Closed Preach and Teach

[Lixue]

Fall Day 20 512 AV "Imagine this. An assistant runs to fetch you for the Icewatch. All you are told is that there was an accident and you are to pack your tools and go. You are not told how many are injured, in what way, or what race to expect. You only have the ability to carry one bag. What do you pack?" The class stared back at Lixue expectantly, waiting for the answer. When she said nothing, a hand hesitantly raised. "Yes?" The class was smaller than Lixue imagined. There were only fifteen students who sat at sterile tables scribbling down notes. A wide smattering of tools were scattered on the tabletops, items the students had brought. Nearly everyone had bandages, a few had herbs, and only one had a canteen. Rags seemed to be rare among the students, a tool Lixue would have liked to have seen more of. The scalpel and the tools for sewing did not grace the tabletop of anyone beside Lixue's front desk. Somehow, Lixue was disappointed in the class. When Seiled had snapped out the order earlier that Lixue would be teaching a class on emergency care, Lixue was aggravated. She had been planning for a day caring for patients who were in critical care and in so much pain she would not have to converse. People generally tried to express their apologies to her for losing her husband or gossip about the strange going-ons in Avanthal. The most popular topic was the wildlife and how out of control it was becoming. After all, besides the Frostfawn hunters being killed by wolves, several hunters had been attacked by caribous and an Icewatch member was even killed. Lixue did not want to gossip. She did not want to talk about the killed hunters or the wild animals. The topics brought too fresh of memories up and, more often than not, Lixue was left holding back to tears as her oblivious patient rattled on. Seeing the look of frustration on her face, Seiled had raised an eyebrow and coolly asked, "Is there a problem with that?" Lixue could have sworn he enjoyed sticking her with the unexpected task and seeing her reaction. Lixue blinked at him. Since when did he actually care about her schedule? Still, Lixue was cautious of entering foreign ground. If she denied him the task, what would happen? "I can find someone else," the tone itself made Lixue do a double-take. Somehow, she felt if she passed this opportunity up she would be disappointing him. Lixue gave him a tired smile, shook her head in denial, and replied softly, "I will take the class. When does it begin?" "In ten chimes," came the quick reply. Automatically, Lixue launched to her feet and shot him a dirty look. Seiled did not visibly react, but there were practically waves of bemusement rolling off of him. Without another word, Lixue pushed off the door jam and left Lixue scrambling to collect her belongings. A student with bright pink eyes was speaking. She hesitated before starting, clearly uncertain in her answer. "Personally, I would take bandages." Judging from the large pile on her desk, the young lady enjoyed bandages. Lixue nodded her approval and the girl let out a soft sigh of relief. Lixue made a mental note that if she was able to teach the class again, the girl would be put into a stressful situation. Obviously it was needed. Soon enough, other students started following suit and a list of supplies was added up. Bandages, wood to set a splint with, a myriad of herbs to stop bleeding, and rags. Lixue was both impressed and disappointed. They were missing some of the most prominent tools. "Keep in mind you do not know what to expect or how many are injured." The class stared back in confusion, trying to decipher what they believed to be a cryptic message. "You, you and you, stand over here by me." Lixue moved to an open space in the room. Hesitantly, the three students gathered around Lixue. "Alright, you. You have a broken leg in three places, and your collar bone pierced through the skin." To the next, Lixue commanded, "You're a Jamoura. Besides weighing nearly four times what you do now, you also need stitches in your skull and have a bite on your side. You are excessively bleeding." The last was simple, "You are dead." Glancing at the three, Lixue commanded, "The floor is the ground. Take your positions." Still cautious, the three pretended on the floor. While they were taking their places, Lixue fetched the items the class had mentioned. A small pile of items sat on the floor next to the three within a couple of chimes. "I am the Icewatch member who fetched you. My job is to keep the predators away. I do not know anything about medicine. You, in the back, come up here. You are to be the doctor that was fetched. You only have what we listed: one set of bandages, wood to set a bone, a myriad of herbs, and rags. I want you to tell me what you would do."

[Coren]

Coren had seen the opportunity to sign up for a class in medicine as a way to find out more about the human body and how it worked, maybe get some more information about how to design and create the shells he used in his animation discipline. Much to his disappointment however, it seemed the majority of the lesson was going to be about how to fix broken parts and not about how a human body worked. He found that decision rather perplexing, why would one just learn routine operations? What if came across a wound or a symptom that one wasn't show in ones education? How would you try to treat that then? Still he wasn't the teacher here, maybe she had a good reason for it. During the entire demonstration Coren kept quiet and just observed and listened to what the others did, not speaking up when the teacher in front of the class asked for suggestions. Even though he knew what they where missing, a needle, thread and something to cut with. His visits to the injured mages and the amount of accidents he had in his youth thought him that much at least. He Did not want to get noticed, it only took a single person who recognize him and call him out as a mage to ruin the entire atmosphere of the room here. And honestly he enjoyed the atmosphere of learning a lot more then barely bottled up fear and disgust aimed at him. Coren sunk a bit more in his seat as the woman began to pick volunteers, offering a small prayer to morwen that she wouldn't pick him and pull any attention to him. But of course that didn't help, of all people she could chose she picked him from the back to come to the front of the class and tell her how he would act in the situation. Coren let out a sigh and slowly trudged over to the front of class, ignoring the few strange looks he got from the other vantha at his clothing. “Well, firstly I would ask where my needle and thread would be. Those are quite standard things in any medical bag.” Coren said in his usual polite and apathetic tone. “Then I would ignore the dead one obviously, leave the jamoura for later and first put my attention to the one with the broken leg and collarbone.” Coren honestly didn't remember well what a Jamoura really was, they where big intelligent apes, but for the rest he didn't know a lot about them. He never had even seen one of them in person for morwen's sake. After he had said that he fell silent for a while, it was obvious the man needed care most urgently, but how to do it. He wanted to say push in the collarbone but it most likely was dirty. Every wound was dirty as far as he knew. So maybe clean the open break and push the collarbone back in? Or maybe just clean it and do a quick patch-job and fix it later when they had better facilities available in the whitevine healing centre? Anyway since he didn't have needle and thread now with him in this hypotical situation it didn't matter much anyway. “After that, I would clean the wound at the collarbone and wrap it in bandages, seeing as I don't have anything to fix the wound and then wrap it up so it at leasts is kept clean. Then tie the wooden spalk to the broken leg.” Coren paused for a moment and waited for any coments from anybody else in the class.

[Lixue]

Lixue walked silently among the tables as the young man trudged to the front of the room. Everyone paid her attention instead of the man and she remedied that problem with a simple nod toward the front of the room. She wondered what the man was doing here. Obviously, he was not dressed the part. Did he not know wearing a cloak and mask would scare the patients? The patients needed to be comforted, assured they were in the best hands. Someone whose face they could not see would only disturb them. After all, patients enjoyed seeing the honesty on a doctor's face. The young man asked where his thread and needle were. Lixue smiled gently and answered both to him and the rest of the class, "You do not have a needle or thread because your classmates did not find it necessary to take on an unexplained call." Several students shifted awkwardly in their seats. "Therefore, the giant bite on the Jamoura's side cannot be roughly stitched. Putting a simple bandage around it would not stop the bleeding of such an intense wound and would only waste your bandages." A pause. "You can measure whether or not a wound needs stitches by how wide it is. You do not need a tool, simply a finger. By laying a finger across the wound, you should be able to see how wide it is. If it goes farther than your first knuckle, it will need stitches. Even if it does not, you should still be cautious about not giving it stitches." The tips of Lixue's lips twisted upward at the mention of leaving the Jamoura and attending to the one with simpler injuries. "Why would you leave the Jamoura? He is larger and will need more of your bandages. He also has a head injury, one of the most dangerous wounds there is to have. I can understand leaving the bite, but he is bleeding excessively by both of his wounds." Speaking not only to him but to the class, Lixue asked, "What is the first step to check for with head injuries?" No one spoke. In fact, the class was deadly silent, eyes wide with indecision and confusion. A few students glanced at each other and the dead guy on the floor sat up to listen. "You should first check the eyes. Have the patient follow one of your fingers and try to focus on something. If he cannot, it is labeled as a dangerous head injury. The next step is to ask the patient questions. General questions. Such as what year it is, how old they are, what is their name, where are they, etc. This helps us know whether or not the patient needs immediate attention." Turning back to the young man, Lixue questioned softly, "Why are you leaving the dead individual? Because I said he was dead? When arriving at a scene, you should always check the pulse of those not moving. It is a simple task and can be done by placing two fingers under the chin on the side of the neck or by placing two fingers on the wrist. With larger individuals, such as the Jamoura, check their pulse by the neck." Lixue demonstrated on herself. "Now, I want to see everyone taking their pulse. We have to make sure everyone is alive, after all." Slowly, the students did so. For some, this would be a basic task. Others would struggle. Lixue could tell when each person found their pulse because their eyes widened slightly. While they did so, the young man was thinking. He correctly mentioned cleaning the collarbone and wrapping it. "Good. Remember: When you are on a call, your task is not to heal. You are there to stabilize the patients so they can be transported without the major risk of death, back to civilization. He has made a correct assumption by cleaning the collarbone and wrapping it until a later time. However, we are not only going to wrap the collarbone to keep it clean but to keep the bone from moving and causing more harm." Lixue listened as he mentioned setting the broken leg. "How would you set the boards on the man's leg? Show me."

[Coren]

Coren fidgeted a bit underneath his heavy cloak as the teacher began to tear his ideas apart and began to lecture the class. While the majority of the information she said was quite useful and certainly worth coming here. Knowing when a wound had to be stitched and how to treat somebody who had a head wound was always handy. Still it kinda rubbed him the wrong way that she either was assuming that all the people in the class knew even the basics of first aids on what was obviously their first lesson on the subject matter or even worse knew that they didn't know it and wanted them to learn by putting them on the spot about it Still it wasn't his class and he wasn't an expert on teaching anyway, besides it was catching the classes attention so she might have a point in doing it that way, might something to keep in mind if he ever had to teach somebody something again. At her comment of him “Well, yes. You did state that in this hypothetical situation the person was dead, since you didn't specify anything other about the person other that he was dead. So I assumed what you said was truth. Still, you are right I should have double checked it.” Coren stated in his apathetic tone as he too bend down next to one of the people laying on the ground and grabbed the pols in his left hand, feeling around for a while, trying to feel the pulse the teacher had been talking about. After some fumbeling around he felt a light pulse underneath his thumb, he tried to remember the general place where he had felt it, while not all humans where build exactly the same the organs and stuff usually where in the same place.. most of the time. He stood back up as she asked him how he would board up the persons leg. “Well, it needs to keep the broken bone from moving after you set it back together, if you had to do that in the first place. So I would just put both pieces of wood to the sides and tightly tie it to the leg with some rope. Taking care I wouldn't cut of the bloodflow.” Coren guessed

[Lixue]

Lixue nodded. "You are extremely close in your description of how to set a leg." Speaking quickly and quietly, Lixue soon had a girl sitting on top of one of the tables. "Let us pretend this is the injured patient. Her leg is broken into three different pieces, as was previously stated. Have you identified which section of the leg is broken or if the breaks are spread through the appendage?" A completely rhetorical question and one designed only as additional information for the class. "Let's say we did not even know if her leg was broken. Only that she claimed it hurt." Turning to the class, Lixue informed them, "An individual who has been in the extreme weather conditions for quite some time, whether hot or cold, may suffer from shock after experiencing a trauma situation. You can usually tell when someone is in shock because they are not reacting as they should, their skin may feel clammy, or they are extremely pale. You can also tell if someone is in shock, or going into shock, by a weak pulse or weak breathing. Someone already in shock may complain of nausea, of feeling faint, say they are feeling the opposite of the current weather; hot in this city. When someone is in the beginning stages of shock, they may be short tempered and or agitated. "The signs and symptoms of shock differentiate extremely per case. Someone with a head injury may have completely different signs of shock than someone who has a broken leg. It is considered safe to assume someone who has gone through a traumatic situation is and will suffer from shock. To help deal with shock, you should keep the individual talking. Have them lie down on a flat surface and raise their legs periodically to encourage blood flow. In weather such as Avanthal, keep the person covered up. The most important thing is to not offer the individual liquid unless they are suffering from dehydration. Someone who is in shock and has shallow breathing may accidentally inhale the liquid. If the person then vomits, they risk becoming dehydrated. Shock is the body's way of coping with a traumatic experience. Someone who has lost a large amount of blood risks death from shock." A pause as Lixue glanced around, meeting the eyes of each individual. "Shock is not something to be taken lightly." Lixue shifted the topic back to the injured girl. "As her leg is the appendage injured, we are not going to have her raise her legs periodically. We will, however, keep her covered up and have her lie flat." With a gentle hand, Lixue pushed the girl to lie flat on the table. "Unfortunately, we do not know anything about her leg injuries besides they hurt. This means we do not know where to place the splint, nor where to not touch. As it is Avanthal, skin should not be bared unless in necessary situations. Thus, her thick pants cannot be rolled up to examine the leg, nor can they be removed. Rolling the pants up risks cutting off blood circulation. "What we are going to do is search her leg for injuries, through the pants. First, you should ask the patient where her leg hurts the most." Lixue answered for the girl, "Below her kneecap." Lixue hovered a hand over the area she was speaking of before continuing. "I am going to take both of my hands and place them on the inner and outer side of her thigh. It is important to place pressure on the leg, but not enough to where if there is a bone protruding you could do more harm." Lixue placed her hands where she had instructed. "Slowly, I will move my hands closer to me." By standing at the end of the girl's leg, Lixue pulled her hands toward her. "When I reach her kneecap, it is necessary to feel the whole cap, including pressing my fingers in on either side of her kneecap to feel for any sharp edges. As the girl complained of her lower leg hurting, I will take extra care here. "With gentle fingers, I will apply pressure to where I know the bones are more easily found. On the shin, or the front of the leg and on the back of the leg, near the ankle. Here, the skin is less tight and holds less meat. The calf would be too thick to safely assume anything from." Lixue pointed to both of the sections while she spoke. "Either side of the ankle is a good place as well, in case the leg was broken at the very bottom. "I am looking for any bumps or dips in the skin where the bone should be. Or if the skin is tugged to the side slightly, as if the bone has shifted. This method is best for complete breaks and it would be difficult to feel any cracks." A pause. "When I felt her leg, I discovered three disjointed sections. All three were on the shin and nearly an inch apart. "Now, it is time to set the bone. As I only know how many times the bone has been broken, I can only assume there could be more injuries in the leg. As such, it is necessary to be careful with the appendage. The first step in setting a bone is to straight out the leg. As she is already lying flat, this is a fairly easy process. Taking the pieces of wood, I would carefully set one on the opposite side of me, taking care to be below where the knee bends and keeping the board in line with the side of the leg. To do so, the board should be level with the ankle and the side of the calf. Taking the other board, I would do the same on the side nearest to me. Holding these two in place, one with my hand and the other with whatever I can, the bandage will be retrieved. "Please note, the bandage will begin at the side farthest from me." Lixue started the bandage by holding it with her fingers and proceeding to wrap it around the leg, going counter clock wise. "Care must be taken to not cut off the circulation. We must also be careful to not move the setting boards, which can cause the bone harm. Our job is to keep the bone from not moving, not put the bone in place." A pause. "When you have reached the end of your bandage, or you feel you have circled the leg enough times to be safe, you should tuck the end through another layer and tie a quick knot." Lixue did as she said, showing the class. Undoing the knot and splint, Lixue let the girl go back to her seat.

[Coren]

As lixue began detailing how she would find and treat the broken leg coren quickly began to dig through the many pockets that lined his robe and pulled out his slightly crumpled quill, a nearly empty vial of ink and some pages of parchment. Before smoothing one out, dipping his quill in the inkwell and beginning to take notes of what she was saying. No way he was going to be able to remember all of that just from hearing it once. As Lixue explained though, coren couldn't begin to help wonder what shock exactly entailed and did to a person. While he had heard of it before and he knew vaguely what it was about, a person reacting badly to an injury or something like that. It was incomplete information though and if there was one thing that Coren absolutely disposed it was incomplete information. He made a note of it to ask it later when the teacher was through with her lesson it seemed the rest of the people in the class already knew mostly what shock was. And breaking the flow of the lesson wasn't something he wanted to do. He pulled his full attention back to the lesson when she began showing how to find out a persons leg was broken in their situation. After she went through the explanation on not only how to find out where a leg was broken but also guidelines on how to tie the spalk and the knot holding the wood to the leg. After a few more moments of silence after she finished her explanation, waiting if she was going to add anything to it he spoke up. “Well, I have a few questions actually. You mentioned that finding cracks in the bone is quite difficult his way, how would you suggest we handle a hurting leg that while we know hasn't been broken but has the possibility that there are smaller cracks in the bone? Just assume the worst and act as if the bone was damaged or is there a way one can be more sure about how the bone is damaged, or if it is damaged at all?” Coren waited on the teachers answer, a faint thought in the back of his skull hoping that this wasn't one of those questions that had an obvious answer hidden in the previous lecture.

[Lixue]

Lixue nodded to show her approval of Coren's questions. He asked good questions and ones she had hoped would be brought up. Though she had had her doubts, Lixue was certain the man could learn the necessary and face the emergency situations she spoke of in this class... with some training. He asked the appropriate questions, ones others would be more timid of asking, and was not afraid to speak his mind. And, given how he has phrased his question, Lixue had no doubt he was holding back words she might not find attractive. This was another good trait; knowing when to bite your tongue. Besides, he was taking notes, something a lot of the other students were not doing. In fact, one of the students was doodling on a piece of paper. Another was tying a roll of gauze in the shape of a giant bow. Was she boring them? Coren's questioned helped transition from a simple bone to something further. This would lead her into the next subject, how to care for bones that were not broken but fractured. "You are speaking of a facture. There are two types of fractures. The first is a known as a simple facture. This is where there is no injury present and the skin is not broken. You could have a hairline fracture here, which is where the bone itself is cracked but cannot be felt or found by just the eyes. Sometimes not even by the hands." As she spoke, Lixue made her way to the front of the room once again. Her hands emphasized her talking and she made sure to speak with an authoritative voice. If one were not careful when broaching this topic, the students would not take her seriously. A break that was not a break? Lixue had known many assistants who scoffed at the idea before facing proof. "The second of facture is known as a compound fracture. This is the most dangerous of the factures. Here, the skin has been broken or damaged. The bone may protrude from the skin even cut the skin. Care must be taken when treating this. The bone may or may not be visible. If the skin is broken or cut, you should automatically take caution. The bone may be resting just under the surface and, if you are not careful, you could bump the bone while prodding around. This could cause the bone to move, possibly come away from the rest of the bone, or even cause another fracture. "When searching for a fracture, you should look for skin that is moved or bulging. This is the first sign that the bone itself is damaged. You should view the opposite side of the patient's body to compare and search for injuries. The second thing you should do is look for an open wound. This does not mean you should take precaution every time you see a scrape, but that you should be wary in the situation where a bone may have been broken. "The third thing you should do is check for pain. You can do so by asking the patient, which is the best and encouraged way. If the patient is unconscious or unable to answer for some reason or another, you should search for redness of the skin or bruising. A patient will, more often than not, be able to pinpoint exactly where the pain is coming from. You can assist in this method by running your hands along the appendage until the patient complains of tenderness or pain. The fourth thing you should do is check for the body's way of telling if something is wrong. This may include feeling hot around the injured area, bleeding, bruising or turning red. Fractures of both kinds swell very rapidly. "When dealing with a simple fracture, the method is similar in both an emergency situation and care at a clinic. You should wrap the arm," here Lixue mimicked the behavior on her own arm. "Again, make sure the gauze is neither too tight nor too loose. The patient should be able to move the limb with relative ease, but not able to flex the muscles. Next, you will want to take a triangle shaped piece of fabric. Place the arm in the middle of the triangle, the top point facing their fingers. Taking both ends of the triangle, loop up and around the individual's neck. Tie the ends together only when the arm is held directly at a ninety degree angle. This will allow the bone to heal straight and not cut off any circulation. If the fracture is in the leg, you would suspend the leg higher than the heart and hold it up by the ankle in a similar manner." Lixue had demonstrated with an invisible piece of fabric as she explained and, though the behavior looked strange at best, she believed it had helped a few students. After all, some were visual learners. Lixue herself learned well all three ways, but tended to enjoy visual learning the best. Learning from books was interesting, but tended to bore her after several bells. And her mind was always working, so Lixue sometimes missed pieces of conversations. "A compound fracture is more difficult to put an exact method to. Unfortunately, the method is for another lesson. I can tell you this much, however, that when you are in an emergency, you should treat the compound such as a broken bone. This means placing a splint on the leg, to keep the bones from moving as the patient is transported. If it has not broken the skin, you should treat it as a simple fracture and place it in a sling. If you are in an emergency and cannot place an appendage, such as the leg, in a sling you should place a splint on the bone. "When in doubt whether there has been a fracture or not, treat it as if there has been one. It is always best to be cautionary when dealing with bodily harm. If you do not accept even the notion that there is a chance of bones being broken or muscles bruises or tendons torn, you make mistakes. If there is a chance of a bone being broken, assume it is until given proof otherwise. This will keep the patient from being harmed further and, as we are all aware, the well being of the patient comes first." Number Count1,075

[Noblesse]

Lixue :

Experience:

• Teaching +3
• Rhetoric +2

Lores:

• Teaching a Class on Emergency Care
• First Aid: How to Determine if a Wound Needs Stitches
• First Aid: Treating Patients with Head Injury
• First Aid: Stabilize, Not Heal
• Signs and Symptoms of Shock In a Trauma Situation
• First Aid: Searching for and Treating Broken Bones
• Two Types of Bone Fracture
• How to Search for Fractures

Coren :

After you update your CS, please send me a PM and I will give you your grade.

Additional Notes :

Very informative medicine thread, as always. Anyway, I just want to point out that you actually need the lore for a certain knowledge to be able to teach it to another. I noticed some of which Lixue taught that she technically knows but don't really have the lore for them. I awarded the lores for those anyway, but please refrain from doing this in the future.

The Aurora flames coldly in the skies above

If you have any questions or concerns regarding your grade, please send me a PM and we can figure it out.