[lit-ideas] Re: Found Poem by Dillard
- From: "Mirembe Nantongo" <nantongo@xxxxxxxxx>
- To: <lit-ideas@xxxxxxxxxxxxx>
- Date: Wed, 27 Apr 2005 06:56:19 +0100
Thanks, Julie. I've *finally* ordered myself a copy. Best, MN
----- Original Message -----
From: <JimKandJulieB@xxxxxxx>
To: <lit-ideas@xxxxxxxxxxxxx>
Sent: Tuesday, April 26, 2005 6:00 PM
Subject: [lit-ideas] Found Poem by Dillard
> 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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