[lit-ideas] Found Poem by Dillard
- From: JimKandJulieB@xxxxxxx
- To: lit-ideas@xxxxxxxxxxxxx
- Date: Tue, 26 Apr 2005 13:00:42 EDT
This is a bit long, but if you tire of reading through it, skip to the last
series of stanzas, headed "AND BEAR IN MIND".... Tomorrow I will post my
favorite from the book, a much shorter and more lyrical piece, "found" in a NT
Apocrypha passage.
"Emergencies
--Brent Q. Hafen, Ph.D., and Keith J. Karren, PhD.,
Prehospital Emergency Care and Crisis
Intervention, 1989
(Few peopl are initially prepared for the sights, smells, and sounds of
intense human suffering.)
FIRST THINGS FIRST
Introduce yourself to the patient.
If you have time and are in doubt,
Simply ask, "What
Would you like me to call you?"
Cut clothing away quickly
To see a bleeding site clearly.
Put on a pair of latex
Or surgical gloves to protect yourself...
Many religious people
Attach great significance
To religious symbols.
Unless it is necessary for treatment,
Do not remove crosses or amulets.
Observe circumstances, collect
Suicide notes, and compile
The relevant materials. Is the patient
Restless, irritable, or combative?
BYSTANDERS
It is best to wait rather
Than try to remove weapons
Or potential weapons from unstable
Victims, relatives, bystanders.
Ask someone, "Will you please
Turn off the TV?" Or do it yourself.
Say, "Please sit
on the ground on her left side,
Ma'am, and hold her hand.
Talk to her. Don't move
Her arm, and don't lt her move
Her head. I'm going
To be checking her hips and legs."
Comment positively on the aid
Already given (for example,
:"You've done a good job
Of immobilizing the head."
TOUCH
Take a hand, pat
A shoulder. Remember that
You have to be comfortable doing it.
And not just trying it as a gimmick.
Squeezing a foot or patting
An ankle, if you are working
Near the foot is not
Usually considered intimate.
Patting above the knee is.
Sometimes a man receiving
Help from a woman EMT
Or a woman patient being treated
By a male EMT will automatically
Respond to comforting physical
Gestures with flirtatious behavior.
Do not respond by flirting back.
ASK
Ask questions about an area
Or organ before you examine it.
Ask: What's your name?
What's happening to you?
Where were you going, or where
Are you? Can you tell me the date
(Day of the week, year)?
Document the patient's condition
Precisely -- "disoriented to time."
Depending on the urgency of the situation,
Either ask yes-or-no questions
("Have you eaten today?" "Does it hurt
When you move your arm?")
Or open-ended questions
("When does the pain come on?"
"Tell me about your lat meal").
How intense is the pain?
Dull? Throbbing? Sharp?
Crushing? Stabbing? Does
The pain change in intensity
Or remain constant? What
Started it? How long ago?
RESPONSIVENESS
What can the patient feel?
Can he identify the stimulus?
How does he respond to pain?
With unconscious or sleeping patients,
Determine how easily
they can be aroused.
By verbal stimuli, can
They be aroused bya pain
Stimulus like a pinch?
If the patient does not respond
To voice, try pain.
Your patient is RESPONSIVE
If he seems to be unconscious but will:
* Open his eyes if you speak to him.
* Respond to a light touch on the hand.
* Try to avoid pain.
The answer you receive from the patient
When you ask, "Can you tell me where
You are hurt?" is the CHIEF COMPLAINT.
In many instances, this
Will be obvious, such as the patient
Who lies bleeding in the street
After being struck by an automobile.
Even in this circumstance, however,
It is useful to determine
What is bothering the patient most.
CHECK
Check the Facial Features.
Feel the Head and Neck.
Check the Clavicles and Arms.
Check the Chest. In injury
Patients, feel for air
Crackling beneath the skin.
Check the Abdominal Region
For Tenderness. Damage here
Can cause great pain,
So be gentle.
Check the Back.
Check the Feet, Ankles, and Legs.
Describe pulse amplitude by using the following scale:
4+ Bounding
3+ Normal
2+ Difficult to palpate
1+ Weak and rapid, thready
0 Absent
HELPFUL TIPS
Avoid traffic accidents
While going to the scene of an accident
Or to the hospital. Use a seat belt...
Park safely and carefully.
Check all equipment.
Keep the interior clean.
Are all your bandage wraps cleaned up?
If there is any question
About the patient's condition, assume
The worst and work from there.
If a patient requests
That you pray with him, do so.
LEGAL SITUATIONS
What Happens if a Patient
Files Suit? [How to document:]
Draw a thin line
Through an error.
Never erase an error.
Another legal situation
Is death. If a person is obviously
Dead (crushed, decapitated,
Rigor mortis setting in),
You may be required
To lave the body at the site.
ANSWER
If death is imminent either
On the scene or in the ambulance,
Be supportive and reassuring
To the patient, but do not lie.
If a patient asks, "I'm dying,
Aren't I?" respond
With something like, "You
Have some very serious injuries,
But I'm not giving up on you."
AND BEAR IN MIND
The heart is a hollow, muscular
Organ the size of the fist.
Once the patient remains
In clinical death for a certain time
(Typically four to six minutes),
Brain cells begin to die.
Along the edges of the eyelids
Are openings of many small oil glands
Which help prevent the tears
From evaporating too rapidly.
From "Mornings Like This: Found Poems", by Annie Dillard
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