ຢາປົວພະຍາດຕາມທ້ອງຖະໜົນທີ່ບໍ່ມີບ່ອນຢູ່: ຖອກໃສ່ຕີນ, ການຮັກສາບາດແຜ, ແລະການເກັບຮັກສາຢາ¶

ໃນເວລາທີ່ທ່ານຢູ່ກາງແຈ້ງ, ນອນຢູ່ໃນ tent ຫຼືຍານພາຫະນະ, ຫຼືຢູ່ໃນທີ່ພັກອາໄສຂອງຊຸມນຸມຊົນ, ບັນຫາທາງການແພດເລັກນ້ອຍທີ່ງ່າຍຕໍ່ການຄຸ້ມຄອງຢູ່ໃນເຮືອນທີ່ມີນ້ໍາປະປາແລະຕູ້ເຢັນສາມາດ escalate ເຂົ້າໄປໃນເຫດການສຸກເສີນເຖິງຊີວິດຫຼືແຂນຂາໃນ 48 ຊົ່ວໂມງ. ຍ່າງມື້ລະ 15 ກິໂລແມັດ (9 ໄມ) ໃນເກີບທີ່ປຽກຝົນໂດຍບໍ່ຖອດເກີບອອກໃນຕອນກາງຄືນເຮັດໃຫ້ ** ການບາດເຈັບທີ່ເຢັນທີ່ບໍ່ແຊ່ແຂໍງ (ແຊ່ນ້ໍາຫຼື "trench" ຕີນ) , shin ຂູດຫຼືຕຸ່ມຜື່ນທີ່ສໍາຜັດກັບຝຸ່ນຕາມຖະຫນົນກາຍເປັນການແຜ່ກະຈາຍຢ່າງໄວວາ ** cellulitis ເຊື້ອແບັກທີເຣັຍ , ແລະຄວາມຮ້ອນໃນລະດູຮ້ອນຫຼືອາກາດຫນາວທີ່ຮຸນແຮງຈະທໍາລາຍ inhaliners.

ແພດຫມໍຕາມຖະຫນົນແລະຜູ້ຕອບສະຫນອງຄັ້ງທໍາອິດໃນຖິ່ນແຫ້ງແລ້ງກັນດານເນັ້ນຫນັກວ່າການປົກປ້ອງຕີນຂອງເຈົ້າ, ເຮັດຄວາມສະອາດບາດແຜໃນຕົ້ນໆດ້ວຍນ້ໍາທີ່ໃຊ້ໄດ້, ຮັບຮູ້ອາການທຸງສີແດງຂອງ sepsis, ແລະການນໍາໃຊ້ຖົງນ້ໍາ evaporative activated ຫຼື insulation ຄວາມຮ້ອນໃນຮ່າງກາຍສໍາລັບຢາປິ່ນປົວທີ່ສໍາຄັນປ້ອງກັນການເຂົ້າໂຮງຫມໍແລະການຕັດແຂນ.

ເຮັດອັນນີ້ດຽວນີ້¶

1. ** ກວດເບິ່ງອາການຄັນແດງສຸກເສີນຂອງພະຍາດຊຶມເຊື້ອ ຫຼື ເນື້ອເຍື່ອເລິກກ່ອນ.** ຖ້າເຈົ້າ ຫຼືຄົນຢູ່ໃນຄ້າຍຂອງເຈົ້າມີອາການອັກເສບບໍລິເວນຜິວໜັງແດງທີ່ອົບອຸ່ນ, ມີອາການໄຂ້ ຫຼື ໜາວສັ່ນ, ສັບສົນ, ວິນຫົວ, ຫາຍໃຈໄວ, ຜິວໜັງສີມ່ວງ/ດຳ, ມີຕຸ່ມຜື່ນຕາມຂະໜາດຂອງບາດແຜ, ຫຼືມີຮອຍແດງແຜ່ລາມຕາມແຂນ ຫຼືຂາ, ໂທຫາເຈົ້າ. ຕົວເລກສຸກເສີນ (911 ໃນສະຫະລັດແລະການາດາ, 112 ໃນທົ່ວສະຫະພາບເອີຣົບ, 999 ໃນສະຫະລາຊະອານາຈັກ) ທັນທີ. ພະແນກສຸກເສີນຂອງໂຮງຫມໍແມ່ນມີຄວາມຈໍາເປັນທາງດ້ານກົດຫມາຍເພື່ອປະເມີນແລະສະຖຽນລະພາບທາງການແພດສຸກເສີນທີ່ເປັນອັນຕະລາຍເຖິງຊີວິດໂດຍບໍ່ຄໍານຶງເຖິງຄວາມສາມາດໃນການຊໍາລະຫຼືວ່າທ່ານມີບັດປະຈໍາຕົວຫຼືປະກັນໄພ.
2. ** ຖອດເກີບ ແລະ ຖົງຕີນປຽກອອກຢ່າງໜ້ອຍ 6 ຫາ 8 ຊົ່ວໂມງ ທຸກໆຄືນ** ຢ່ານອນໃນເກີບທີ່ປຽກ ຫຼື ຖົງຕີນປຽກ. ເຖິງແມ່ນວ່າອຸນຫະພູມພາຍນອກແມ່ນສູງກວ່າຄວາມເຢັນ, ເຖິງ ** 15 ອົງສາເຊນຊຽດ (60 ອົງສາຟາເຣນຮາຍ)**, ການເຮັດໃຫ້ຕີນຂອງທ່ານຕິດຢູ່ພາຍໃນທີ່ປຽກ, ເກີບທີ່ແຫນ້ນແຫນ້ນເປັນເວລາ 24 ຫາ 48 ຊົ່ວໂມງເຮັດໃຫ້ເສັ້ນເລືອດຕັນ, ຂ້າເສັ້ນປະສາດຕີນ, ແລະເຮັດໃຫ້ເກີດ ** ຕີນ (trench) **.
3. ** ບໍ່ເຄີຍມີອາການປວດເມື່ອຍ, ຈືດໆ, ຫຼືຕີນທີ່ຖືກກັດ / ແຊ່ນ້ໍາທີ່ຖືກທໍາລາຍຢູ່ຂ້າງເຕົາໄຟ camp, ໄຟ, ຫຼືທໍ່ລະບາຍຄວາມຮ້ອນໃນລົດ.** ເນື່ອງຈາກວ່າຕີນທີ່ເຢັນຫຼືເປັນພະຍາດເບົາຫວານມີເສັ້ນປະສາດທີ່ງ່າ, ທ່ານບໍ່ສາມາດຮູ້ສຶກໄດ້ໃນເວລາທີ່ຄວາມຮ້ອນ radiant ເຜົາໄຫມ້ຜິວຫນັງຂອງທ່ານ, ແລະຄວາມຮ້ອນສູງຢ່າງໄວວາຂອງ ** ຕີນແຊ່ນ້ໍາ ** ເຮັດໃຫ້ເກີດອາການບວມ, ບາດແຜບວມ, ອາການບວມຂອງເນື້ອເຍື່ອອ່ອນໆ. (* hyperemia*). ອຸ່ນຕີນເຢັນຄ່ອຍໆໃນອຸນຫະພູມຫ້ອງ ຫຼືຕໍ່ກັບເນື້ອຕົວ/ຂີ້ແຮ້ທີ່ອົບອຸ່ນຂອງຄູ່ຮັກ.
4. ** ຕິດຕາມເສັ້ນຂອບນອກຂອງຜິວໜັງທີ່ເປັນສີແດງດ້ວຍປາກກາ ແລະ ຂຽນເວລາ.** ຖ້າມີແຜ, ແມງໄມ້ກັດ, ຫຼື ບາດແຜຂາປ່ຽນເປັນສີແດງ, ຮ້ອນ ແລະ ບວມ, ໃຫ້ແຕ້ມເສັ້ນປາກກາຢູ່ທາງນອກຂອງຮອຍແດງ. ຖ້າຮອຍແດງແຜ່ລາມຜ່ານເສັ້ນປາກກາຂອງທ່ານພາຍໃນ 2 ຫາ 4 ຊົ່ວໂມງ, ທ່ານມີເຊື້ອແບັກທີເຣັຍ ** cellulitis** ຕິດເຊື້ອທີ່ຕ້ອງໃຊ້ຢາຕ້ານເຊື້ອທາງປາກຫຼື IV ຈາກຄລີນິກຢາຕາມຖະຫນົນຫຼືການດູແລດ່ວນໃນມື້ນີ້.
5. ລ້າງບາດແຜດ້ວຍນ້ຳດື່ມທີ່ສະອາດ ຫຼືນ້ຳເຄັມທີ່ຂ້າເຊື້ອແລ້ວ, ຢ່າໃຊ້ໄຮໂດຣເຈນ ເປີອອກໄຊ ຫຼືເຫຼົ້າຖູບໍລິເວນບາດແຜເປີດ. ເທທາດໄຮໂດຣເຈນ ເປີອອກໄຊ ຫຼື isopropyl alcohol ທີ່ມີຄວາມເຂັ້ມແຂງເຕັມໃສ່ບາດແຜດິບຈະຂ້າເມັດເລືອດຂາວ ແລະ ເຊລຜິວໜັງໃໝ່ທີ່ແຂງແຮງເພື່ອປິ່ນປົວບາດແຜ. ລ້າງສິ່ງສົກກະປົກອອກດ້ວຍນ້ຳທີ່ມີພະລັງແຮງ (ເຈາະຮູໃສ່ຝາກະຕຸກນ້ຳທີ່ຜະນຶກເຂົ້າກັນເພື່ອສ້າງກະຕຸກນ້ຳຊົນລະປະທານທີ່ມີແຮງດັນສູງ), ເຊັດໃຫ້ແຫ້ງ, ທານ້ຳມັນວຸ້ນທຳມະດາ (Vaseline) ຫຼືຢາຕ້ານເຊື້ອ, ແລະປົກຄຸມມັນໄວ້.
6. ** ປົກປ້ອງ insulin ແລະ epinephrine ຈາກການແຊ່ແຂໍງຂອງກ້ອນໃນລະດູຫນາວແລະການອົບໃນກະເປົ໋າໃນລະດູຮ້ອນ.** ໃນສະພາບອາກາດເຢັນ, ເອົາປາກກາ insulin ແລະຢາຫາຍໃຈຫອບຫືດຂອງທ່ານໃສ່ຖົງໃສ່ເສື້ອ ** ພາຍໃນຖົງໃສ່ກັບຜິວຫນັງທີ່ອົບອຸ່ນຂອງເຈົ້າ ** ດັ່ງນັ້ນມັນບໍ່ສາມາດແຊ່ແຂງໄດ້ ( insulin ແຊ່ແຂງຖືກທໍາລາຍຢ່າງຖາວອນແລະບໍ່ເຄີຍຖືກສັກ). ໃນລະດູຮ້ອນທີ່ສູງກວ່າ 30 ອົງສາເຊນຊຽດ (86 ອົງສາຟາເຣນຮາຍ), ເກັບຮັກສາອິນຊູລິນໄວ້ໃນກະເປົ໋າກະເປົ໋າເຮັດຄວາມເຢັນແບບລະເຫີຍຂອງນໍ້າ ** ຖົງເກັບຄວາມເຢັນ FRIO (ກະເປົາເງິນ FRIO)** ຫຼືເຄື່ອງເຮັດຄວາມຮ້ອນທີ່ມີຮົ່ມທີ່ມີຮົ່ມ, ບໍ່ເຄີຍຢູ່ໃນກະເປົ໋າກະເປົ໋າທາງນອກທີ່ມືດຢູ່ໃນບ່ອນແດດ.

ຕາຕະລາງການໄຫຼວຽນຂອງບາດແຜຂອງຢາປົວພະຍາດຕາມທ້ອງຖະໜົນ¶

ໃຊ້ຕົ້ນໄມ້ການຕັດສິນໃຈທາງດ້ານຄລີນິກນີ້ເພື່ອປະເມີນຄວາມເຈັບປວດຕີນ, ອາການຄັນ, ການຕິດເຊື້ອຕາມຜິວຫນັງ, ແລະຕຸ່ມໂພງໃນພາກສະຫນາມ.

flowchart TD
    A["ເຈັບຕີນ, ອາການຄັນ, ຕຸ່ມ, ຫຼືບາດແຜຕາມຜິວຫນັງ"] --> B{"Are there systemic emergency red flags?"}
    B -->|"Fever/chills, confusion, red streaks, black tissue, or crackling gas under skin"| C["LIFE-THREATENING SEPSIS / NECROTIZING INFECTION: Call 911/112/999 or go to ER now"]
    B -->|"No systemic fever or confusion"| D{"What does the foot or wound look like?"}
    D -->|"Feet were wet/cold for 12+ hrs; skin is pale, wrinkled, numb, and waxy"| E["IMMERSION (TRENCH) FOOT: Remove wet boots/socks, pat dry gently, elevate, and warm slowly at room temp"]
    D -->|"Feet were below 0°C (32°F); skin is frozen hard, white/grey, and wooden"| F["FROSTBITE: Do NOT walk on frozen toes if refreezing is possible; seek hospital warm-water bath"]
    D -->|"Hot, swollen, tender, expanding red patch around a cut or bug bite"| G["CELLULITIS OR ABSCESS: Draw pen border around redness and visit Street Medicine / FQHC clinic for antibiotics"]
    D -->|"Fluid-filled friction blister or shallow scrape"| H["Leave intact blister roof UNPOPPED; pad with moleskin donut or wash cut with clean water + Vaseline"]

Immersion Foot ("Trench Foot") vs Frostbite: Prevention and Field Treatment¶

Immersion foot (historically called Trench Foot) is one of the most common and devastating conditions treated by street medicine teams in autumn, winter, and rainy spring weather.

Why you do NOT need freezing weather to lose toes to Immersion Foot¶

Unlike frostbite (which only happens when tissue literally freezes into ice crystals at temperatures below 0 degrees Celsius / 32 degrees Fahrenheit), immersion foot occurs at any cool, wet temperature between 0 and 15 degrees Celsius (32 and 60 degrees Fahrenheit) whenever your feet stay continuously damp inside constricting shoes or boots for 12 to 48+ hours.

When your feet are wet and cool, the body clamping down on blood vessels (vasoconstriction) starves the nerves, skin, and blood vessel walls in your feet of oxygen. Meanwhile, water-logged skin (maceration) breaks down its protective barrier, allowing fungi and bacteria on your socks to invade deep tissues.

Clinical comparison: Immersion Foot vs Frostbite vs Diabetic Neuropathy¶

The 5 Street-Medicine Rules to Prevent Immersion Foot¶

1. The "Sleep Socks vs Walking Socks" Rule: Always keep one pair of thick wool or synthetic fleece socks sealed inside a waterproof Ziploc freezer bag at the bottom of your pack, used strictly for sleeping. Even if you have to put damp walking socks back on in the morning to hike to a day shelter, taking off your boots and letting your bare feet air-dry inside dry sleeping socks for 7 hours every night resets the clock and prevents trench foot completely.
2. Choose Merino wool or synthetic polypropylene socks, refuse 100% cotton socks: When well-meaning outreach groups hand out white 100% cotton athletic socks, use them only in dry summer weather or as inner hand mittens. Cotton holds sweat against your skin like a wet towel. Ask outreach vans specifically for wool-blend or polyester/acrylic boot socks.
3. Dry damp walking socks inside your sleeping bag using body heat: When you take off damp (not mud-soaked) walking socks at night, flatten them out and tuck them inside your shirt against your chest or around your waist inside your sleeping bag, your body heat will dry them out by morning.
4. The Plastic Bread-Bag Vapor Barrier Trick (Emergency short-term use only): If your shoes or boots are completely soaked through with freezing slush and you have to walk 2 hours to a shelter with your last pair of dry socks, put your dry socks on first, slip a plastic grocery bag or bread bag over the dry sock, and step into the wet shoes. This keeps the icy outside puddle water from soaking your dry socks during the walk, but you must remove the plastic bags as soon as you stop walking so trapped sweat does not macerate your skin.
5. Never lace wet boots tightly: Swollen cold feet laced tightly inside narrow boots lose remaining arterial blood flow. Loosen your laces by one notch and wiggle your toes for 60 seconds every 20 minutes to pump warm blood down to the tips.

Field Wound Care: Treating blisters, cuts, abscesses, and cellulitis without a bathroom¶

When living rough, minor skin breaks are constantly exposed to Staphylococcus aureus (including MRSA, methicillin-resistant Staph aureus) and Streptococcus bacteria. Follow these street-medicine wound protocols:

1. How to make a High-Pressure Sterile Irrigation Bottle from a 1-dollar water bottle¶

In wilderness and street medicine, the #1 factor that prevents wound infection is not expensive antibiotic cream, it is high-pressure mechanical water irrigation (flushing bacteria and grit out of the cut).

• Take a brand-new, sealed bottle of plain drinking water (never flavor-added or sparkling water).
• Heat the tip of a safety pin or paperclip (or use the point of a clean knife) to poke a single 1- to 2-millimeter pinhole right in the center of the plastic screw cap.
• Squeeze the bottle firmly with both hands, aiming the high-pressure stream at a 45-degree angle across the open cut using at least 250 to 500 milliliters (1 to 2 cups) of water until zero visible dirt remains.

2. Why plain White Petrolatum (Vaseline) beats Triple-Antibiotic Ointment for routine cuts¶

Dermatologists and street medicine clinics increasingly stock single-use packets of plain white petrolatum (Vaseline) or Aquaphor alongside or instead of over-the-counter triple-antibiotic ointment (neomycin / polymyxin B / bacitracin):

• Up to 10 to 15 percent of people develop an allergic contact dermatitis reaction to Neomycin after several days of use, causing the skin around the cut to turn red, itchy, and blistered, which looks just like a worsening bacterial infection.
• Keeping a clean, irrigated cut coated with a thin layer of plain petroleum jelly under a clean bandage keeps the wound bed moist so skin cells migrate across twice as fast without scabbing, cracking, or causing antibiotic-allergy rashes.

3. Friction Blisters: When to leave them intact vs how to drain a giant crippling foot blister¶

Walking 10+ kilometers a day with a heavy backpack causes painful fluid blisters on the heels and balls of the feet:

• If the blister is small (< 2 cm / 0.8 inches) and intact: DO NOT POP IT. The unbroken dome of skin over a blister is the most sterile biological bandage on earth. Cut a piece of moleskin, felt, or folded duct tape/gauze into a "donut" shape (with a hole cut in the center right over the blister dome) and tape it around the blister so your shoe rubs on the surrounding pad instead of crushing the blister.
• If a large tension blister on the sole of your foot is about to burst on its own because you have no choice but to walk: Rather than letting your dirty sock rip the roof off the blister inside your boot, drain it cleanly:
  1. Wash the blister and your hands thoroughly with soap and potable water, and wipe the blister edge with a 70% alcohol prep pad or povidone-iodine wipe.
  2. Sterilize a sewing needle or safety pin with an alcohol pad (do not use an open match flame if it leaves black carbon soot on the needle unless you wipe the soot off with alcohol).
  3. Poke two tiny side-entry holes right at the base edge of the blister parallel to the foot sole, gently press the clear fluid out with clean gauze, LEAVE THE SKIN ROOF COMPLETELY IN PLACE OVER THE BLISTER BED, coat with Vaseline, and cover securely with a hydrocolloid blister plaster or gauze taped down with cloth athletic tape (or duct tape over a square of gauze).

4. Recognizing Cellulitis, MRSA Abscesses ("Spider Bites"), and Necrotizing Infections¶

Outdoors and in shelters, people frequently point to a painful, swollen, red boil oozing pus on their leg or arm and say, "A spider bit me in my tent last night." In clinical reality, 95 percent of suspected "spider bites" in camps and shelters are actually community-acquired MRSA (Staphylococcus aureus) bacterial skin abscesses.

How to store Insulin, Inhalers, and Epinephrine without a refrigerator¶

If you have diabetes, asthma/COPD, severe allergies, or take daily psychiatric or heart medications while unhoused, extreme temperatures and theft are constant threats. For power-outage storage rules at home, see our cold-chain medications guide; when living outdoors or in a vehicle, follow these specialized street-medicine rules:

ປ້ອງ​ກັນ​ທີ່​ພັກ​ອາ​ໄສ​ແລະ​ການ​ລະ​ບາດ​ທາງ​ຜິວ​ຫນັງ camps​: ຂີ້​ກະ​ກາດ​, ເຫົາ​ໃນ​ຮ່າງ​ກາຍ​, ແລະ​ອາ​ການ​ໄຂ້​¶

ທີ່ພັກອາໃສຄ້າງຄືນທີ່ແອອັດ, ຜ້າຫົ່ມຮ່ວມກັນ, ແລະບໍ່ສາມາດຊັກເຄື່ອງນຸ່ງໃນນ້ໍາຮ້ອນເຮັດໃຫ້ບຸກຄົນທີ່ບໍ່ມີບ່ອນຢູ່ອາໄສໄປສູ່ສອງ ectoparasites ທີ່ສໍາຄັນ: ** ເຫົາໃນຮ່າງກາຍ (* Pediculus humanus corporis*)** ແລະ ** ພະຍາດຫືດ (* Sarcoptes scabiei*)**.

1. ** ເຫົາ​ໃນ​ຮ່າງ​ກາຍ vs ເຫົາ​ຫົວ (ເປັນ​ຫຍັງ​ເຫົາ​ໃນ​ຮ່າງ​ກາຍ​ອາ​ໄສ​ຢູ່​ໃນ​ເຄື່ອງ​ນຸ່ງ​ຫົ່ມ​ຂອງ​ທ່ານ​, ບໍ່​ແມ່ນ​ຜົມ​ຂອງ​ທ່ານ​)​: **
   • ບໍ່ເຫມືອນກັບເຫົາຫົວ, ** ເຫົາໃນຮ່າງກາຍບໍ່ຢູ່ໃນຜິວຫນັງຫຼືຜົມຂອງທ່ານ , ພວກມັນອາໄສຢູ່ແລະກາວໄຂ່ (nits) ພາຍໃນ ** ຜ້າ stitched seams ຂອງ underwear, waistband, collar, ແລະຊັ້ນພື້ນຖານຄວາມຮ້ອນ, crawling ເທິງຜິວຫນັງຂອງທ່ານພຽງແຕ່ເປັນອາຫານແລະເຮັດໃຫ້ເກີດອາການຄັນແລະຮອຍຂີດຂ່ວນຫຼາຍ (ເຊັ່ນດຽວກັນກັບການແຜ່ກະຈາຍເຊື້ອແບັກທີເຣັຍ * Bartonnch Fquintever).
   • ວິທີກຳຈັດເຫົາໃນຮ່າງກາຍໃນຕອນບ່າຍໜຶ່ງ: ເຈົ້າບໍ່ຈຳເປັນຕ້ອງມີໂລຊັນຕາມໃບສັ່ງແພດສຳລັບເຫົາໃນຮ່າງກາຍສ່ວນໃຫຍ່ ຖ້າເຈົ້າສາມາດລ້າງ ຫຼື ປິ່ນປົວເຄື່ອງນຸ່ງຂອງເຈົ້າໄດ້. ການຜະນຶກເຄື່ອງນຸ່ງ, ຜ້າຫົ່ມ, ແລະຖົງນອນທີ່ຕິດເຊື້ອຢູ່ໃນເຄື່ອງຊັກຜ້າທາງການຄ້າ ເຄື່ອງເປົ່າເສື້ອຜ້າດ້ວຍຄວາມຮ້ອນສູງ (> 55°C / 130°F) ເປັນເວລາ 30 ຫາ 40 ນາທີ ຂ້າເຫົາຂອງຜູ້ໃຫຍ່ໄດ້ 100 ເປີເຊັນ ແລະ ໄຂ່ຂອງມັນພາຍໃນ seams. ຖ້າເຈົ້າບໍ່ສາມາດຊັກເຄື່ອງນຸ່ງຂອງເຈົ້າໄດ້, ໃຫ້ຖາມທີມແພດຕາມຖະຫນົນເພື່ອແລກປ່ຽນເຄື່ອງນຸ່ງທີ່ສະອາດ ແລະ ປະລິມານຢາ 1% permethrin cream ຫຼື ivermectin ປາກ.
2. ** ຂີ້ກະເທີ່ (ເປັນຕຸ່ມຜື່ນບໍລິເວນເວັບທີ່ມີອາການຄັນກາງຄືນ):**
   • ສາເຫດມາຈາກແມງກ້ອງຈຸລະທັດທີ່ຝັງເຂົ້າໄປໃນຊັ້ນເທິງຂອງຜິວໜັງ, ໂດຍສະເພາະລະຫວ່າງນິ້ວມື (ຊ່ອງຫວ່າງ), ບໍລິເວນຂໍ້ມື, ຮອບສາຍແອວ, ແລະບໍລິເວນຂີ້ແຮ້ ເຮັດໃຫ້ເກີດມີຕຸ່ມແດງໆ ແລະ ເປັນຮ່ອງເປັນຄື້ນ 5 ມິນລິແມັດ ເຮັດໃຫ້ເກີດອາການຄັນໃນຍາມກາງຄືນ ເມື່ອເຈົ້າອຸ່ນເຄື່ອງຢູ່ໃຕ້ຜ້າຫົ່ມ.
   • Treatment: Requires prescription 5% Permethrin cream (applied from the neck down to the soles of the feet for 8 to 14 hours overnight, then repeated in 7 days) or two doses of oral Ivermectin tablets (which street medicine doctors often prefer when a patient has no private shower to wash off full-body cream) plus heat-drying or bagging your clothing in sealed plastic bags for 72 hours (scabies mites starve to death off human skin within 3 days).

ຄຳຖາມທີ່ມັກຖາມເລື້ອຍໆ¶

ກວດສອບແຫຼ່ງທີ່ມາ¶

• Street Medicine Institute (streetmedicine.org) and National Health Care for the Homeless Council (nhchc.org, United States): Clinical Guidelines for Street Medicine, lower-extremity immersion foot and wound care in unsheltered populations, and chronic disease management without housing.
• Centers for Disease Control and Prevention (CDC, United States): Trench Foot (Immersion Foot) Prevention and Treatment Guidelines, community-associated MRSA skin infection triage, and Emergency Wound Care After a Natural Disaster.
• Wilderness Medical Society (WMS): Clinical Practice Guidelines for the Prevention and Treatment of Frostbite and Non-Freezing Cold Injuries (Immersion Foot) and field wound irrigation pressures.
• United States Food and Drug Administration (US FDA) and American Diabetes Association (ADA): Information Regarding Insulin Storage and Switching Between Products in an Emergency (28-day room-temperature stability, freezing ruin hazard, and evaporative cooling guidance).
• National Health Service (NHS, United Kingdom) and Faculty for Homeless and Inclusion Health (United Kingdom): Clinical standards for street outreach wound care, trench foot, scabies/ectoparasite protocols, and free emergency care access.
• Centers for Medicare & Medicaid Services (CMS, United States): Emergency Medical Treatment and Labor Act (EMTALA, 42 U.S.C. 1395dd) patient rights guaranteeing emergency hospital stabilization regardless of insurance, ID, or ability to pay.

ຄູ່ມືທີ່ກ່ຽວຂ້ອງ¶

• ການຢູ່ລອດທີ່ບໍ່ມີບ່ອນຢູ່ ແລະການທົດລອງສະພາບອາກາດທີ່ຮ້າຍກາດ
• hypothermia ແລະ frostbite
• Sepsis ແລະ septic shock
• ການປິ່ນປົວດ້ວຍລະບົບຕ່ອງໂສ້ເຢັນໃນບັນຫາໄຟຟ້າ