Kickback Saw Papa, Pahi Riving, a me ka oki lima¶

Ma waena o nā hale kūʻai keʻena kalepa, nā kahua hana, a me nā hale kaʻa kaʻa hale, ua ʻike ka ** paʻa a i ʻole portable 254-milimeter (10-ʻīniha) pākaukau pōʻai** i ʻoi aku ka nui o ka ʻoki ʻana i nā manamana lima a me nā ʻeha ʻeha o ka ʻōpū ma mua o nā mīkini hana lāʻau ʻē aʻe i hui pū ʻia. ʻIkepili mai ka U.S. Consumer Product Safety Commission (CPSC) a me ka Occupational Safety and Health Administration (OSHA) palapala ma luna o 30,000 kipa keʻena pilikia a me 4,000+ mau oki manamana lima a me nā manamana nui i kēlā me kēia makahiki ma ʻAmelika Hui Pū ʻIa wale nō mai ka papaʻaina i ʻike i ka pahi. Kokoke kēlā me kēia papaʻaina koʻikoʻi i ʻike i ka ulia pōpilikia e alakaʻi ʻia e kahi hanana mīkini ʻelua ʻāpana i kapa ʻia ʻo kickback: i ka wā e hele ai ka papa ma mua o nā niho ʻoki ʻoki i lalo o kahi pahi e wili ana ma 3,450 a 5,000 mau kipi i kēlā me kēia minuke (RPM), ʻo ke koʻikoʻi o ka lāʻau i loko ke kumu o ka ʻoki hou ʻana o ke kua a i ʻole ka ʻoki ʻana o ke kua a i ʻole ka ʻoki ʻana o ka papa ma waena o ka ʻaoʻao. ka maka. Hiki koke, ʻo ka piʻi hope (piʻi) carbide niho ma ke kua o ka lau, e neʻe ana i luna a i mua i ka mea hoʻohana ma ka wikiwiki rim o 160 a 290 mau kilomita i kēlā me kēia hola (100 a 180 mau mile i kēlā me kēia hola), hoʻopaʻa ʻia i loko o nā lālā lāʻau. I loko o 0.05 kekona, e hoʻolele ʻia nā niho hope e piʻi aʻe i hope e like me ka missile pololei i loko o ka ʻōpū o ka mea hoʻohana, ka ʻāʻī, ka ʻāʻī, a i ʻole ka maka, me ka huki ʻana i ka lima hema a i ʻole ka lima ʻākau o ka mea hoʻohana mai ka lāʻau a huki pololei i ko lākou mau manamana lima i loko o ka pahi wili. Inā ʻike ka papa ʻaina i ka ʻoki ʻana i ka manamana lima, ʻoki ʻia ke aʻa lima lima, a hoʻolei i ka papa kickback i loko o ka ʻōpū o kekahi, e kelepona koke i kāu helu pilikia kūloko (911 ma United States a me Kanada, 112 ma ʻEulopa, 999 ma United Kingdom, 000 ma Australia, 111 ma New Zealand) a i ʻole e nānā i kā mākou papa kuhikuhi honua. helu pilikia. No nā papa hana pili pili a me nā protocol mālama trauma, e heluhelu i kā mākou alakaʻi ma ka ʻoki ʻoki ʻoki ʻoki ʻoki, ka ʻike kickback, a me ka wili ʻana o ka lathe, ke koko nui a me ka noi tourniquet, ka hoʻopaʻa ʻana a me ka hoʻopaʻa ʻana i nā mea haole, a ʻeha ka mea holoi holoi a me nā ʻeha kickback.

E hana i kēia i kēia manawa¶

1. E pā i ke kī OFF a i ʻole e wehe koke i ka pahi, a e noho a hoʻomoe i ka mea ʻeha i lalo i ka papahele i loko o 15 kekona: Mai hōʻea i kahi pahi ʻike kai e hoʻopau i kahi kī. E hoʻomoe palahalaha a i ʻole e noho koke ma ka papahele: ʻo ka poʻe hana lāʻau e nānā ana i ka lima ʻeha e loaʻa mau i ka vasovagal syncope (maule) i loko o 30 a 60 kekona a paʻi i ko lākou poʻo i ka papahele.
2. E ʻōwili paʻa i ka lima koko a i ʻole nā ​​kumu manamana lima i ka gauze sterile mānoanoa, e hoʻokau pono i ke kaomi pololei, a e hoʻokiʻekiʻe i ka lima ma luna o ka pae o ka puʻuwai: Holo nā ʻaʻa kikohoʻe ma nā ʻaoʻao ʻelua o kēlā me kēia manamana lima. E kaomi pono i nā pad gauze mānoanoa i pelu ʻia ma luna o nā kumu manamana lima e kahe ana a hoʻopaʻa maikaʻi ʻia me kahi kāʻei wili elastic me ka paʻa ʻana i ka lima kiʻekiʻe. Mai hoʻohana i nā wili metala a i ʻole nā ​​kī hemostat no ke kuʻi ʻana i ke aʻa koko i loko o kahi kumu manamana, no ka mea, ʻo ka hoʻopaʻa ʻana e haki i ke aʻalolo kikohoʻe e pili ana. E mālama i ka forearm windlass tourniquet no ka ʻoki ʻana i ke aʻa o ka pāma a i ʻole ka pulima lima e hoʻoheheʻe ʻia ma nā ʻaʻahu kaomi pololei.
3. ** ʻAʻole loa e ʻoki, wili, a huki paha i kahi manamana lima i ʻoki hapa ʻia e kau mau ana e ka ʻili a i ʻole ka ʻiʻo:** ʻOiai ke ʻoki ʻia ka iwi manamana a kau ʻia e kahi alahaka 3-milimita o ka ʻili, aia i kēlā alahaka ʻili haiki i nā ʻaʻa hope e ola ana a i ʻole ke aʻa kikohoʻe e pono ai ke ola o ka manamana lima. E hoʻopololei mālie i ka ʻoki ʻoki ʻia ʻana ma ka ʻaoʻao o ka manamana lima e pili ana ma kahi maʻa i hoʻopaʻa ʻia, e uhi iā ia me ka gauze i hoʻomoʻu ʻia i ka wai paʻakai, a uhi māmā.
4. E hoʻopaʻa i nā manamana lima i ʻoki loa ʻia a i ʻole nā ​​ʻāpana manamana nui me ka "Damp Gauze + Sealed Dry Bag + Ice-Water Slurry" ʻAha Palua-Barrier: E ʻimi i ke keʻena ʻike a me ka papahele no nā ʻāpana manamana lima i ʻoki ʻia. E holoi mālie i ka ʻōpala me ka wai paʻakai maʻemaʻe a i ʻole ka ʻōmole wai (ʻaʻole e holoi ʻia), e uhi i ka huahelu i ka ** gauze sterile i hoʻomaʻemaʻe ʻia me ka paʻakai**, e hoʻopaʻa i loko o kahi ** ʻeke ʻeke paʻa wai maloʻo-luna**, a lana i kēlā ʻeke i loko o kahi pahu lua i hoʻopiha ʻia me ka 50/50 slush o nā pahu hau a me ka wai anuanu. AOLE e kau pololei i ka manamana lima i okiia ma ka hau a i ole ka hau maloo, a mai hookomo iho i ka wai.
5. E hoʻokiʻekiʻe i ka pālule o ka mea i pepehi ʻia a nānā i ka ʻōpū, ka umauma lalo, a me ka ʻāʻī no ka hopena o ka kickback a i ʻole nā mamala lāʻau i maʻi ʻia: ʻO nā mea hana i hahau ʻia ma ka ʻōpū e ka papa kickback 160 km/h (100 mph) ua hoʻohilahila pinepine ʻia e ko lākou lima koko a ʻaʻole lākou i kahi ** ʻāhaʻi ʻāʻī, ʻāwīwī** liʻiliʻi. E nānā i ka ʻōpū a i ʻole ka ʻōpū ʻoʻoleʻa, a ʻaʻole ** ʻaʻole e huki i kahi maʻa lāʻau i hoʻopaʻa ʻia ma ka ʻōpū, ka umauma, a me ka ʻūhā**; hoʻopaʻa i kahi me nā ʻōwili gauze nui.
6. Mai hoʻohana i kekahi papa ʻike ke ʻole i hoʻokomo ʻia kahi Riving Knife i hoʻonohonoho pono ʻia i loko o 3 a 8 millimeters (⅛ a 5/16 ʻīniha) ma hope o ka maka: ʻO ka riving knife he ʻili kila ʻāwili i kau ʻia ma hope o ka pahi ʻili e piʻi, e hoʻohaʻahaʻa, a e hili ʻakomi me ka ʻoki ʻana i ka lāʻau mai ka ʻoki ʻana i ka lāʻau mai ka ʻoki ʻana i ke kino. e hoʻopau ana ma luna o 80 a i ka 90 pākēneka o nā kickback ʻoki ʻoki ʻia.

lāʻau hoʻoholo: ʻike ka papa ʻaina i ka trauma kickback a me ka ʻoki ʻana i nā manamana lima¶

flowchart TD
    Start["Pākuʻi Paʻa ʻIke: Hoʻopili ʻana i ka Blade, ʻoki ʻana i nā manamana lima, a i ʻole Kickback Papa Kūleʻa Kiʻekiʻe"] --> SceneSafe["1. PIKI KOWAI & PAU OLE: 1. Pa'i i ka Knee-Paddle Switch a i 'ole Unplug Saw Cord."]

    SceneSafe --> InjuryType{"2. He aha nā ʻeha i loaʻa i ka mea hoʻohana?"}

    InjuryType -->|"1. HOʻokiʻoki ʻia ka manamana lima a i ʻole nā manamana lima"| AmpCare["STUMP HEMOSTASIS & DOUBLE-BARRIER DIGIT COOLING: 1. E kaomi pono i ke kāwele Sterile mānoanoa ma luna o nā ʻōpala koko + e hoʻokiʻekiʻe i ka lima ma luna o ka puʻuwai (ʻaʻohe paʻa moku) 2. e hoʻopau i ka ʻohi lepo a ʻimi i nā ʻāpana helu i ʻoki ʻia i loko o ka Saw Cabinet/Floor in P. ʻEke lana i loko o 50/50 hau-wai slurry (ʻaʻole loa hau hau)"]

    InjuryType -->|"2. PARTIAL AMPUTATION OR MANGLING LACERATION (Digit Attached by Skin/Tendon Bridge)"| PartialCare["PALAPALA PALAPALA ILI-BRIDGE: 1. Mai ʻoki a wili paha i kahi ʻāpana manamana lima e lele ana (Paʻa ka Alahaka ʻili i nā veins koʻikoʻi) 2. E hoʻopololei mālie i ka manamana lima ma ka ʻaoʻao o nā ʻaoʻao e pili ana i kahi maʻa palahalaha 3. uhi ʻia me ka wai paʻakai i hoʻomoʻa ʻia a maloʻo nui."]

    InjuryType -->|"3. KA PALAPIMA / FOREARM ARTERIAL SLASH OR SEVERE PALM CLED"| TourniquetCare["ARTERIAL HEMORRHAGE PROTOCOL: 1. E hoʻopili koke i ke kaomi ʻelua-lima ma luna o ka gauze."]

    InjuryType -->|"4. KA PALAPALA PALAPALA A I ʻole Ihe lāʻau i hoʻopaʻa ʻia mai ka PAPA KICKBACK."| TorsoCare["'ĀPU / THORACIC KICKBACK PROTOCOL: 1. E hāpai i ka Pālule & E nānā i ka ʻōpū hema o luna (Spleen), ʻO ka ʻōpū ʻākau (Liver), ʻūhā a me ka ʻāʻī 2. ʻAʻole loa e huki i nā mamala lāʻau i hoʻopaʻa ʻia; E hoʻopaʻa ma kahi me ke apo aniani nui 3. Inā ʻoʻoleʻa/ʻoluʻolu ka ʻōpū a i ʻole nā ​​maʻi maʻi maʻi: E mālama i ka palahalaha, ʻaʻohe mea ma ka waha, ka lawe wikiwiki ʻana i ka Center Trauma."]

Luʻu hohonu 1: Ua ʻike ka ʻepekema mechanical o ka papaʻaina i nā kinematics kickback a me nā niho lau¶

No ka hoʻomaopopo ʻana i ke kumu e hoʻolale ai ka ʻike papa i ka papa ʻoka paʻa ma mua o ka pitch baseball a no ke kumu e koi ʻia ai ka pahi holoʻokoʻa i kēlā me kēia ʻokiʻoki, e hoʻohālikelike i ka neʻe ʻana o nā niho mua me ka niho hope o kahi pahi ʻili pōʻai 254-milimeter (10-ini).

1. Nā niho e iho ana i mua a me nā niho e pi'i ana ma hope (160 a 290 km/h ka holo o ka Rim)¶

Ua ʻike ʻia kahi pākaukau maʻamau 254-milimika (10-ʻīniha) i ka wili arbor ma 3,450 a i 5,000 RPM. Ma 4,000 RPM, hele ka ʻaoʻao o waho o nā niho carbide ma \(53\text{ mika i kekona}\) (\(191\text{ kilomika i kēlā me kēia hola}\) a i ʻole \(119\text{ mile i kēlā me kēia hola}\)), aʻo ka 305-milimita (12-ʻīniha) ʻike maka a hiki i ka \(64}\text (\) i kēlā me kēia hola) } no kekona\text (${2\(143\kikokikona{ mph}\)). - Ke alo o ka Lahi (Ke ʻoki ʻoki i lalo = Safe): Ma kahi e hui mua ai ka mea hana i mua o ka maka, e neʻe ai nā niho carbide i lalo i ka ʻili o ka pākaukau hao, e hoʻokuke ana i ka papa lalo i lalo i ka papakaukau. - Ka Lifting Force = The Kickback Engine): Ma ka ʻaoʻao hope o ka ʻaoʻao o ka pahi, e piʻi aʻe nā niho carbide like ** i luna mai ka slot papaʻaina a piʻi i mua i ka umauma o ka mea hana**. ʻO ka maʻamau, ʻo kēia mau niho piʻi hope e wili manuahi i loko o ka 3.2-milimita (⅛-ʻīniha) ʻike i ke kerf me ka pā ʻole i ka lāʻau. - He aha ka lāʻau e hoʻopā ai i nā niho e piʻi aʻe ana: Inā pā ka lāʻau i nā ʻaoʻao o nā niho e piʻi aʻe ana no 10 mau milliseconds, e hāpai nā niho e neʻe ana i luna i ke kua o ka papa i ka lewa a kau i luna ma luna o ka lei aliʻi ma luna o ka pahi wili, ka mea ** hoʻopale i ka papa ma ka 1/h pololei i ka mea hoʻohana.

====================================================================================
     PHYSICS OF TABLE SAW KICKBACK: WITHOUT RIVING KNIFE vs. WITH RIVING KNIFE
====================================================================================

 [A] WITHOUT RIVING KNIFE (LETHAL KICKBACK)   [B] WITH RIVING KNIFE INSTALLED (SAFE)

   Internal Wood Stress Pinches Kerf Shut       Curved Steel Riving Knife (3-8 mm
   OR Board Twists Between Fence & Blade        Behind Blade) Holds Kerf Open

         +-------+     +-------+                     +-------+  ||  +-------+
         |       | --> | <--   |                     |       |  ||  |       |
         | WOOD  | \ / | WOOD  |                     | WOOD  |  ||  | WOOD  |
         |       | (U) |       |                     |       |  ||  |       |
         +-------+ / \ +-------+                     +-------+  ||  +-------+
              Rear Rising Teeth                           Riving Knife Blocks
              Hook Pinched Wood                           Wood From Touching
              at 160-230 km/h                             Rear Rising Teeth
                    ||
                    vv
        LAUNCHES BOARD AT OPERATOR'S
        ABDOMEN & PULLS HAND OVER BLADE
====================================================================================

2. ʻEhā mau mea hoʻoheheʻe e hoʻopiʻi ai i ka lāʻau i nā niho hope¶

1. Laau Hoʻoula (Hoʻopaʻa Paʻa Kūloko a me ka Hoʻoulu ʻana): ʻO ka lāʻau paʻa maloʻo kiln (maple, ʻoka, cherry, hickory) a me nā lāʻau kūkulu hale (2x4 pine/fir) loaʻa i ka paʻa i loko. Ke ʻoki ʻoe i ka papa i ka lōʻihi ma ka waena, me ka hoʻomaha ʻana i ke kaumaha e hoʻomaka ai nā ʻāpana ʻelua ma hope o ka maka e kulou i loko e like me ke kui lole, e hoʻopaʻa ana ma nā niho e piʻi aʻe ana o ka maka ke ʻole kahi ** pahi hoʻi e kū i waena o lākou.
2. Ke ʻoki ʻana i kahi ʻoki ʻoki ʻoki ma waena o ka Lapa a me ka Pa ʻoki ʻia: Ke hoʻohana nei i ka miter gauge e ʻoki ai i ka papa i ka lōʻihi i ka wā e hoʻoheheʻe ana i ka parallel rip fence i luna ma ka ʻaoʻao ʻākau o ka papa e hoʻopaʻa paʻa i ka poloka ʻoki ʻoki ma waena o ka pa hao hao ʻoʻoleʻa ma ka ʻākau a me nā niho hope o ka maka ma ka ʻaoʻao hema. Hoʻopili nā niho hope i ka poloka a puhi i loko o ka ʻōpū a i ʻole ka maka o ka mea hana. (Rule: Mai hoʻohana pū i ka pā ʻāhaʻi a me ke ana ʻana o ka miter ke ʻole ka hoʻopaʻa ʻia ʻana o kahi poloka kōkua pōkole ma ke alo o ka pā ma mua o ka maka).
3. Ka Laau Iwi, wili, a i ʻole ʻApe i ka Pa: Inā concave (hollow) a wili paha ka ʻaoʻao o ka papa e pili ana i ka pā ʻāhaʻi ma mua o ka hui ʻana, e pōhaku ka papa i waena o ka ʻoki a hoʻohuli pono i kona huelo ma hope o ka maka.
4. Ke Kiʻi ʻana ma hope o ka Laʻau a i ʻole ka hoʻokuʻu ʻana i ka lāʻau pana: Ke hoʻokuke nei i kahi lāʻau haiki (<15 knm / 6 ka laulā) me nā manamana lima ʻole ma waena o ka lau a me ka pa, a i ʻole ka hoʻohana ʻana i hoʻokahi lāʻau pana ʻole i kanu ʻia i waenakonu o ka papa ma mua o ka hoʻomalu ʻana i ka kuʻekuʻe wāwae i ka pā.

Luʻu hohonu 2: Nā mana ʻenekinia (Riving Knife, Push Sticks, a me Active Flesh-Sensing Brakes)¶

ʻO ka hierarchy palekana ʻoihana ʻaʻole hiki iā ʻoe ke hilinaʻi i ka manawa pane kanaka (\(0.20\text{ kekona}\)) e paʻi i ka pahi e wili ana ma 66 kipi i kēlā me kēia kekona (\(0.015\text{ kekona no ke kipi}\)). ʻEkolu mau mana ʻenehana e pale i ka kickback a me ka ʻoki ʻana:

1. No ke aha i ʻoi aku ka ʻoi o ka "Riving Knife" o kēia wā ma mua o kahi "Splitter" kahiko.¶

Ua hele mai nā ʻeli papaʻaina ma mua o ka makahiki 2008 me kahi metala paʻa splitter i hoʻohui ʻia i loko o ka hui kiaʻi ʻili ma luna o ke poʻo i hoʻopaʻa ʻia ma ke kua o ke keʻena ʻike. - No ke aha i wehe ai ka poʻe hana lāʻau i nā mea ʻoki kahiko: i nā manawa a pau e pono ai ka mea hana lāʻau e hana i kahi ** ʻoki ʻole ʻia** (kahi ʻāpana dado, rabbet, a i ʻole ka hui hapa hapa kahi i ʻole ai ka pahi ma luna o ka papa), paʻi ka mea hoʻokaʻawale kiʻekiʻe i ka lāʻau. Ua wehe ka poʻe hana lāʻau i ka hui ʻoki a pau a waiho i ka ʻike me ka mālama ʻole ʻia. - Pehea e Hoʻoponopono ai ka Pahi Hou Hou i ka pilikia (UL 987 / IEC 62841 Standard): Mai ka makahiki 2008 a hiki i ka 2014, UL 987 a me nā kūlana hana lāʻau honua e kauoha i kēlā me kēia papaʻaina hou e ʻike i kahi modular riving knife kūʻokoʻa i kau pololei ʻia i ka ʻauamo o loko. 1. Neʻe i luna, i lalo, a hoʻokuʻu ʻia me ka maka: Ke ʻoki nei ʻoe i ka maka i lalo no ka ʻoki dado makapō a i ʻole ke hoʻoemi ʻana iā ia i ke 45 degere, e neʻe ʻokoʻa ana ka pahi hoʻoneʻe ** i lalo a hili ma ka ʻaoʻao hoʻokahi**, e mālama mau ana i ka 3 a 8 millimeter (⅛ a 5/16 iniha) āpau ma hope o ka hope ** 2. Noho ma lalo iki o ka lei aliʻi o luna o ka maka: Ma kona kūlana haʻahaʻa "non-through-cut" haʻahaʻa, noho ka piko o luna o ka pahi hoʻoneʻe 1 a 2 millimeters ma lalo o ka niho kiʻekiʻe o ka maka ʻike, ʻo ia hoʻi, hiki iā ʻoe ke hana i nā ʻāwī makapō, rabbets, a me nā tenon ** me ka wehe ʻole ʻana i ka pahi wili.

2. ʻenehana hoʻomaʻamaʻa hoʻomaʻamaʻa ʻiʻo ʻeleu (Capacitive Contact Mitigation / "SawStop" Physics)¶

ʻO nā ʻoki pākaukau hoʻēmi ʻeha ʻeha (i paionia e SawStop a loiloi ʻia e ka U.S. CPSC) e hoʻopau i ka ʻoki ʻana i nā helu he nui ke komo ka lima ʻole i loko o ka lau wili: 1. Ka 3-Volt, 12-Megahertz Capacitive Signal: Hoʻoulu ka ʻili i kahi hōʻailona uila liʻiliʻi ma luna o ka ʻili kila a nānā mau iā ia. 2. Ka ʻike ʻana i ka mana o ke kino kanaka: No ka mea, ua haku ʻia ke kino o ke kanaka me ka wai conductive a me nā electrolytes, ʻae ʻo ia i kahi ʻāpana o ka hōʻailona ma ka hoʻopili ʻana, akā ʻaʻole ʻo ka lāʻau maloʻo a me ka plastic. 3. Ka 5-Millisecond Aluminum Brake Cartridge Activation: Ke pā koke ka manamana lima i ka niho, e puhi ka mea hana i kahi mea hoʻohenehene e hoʻolei i ka aluminum brake pawl paʻa i loko o nā niho carbide wili i ka wā e hoʻolei ana i ka pahi ma lalo o ka papaʻaina i ** emi iho ma mua o 3 a 5 milliseconds**, e waiho ana i ka ʻili nick-**i-2 wale nō.

Luʻu hohonu 3: ʻO ka mālama ʻana i ka trauma ma mua o ka hale hoʻomaha no ka ʻike ʻana i ka ʻoki ʻana a me ka kickback o ka ʻōpū.¶

1. No ke aha e hooloihi ai ka hooluu huahelu kupono i ka pukaaniani hooulu ana i ka microsurgical mai 6 hola a i 12 a 24 hola¶

Ke ʻoki loa ʻia ka manamana lima a i ʻole ka manamana nui e ka lau ʻike papaʻaina, ʻaʻohe koko oxygenated (ischemia) nā ʻiʻo i wehe ʻia. - Wam Ischemia Wā (Ma ka lumi wela, \(20\text{ a i }25\text{ °C}\)): No ka mea, aia i loko o nā manamana ka zero muscle mass (iwi wale nō, nā aʻalolo, nā aʻalolo, nā kīʻaha koko, a me ka ʻili), ʻae ʻia nā huahelu i ʻoki ʻia ʻaʻole ke kahe koko ʻoi aku ka lōʻihi ma mua o ka lima ʻoki ʻia a i ʻole ka wāwae, e loaʻa ana 6 ischemia mahana ma hope o . - Ka Wā Ischemia Cold (Hoʻoluʻu i \(+4\text{ °C} / 39\text{ °F}\) ma o Indirect Ice-Water Slurry): ʻO ka hoʻoluʻu ʻana i ka huahelu i ʻōwili ʻia me ka maluhia i 4 degere Celsius (39 degere Fahrenheit) e hoʻolohi i ke koi ʻana i ka oxygen metabolic e 80 a 90 pakeneka, e hoʻolōʻihi ana i ka pukaaniani hiki ke hoʻolālā ʻia i 12 mau hola microsurgical. - ** ʻO nā ʻoki ʻoki ʻana he poʻe moho mua no ka kanu hou ʻana? Hoʻomaka mua ka poʻe ʻokiʻoki i ke kanu hou ʻana: (1) KE ʻoki ʻana i ka manamana lima (40 a 50 pakeneka o ka hana lima); (2) ʻoki ʻana i nā huahelu lehulehu; (3) ** ʻoki lima, lima, a i ʻole ka lima mua; (4) ʻoki ʻana i ka manamana lima hoʻokahi ma kahi mamao loa i ka phalanx waena; a me (5) kekahi oki huahelu o ke keiki. E hōʻiliʻili mau, ʻōwili a hoʻoluʻu i kēlā me kēia ʻāpana i ʻoki ʻia mai ka papahele hale hana i hiki i ke kauka lapaʻau lima ke kanu hou iā ia a hoʻohana paha no ka grafting tissue.

====================================================================================
    THE DOUBLE-BARRIER AMPUTATED FINGER PRESERVATION METHOD (+4 C / 39 F TARGET)
====================================================================================

   +-----------------------------------------------------------------------+
   | OUTER CONTAINER (Plastic Bowl, Cooler, or Heavy Ziploc Bag)           |
   |                                                                       |
   |   * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *   |
   |   *  50/50 SLURRY OF CRUSHED ICE CUBES + COLD TAP WATER (+4 C)    *   |
   |   *         +-------------------------------------------+         *   |
   |   *  [ICE]  | INNER SEALED WATERTIGHT PLASTIC BAG (DRY) |  [ICE]  *   |
   |   *         |   +-----------------------------------+   |         *   |
   |   *         |   | STERILE GAUZE LIGHTLY DAMPENED    |   |         *   |
   |   *  [ICE]  |   | WITH SALINE (WRAPPED AROUND DIGIT)|   |  [ICE]  *   |
   |   *         |   +-----------------------------------+   |         *   |
   |   *         +-------------------------------------------+         *   |
   |   * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *   |
   +-----------------------------------------------------------------------+
   * NEVER put naked tissue directly on bare ice or dry ice (causes frostbite)
   * NEVER submerge naked tissue in liquid water (causes osmotic cell burst)
====================================================================================

2. Ka ʻike ʻana i ka lohi ʻana o ke koko i loko ma hope o ka ʻike ʻana o ka papa ʻaina i ka kickback i ka ʻōpū.¶

Ke hoʻokuʻu ʻia ka papa lāʻau paʻa 2-kilogram (4.4-pauna) i hope ma 180 km/h (112 mph), hāʻawi ʻo ia i ** ma luna o 2,500 Joules o ka ikehu kinetic blunt** i loko o ka ʻōpū o ka mea hana: 1. ** Hollow-Organ Perforation (Small Intestine / Mesentery):** Hoʻopiʻi ka papa i ka ʻōpū liʻiliʻi ma luna o ka iwi kuamoʻo, haehae i nā moku mesenteric a i ʻole nahae ka paia o ka ʻōpū. 2. ** ʻAha ʻŌnaʻi Paʻa (Spleen ma ka ʻaoʻao hema o luna / ate ma ka ʻaoʻao ʻākau o luna):** ʻO ka pā ʻana i ka ʻaoʻao hema hema hiki ke hoʻoulu i kahi splenic hematoma e kahe ana ke koko i loko o ka lua peritoneal. 3. Nā hōʻailona Hae ʻulaʻula e koi ana i ka lawe kaʻa kaʻa kaʻa koke: E kelepona iā 911 / 112 / 999 ma hope koke o ka hahau ʻana i ke kino inā hoʻomohala ka mea hana: - Holomua ** ʻeha ʻōpū, kiaʻi ʻana, a i ʻole ka ʻiʻo o ka ʻiʻo e like me ka papa**. - Ka ʻeha i kuhikuhi ʻia ma ka piko o ka poʻohiwi hema ("Kehr's sign") ma hope o ka ʻeha splenic. - ** ʻO ka noʻonoʻo ma ke kū ʻana, haʻihaʻi ka ʻili, ka puʻuwai wikiwiki (\(>100\text{ bpm}\)), ka luaʻi ʻana, a i ʻole ke koko i loko o ka mimi**. - He ihe lāʻau i hoʻopaʻa ʻia e puka mai ana mai ka ʻōpū, ka ʻāʻī, a i ʻole ka ʻūhā: E waiho ma kahi paʻa a hoʻopaʻa ʻia me nā ʻōwili gauze nui.

Nā helu ulia pōpilikia āpana a me nā protocols oihana¶

Nīnau pinepine¶

He aha ke kumu i ʻike ai ka papaʻaina e hoʻihoʻi i ka papa ma mua o 160 km/h (100 mph)?¶

He 254-millimeter (10-inihi) i ike i ka pahi e wili ana ma ka 4,000 RPM he elua wahi oni e kue ana: na ** niho mua** e nee ilalo i ka pakaukau hao, e kaomi pono ana i ka laau ilalo, oiai na **niho hope** e pii iluna mai ka slot papaaina a holo i mua i ka mea hana i ka 2000 mile a oi 2000 mile. hola)**. Inā wili ʻia ka mea hana ma waena o ka pā a me ke kua o ka lāʻau, ʻo nā niho hope e piʻi aʻe i ka lāʻau, e hoʻokiʻekiʻe i ka papa mai ka papaʻaina, a hoʻokuʻu i hope i ka ʻūhā o ka mea hoʻohana me ka huki pololei ʻana i ka lima o ka mea hana ma luna o ka maka wili.

He aha ka ʻokoʻa ma waena o ka pahi riving a me ka papa ʻaina ʻano kahiko i ʻike i ka mea hoʻokaʻawale, a no ke aha e hoʻōki ai ka pahi riving kickback?¶

ʻO ka **splitter** kaila kahiko, he ʻāpana metala paʻa i hoʻopaʻa ʻia ma ke kua o ke keʻena ʻike ma ke ʻano he ʻāpana o kahi kiaʻi o luna; Pono nā mea hana lāʻau e wehe a wehe iā ia i nā manawa a pau e ʻoki ʻia ai ka ʻoki dado makapō, rabbet, a i ʻole ka bevel. ʻO ka **pahi hoʻoholo hou** he ʻili kila ʻāwili i hoʻopaʻa pololei ʻia i ka mekani o loko o ka pahi-arbor i loko wale nō **3 a 8 millimeters (1/8 a 5/16 ʻīniha) ma hope o nā niho hope** no laila e piʻi aʻe, hoʻohaʻahaʻa, a hili ʻakomi me ka maka, a ʻo kona piko e noho iki ma lalo o ka niho luna. No ka mea, ʻaʻole pono ʻoe e wehe iā ia no ka ʻoki ʻole ʻana, kū mau ia ma hope o ka lau e pale aku ai i ke kiʻi ʻana i nā niho hope.

Pehea wau e mālama ai i ka manamana lima a i ʻole ka manamana lima i ʻoki ʻia ma hope o ka ʻike ʻana o ka papa ʻaina i kahi pōʻino i hiki i ke kauka lapaʻau ke hoʻopili hou iā ia?¶

E hoʻohana i ka **Double-Barrier Indirect Cooling Method**: (1) Holoi mālie i ka ʻōpala me ka paʻakai maʻemaʻe a i ʻole ka ʻōmole wai maʻemaʻe me ka holoi ʻole ʻana; (2) wahī loa i ka huahelu i ʻoki ʻia me ka ** gauze sterile i hoʻomaʻemaʻe ʻia me ka paʻakai sterile**; (3) e waiho i ka huahelu i ʻōwili ʻia i loko o kahi ** ʻeke ʻeke kiʻi maloʻo a paʻa i ka wai** a pani i ka sila; a (4) lana i kēlā ʻeke plastik i hoʻopaʻa ʻia i loko o kahi pahu waho i hoʻopiha ʻia me ka hui ʻana o **50/50 slush o nā pahu hau a me ka wai anuanu**. **Mai kau pololei i ka manamana lima i oki ma ka hau, ka pahu pahu hau gel, a i ka hau maloo**, ka mea e paakiki ai na aa koko microscopic a hiki ole ke kanu hou.

Inā ʻaneʻane ʻoki loa ʻia kahi manamana lima e ka ʻili papaʻaina a kau ʻia e kahi ʻili ʻili lahilahi, pono anei iaʻu e waiho iā ia i hoʻopaʻa ʻia a i ʻole e ʻokaʻawale paha?¶

**Mai ʻoki, wili, a huki paha i ka ʻili a i ʻole ke alahaka ʻuʻuku ma ka manamana lima i ʻoki hapa ʻia, ʻoiai ka lahilahi o ke ʻano o ia alahaka. E hoʻopololei mālie i ka ʻāpana manamana lima e lele ana i kona ʻano kūlohelohe ma ka ʻaoʻao o ka manamana lima ʻaʻole i ʻeha ʻia ma kahi maʻa i hoʻopaʻa ʻia, uhi ʻia me ka gauze sterile i hoʻomoʻu ʻia i ka paʻakai, ʻōwili i ka lima me kahi lole maloʻo nui, a hoʻokiʻekiʻe i ka lima.

No ke aha he mea weliweli ka hoʻohana ʻana i ka pā ʻāhaʻi a me ke anana miter i ka manawa like ke ʻoki ʻana i nā ʻāpana lāʻau pōkole?¶

Ke hoʻokuʻu ʻoe i ka papa ma ka ʻaoʻao o ka lau me ka **miter gauge** a ʻo ka **paʻi paʻa** e kū pono ana ma ka ʻaoʻao ʻākau o ka papa e like me ke kū lōʻihi, e paʻa ka poloka ʻoki ʻoki hou ʻia ** i loko o kahi paʻa paʻa ma waena o ka pa hao hao ʻoʻoleʻa ma ka ʻākau a me nā niho piʻi hope o ka maka milo ma ka hema**. I ka pau ʻana o ka ʻoki ʻana, hoʻololi ka poloka, hopu i ka 180 km/h piʻi ʻana o nā niho hope, a puhi i hope e like me ka pōkā. I kēlā me kēia manawa e hoʻohana ai i ka pā ʻeha ma ke ʻano he hoʻomaha lōʻihi no nā ʻoki ʻoki hou ʻana, e hoʻopaʻa mau i kahi ** ʻāpana kōkua lāʻau pōkole i mua o ka pā ʻāhaʻi MAMUA o ka ʻaoʻao mua o ka maka** i hoʻomaʻemaʻe ka lāʻau i ka pā ma mua o ka pā ʻana i nā niho.

He aha nā lako kōkua mua e kau ʻia ma ka paia o kēlā me kēia hale kūʻai hana lāʻau?¶

Pono nā hale kūʻai hana lāʻau i paʻa i ka paia **Stop the Bleed and Amputation Trauma Kit** hiki ke kiʻi ʻia i loko o 5 kekona o ka papa ʻaina: **ʻelua CoTCCC windlass tourniquets**, **mānoanoa sterile 4x4 a me ka ʻōpū gauze pads**, **elastic pressure wraps**, **sterile maʻamau saline pods**, **ʻekolu ʻeke paʻakai maʻamau**, **ʻekolu ʻeke paʻakai maʻamau. ka mālama ʻana i nā huahelu pāpālua), ** nā māmala manamana lima i hoʻopaʻa ʻia**, **nā ʻāʻā ʻeha**, a me **nā pale maka ʻoʻoleʻa**. ʻO ka lawe ʻana i kahi kōkua mua i hōʻoia ʻia, CPR, a Stop the Bleed course mai ke Keʻa ʻulaʻula, St John Ambulance, a i ʻole kahi mea lawelawe kūloko e hoʻomākaukau iā ʻoe e hana hoʻoholo i kahi pilikia pilikia.

Nā alakaʻi pili¶

• ʻO ka ʻoki ʻoki ʻoki ʻoki ʻoki ʻia, ka ʻike kickback, a me ka wili ʻana o ka lathe
• Ka hoʻohana ʻana i ke koko a me ka windlass tourniquet
• Hoʻopaʻa ʻia a hoʻopaʻa ʻia i nā mea haole
• ʻO ka hoʻoheheʻe ʻana i ka mīkini holoi a me nā ʻeha kickback
• Chainsaw kickback, reactive forces, a me ka wahinekanemake i ke kua laau

Nā kumu a me ke alakaʻi kūhelu¶

• Occupational Safety and Health Administration (OSHA, United States): 29 CFR 1910.213 (Woodworking Machinery Requirements: Circular Hand-Fed Ripsaws, Hood Guards, Spreaders/Riving Knives, and Non-Kickback Fingers) and eTool Machine Guarding Standards.
• U.S. Ke Komisina Palekana Huahana Mea Hoʻohana (CPSC) a me Underwriters Laboratories (UL): UL 987 / IEC 62841-3-1 Modular Riving Knife Standards and Active Injury Mitigation (AIM / Capacitive Flesh-Sensing Brake) Rulemaking Technical Reports.
• Health and Safety Executive (HSE, United Kingdom): Aponoia Code of Practice L114 (Safe Use of Woodworking Machinery) and Woodworking Information Sheet WIS16: Circular Saw Benches, Safe Working Practices (Riving Knife Adjustment and Push Stick Rules).
• Ahahui ʻAmelika no ka ʻoki ʻana o ka lima (ASSH) a me ka Society British for Surgery of the Hand (BSSH): Nā Kuhikuhi Kauka no Prehospital Hemostasis, ʻili-Bridge Splinting, a me Indirect Ice-Water Slurry Preservation (\(+4\text{ °C}\)) o nā Digitated Digitated for Microsurgical Replantation.
• Komike o ke Kulanui o ʻAmelika Hui Pū ʻIa (ACS) no ka Trauma: Advanced Trauma Life Support (ATLS) a me ka hoʻopau ʻana i nā Kūkākūkā koko no ka High-Velocity Blunt Abdominal Trauma and Extremity Arterial Hemorrhage.