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Save Your Own Life

We’ve all heard the miracle stories: The Boy Scout who survived for four days in the mountains of North Carolina. The Montana couple who fought off a bear. The guy in Utah who cut off his arm to free himself from under a fallen rock. You’ve probably read many stories like this and wondered how to keep yourself out of the ers. Here’s what to do in some life- threatening emergencies when no one’s around to help.
Allergic Reaction
Bee stings, food allergies, and medications can be deadly, even if you think you don’t have allergies. Symptoms include itching in one spot or all over your body, sometimes accompanied by a rash, swelling, and, in the extreme, swelling of the airways, which hampers your ability to breathe. If you know you have a life-threatening allergy, form an action plan with your doctor, who will probably prescribe an EpiPen, which comes in child and doses. It delivers the drug epinephrine (肾上腺素), which keeps the heart pumping, improves breathing, and gives you about 20 minutes to get to a hospital. Even if you don’t have severe allergies, you can still be prepared for a spontaneous reaction. Slip a few maximum-strength antihistamines (抗组胺剂), into your wallet. The fast-acting tablets will begin to fight an allergic reaction while you wait for help to arrive. But since antihistamines can make you drowsy, don’t drive yourself to the ER (急诊室).
Choking
Richard Stennes, MD, was home alone in La Jolla Shores, California, eating a steak, when the phone rang. The -year-old swallowed down the bite still in his mouth and answered the call. But the steak was stuck, and he couldn’t talk or breathe. He put his finger down his throat to grab the meat, but he couldn’t reach it. Gagging (使呕吐) didn’t help either. So he walked over to the couch and forcefully thrust his abdomen on the hard arm of the couch, sending the meat flying and allowing him to breathe again.
If you’re ever in the same situation, quickly find a chair or other piece of furniture or a kitchen counter, says Maurizio Miglietta, MD, chief of trauma at New York Presbyterian Hospital/Columbia University Medical Center. Aim to hit the top of the chair or edge of the counter against your upper abdomen, in the soft part below the bony upside-down V of the ribs. Thrust up and inward. If you still can’t breathe after six tries, call 911 from a landline, even if you can’t talk. They’ll find you. Write the word choking somewhere nearby, and leave the line open until help arrives.
Heart Attack
If you’re experiencing crushing chest pain with or without pain in your left arm, are short of breath, or have a sense of impending doom, you may be having a heart attack. (Women are more likely to have atypical symptoms like severe fatigue, nausea, heartburn, and profuse sweating. ) Call 911 and chew one 325 mg uncoated aspirin, to get it into your bloodstream fast. This will thin your blood, often stopping a heart attack in its tracks. While waiting, lie down so that your heart doesn’t have to work as hard, says Sandra Schneider, MD, a spokeswoman for the American College of Emergency Physicians. If you think you might pass out, try forcing yourself to cough deeply. It changes the pressure in your chest and can have the same effect as the thump given in CPR, says Dr. Schneider, "Sometimes it can jolt the heart into a normal rhythm."
If someone else goes into cardiac arrest, note that the American Heart Association now recommends CPR without the mouth-to-mouth: Call 911, then push hard and fast on the person’s chest until help comes.
Bear Attack
If you surprise a bear, don’t run away. That invites an attack. Instead, stand up and back away slowly, without looking the bear in the eyes. Speak softly to the animal (no loud shouting). If it does charge at you, try to make yourself look as large as possible: Stick out your chest, raise your arms, and spread your legs. Now you can yell at the bear, to frighten it.
If it’s going to attack, lie facedown, with your hands clasped behind your neck. Play dead and don’t get up until you’re sure the bear is gone. Leave the area immediately in case it returns.
If you’re in bear country, carry a bear-deterrent pepper spray. Make sure the wind isn’t blowing toward you, and spray for one to two seconds when the bear is 30 to 40 feet away.
Severe Bleeding
You’re bleeding severely — and getting scared. Forget about tourniquets (止血带), says Dr. Schneider of the American College of Emergency Physicians. Use your hand or a clean cloth, paper towels, a scarf, or any fabric you can grab, and push down on the wound until the bleeding stops. Tourniquets, which every Boy Scout learned how to make back in the day, are now a first-aid no-no. "If you have a cut on your upper leg and you put pressure on it, you’re just closing that vessel. But if you put a tourniquet on, you’re going to close the vessels to the entire leg," says Dr. Schneider, "You could lose your foot."
The only time to use a tourniquet, says Charles Pattavina, MD, chief of emergency medicine at St. Joseph Hospital in Bangor, Maine, is when you know that everything below the wound is beyond repair (say, the accident has severed your finger, arm, or leg).
Rising Water
Rule No. 1: Never drive through standing water. As thousands of stranded motorists can attest, what looks like a small puddle can be much deeper. "It takes just 12 inches of water to carry a car away," says Robert Sinclair, Jr., of AAA New York. If you do get stuck, step out of the car, which will likely stop when the water reaches the vehicle’s electronic controls. If the water is higher than the bottom of your knees or is moving too quickly for you to wade (涉水) through, climb on top of your car and wait for help. Otherwise, get to higher ground.
If you suddenly become immersed (say, you drive off a bridge or into a lake or river), roll down the windows as soon as you can. Yes, it allows water to rush in, but that’s a good thing, says Sinclair. It equalizes the pressure, so you can open the door or swim out the window. Do it quickly, though, as the electrical systems on automatic windows can get damaged and stop working when wet. A life hammer can shatter automotive glass and cut through seat belts; Sinclair keeps one between the driver’s seat and the center console in case of such emergencies. Break the side windows (windshields are usually thicker and harder to crack), and swim toward high, dry land.
Trapped in a Burning Building
If you’re in an office building and can’t get out, don’t panic. "In any emergency situation, the difference between survivors and non-survivors is that survivors remain calm and fight through their fear to find out, ’What can I do’" says Dr. Schneider. So think back to those fire-safety lessons you learned in grade school. Call 911. Close yourself in a smoke-free room and place a wet towel underneath the door to pr any smoke from entering, says Dan McBride, a firefighter in New York City. Then get low to the ground, where you can breathe and see better, until help arrives. If you’re in a house, get as low as you can and crawl outside as fast as possible. Don’t stop until you’re well away from the fire. Then call for help.
______is last recommended to the readers when they are under a bear attack.

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举一反三

【多选题】肾上腺素的主要作用有()

A.
兴奋心脏作用
B.
扩张支气管作用
C.
有收缩血管和舒张血管作用
D.
改善肾功能作用
E.
降低心肌耗氧量,提高心脏作用效率作用

【多选题】去甲肾上腺素消除的方式有

A.
单胺氧化酶破坏
B.
单加氧酶氧化
C.
儿茶酚氧位甲基转移酶破坏
D.
经突触前膜摄取

【单选题】患者,女性,70岁。因糖尿病酮症酸中毒急诊人院。急诊室已给予输液、吸氧等处理,现准备用平车送患者入病区。护送途中护土应注意

A.
暂停输液、吸氧继续
B.
继续输液、吸氧,避免中断
C.
暂停吸氧,输液继续
D.
暂停输液、吸氧
E.
若酸中毒严重应暂停护送,症状好转后再送入病区

【多选题】具有舒张冠状血管的拟肾上腺素药物是

A.
去甲肾上腺素
B.
肾上腺素
C.
麻黄碱
D.
多巴胺
E.
异丙肾上腺素

【多选题】急诊室的护理工作包括 ( )

A.
预检分诊
B.
健康教育
C.
留观室护理工作
D.
配合抢救
E.
保健门诊

【单选题】局麻药内加肾上腺素的主要目的是( )

A.
预防过敏反应
B.
延缓药物吸收,延长作用时间
C.
使局部血管收缩,减少出血
D.
预防术中血压下降
E.
预防术中脉搏减慢