma is also an anesthetic and will lower the pain considerably caused by the fracture.
Reseting the Fracture:
- You will lightly place your hands at the joints or end of the bone
- Use the various X-ray pictures taken and your common sense to correctly align the bone to a near perfect position.
- The patient may feel pressure or a crunching sensation while doing this, reassure them that this is a normal reaction.
- Once that is completed you double check your alignment by observing the skin looking for any protruding sections, swelling, or abnormalities.
Splint and Final Observations
- Create a disposalable splint for the patients dammaged limb.
- Using the X-ray once more you will take two to three more pictures at different angles to confirm the treatment was a success.
- Once that is complete you will move the patient to the bed and make preparations for casting.
Casting
- This procedure recommends two medical units but one will suffice.
- One medical unit will hold the injured limb 45 degree angle while the second one wraps the injured limb in bandages.
- Gather a large container or bucket of water from the sink.
- Collect three or more rolls of plaster bandaging located in storage.
- Cut off suitable amounts of the roll and imerse the plaster rolls one at a time into the warm water container until the bubbling stops
Gently squeeze out the excess water from the roll. - Begin to wrap the roll around the patients injured limb and smooth out the plaster with your palms to remove any creases or air pockets
- You will then apply two or more layers over the first plaster roll on the limb and cut off the excess amount of bandaging.
- Keep the cast suspended in air and allow the cast to dry for 30 to 60 minutes.
Cardiovascular Training
- The goal in treating diseases of your arteries (cardiovascular disease) is often to open narrowed arteries that cause your symptoms. Depending on how severe the blockages in your arteries are.
- Start by obtaining the casualties medical history.
- Start treating the patient with Beta Blockers. (Normodyne)
- After hours pass, you make a medical log, examining the patient and the breathing.
- If the breathing is abnormal, you will report to an EmU+ for further examination.
Patient Care
- Transport the patient to a hospital bed for recovery after surgery.
- Hook the patient up to any necessary life monitoring apparatus (breathing treatments, IV bags, blood transfusions, heart monitor, etc.)
- Monitor the patient to ensure their condition is improving.
- Administer any necessary medications and supplements during recovery.
- Change any bandages when necessary. Burn wound bandages should be changed multiple times daily.
- Be ready on standby in case any condition gets worse.
Intermediate Medical Treatment
Burns
Shock
Shrapnel Wounds
Gunshot Wounds (treatment)
- If first degree, cool with running water. If 2nd or 3rd, cool with standing cold water.
- Apply biogel to the wound.
- Dress the burn loosely with bandages.
- Leave the patient to rest.
- Change patient's bandages often by getting the bandages wet before removing them.
Shock
- Attempt to communicate with the patient to get their mind off the situation.
- Cover the patient with a blanket to raise the body temperature.
- Treat any injuries the patient has that may be causing shock.
Shrapnel Wounds
- Execute the principles of DRABC.
- Apply pressure on non-impaled wounds with a bandage or gauze patch to slow the bleeding.
- Create a "doughnut" bandage to secure any impaled objects.
- Evacuate the patient to the medbay.
- Remove any debris carefully with the assistance of another medical unit.
- Disinfect wounds, stitch, and apply dressing.
Gunshot Wounds (treatment)
- Remove any projectiles from the body. If they are close to the skin, remove with foreceps. If they are deep, initiate surrgery.
- Disinfect wounds, stitch, and apply dressing.
Hazard Management 101
- Hazard – is a situation that has the potential to harm a person, the environment or damage
property.
Roles and Responsibilities
- Provide stability within the environment. (Make sure there aren't any virus outbreaks/chemical leaks.)
- Make sure that there are no virus outbreaks within the Nexus or the UCH.
- Must assure that there are no chemical leaks.
- Must have the HAZMAT suit's inspected by a GRID unit at a weekly basis.
Chemical Spills
- Make sure all units dealing with the situation are trained to do so, and are suited up in HAZMAT suits.
- If the chemical spill is large enough, use chemical protection barriers to contain the area the spill is located. Attempt to place barriers around the source if possible. Chemical protection barriers can only contain acidic chemicals for a limited time before they decay.
- Keep the area clear of all personnel that aren't trained to deal with the chemical spill. This includes citizens and CWU workers as well as other units.
- Ensure the head cover of the HAZMAT suit you're wearing isn't compromised to ensure you don't breathe any hazardous gases rising from any chemical spills.
- Using special cleanup tools, hoses, pumps, and other equipment, gradually clean up the chemical spill and keep the area quarantined until it is deemed non hazardous by your Hazard Management team leader.
Hazardous Gas
- Ensure all involved personnel are suited up in HAZMAT suits, and the head cover isn't compromised and the air filter is properly working.
- Locate the source of the hazardous gas and seal off the area if possible. If outdoors, keep everyone up-wind of the gas leak.
- Use gas hoods (parachute shaped cloth designed to trap gas and contain it or focus it through a different point) to contain leaking gas.
- Find the source of the leak, and use whatever means necessary to stop it. (Ex. if the source is a liquid chemical spill, clean up the liquid. If its a gas leak from a pipe, locate and seal the pipe. Use common sense to adapt to different situations).
Viral Outbreaks
- Viral outbreaks almost always originate from a biotic source, such as a human or other living organism. The objective of preventing and stopping viral outbreaks is to locate the source, and remove that source.
- Keep any infected personnel quarantined in a secured located where the virus can't spread and everyone can be easily managed.
- Inform NOVA Research and Development of the situation as soon as possible and allow them to use any resources needed to conduct an investigation and tests.
- Monitor any infected personnel for changes.
- Use HAZMAT suits and ensure the air filter isn't compromised for your own safety during a viral outbreak.
- Issue HAZMAT suits to CCA personnel or other high priority personnel.
- Maintain order and sociostability at all times and obtain a cure for any virus as soon as possible.
- If a virus can't be cured, or there doesn't appear to be enough time to get a cure, amputate any and all infected biotics, including CCA personnel if necessary to prevent spreading of the virus.
Surgery Preparation
Your main responsabilities will involve:
- Reading the patients' medical history.
- Linking the patient to any required life monitoring apparatus.
- Removing the patient from consciousness through the use of Nitroux Oxide gas.
- Preparing and disinfecting any surgery equipment.
- Executing any specific instructions given by the surgeon.
Surgery Assistance
Your main responsabilities will involve:
- Reading the patients' medical history.
- Constantly checking the life monitoring apparatus, reporting any dangers or concerns to the main surgeon.
- Handing the surgeon any tools and instruments that they may require.
- Physically assisting the surgeon by holding wounds open via clamps if requested.
- Executing any specific instructions given by the surgeon.
Advanced Medical Treatment
Abdominal Injuries
- Execute the principles of DRABC.
- Ensure that any organs being protruding or exposed are not pushed.
- Cover all abdominal wounds completely with dry and preferable sterile dressings to prevent contamination and excessive bleeding.
- Manage the patient for shock.
Severed Limbs/Appendages
- Execute the principles of DRABC.
- Evacuate the casualty to the Med Bay and hook them up to life monitoring apparatus and blood transfusions.
- Apply bleeding management to slow bleeding as much as possible. Treat for shock if necessary using an IV drip bag.
- Using a surgical laser, locate the wounded area and cauterize all blood vessels, arteries, and capillaries to stop bleeding.
- If a limb can be re-attached, clean the limb and the area of re-attaching well, and stitch it back together correctly. Be sure to have placed metal pins to re-attach the bone.
- Apply biogel to the wounded areas and place a bandage around either the cauterized area, or the stitched area, depending on the treatment.
- Change bandages regularly and manage the patient's healing progress.
Prosthetic Limb Surgeries
- Ensure the patient has been treated using Severed Limb/Appendage treatment, and has had plenty of time for their wounds to fully heal.
- Using a liquid molding substance and a mold, cover the area in need of a prosthetic attachment in the molding plaster, and apply the mold, allowing an impression to be made inside the mold cavity.
- After the mold has hardened after a few minutes, pull the two sides of the molding apparatus apart. A perfect impression of the area needing the limb should be in the molding cast.
- Using a special polymer liquid plastic, create the part of the prosthetic that will be attach to the body of the patient. Do this by pouring it into the molding cast and allowing it to harden.
- Remove the hardened fitting from the molding cast and make sure it fits comfortably on the patient. If there are no problems, screw on the correct limp attachment (arm, leg, hand, etc.) to the fitting and slide the fitting onto the patient's area where they are missing the limb. It should fit tightly, but comfortably.
- Help the patient through physical therapy exercises to get them used to using their limb.
Chest Wounds
- Execute the principles of DRABC.
- Cover the chest wound with an airtight material and secure it on three sides with tape, leaving the lowest side open to drain blood.
- Provide an adequate airway and sustain respiration if necessary.
- (NOTE) If the patient is conscious, the first aider should position the patient comfortably with the injured side down.
- (NOTE) If the patient is unconscious, the first aider should position the patient comfortablyin a lateral position with the injured side down.
- Treat for shock.
- Patient should be immediately prepared for surgery.
- (NOTE) If no surgeon is available, the patient should be placed in extended medical stasis until trained SHIELD unit is able to assist.
Flail Chest
- Execute the principles of DRABC.
- (NOTE) If the patient is conscious, the first aider should position the patient into a comfortable sitting position leaning towards the injured side.
- (NOTE) If the patient is unconscious, the first aider should position the patient into a lateral position with the injured side down.
- Administer pressurized oxygen flow and non-narcotic analgesics.
- Treat for shock.
- (NOTE) If no surgeon is available, the patient should be placed in extended medical stasis until trained SHIELD unit is able to assist.
Respiratory Therapy
Respiratory therapy is often prescribed to treat conditions such as asthma, cystic fibrosis, emphysema, and other respiratory diseases. There are several different types of Respiratory Therapy:
Breathing Treatments:
• Used for treating asthma and emphysema
• Administer bronchodilator inhaler aerosol
• Watch for side effects (Increased heart rate and headache)
Chest Physiotherapy:
• Used when mucus builds up in lungs
• Using a cupped hand, pound over the unit’s back over his lungs
• Be careful not to cause a severe coughing fit
Incentive Spirometry
• Used for measuring lung capacity
• Using an incentive spirometer, instruct the unit to inhale slowly
• Measure the unit’s lung capacity
• Do not rush the procedure. Hyperventilation is possible.
Noninvasive Positive Pressure Ventilation
• When unit is undergoing respiratory distress, a tube does not necessarily need to be shoved down his throat.
• Using a CPAP located in the medbay, apply the oxygen mask to the unit’s face
• Set a specific pressure and start pumping oxygen as soon as possible
Tattoo Removal Procedure
- Locate removal sites of tattoos on the patient's body
- Retrieve handheld laser removal device from treatment cabinet
- Adjust knob setting to medium for tattoo removal
- Clear region of removal of any clothing articles, bandaging, etcetera
- Turn on the device, aiming the laser in such a way that it will create a 65 degree angle against their skin
- Too burn away the tattoo, move the laser over the body, burning away the ink. Hold the laser in place for no longer than five seconds! Any longer may cause permanent damage to the skin.
- Apply bandaging if necessary
Standard Surgery
- Place the patient under N20.
- Make sure that the clothes of the patient are completely off.
- Start by spectating the wound. Clean up blood around the wound if you have to.
- Make an incision around the wound or area that you are going to be performing surgery.
- Monitor the patients breathing to make sure there are no difficulties.
- Treat the patient with 100ML of Amoxicillin.
- Treat the wound regarding the surgery type. (Use your brain)
- After treating the patient, stitch the wound shut. Apply bio-gel around the stitches and patch it up.
[/ul][/spoiler]
Brainwashing
- Turn the subject towards a specialized moniter/light. (Just use the treatment room's laser, it servers no purpose)
- Once ready, begin typing in the preparation sequence. During this time, set the proper time parameters for the subject. (Can go up to their entire life if needed)
- Make sure everyone that is not being mind wiped/brain washed is facing AWAY from the moniter/light.
- Type in the final command, thus beginning the sequence and causing the light to flash a near blindingly bright light at the subject.
- The light/moniter will turn black, then back to its normal color once the sequence is complete, at this time fill in the subject on a fake reason to have ended up where he/she is currently. (Assuming you did not brainwash a reason into said subject)
Pharmaceutical Training
- Start by examining the different medications.
- Start out with the Morphine.
- Explain what the morphine does and the affects of it.
Fracture Treatment
The first thing you will do once you meet the patient who has suffered a possible fracture of bone break is to evacuate them to the medbay. Once you have arrived at the Medbay you will make them lay down onto the surgical as you proceed to bring forward the X-ray to the injured limb. The surgical light above the table doubles as a basic X-ray.
Hematoma Block:
• Used to reduce the fracture and stop the internal bleeding caused by the fracture.
• Administer the Hematoma Block directly to the Hematoma of the fracture (Bleeding/ Blood build up from fracture)
• The Hematoma is also an anesthetic and will lower the pain considerably caused by the fracture.
Reseting the Fracture:
• You will lightly place your hands at the joints or end of the bone
• Use the various X-ray pictures taken and your common sense to correctly align the bone to a near perfect position.
• The patient may feel pressure or a crunching sensation while doing this, reassure them that this is a normal reaction.
• Once that is completed you double check your alignment by observing the skin looking for any protruding sections, swelling, or abnormalities.
Splint and Final Observations
• Create a disposalable splint for the patients dammaged limb.
• Using the X-ray once more you will take two to three more pictures at different angles to confirm the treatment was a success.
• Once that is complete you will move the patient to the bed and make preparations for casting.
Casting
• This procedure recommends two medical units but one will suffice.
• One medical unit will hold the injured limb 45 degree angle while the second one wraps the injured limb in bandages.
• Gather a large container or bucket of water from the sink.
• Collect three or more rolls of plaster bandaging located in storage.
• Cut off suitable amounts of the roll and imerse the plaster rolls one at a time into the warm water container until the bubbling stops
• Gently squeeze out the excess water from the roll.
• Begin to wrap the roll around the patients injured limb and smooth out the plaster with your palms to remove any creases or air pockets
• You will then apply two or more layers over the first plaster roll on the limb and cut off the excess amount of bandaging.
• Keep the cast suspended in air and allow the cast to dry for 30 to 60 minutes.
Hematoma Block:
• Used to reduce the fracture and stop the internal bleeding caused by the fracture.
• Administer the Hematoma Block directly to the Hematoma of the fracture (Bleeding/ Blood build up from fracture)
• The Hematoma is also an anesthetic and will lower the pain considerably caused by the fracture.
Reseting the Fracture:
• You will lightly place your hands at the joints or end of the bone
• Use the various X-ray pictures taken and your common sense to correctly align the bone to a near perfect position.
• The patient may feel pressure or a crunching sensation while doing this, reassure them that this is a normal reaction.
• Once that is completed you double check your alignment by observing the skin looking for any protruding sections, swelling, or abnormalities.
Splint and Final Observations
• Create a disposalable splint for the patients dammaged limb.
• Using the X-ray once more you will take two to three more pictures at different angles to confirm the treatment was a success.
• Once that is complete you will move the patient to the bed and make preparations for casting.
Casting
• This procedure recommends two medical units but one will suffice.
• One medical unit will hold the injured limb 45 degree angle while the second one wraps the injured limb in bandages.
• Gather a large container or bucket of water from the sink.
• Collect three or more rolls of plaster bandaging located in storage.
• Cut off suitable amounts of the roll and imerse the plaster rolls one at a time into the warm water container until the bubbling stops
• Gently squeeze out the excess water from the roll.
• Begin to wrap the roll around the patients injured limb and smooth out the plaster with your palms to remove any creases or air pockets
• You will then apply two or more layers over the first plaster roll on the limb and cut off the excess amount of bandaging.
• Keep the cast suspended in air and allow the cast to dry for 30 to 60 minutes.