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Emergency Medicine

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Emergency Medicine is the medical specialty concerned with the stabilization, management and diagnosis of individuals with acute (and usually life threatening) illness and injury. Emergency Medicine encompasses a large amount of general medicine, involving the technical and cognitive aspects of virtually all fields of medicine and surgery. In modern times, Emergency Medicine Technicians stabilize a person in dire medical straits, and further treatment is administered in a hospital. However, even today there are rare times where a hospital is inaccessible, and the technician (or layperson) must do what they can to keep the person alive. Obviously, in a zombie pandemic, hospital trips are at best inadvisable due to the high number of infected likely there, or at worst, impossible.

Common medical emergenciesEdit

Emergency medicine encompasses a broad knowledge base including (but not limited to) the following tasks.

  • Open a blocked or closed trachea
  • Suture a complex laceration
  • Set a fractured bone or dislocated joint
  • Treat a cardiac arrest or seizure
  • Administer CPR
  • Deliver a baby
  • Stop a bad nosebleed
  • Manage suicide attempts and complex overdoses
  • Tap a septic joint
  • Neutralize an allergic reaction
  • Treat an ingested poison, a venomous bite or sting
  • Remove a bullet, and treat the wound
  • Rescue and stabilize someone trapped in a car wreck or destroyed building

In a zombie apocalypse, with medical supplies, sterile environments, and trained medical workers all in short supply, the chances of emergency medicine working is much worse than in the modern era. This chance lowers greatly if surgery is involved. Euthanasia will often be a more realistic option. Still, the effort to save the life is often appreciated, and sometimes (despite the odds) successful.

Airway managementEdit

Airway management is a very important component of medical response. Any patient without a patent airway will be dead in minutes.

There are many things that might be wrong with an airway, but the first concern is to put the head in a neutral "sniffing" position. Doing so might cause spinal injury, but any patient with spinal injuries is already a candidate for euthanasia. If the patient does not begin to breath when the airway is open, euthanasia should be considered.

The second airway consideration is somewhat more subtle, though no less deadly. If there is air building up into the area surrounding the lungs from an open wound to the chest the lung can quickly collapse, rendering the patient unable to breath. An occlusive bandage must be used to keep the air out and allow buildup to escape. The bandage should be made of something impermeable to air, such as sheet plastic, tarp or cloth coated heavily in petroleum jelly. The dressing should be secured to the torso with tape (duct tape is fine) on only three sides. The down side (whether the patient will be standing or laying) should be left untaped to allow air and fluid to escape.

Air can also build up from a rupture the inside of the lungs, but treatment is much too involved for most people and is certainly too complex for instruction in such a limited format.

BleedingEdit

Bleeding (or hemorrhaging) is the one of the more dramatic of the traumatic injuries. It is a malfunction of the circulatory system.

Bleeding that can be controlled typically requires nothing more than a dressing pressed firmly onto the wound and elevation above the level of the heart. If this does not work, a tourniquet is the next step. (In the past, instructions have been given out concerning pressure points, but all of that has been retracted due to recent research which shows that cell damage due to tourniquet related hypoxia does not begin for over two hours.)

There are many ways to fashion a tourniquet and there are many commercially available. Probably the best unit is the one currently used by the united states military. It is compact, easy to use with only one hand, reusable, and effective. It is called the "mechanical advantage tourniquet" and costs about $50.

But a unit need not cost much to be effective. Torn cloth for a band and a bayonet for a tightening peg are equally effective, if harder to use. Also in an emergancy, a belt can be used. 

Ambulances carry disposable tourniquets for installing IV's on patients, which the ambulance operators might be willing to give anyone who asked nicely. They look like rubber ribbons. A blood pressure cuff can also be used as a tourniquet.

The body can bleed from any of the three types of vessels: capillary bleeding is more dangerous in terms of infection; veins typically produce profuse yet easily controlled, steady flow; and arteries produce violent ejaculations of blood. Major arteries typically stop bleeding when there is nothing more to bleed. Never use crude cauterization (i.e. Branding hot metal, lighters, cigarette butts) to stop the bleeding of a major artery. Although it may look effective in Hollywood film, cauterization creates third degree burns internally, turning the wound into the perfect breeding ground for bacteria and infection. It is better off applying direct pressure onto the artery for an extended period of time (recommended 20+ minutes), and elevating the affected limb.

Losing more than 3 pints of blood is dangerous and can lead to side effects such as blurred sight, loss of balance/control, dizziness, unconsciouness and maybe even total body shock. The human body has an average of 6-12 pints of blood. In order to recuperate from severe blood loss, the body might shut down or be in a coma. People who have severe blood loss should be given fluids to drink and/or an IV but the chances of survivng is very slim.

But the most dificult type of bleeding to control is largely invisible. Internal bleeding is more dangerous as any of the other types because surgery is required for effective control.

In the context of zombies, remember that severe bleeding might be something that the patient might not recover from. Use judgement and prudence.

Skeletal InjuriesEdit

Skeletal injuries are something that the body heals from very well. Even without expert bone-setting or competent casting, most broken bones will eventually heal. Healing may be, however crooked, cockeyed or clumsy. However, if spinal injury takes place, Immediate and attentive care is needed.

Bone setting is extremely painful, and consequently is not something that many people will be willing to allow zombie-certified medics to do. Consequently, no procedural description is given here.

There are two main types of skeletal fractures, compound and simple. A compound fracture is when the bone protrudes outside the skin. These kinds are extremely painful and hard to heal/set without proper alignment or surgery (if available). A simple fracture is when the bone breaks internally and doesn't break into pieces. These can be set normally and will heal within 6-8 weeks.

The important thing in healing bones is to keep it from moving for several weeks. Medical professionals do this with very expensive fiberglass-epoxy tape, but it really isn't necessary. A patient who is diligent in keeping his or her arm still could use spare cloths and duct tape to achieve a very similar effect. Simply wrap tightly around the affected area (but not too tight as to constrict blood flow) and secure either with a latch, safety pin or by tying off.

Gunshot woundsEdit

Gunshot Wounds are a major worry, but in actuality differ little from other forms of trauma. Treat symptomatically, that is treat the symptoms: secure airway, stop any bleeding (point blank gunshot wounds may exhibit cauterization from muzzle flash), and immobilize broken bones. Anything much beyond the aforementioned treatments mark a patient for possible euthanasia in the absence of competent surgery.

One thing peculiar to gunshot wounds is the pattern: a gunshot wound typically follows the form of a cone, with the tip of the cone being the entry wound and cavitation expanding beyond in ever expanding concentric rings. This is caused by Hydrostatic Shock

If the bullet remains in the patient, there is a temptation to search for the bullet. However, the search for a slug can cause further damage and might not do much to better the chances of the patient. It is possible that bullet removal may need to wait until the patient is more stable. Most small diameter rifle munitions practically explode on impact as well, leaving potentially dozens of fragments in the victim's body that simply cannot be removed.

Visible EntrailsEdit

Visible Entrails can be particularly disturbing. Unfortunately, little can be done for protruding gut. Attempts to replace intestine can result in blocked gut or internal bleeding. If hope of surgery is viable, the parts should be kept covered and moist with saline solution, but euthanasia may be more kind.

Zombie BiteEdit

Not much can be done to save someone from succumbing to a Zombie Bite. A zombie bite will most likely cause severe bleeding that will kill the victim within minutes. Applying measures as to alleviate major bleeding may slow down the infection, but these actions will not outright eliminate the infection itself. The only possible way to stop zombification from a bite is to amputate the affected limb immediately. If an area such as the torso, neck, or head is bitten, there is no hope to rescue the victim.

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