by Trevor Hightly on July 24th, 2017, 7:07 pm
It was true that Trevor's face was generally peaceful and more prone to expressing emotions that were softer and more subtle than some others when he was relatively calm and at rest; the expression that Nya had seen crossing across the young man's face was indeed somewhat rooted in respect, but it was not an admiration that was solely directed at or for Jansen, but for the weight of what the man was teaching as well.
Trevor had drawn much the same conclusion as his fellow student had when she'd mentally noted the fatal danger of some wounds, but his thoughts also went on with a bit of a diversion from Nya's own; although Trevor was indeed also careful to make sure that he grasped the fragility of his body and the dangers of certain types of injuries, what he mostly heard from Jansen's words was not only that any severe injury could kill a person but that a person could be saved from almost any such damage as well.
As he took his carefully penned notes, the young man's mind worked and turned in a relaxed but fruitful state, opening itself more and more up to a certain conclusion that it seemed that all of his life experiences had slowly been working to reveal to him: that perhaps nothing was truly beyond the reach of anyone--whether they were mortal, god, or beast--if they simply knew what was necessary to accomplish a goal. This was not a life breaking and spontaneous epiphany on Trevor's part, but more a gentle, natural evolution of his thinking that Jansen's teaching was further nurturing.
Once, when he was a child, an infant Trevor had thought his parents' home was the entirety of the known universe, only to find out otherwise when he had grown bold enough to walk on his own two feet and out into the nearby world; and once he had also thought himself bound to his human form, but that too had been proven a logical fallacy thanks to his discovery that one's own djed was less than a concrete and unchangeable thing... and once his wife had been his entire world, but she too had faded into the past. And now, Jansen had revealed that even death itself could be combated and staved off... perhaps even prevented entirely with the right medicine or techniques, although this was not something that the akalak had hinted at directly, more a random musing of Trevor's mind.
Trevor did not go through all of these thoughts individually or even consciously, nor did he relive his memories. Rather, the cumulation of all of his past experiences allowed him to receive Jansen's teachings in a way that caused the knowledge that the akalak healer was passing on to support the mindset that Trevor was more and more slipping into as the days of his life went by--one of freedom, of limitless possibilities, and of there being a choice in all things. In truth, as of late, the young man was beginning to wonder if one's own beliefs about what was and what wasn't were'nt mere self-imposed limitations and that if a faith in what might be possible was a more freeing and favorable foundation for one's personal belief system and morality.
But, again, Trevor was still absorbed into the lesson and with his surroundings; for the most part, he was entirely present in the moment and merely found Jansen's words informative and interesting. His attentions were mostly concentrated on his notes in truth, but he did notice the absolute comfort which Nya had seemed to develop with her surroundings and couldn't help but muffle a chuckle in his throat upon his noticing how a fairly well-sized glob of ink had found its way onto her cheek; Trevor approved of the almost night and day change in the woman and her own light mood helped to further uplift his own cheery disposition. The girl's purr did raise his eyebrow, however--not in a hostile or violent way, but in a whimsical and curious manner.
Jansen's lecturing on wound cleaning and his demonstration on the proper method of doing so moved a bit slower than the rest of the lesson had. On one hand, Trevor was happy to learn the practical skills and to go through the motions of learning to bandage all the many parts of the body with the other students, but on another hand, he was also somewhat eager to go back to the more fast-paced lecturing of Jansen--as the akalak's informative words quenched his desire for knowledge and occupied his interested mind. Nonetheless, Trevor was not too bothered by the bell that was dedicated to practicing what the class had been taught, perhaps he just slightly wished it would pass more quickly.
During the next break, Trevor deigned to stretch instead of simply sitting and to fetch a bit of water for himself and looked forward to what might come next.
"So, we've covered bandaging and blood loss, checking a pulse, and choking," Jansen reviewed, as the break he'd given everyone came to a close. "We might have time for bone-setting and we might not. That said, what we still really need to cover is shock treatment and then suturing. There's nothing more common than cuts and almost nothing worse than shock."
"Still, we've already covered bleeding and I remembering warning you all that someone with an arterial bleed was likely also to slip into shock," Jansen reminded himself. "We can start there."
"What you really need to know is that medical shock isn't just being upset or stunned, it's something that happens when your body is shutting down or just can't get enough blood to every part of you," Jansen stated. "Everyone dies of shock in a way, no matter the wound or illness, because it's simply your body failing in the simplest sense. Your body needs blood to operate, that's why bleeding causes shock; damage to the spine can cause shock; infections can cause shock; and heart damage can cause shock."
"When someone begins to slip into shock, they're going to get cold and they're going to become disoriented," Jansen explained. "That said, there's a chance that they won't lose consciousness right away--and if you can stop them from doing so, this might be your best chance to save them before their life is truly in very real danger."
"Firstly, to tell if someone is in shock, as I said when I talked about bleeding, you can check their responsiveness and their temperature. The best way to check if someone is going into shock, however, is to simply pinch their fingertip. It should only take a moment or two for a pinched fingernail to go from purple and back to its normal color; if it takes longer, then it's a good indicator that the person is in shock or is going into shock. This happens because blood flow is slowed or even almost stopped when a patient is in shock; their body is failing," Jansen stated. "If you let this go on for too long, then it's almost a definite that your patient will die."
"The good news is that you can prevent most shock from escalating to an extreme case, unless the patient's injury is truly severe," Jansen said. "Most importantly, if you can identify the cause for someone's shock, then you almost always need to treat that before doing anything else; if someone is bleeding, you stop the bleeding, if they're choking then you stop the choking. Sadly, if someone is going into shock because of an infection then there is usually very little you can do; if you can't treat an infection with herbs, cleaning, or upkeep care, then sometimes it's best to completely remove the infected area well before it can compromise the entire body--I'm speaking of amputation, which should always be a last resort, but it is a last resort that should be done the moment that it is needed, nonetheless. Amputation is something that should only really be done by someone who is experienced, however. Honestly, in the case of septic shock, its causes should have been treated long before they became anywhere near fatal--which is why we do everything we can to avoid infections, even in the most minor of wounds, and why we should viciously combat any infections that do arise before they worsen or even spread to other parts of a victim's body."
"Moving on, once you treat any obvious cause of shock, then if your patient is awake, then you can do a few things to give their body the chance to regulate itself," Jansen stated. "First, you can raise their legs above their head--this will help with their blood flow; just remember never to lift any injured or broken limbs. After that, you can keep them warm with a blanket or thick piece of clothing; as I said, shock hinders blood flow and can cause chills and a drop of body temperature--the body needs to be warm and if you can keep it at a decent temperature, even despite the onset of shock, then you give it a better chance of bouncing back before things worsen."
"If you've treated the symptoms of their injury and put your patient in a position to recover, then you can either wait to see if their body begins to move away from going into shock, or you can get help," Jansen stated. "It's generally never a good idea to leave a patient who is in shock or who has recently been in shock alone, however, so if you have the skills to treat said person yourself or someone else can fetch someone who does, then those options are always best."
"If your treatments are successful, then generally your patient's blood flow will be restored and they will slowly warm back up with time," Jansen stated. "If someone has lost a lot of blood, though, then this may take longer and they will likely be fragile and weak for a time. Once the threat of shock has subsided, it's generally alright for a patient to sleep. However, you should keep a close watch on them for quite some time."
Trevor turned yet another page in his journal; the formerly blank book was quickly beginning to resemble the beginnings of a basic textbook on medicine.
"If a patient falls asleep while being in shock, though, you're going to need to watch them very closely," Jansen stated. "If at any point they stop breathing, or if their pulse fades, then you're going to have to move into giving them emergency treatment--the same goes for patients that you previously thought were okay."
"If someone isn't breathing and they have no pulse, then their body has either stopped or almost stopped fighting," Jansen warned. "If you want someone in this state to live, then you're going to have to do their body's job for them."
"In order to pump someone's heart for them, you're going to want to take the palm of your hand and place it over a patient's chest. To find the right place to do this, you can touch their sternum with two fingers and then place your other hand's palm above that. Once your palm is on their chest, lock the fingers of that palm's hand with your free hand's. Then you're going to push deeply into their chest; most people don't push hard enough when they do this, but if you don't then you might very well fail in keeping someone's heart pumping."
"We call what I just described chest compressions," Jansen stated. "You not only have to do them hard but also fast as well--at least two a second are needed. You'll get tired, and if someone else is around then it's best to alternate who is working on the patient if you can. No matter who is giving the compression, though, after you deliver thirty in a row then you should immediately move into giving your patient air."
"If someone is truly not breathing, then you'll have to open their airway manually. To do that you simply tilt their chin into the air and hold it there. Then you blow a breath into their mouth while holding their nose sealed. If you feel that person inhale, then you know that what you've been doing has worked and their body has re-started, but if they don't feel them inhale then you need to tilt their head back into a resting position, and then tilt their chin back up all over again and attempt to give them another breath. If you still fail to get them breathing even after this, then you want to put their chin and head back down and repeat everything--including the chest compressions," Jansen stated. "You can keep doing this until there's just no way that you can go on, but there is a chance that there might come a point when the patient is obviously just not going to come around."
Jansen paused to let the gravity of what he said drift and fade a bit.
"If a person does accept your breath or takes one of their own at any time, then you can continue to treat their wounds or to monitor the patient; there's a chance, and sometimes a good one, that they may slip back into shock and that you may have to repeat everything once more to save their life," Jansen explained. "A truly critical patient may very well need around-the-clock monitoring to ensure that they don't fade away."
"As a side note, if it's a truly young or fragile child that isn't breathing then you'll need to use only two or three fingers to give them chest compressions," Jansen added. "It's also probably good to note that chest compressions and giving someone breath also works extremely well to dislodge an obstruction from a person who has fallen unconscious from choking. You can give such a person the same thirty compressions as you give a shock victim, and then you can enter their mouth with your index finger from an angle to attempt to clear any obstructions or blockages, and then you can give them a breath; if you know someone has choked but can't see a blockage, then just repeat the compressions and breaths until you can see what's choking them and then remove it, or until the blockage is removed by your breaths and the patient begins breathing on their own."
"On the subject of breathing, if someone appears to be taking very weak breaths that sound very strained, it's usually best to count that as the same as them not breathing--the body will often times fight on and continue to try to breathe even when no air is coming into it, and that's still a case where a patient needs your help," Jansen stated.
Seasonal Wordcount: 18,788 + 2,480 = 21,268
