E hele ana ma ka puka aniani a i ʻole ka pā ua haʻahaʻa¶

Hāʻule nā ​​pōʻino aniani i loko o nā hale, nā hōkele, a me nā pā hale i ʻelua mau ʻāpana kino a me nā lāʻau lapaʻau ma muli o ke ʻano o ke aniani ʻo **keaniani kīʻaha kahiko ʻole (annealed) ** a i ʻole ** aniani palekana thermally tempered hou **. Ma nā hale kahiko, nā lumi lā, a me nā keʻena i hoʻoponopono ʻole ʻia i kūkulu ʻia ma mua o ke kūkulu ʻia ʻana o nā code hale e hoʻoheheʻe ʻia i kēia wā (a i hoʻokomo ʻia me nā pani pani makamae), nā puka pā aniani hoʻoheheʻe, nā puka makani ʻino, nā puka makani haʻahaʻa, a me nā kīʻaha kīʻaha a i ʻole nā ​​papa ʻaina i hana pinepine ʻia me ka ** aniani lana i hoʻopili ʻia . Ke ʻike ʻole ke keiki a makua paha i ka puka patio paʻa maʻemaʻe a hele a holo paha i loko, a i ʻole e noho ana ma luna o ka papa aniani i hoʻopaʻa ʻia, ua haki ka pane i loko o ** nā pahi pahi triangular nui, kaumaha, a me nā pahi guillotine. I ka hele ʻana o nā lima, ʻāʻī, ʻāʻī, a me nā wāwae o ka mea i pepehi ʻia i loko o ke kiʻi a huki i hope, e hāʻule ana nā huinakolu luna e kau ana i lalo e like me kahi guillotine, e ʻoki pinepine ai i ka brachial artery ma ka lima luna, ka radial and ulnar arteries ma ka pulima lima, ka carotid artery a i ʻole internal jugular vein ma ka ʻāʻī a me ka poplite ma ka ʻāʻī. exsanguination i loko o 2 a 4 minuke ke ʻole ka hoʻohana ʻana i ka tourniquet a i ʻole ke kaomi pololei.

ʻO ka ʻokoʻa, hana ʻia nā pā wai aniani ʻaʻole, nā puka patio hou, a me nā papa papa i hoʻoluliluli ʻia ma lalo o ke koʻikoʻi wela a hiki i ka wā e hāʻule ai lākou (mai kahi hinge misalignment, tile maka nick, thermal shock, a i ʻole ** nickel sulfide (\(\text{NiS}\)) i hoʻokomo ʻia**), ʻo ka pepa holoʻokoʻa e pahū koke i loko o kahi puʻupuʻu liʻiliʻi. ʻOiai e hoʻopau ana ke aniani aniani i nā pahi kaua guillotine nunui o ke aniani pā i hoʻopili ʻia. ʻO nā pahele wale nō kahi e haʻalele ai i ka moena ʻauʻau e hoʻoneʻe i nā ʻāpana aniani ʻoi-ʻohi i loko o ka fascia kanu. ʻO ka ʻike pehea e hoʻopau ai i ka hemorrhage o ke kino mai ka ʻoki ʻana i ke aniani i loko o kekona, hoʻopaʻa i kahi ʻāpana aniani i hoʻopaʻa ʻia me ka huki ʻole ʻana, a hoʻokuʻu me ka palekana i kahi ʻauʻau olohelohe i paʻa ʻia me ke kamaʻa ʻole i loko o ka pā wai aniani nahā e hoʻopakele i nā ola a me ka ʻike.

E hana i kēia i kēia manawa¶

1. E hoʻopili koke me ka ikaika a i ʻole ka ʻeke makani pāʻoihana i kekahi ʻeha ʻulaʻula, hū, a i ʻole e hui pū ʻia me ka wikiwiki o nā lālā. kenimika (2 a 3 iniha) ma luna aʻe o ka ʻeha lālā a hoʻopaʻa i ke aniani a hiki i ka pau ʻana o ke koko; ike ke koko nui.
2. ** ʻAʻole loa e huki i waho i kahi ʻāpana aniani nui e puka mai ana mai ka ʻāʻī, ka umauma, ka ʻōpū, ka ʻāʻī, ka ʻūhā, a i ʻole ka maka. ʻo ka huki ʻana i waho e hoʻoulu ai i ka hemorrhage i loko a i ʻole ka arterial. E hoʻopili i ke kaomi paʻa a puni ke kumu o ka shard me ka ʻole o ka pahu ʻana i ke aniani ponoʻī, a hoʻopaʻa ʻia me ka paʻi nui; ike ka hoʻopaʻa ʻana a me ka hoʻopaʻa ʻana i nā mea haole.
3. **Huki i ka mea i pepehiia (ai ole ia e hehi aku ia lakou) mai ka puka o luna WALE NO ina e haule ana na mamala aniani "guillotine" maluna o lakou, a i ole e kikeke i na mamala kaula e waiho ana WALE NO ke hiki ke hana me ka oki ole i kekahi.
4. **E kāhea koke i kāu helu ulia pōpilikia (911 ma ʻAmelika Hui Pū ʻIa a me Kanada, 112 ma waena o ka Hui ʻEulopa, 999 ma United Kingdom) no ka hui ʻana o ke aniani nui, ke koko koko, ʻoki ʻia ka ʻāʻī/ ʻoki ʻāʻī, poho a i ʻole ʻeha maka. ʻaʻahu mahana e pale aku i ka haʻalulu hemorrhagic; nānā helu pilikia a ike haʻalulu.
5. Inā pahū ka puka wai aniani a puni ʻoe oiai ʻoe e kapa ʻole a kamaʻa ʻole, e hoʻokuʻu ma kahi a mai hele i waho ma ka papahele i uhi ʻia i ke aniani. E uhi i kou mau maka a me kou alo me kou mau lima a i ʻole ke kāwele inā hāʻule mau ke aniani, e hoʻōho i kekahi ma waho o ka lumi lumi e lawe mai ** nā kāmaʻa paʻa a me nā kāwele ʻauʻau mānoanoa**, e waiho i kahi kāwele mānoanoa i pelu ʻia i lalo o ke alahaka, e waiho i kahi kāwele mānoanoa o ke alahaka ma mua o kou mau wāwae, e waiho pono i kou mau wāwae ma mua o ke aniani, e waiho i lalo o kou mau wāwae. a hele pololei i nā kāmaʻa.
6. ** MAI hamo i kou mau maka a holoi paha i kou mau maka me ke kāwele lepo aniani ke nahae ke aniani ma kahi kokoke i kou poo.** E pani i kou mau maka, e hilinai i mua, a na kekahi e ninini malie i ka wai mehana ma'ema'e ma kou lae a me na lihilihi maka e holoi i ka lepo aniani ma mua o ka wehe ana i kou mau maka; ina he kiko maloko o ka maka, pale i ka maka me ke kaomi ole a hele i ke keena pilikia; ike ʻeha maka.

flowchart TD
    Start["Kūlana Kūlana Kūlana Kūʻai Kūʻē"] --> GlassType{"He aha ke ʻano o ka pilikia aniani i hiki mai?"}
    GlassType -->|"Hele ma ka puka aniani a hina paha ma ka papa aniani"| BleedCheck{"Aia ke koko ʻaʻaʻa spurting a i ʻole ke kahe wikiwiki ʻana o ke koko?"}
    BleedCheck -->|"ʻAe: Severe Limb or Junctional Hemorrhage"| Hemorrhage["1. E makaʻala no ke kau ʻana o nā ʻāpana guillotine aniani ma luna o ke poʻo<br/>2. E hoʻopili i ka mea hoʻoheheʻe makani 5 a 7 kenimika (2 a 3 in) ma luna o ka ʻeha lālā<br/>3. E hoʻopaʻa i nā ʻeha ʻāʻī/ ʻāʻī / ʻāʻī a hoʻopili ikaika i nā lima ʻelua<br/>4. E kāhea koke iā 911 / 112 / 999 a waiho i ka mea i palahalaha"]
    BleedCheck -->|"ʻO ka ʻāʻī aniani i hoʻopaʻa ʻia ma ka ʻāʻī, ke kino, ka maka, a i ʻole ka lālā"| Impaled["1. MAI uhuki i ka maa aniani i hookomoia<br/>2. E kaomi ikaika ma ka ʻili a puni ke kumu o ka shard e hoʻomalu i ke koko<br/>3. E kūkulu i ke apo apo a i ʻole ke kākoʻo i ʻōwili ʻia a puni ka shard<br/>4. E kāhea iā 911 / 112 / 999 a e mālama pono i ka mea i pepehi ʻia"]
    GlassType -->|"Puka Poha Makani ka Pahu Puka"| Shower["1. FREEZE ma kahi; MAI hele wāwae wāwae ʻole ma ke aniani nahaha<br/>2. E hoʻomoe i nā kāwele mānoanoa i pelu ʻia a lawe mai i nā kāmaʻa wāwae paʻa<br/>3. Holoi aniani i ka lauoho/poʻohiwi me ke poʻo i hili ʻia i mua (pani nā maka)<br/>4. E nānā no ka ʻoki ʻia ʻana o ka ʻāʻī o ka lima/kuʻekuʻe wāwae a me nā kiko koʻo"]

ʻO ke aniani pāʻani Annealed vs. ke aniani palekana palekana: No ke aha i make ai nā puka kahiko a me nā papa ʻaina¶

ʻO ka hoʻomaopopo ʻana i ka physics haʻihaʻi o nā ʻano aniani ʻekolu e wehewehe i ke kumu o ka hele ʻana ma ka puka pā hale kahiko a i ʻole ka hāʻule ʻana i luna o ka papa kīʻaha kīʻaha ʻo ia kekahi o nā hana ʻeha make loa o ka home.

ʻO ka hoʻomalu ʻana i ka hemorrhage ulia pōpilikia ma hope o ka hele ʻana ma ka puka aniani a i ʻole ka hāʻule ʻana i luna o ka papa aniani¶

ʻElima anatomical "kill zones" i loko o nā hui aniani pā¶

Ke hele a holo paha ke kanaka ma ka puka aniani i pani ʻia a i ʻole ka hele ʻana ma luna o ka papaʻaina kīʻaha kīʻaha, hoʻolei ʻia ko lākou mau lima a me nā lima i mua o ko lākou alo i ka wā e hāʻule ai ko lākou poʻo, ʻāʻī, a me nā wāwae alakaʻi ma ka pane. ʻElima mau ʻāpana ʻehaʻeha a me ka neurological pono e loiloi koke i loko o nā kekona 30 mua:

1. Ka Medial Upper Arm and Cubital Fossa (Brachial Artery): I ka wā e kīkoʻo ai nā lima o ka mea i pepehi ʻia ma ke aniani a hoʻomaha ma ka puka makani haʻahaʻa a huki paha i hope, ua ʻoki ʻia ke aniani i luna i ka ʻaoʻao o loko o ka kuʻekuʻe a i ʻole ka lua biceps i loko, e ʻoki ana i ka brachial artery a me ka median. ʻO ke aʻa brachial i ʻoki ʻia e pāpaʻi i ke koko ʻulaʻula ʻulaʻula ma waena o ka lumi a make ke koko i loko o 3 a 5 mau minuke.
2. Ka Volar Wrist (Radial and Ulnar Arteries, Flexor Tendons, and Median Nerve): I kapa ʻia he "spaghetti wrist" i ka ʻoki lima ʻana, hiki i kahi kīʻaha ākea hohonu hoʻokahi ma ka ʻaoʻao pāma o ka pulima lima hiki ke ʻoki i nā aʻa ʻelua a me ka ulnar arterial, nā aʻalolo manamana lima a me nā aʻalolo.
3. Ka Aʻi Mua (Carotid Artery, Internal Jugular Vein, and Trachea): Ke piʻi ke poʻo o ka mea i pepehi ʻia i mua ma ke aniani a i ʻole i ka wā e hāʻule ai ka huinakolu aniani luna e kau ana mai ka piko o ka pā puka, paʻi ia i ka ʻāʻī. Ma waho aʻe o ke kahe ʻana o ke aʻaʻa nui mai ke aʻaʻa carotid, hiki i kahi ʻaʻa ʻaʻa ʻokoʻa o loko ** ke omo i ka ea o ka lewa i loko o ke kahe koko i ka wā o ka inhalation (fatal venous air embolism).
4. ** ʻO ka ʻūhā mua, ka ʻūhā, a me ke kua o ke kuli (Femoral and Popliteal Arteries):** I ka wā e piʻi ai ka wāwae alakaʻi ma ka hapa o lalo o ka puka a hāʻule paha i loko o ka papa kīʻaha kīʻaha haʻahaʻa, ua hoʻopaʻa ʻia ka ʻāʻī o ke aniani kiʻekiʻe i ka ʻāʻī (femoral artery), ʻūhā i loko, a i ʻole ke aʻa ma hope o ke kuli (**popliteal).
5. Ke Kuʻekuʻe wāwae ma hope (Achilles Tendon a me Posterior Tibial Artery): Ke hele ka mea i pepehi ʻia ma ka ʻaoʻao haʻihaʻi o lalo a huki i ko lākou wāwae i hope, a i ʻole ka paheʻe ʻana o kahi pā aniani ma hope o ko lākou wāwae haʻahaʻa, ʻoki maʻemaʻe ia i ka Achilles tendon ma luna pono o ka kuʻekuʻe.

ʻO ka mālama ola ʻana i kēlā me kēia ʻanuʻu no nā haki aniani koʻikoʻi¶

KaʻAnuʻu Hana 1: E mālama pono i ke kiʻi mai ka hāʻule ʻana o ke aniani "guillotine".¶

Ma mua o kou kukuli ʻana ma luna o kahi mea kahe koko e moe ana ma ka paepae o ka puka hoʻoheheʻe nahaha a i ʻole ka puka makani:

1. Nānā i luna a me nā ʻaoʻao o ka puka puka no nā huinakolu aniani e kau ana: Inā he 10 kilo (22-pauna) pahi o ke aniani i hoʻopaʻa ʻia e uwē ana ma luna o ke kua a i ʻole ka ʻāʻī o ka mea i pepehi ʻia, ** kauo i ka mea i pepehi ʻia ma ko lākou mau poʻohiwi a i ʻole nā lole 1.5 mika (5 kapuaʻi) i hope i waho o ka wahi hāʻule** (e hoʻopaʻa i ko lākou poʻo a i ʻole ka ʻāʻī ma mua o ka hoʻomaka ʻana o ke kuamoʻo. lima a kikeke i ka ʻāpana e kau ana ma waho o ka mea i pepehi ʻia.
2. Paʻa i kou mau lima a me kou mau kuli: Mai kukuli kuli ʻole i loko o ka puʻu aniani nahā; e hoʻolei i kahi ʻūlū moe i pelu ʻia, ka moena puka mānoanoa, a i ʻole ka ʻaʻahu i pelu ʻia ma ka papahele e kukuli ai i ʻole ʻoe e ʻoki i kou ʻāʻī patellar a i ʻole nā ​​moku femoral i ke kau ʻana i ke kaomi.

KaʻAnuʻu 2: Hoʻopau koke i ke koko weliweli (Ma mua o ka hopohopo no nā ʻoki liʻiliʻi)¶

ʻO ke kanaka i uhi ʻia i nā ʻoki aniani he nui ke nānā aku i ke koko weliweli loa mai ke poʻo a i ka wāwae, hiki ke hoʻohuli i ka poʻe e kū ana mai ka ʻeha ʻāʻī hohonu hoʻokahi e pume nei i ko lākou koko:

1. E nānā i nā lima, nā pulima lima, ka ʻāʻī, nā ʻūhā, a me nā kuʻekuʻe wāwae no ke koko ʻulaʻula ʻulaʻula e kahe ana a i ʻole kahi punawai e hoʻonui wikiwiki ana o ke koko ʻulaʻula ʻeleʻele:
2. No ke kahe koko nui o ka lālā (lima luna, lima lima, ʻūhā, a i ʻole wāwae lalo):
3. ** E hōʻoia ʻaʻole ʻōpuʻu mai kahi ʻāpana aniani nui mai kahi kikoʻī āu e kaomi ai:** Inā he ʻāpana maʻemaʻe ka ʻeha me ka ʻāpana aniani ʻole nui, e kaomi i kahi papa mānoanoa o ka gauze maʻemaʻe a i ʻole kahi kāwele pulupulu i pelu ʻia ** pololei a ikaika i ka ʻeha koko me nā lima ʻelua**.
4. E hoʻopili koke i ka ʻāpana limb tourniquet inā ʻaʻole e hoʻōki ke kaomi pololei i ke kahe ʻana o ke aʻa a i ʻole ke kahe koke ke koko ma ka pā: E kau i kahi tourniquet pahu makani pāʻoihana (e like me CAT a i ʻole SOFTT-W) 5 a 7 kenimika (2 a 3 ʻīniha) ma luna o ka ʻeha aniani (ma waena o ka ʻeha a me ka puʻuwai, ʻaʻole e huki pololei ma luna o ka ʻāpana o ke kuli, ʻaʻole e huki pololei ʻia ma luna o ka ʻāpana o ke kuli. e paʻa i ke kaula, a wili i ke koʻokoʻo makani a hiki i ka pau ʻana o ke koko ʻulaʻula ʻulaʻula; ike ke koko nui.
5. No ka ʻāʻī ʻāʻī hohonu (Carotid artery or Jugular vein):
6. ʻAʻole loa e hoʻopaʻa i kahi kāʻei pōʻai a i ʻole tourniquet ma ka ʻāʻī.
7. E kaomi koke i kahi paʻi lole maʻemaʻe, ka lole hemostatic, a i ʻole ka lole i pelu ʻia ** me ka paʻa i ka wahi koko ma ka ʻaoʻao o ka ʻāʻī me kou mau manamana lima i hoʻopaʻa ʻia**, e hoʻohuli iki i kou kaomi i hope i ka ʻiʻo cervical ma mua o ka hoʻokuʻu pololei ʻana i loko ma waena o ka ʻōpū makani (trachea).
8. ʻO ka hoʻopaʻa ʻana i ka ʻāʻī ʻāʻī me ka ʻaʻahu ʻaʻahu ʻāʻī a i ʻole ka pā lole mānoanoa i hoʻoheheʻe ʻia ma lalo o ke kaomi manamana lima paʻa e pale ai i ka ea mai ka omo ʻana i loko o kahi vein jugular haehae (venous air embolism).
9. No kahi ʻeha hohonu i loaʻa kahi ʻāpana aniani i hoʻopaʻa ʻia:
10. MAI ʻole e wehe i ka ʻāpana aniani, a MAI kaomi pololei ma luna o ke aniani.
11. E kaomi paʻa i lalo me kou manamana lima ma ka ʻili ** ma nā ʻaoʻao ʻelua o ka ʻāʻī ** e hoʻopī i ka ipu koko lalo, a kūkulu i ka gauze i ʻōwili ʻia a i ʻole nā ​​apo lole i pelu ʻia ma nā ʻaoʻao ʻelua o ke aniani a ʻoi aku ka lōʻihi o ka paʻi ma mua o ka ʻāpana, a laila hoʻopaʻa paʻa i kahi; ike ka hoʻopaʻa ʻana a me ka hoʻopaʻa ʻana i nā mea haole.
12. No nā ʻūhā aniani o ka umauma a i ʻole ka ʻōpū:
13. Inā komo ka pahi aniani i ka paia o ka umauma a lohe ʻoe i ka omo ʻana o ka ea a i ʻole ka hū ʻana mai ka ʻeha, e uhi iā ia me ka ʻaʻahu occlusive vented ʻekolu ʻaoʻao (a i ʻole ke sila pahu pahu pāʻoihana) ma hope o ka holoi ʻana i ke aniani ākea; ike ka pneumothorax a me ka omo umauma eha kokua mua.
14. Inā puka mai nā ʻōpū o ka ʻōpū i loko o ke aniani aniani hohonu ma ka ʻōpū, mai hoʻihoʻi iā lākou i loko; e uhi mālie iā lākou me kahi lole maʻemaʻe i hoʻomaʻemaʻe ʻia me ka saline sterile a i ʻole ka wai hoʻomaʻemaʻe mehana; ike ka wehe ʻana o ka ʻōpū a me ka mālama ʻana i ka ʻeha ʻōpū.

ʻO ka puka ʻauʻau aniani ʻeleʻele a i ʻole ka pahū ʻana o ka papa papa: Hoʻopakele iā ʻoe iho i kēlā me kēia pae¶

No ke aha e pahū ai nā puka wai aniani "no ke kumu ʻole"¶

I kēlā me kēia makahiki, ʻāhaʻi pahū nā tausani o nā pā wai aniani a me nā puka patio i ka wā e ʻau ana kekahi a i ʻole i ka wā ʻole o ka lumi ʻauʻau. ʻEkolu mau hana ʻenekinia ke kumu o kēia hāʻule koke ʻana:

1. Pino ma ka ʻaoʻao a i ʻole ka hoʻopili ʻana i nā lako metala-i-aniani: He ʻili waho ko ke aniani hoʻoheheʻe ʻia i ka paʻi kiʻekiʻe a me ke kumu i loko i ka ʻāʻī kiʻekiʻe. ʻOiai he ikaika loa ka helehelena palahalaha o ke aniani aniani, ʻo kona mau ʻaoʻao lahilahi waho ke kuʻekuʻe wāwae o Achilles. Inā hemo ka wili hinge no laila ʻo ka puka aniani kaumaha a ʻokiʻoki i kona kihi lalo e pili ana i ka tile papahele seramika, a i ʻole nalo ka pahu kāwele metala i kona ʻeke ʻeke a kiʻi pololei i ke aniani, ua haki ke kīpē microscopic i ka ʻāpana hoʻopiʻi waho a hoʻopau i ka papa holoʻokoʻa.
2. ** Hoʻonui hoʻokomo ʻia ʻo Nickel Sulfide (\(\text{NiS}\)):** I ka wā e hana ana i ke aniani, hiki ke hoʻopaʻa ʻia nā ʻāpana microscopic o ka nickel sulfide i loko o ka ʻāpana hoʻopaʻapaʻa waena o ke aniani. I loko o nā mahina a i ʻole mau makahiki (hoʻonui ʻia e ka mahu ua wela a me nā loli wela), hoʻololi mālie ke aniani nickel sulfide i kona ʻano alpha a hiki i ka beta molecular form a hoʻonui i ka leo ma 2% a hiki i 4%, e hana ana ma ke ʻano he wili kūloko e uhaʻi i ka puka me ka ʻole o ka hoʻopā ʻana iā ia.
3. Nā ʻokoʻa koʻikoʻi wela: ʻO ka hoʻoheheʻe wikiwiki ʻana i ka wai wela ma luna o kahi pā aniani ʻauʻau anuanu me ka ʻaoʻao ʻokiʻoki e hana i ka hoʻonui ʻana i ka wela e hoʻomaka ai ka haki.

Pehea ʻoe e pakele ai i ka pā wai aniani i haki ʻia ke ʻōlohelohe ʻoe a me ke kamaʻa ʻole¶

Ke pahū ka puka ʻauʻau aniani ʻoiai ʻoe e kū ana i loko o ka hale kūʻai, ua hoʻopuni koke ʻia ʻoe e kahi ʻāpana ʻāpana aniani o ka ʻumi a hiki i ka 5 kenimika hohonu e uhi ana i ka ipu ʻauʻau a me ka papahele ʻauʻau ma waho, me nā tausani o nā māmala aniani liʻiliʻi e pili ana i kou lauoho pulu, nā poʻohiwi, nā lihilihi, a me nā wāwae:

1. FREEZE koke i kou wahi e kū nei:
2. ʻO nā kapuwaʻi o kou mau wāwae ma lalo pono o kou pale ʻia mai ke aniani hāʻule e kou mau kapuaʻi. Mai hāpai i ka wāwae a hele i kahi ʻanuʻu. ʻO ka iho ʻana i lalo me ke kaumaha o ke kino piha ma luna o nā ʻāpana aniani pulu ʻeleʻele e hoʻokuʻu i nā ʻāpana he nui ma ka ʻili kumu lāʻau paʻakikī o kou kuʻekuʻe wāwae a me kou poʻo, e ʻoki ana i nā ʻuʻu a hoʻopaʻa iā ʻoe ma ka papahele i loko o kahi wai koko a me ka wai.
3. Piki kou mau maka a hoʻopau i ka ʻauʻau wai wale nō inā hiki iā ʻoe ke hele i laila me ka ʻole o ka neʻe ʻana i kou mau wāwae:
4. Inā pono ʻoe e ʻakaʻaka i kou mau maka, e hoʻoluli mua i kou poʻo ** i mua** a hoʻohana i nā lima pulu (ma hope o ka holoi ʻana i kou mau lima ma lalo o ke poʻo ʻauʻau) e kahili mālie i nā ʻāpana aniani mai kou mau kuʻemaka a me kou lae i ʻole e hāʻule i luna o kou poʻo i ka wā e ʻapo ai ʻoe.
5. Kahea aku i ka ʻohana a i ʻole ka hoalauna, a i ʻole e hoʻokō i kahi pakele "kāwele-bridge":
6. Inā aia kekahi i loko o ka hale: E hoʻōho akaka: * "Mai hele wāwae ʻole i loko o ka lumi ʻauʻau. E hoʻokomo i nā kāmaʻa mānoanoa, e lawe mai i ʻelua kāwele ʻauʻau kaumaha a me koʻu mau kāmaʻa, a kahili i ke ala i ka ʻauʻau." E hoʻokiʻekiʻe i hoʻokahi kapuaʻi i ka manawa, ** holoi i kou wāwae me ka hoʻomaʻemaʻe loa i nā ʻāpana aniani i hoʻopaʻa ʻia me ke kāwele lima maʻemaʻe ʻokoʻa**, a e komo pololei i kou kāmaʻa ma mua o ka hoʻohaʻahaʻa ʻana i ke kaumaha.
7. Inā ʻoe hoʻokahi i ka home me ke kelepona ʻole: E ʻimi i ka lole mānoanoa loa i hiki i ka lima ke hiki (he kāwele ʻauʻau kaumaha e kau ana ma ka paia, kahi moena ʻauʻau i pelu ʻia, a i ʻole kahi pale wai ʻauʻau i ʻoki ʻia mai kona mau apo a pelu ʻia i 6 a 8 mau papa mānoanoa). E hoʻokuʻu i ke kāwele i pelu ʻia a i ʻole ka pale i pelu ʻia ma ka papahele i mua ou e hana i kahi paʻa kūʻokoʻa, e holoi i ka lalo o kou wāwae mua i hoʻomaʻemaʻe loa ma mua o ka heʻe ʻana i ka pā, a lele i kahi kāwele lua a i ʻole ʻauʻau i mua a hiki i nā kāmaʻa.
8. Hoʻomaʻemaʻe i ka ʻili a me ka lauoho me ka ʻole o ka hamo ʻana i ke aniani i loko o kou ʻiʻo:
9. Mai hoʻomaloʻo iā ʻoe iho ma ke kāwele ʻana i kou ʻili me ke kāwele ma hope o ka pahū ʻana o ka ua aniani; ʻO ka hamo ʻana e like me ka pepa ʻeleʻele e wili ana i nā tausani o nā aniani aniani microscopic i ʻike ʻole ʻia i loko o nā pores o kou ʻili.
10. Ke kū maluhia ʻoe me nā kāmaʻa paʻa paʻa i loko o ka ʻauʻau ʻē aʻe a i ʻole ma luna o kahi papahele maʻemaʻe, e hoʻolei i kou poʻo i mua me ka pani paʻa ʻana o nā maka a hoʻohana i kahi holoi wai mālie mālie (a i ʻole e hoʻohana i nā ʻāpana ** lipine lint-roller i kaomi māmā a huki ʻia** ke maloʻo ka ʻili) e hāpai i nā mamala aniani liʻiliʻi mai kou poʻohiwi, lima, a hoʻi i hope.

Ka loiloi ʻana i nā ʻeha o ke aʻalolo, ke aʻalolo, a me ka maka ma hope o kekahi ʻoki aniani¶

ʻO kahi ʻoki aniani paha **1 kenimika (0.4-ʻīniha) liʻiliʻi ma ka manamana lima, lima lima, ka lima, a me nā kuʻekuʻe wāwae paha ua kaulana i ka lāʻau lapaʻau no ka hūnā ʻana i kahi 100% o ka ʻāʻī a i ʻole ke aʻalolo kikohoʻe ma lalo o ka ʻili, no ka mea, ua ʻoki ʻia ke aniani e like me ka scalpel a hiki i ka iwi:

• E nānā i ka hana o ka manamana lima a me ka pulima lima: Me ka ʻole o ka hoʻoikaika ʻana i ke kūʻē ʻana i ka ʻeha, e nānā inā hiki i ke kanaka ke kulou mālie i ka piko a me ka hui waena o kēlā me kēia manamana lima (flexor digitorum profundus a me nā tendon superficialis), e hoʻopololei i kēlā me kēia manamana lima (extensor tendons), a hoʻopā i ko lākou manamana lima i ko lākou manamana lima pinky. Inā hāʻule ka manamana lima a ʻaʻole e kūlou a pololei paha, ua ʻoki ʻia kahi tendon a pono ke ʻoki lima koke.
• E nānā i ka manaʻo mamao a me ke kaʻa ʻana: Hoʻopā mālie i nā ʻaoʻao ʻelua o ka piko o kēlā me kēia manamana lima a i ʻole ka manamana wāwae e nīnau inā he mea maʻamau a ʻeha paha (ka ʻeha nerve digital), a nānā i ka ʻulaʻula o ka manamana lima a i ʻole ka moena manamana wāwae i loko o 2 kekona ma hope o ke kaomi ʻana (capillary refill).
• E koi i ka X-ray no nā ʻeha aniani hohonu: Manaʻo hewa ka poʻe he nui ʻaʻole ʻike ʻia ke aniani ma nā kukui X. ʻO ka ʻoiaʻiʻo, ua hōʻoia ka noiʻi lāʻau lapaʻau hou ʻo ** ʻaneʻane he radiopaque nā hale kiʻi, kaʻa, a me nā aniani ʻōmole (me ka ʻike ʻole o ke kepau) a ʻike maopopo ʻia ma nā kukui X maʻamau** a hiki i nā ʻāpana liʻiliʻi e like me 1 a 2 millimeters, ʻoiai hiki ke ʻike i nā ʻāpana liʻiliʻi. ʻO kēlā me kēia puka aniani hohonu a ʻoki ʻia paha kahi i haki ai ke aniani, pono e kiʻi ʻia ma ka haukapila a i ʻole e mālama wikiwiki ʻia ma mua o ka hoʻokomo ʻana i nā humuhumu no laila ʻaʻole humu ʻia ke aniani paʻa i loko o ka ʻeha.

ʻO ka papa inoa palekana home a me ka pale ʻana i ka haki¶

• E nānā i nā puka pā hale hoʻoheheʻe a pau, nā puka makani ʻino, a me nā puka makani haʻahaʻa no ke kihi Tempered Safety Stamp: E nānā i nā kihi ʻehā o kēlā me kēia puka aniani nui a me ka puka makani papahele no kahi hōʻailona palekana ANSI Z97.1 / CPSC 16 CFR 1201 / EN 12150.
• **E hoʻopili i ka 4-mil a i ka 8-mil kiʻi ʻoniʻoni ʻoniʻoni akaka i nā puka aniani ʻaʻole i hoʻoheheʻe ʻia: ** Ke hoʻohana ʻana i ke kiʻiʻoniʻoni palekana polyester paʻa kaumaha e hoʻohuli i ke aniani annealed weliweli i loko o ke aniani pseudo-laminated e paʻa ai nā ʻāpana nahā i hoʻokahi pepa i ka hopena.
• **E kau i nā kiʻi kiʻi kiʻekiʻe o ka maka ma nā puka patio hoʻoheheʻe maʻemaʻe. ka ʻākoakoa ʻana o ka pā hale.
• E nānā i nā ʻūneki puka wai aniani frameless, bumpers, a me lalo o nā ʻūlili i kēlā me kēia mahina: E hōʻoia ʻaʻole i paheʻe ka pā aniani i loko o kona mau hinge i hiki ai i kona ʻaoʻao lalo ke ʻoki i ka tile ceramic, e hoʻololi i nā ʻāpana pale vinyl akaka, a ʻaʻole e kau i nā ʻaʻahu ʻauʻau pulu ma luna o ka ʻaoʻao o luna o ka puka aniani ʻole.
• Mai ʻae i nā keiki e noho, kū, a hilinaʻi paha ma luna o nā kīʻaha kīʻaha a i ʻole nā ​​papa pākaukau: ʻO nā papa aniani hoʻoheheʻe ʻia hiki ke haki inā paʻi ʻia ma ka ʻaoʻao e kahi kīʻaha keramika kaumaha a i ʻole inā wili ʻia nā papa patio alumini ma lalo o ke kaumaha kaulike.

Nīnau pinepine¶

Hōʻike ʻia ka puka aniani, ʻauʻau, a i ʻole ke aniani pākaukau ma kahi X-ray maʻamau inā paʻa kahi ʻāpana i loko o kahi ʻoki?¶

ʻAe. He moʻolelo laha ʻia ʻo ke aniani ke loaʻa ke kēpau a i ʻole nā ​​metala kaumaha e hōʻike ʻia ma kahi X-ray. No ka mea, ʻoi aku ka kiʻekiʻe o ke aniani o ke aniani o ka soda-lime, ke aniani wai ʻauʻau, a me ke aniani omole maʻemaʻe ma mua o ke kino palupalu o ke kanaka, ʻoi aku ma mua o 95 pākēneka o nā ʻāpana aniani i hoʻokomo ʻia he 2 millimeters a ʻoi aku paha (a ʻo ka hapa nui o nā ʻāpana a hiki i ka 0.5 a hiki i ka 1 millimeter) ke ʻike maopopo ʻia ma nā radiographs maʻamau, a hiki i nā lāʻau lapaʻau kiʻekiʻe ke splinter. E hoʻomaopopo mau i ke kauka ulia pōpilikia ʻo ke ʻoki ʻia ma ke aniani ʻāhaʻi no laila e kauoha lākou i kahi X-ray lole palupalu ma mua o ka pani ʻana i ka ʻeha.

No ke aha ʻaʻole pono iaʻu e huki i waho i kahi ʻāpana aniani i haki ʻia mai loko mai o ka lima, ka wāwae, a me ka ʻāʻī o kekahi?¶

Ke hoʻokomo hohonu ka ʻāʻī aniani e like me ka pahi i ka ʻāʻī, ka ʻūhā, ka ʻāʻī, a i ʻole ka lima, ʻoki pinepine ʻo ia i ka ʻāpana a i ʻole ka holoʻokoʻa ma ke aʻa nui a i ʻole ke aʻa nui, akā ʻo ka mānoanoa kino o ka maka aniani e hoʻopaʻa paʻa ʻia i loko o ka ʻeha, ke kui ʻana i ka moku i haehae ʻia (tamponade). Inā ʻoe e huki i kēlā ʻāpana aniani i waho ma ka home, e ʻoki ʻia nā ʻaoʻao koʻikoʻi i nā aʻalolo a me nā moku e pili ana i ka lua o ka manawa ma ke ala i waho, a hoʻomaka koke ke aʻa i hoʻopaʻa ʻole ʻia e kaomi i ke koko i loko o ka ʻiʻo hohonu a i waho paha o ke kino ʻoi aku ka wikiwiki ma mua o kou hiki ke hoʻomalu. E waiho mau i ke aniani i hookomo pono ia, e kaomi i ka ili a puni kona kumu no ka hoomalu ana i ke koko, a e uhi a puni ia mea a hiki i ka wa e wehe ai ke kahuna lapaau ma ke keena hana.

No ke aha e pahū ai nā puka wai aniani i ke aumoe i ka wā ʻaʻohe kanaka i loko o ka lumi lumi?¶

Hana ʻia ke aniani palekana wela wela me kona mau ʻaoʻao o waho i paʻa i ka paʻa kiʻekiʻe a paʻa kona kumu i loko o ka ʻāʻī mau, e like me ka pūnāwai wili paʻa. I ka wā o ka hana ʻana i ke aniani lana, hiki ke hoʻopaʻa ʻia nā mea haumia microscopic o ka nickel sulfide (NiS) i kekahi manawa i loko o kēlā wahi hoʻopaʻapaʻa waena. I loko o nā mahina a i ʻole mau makahiki o ka hoʻololi ʻana i ka mahana o ka lumi hale lole maʻamau, e hoʻololi mālie ʻia kahi hoʻopili nickel sulfide i kahi hoʻololi crystallographic e hoʻonui ai ka mea liʻiliʻi ma 2 a 4 pakeneka; I ka manawa e hele ai ka hoʻonui i loko i ka palena o ka papa hoʻopaʻapaʻa waena, e hoʻokuʻu ka ikehu elastic o ka pepa aniani holoʻokoʻa i ka manawa like, e pahū ana i ka puka i loko o nā ʻāpana he mau tausani me ka ʻole o ka hopena o waho.

Pehea e loaʻa ai iaʻu nā māmala aniani liʻiliʻi i ʻike ʻole ʻia mai koʻu ʻili ma hope o ka pahū ʻana o ke aniani me ka ʻole o ka hoʻokuʻu ʻana iā lākou?¶

Mai hamo i kou ʻili me ke kāwele a i ʻole ka lole holoi, e hana ana e like me kahi poloka one e hoʻoneʻe i nā spicules aniani microscopic i loko o kou epidermis. Akā, holoi mua i kou ʻili ma lalo o kahi kahawai haʻahaʻa haʻahaʻa o ka wai kahe ʻoluʻolu me ka mālama ʻana i kou mau lima mai ka ʻili no laila e holoi ka lepo i ka ʻili, a laila e maloʻo loa kou ʻili. Ke maloʻo kou ʻili, e lawe i kahi ʻāpana lipine paʻa paʻa ākea, lipine paʻi, a i ʻole kahi pepa lint-roller, e kaomi māmā ma luna o ka ʻili kahi āu e ʻike ai i nā fiber aniani ʻino, a ʻili pololei i luna; e huki maʻemaʻe ka lauoho aniani i waho o ka ʻili papa.

Ke hāʻawi nei kēia alakaʻi i ka ʻike no ka hoʻomākaukau ʻana i ka pilikia a me ka ʻike kōkua mua no ka hui ʻana o ke aniani kiʻi a me nā aniani ʻeleʻele i uhaʻi ʻia a ʻaʻole ia e pani i ka mālama lāʻau lapaʻau a i ʻole ka mālama ʻana i ka hemorrhage. E noʻonoʻo e lawe i kahi kōkua mua i ʻāpono ʻia, CPR, a Stop the Bleed tourniquet course mai ke Keʻa ʻulaʻula, St John Ambulance, ke Kulanui o ʻAmelika Hui Pū ʻIa, a i ʻole kāu hui palekana aupuni.

Nā alakaʻi pili¶

• ʻO ke koko koʻikoʻi a me ka noi tourniquet
• Hoʻopaʻa ʻia a hoʻopaʻa ʻia i nā mea haole
• Nā ʻeha maka a me nā paʻi kemika
• ʻO ka mea ʻē aʻe ka maka, ka ʻāʻī ʻana o ke kino, a me ka uila uila
• ʻOki, ʻoki, a me ka mālama ʻeha liʻiliʻi
• ʻIke haʻalulu a me ke kūlana pilikia

Nānā ʻia nā kumu¶

• US Consumer Product Safety Commission (CPSC, United States): Palekana Palekana no Architectural Glazing Materials (16 CFR Part 1201) a me CPSC Safety Alert on Tempered Glass Shower Door Spontaneous Shattering
• Komite ʻAmelika Hui Pū ʻIa o ʻAmelika Hui Pū ʻIa no ka Trauma (ACS COT, ʻAmelika Hui Pū ʻIa): Hoʻopau i nā alakaʻi hoʻomalu ʻana i ke koko koko no ka Extremity and Junctional Vascular Trauma.
• Luna Hoʻokele Ola a me ka Maluhia (HSE, United Kingdom): Nā Kūlana Ola, Palekana a me ka Pono (Reglatory 14: Palekana o ka Glazing ma nā Puka, nā ʻīpuka, a me nā Windows Level Haʻahaʻa / BS EN 12600)
• ʻAmelika Hui Pū ʻIa no ka ʻoki ʻana o ka lima (ASSH, ʻAmelika Hui Pū ʻIa): Ka Loiloi ʻana i nā Lacerations Volar Wrist ("Spaghetti Wrist"), Flexor Tendon Severance, a me Radiopacity of Glass Foreign Bodies
• American Academy of Ophthalmology (AAO, ʻAmelika Hui Pū ʻIa): Hoʻoponopono i nā kino ʻē aʻe o Penetrating Ocular Trauma a me Corneal Glass