Sterile rep cloth pads
Bandages - assorted sizes
Scissors - large for cutting clothing and small scissors for general use
Suture kits
Flat bladed forceps
Scalpels - various sizes
Various salves
Tweezers
Pliers
Cupped spoons for removing arrow heads
Metal cutters
AdhesiveTape
Safety pins
Silk strips
Antiseptic Solution - boiled water with green powder pre mixed in
Paga for cleansing hands and surfaces. NOT for cleansing skin (just imagine neat alcohol on an open wound - "ouch")
Selection of sedatives plus needles and syringes - only to be used by a Physician
Saline solution plus IV needles and infusion sets - only to be used by a Physician
Skin bags (for heat and cold compresses)
Sterile rep swabs
Suture kits will be made up and kept ready in med kits at all times.
These will comprise of a small tray containing :
-a selection of curved needles threaded with silk and vulo gut of varying thicknesses,
-a scalpel
- toothed forceps to pull tissue edges together
- a pair of clamp style forceps with smooth edges to clamp bleeding vessels
-a small pair of scissors
-a needle holder similar to the clamp forceps but with ridged ends to the blades
-a small pair of scissors
Sedation
Kanda leaves will not be used for sedation or healing purposes. The only use kanda had was to provide a "high" effect and render the user almost senseless. The roots contain a deadly poison which is made into kanda paste and used on weapons.
If sedation needs to be used, We will use the following drugs. Please see quotes pages for references:
Capture scent (chloroform) - but a second person must be available to check the Patient's airway,
Sleeping powder - an amber powder which when mixed with water turns dark blue
Tassa powder - which is a reddish powder, usually mixed with red wine to disguise the colour, this makes the patient unconscious
Frobicain which can be injected Intravenously or Intramuscularly.
Suturing Techniques
Before attempting to suture any wound the person healing should douse their hands in paga to cleanse them, the only exception to this is if a wound is life threatening where speed is of the essence.
Sutures are inserted individualy and not as a continuous suture. That way if a suture bursts the whole wound doesn't open.
1. Grasp the needle with the needle holder at the threaded end.
2. Push through the tissue to be sutured, releasing the needle holder, making sure the edges of the tissue are not overlapping.
3. Pull the thread through, grasp the tail with the needle holder and tie off the suture.
4. Cut the suture
5. Repeat till the wound is closed neatly.
6. Now close the skin layers using the same technique
NO HEAT WILL BE SHOWN BY SLAVES WHILE HEALING. MAKE IT SHORT AND TO THE POINT. Cleanse, apply numbing salve, suture if needed and apply a dressing.
Slash/stab type wounds
For wounds that penetrate muscle, the tissue must be repaired in layers, starting with the muscle and using gut for the suture as it is dissolvable.. Carefully align the muscle edges, making sure no debris remains in the wound and follow the instructions for suturing techniques
The skin can then be repaired using silk interrupted stitches where each stitch is placed individually and knotted before moving on to the next stitch
Arrow and Crossbow wounds.
"The hunting arrow, incidentally, has a long, tapering point, and this point is firmly fastened to the shaft. This makes it easier to withdraw the arrow from its target. The war arrow, on the other hand, uses an arrowhead whose base is either angled backwards, forming barbs, or cut straight across, the result in both cases being to make the arrow difficult to extract from a wound. The head of the war arrow, too, is fastened less securely to the shaft than is that of the hunting arrow. The point thus by intent, if the shaft is pulled out, is likely to linger in the wound. Sometimes it is possible to thrust the arrow through the body, break off the point and then withdraw the shaft backwards. At other times, if the point becomes dislodged in the body, it is common to seek it with a bone or greenwood probe, and then, when one has found it, attempt to work it free with a knife. There are cases where men have survived this. Much depends, of course, on the location of the point."
-Savages of Gor pg. 40
Here, we do not use bone or wood instruments but the principal remains the same, The barb must be removed.
The probes take the shape of 2 spoon like instruments that will fit round the head of the arrow to allow it to be pulled free without causing any further tissue damage, however, if the arrow is in a limb and not pressing on bone, nerves or blood vessels it is acceptable to push it through the wound, remove the head and pull the shaft free.
In many instances, if the wound is deep then it should not be sutured the first day but merely packed with ribbon gauze to allow healing to take place from the inside of the wound out. This allows for quicker healing and less chance of infection.
Fractures
The principals are to stabilise and then immobilise the area.
If a limb is fractured, keep the limb still and if it is an open fracture, cover the wound with a clean dry cloth.
Immobilise by carefully aligning the bones by applying gentle traction till the limb is straight and no grating of the bone edges are felt. Apply a splint to keep the limb stable and prevent any movement.
IF a patient has fractured ribs, DO NOT apply any splints or bandages to this area. This will only hamper breathing. The chest muscles and ribs provide a natural splint. The only treatment is rest and pain medication.
Minor Wounds
All that is needed for minor cuts and grazes is for the area to be cleansed and allow to heal naturally. Not every wound needs sutured or bandaged.
General Healing Instructions
The basic assesment of the patient should start with ABC
Airway - There is no point in attending to a Warriors wounds if He is choking to death in front of you. Tilt the head back to make sure the airway is open
Breathing-Again, what's the point of merrily suturing away if He's blue because His breathing has stopped
Circulation-Now check the bleeding and deal with it
Numbing salves should be used on all wounds if at all possible and allowed to work before suturing. NO kanda is to be used. We will not use kanda salve which has never existed. If a wound is so severe that the Patient requires surgery then He will be sedated after ensuring He is not in shock from blood loss.
Asses the wound and the type of bleeding, Arterial bleeding is bright red and will spurt at the same rate as the heart beat and is the more serious type of bleed, Venous bleeding is slower and steadier, darker and is easier to control. Apply direct pressure to the wound to try and press on the vessel that is bleeding either by pressing firmly with the palm of the hand or by using pads until the torn vessels can be sutured with very fine gut. DO NOT CAUTERISE.
If the patient appears to be going into shock, becoming pale, clammy and cold then an immediate blood transfusion needs to be given or at least infused with premade bags of IV saline(salt water) after inserting a large bore IV nedle into a large VEIN. These are kept in the Med Center when the ones in the Med Kits are finished. Elevate the legs.
Blood Group O negative is the universal donor type blood and can be given without matching to the pataients own group
Should someone's life be in danger, then drastic measures may have to be taken, treat the patient where they lie and use whatever instruments are to hand while someone else brings a med kit. NO flowerieness to be used in descriptiveness, TREAT, STABILISE and MOVE if able.
If an injury is to a limb, elevate that limb to cause bleeding to slow down.
NO CAUTERY WILL BE USED - This does much more damage to the vessels and underlying tissues that it ever saves. The only time cautery is ever used is on tiny leaking vessels during surgery that are too small to be tied. Think about it...why would you ever burn two edges of a wound and think it would close. Clamps with flat blades will be used on all bleeding arteries before a repair is attempted.
Do NOT apply heat to a fresh injury as heat dilates (opens) blood vessels and will cause the bleeding to increase. Ice will constrict blood vessels but be careful when applying ice packs that an ice "burn" is not caused. Always make an ice pack by enclosing the ice in a rep cloth.
NO tourniquets should be applied without instruction from a Physician. Wrong use of tourniquets can cause gangrene and the loss of a limb.
Burns
Burns and scalds will be treated by immersing the part in cold water or pouring copious quantities of cold water over the burned areas.
Do not try to remove burned clothing that is stuck to the skin. This will tear off the surface layer of skin and allow infection into the raw surface. Remember that under the burned clothing is sterile
Do not burst blisters unless ordered by a Physician. Medical help should be sought quickly.
NO salves will be applied unless ordered by a Physician.
Cover the burned area with clean non fluffy cloths, rep is ideal
Burns or scalds to a child MUST be treated quickly by a Physician
