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HƯỚNG DẪN SƠ CỨU (FIRST AID)
KHI BỊ CÔN TRÙNG, ĐỘNG VẬT VÀ NGƯỜI CẮN TRONG LÚC SINH HOẠT NGOÀI TRỜI Lynn Ly phỏng dịch theo "The Everything First Aid"


Những hoạt động ngoài trời như làm việc, vui chơi, giải trí, du ngoạn ở trong một số hoàn cảnh , khí hậu , và thời tiết . Khí hậu nóng và lạnh đều có thể gây ra những hệ quả đối lập (adverse consequences), và những sinh vật (critters) sống bên ngoài thỉnh thoảng gây dị ứng (ngứa ngáy khó chịu) hoặc tổn thương . Cơ thể bị thiếu nước hoặc ở cao độ (thí dụ lên đỉnh núi) và ở trong một số điều kiện ngoài trời khác cũng có thể làm bạn cảm thấy suy yếu đi .

Cho dù không có vấn đề ǵ khi bạn hoạt động ngoài trời, nhưng thật quan trọng bạn biết làm ǵ để chăm sóc hoặc trợ giúp những người bị chấn thương, bị bệnh tật bất ngờ .

I) BỊ CÔN TRÙNG, LOÀI VẬT VÀ NGƯỜI CẮN

Nhiều loại côn trùng và các sinh vật khác, bao gồm cả con người, gây ra các vết cắn và vết châm chích có thể cho cảm giác không thoải mái hoặc đe dọa tính mạng từ nhẹ nhẹ đến trung b́nh. Điều quan trọng là biết làm ǵ, làm thế nào để trị liệu, và khi nào th́ cần t́m kiếm đến trợ giúp từ chuyên gia y tế để trị liệu bất kỳ thương tổn tàng ẩn bên trong.

1) B̉ CẠP CẮN (SCORPION BITES)

Ḅ cạp là loại côn trùng nhiều chân có h́nh dạng giống tôm hùm (lobster-like arthoropods) nằm trong xếp loại côn trùng có nọc độc (arcahnid class, cùng loài nhền nhện = spider class), có một ng̣i / kim xoăn ở phần cuối nơi đuôi, và chúng thường được t́m thấy ở vùng sa mạc phía Tây Nam của Mexico (nước Mễ Tây Cơ). Những vết chích / đốt của bọ cạp dường như không có khả năng gây tử vong và dễ dàng điều trị, nhưng lại nguy hiểm cho trẻ nhỏ và người già hơn . Những triệu chứng bao gồm đau nhức ngay lập tức (immediate pain), nóng rát (burning), sưng tấy chút chút (minor swelling) và cảm giác tê (numb) hoặc ngứa ran (tingling sensation).

Những buớc sau đây cần nên thực hiện để trị liệu vết ḅ cạp cắn:
1. Rửa vùng bị ḅ cạp cắn bằng xà pḥng / xà bông và nước

2. Dùng túi trườm lạnh đặt lên vùng bị ḅ cạp cắn trong ṿng 10 phút , nếu cần thiết th́ lập đi lập lại việc trườm lạnh vùng bị cắn với khoảng cách giữa các lần trườm lạnh là 10 phút .

3. Gọi điện thoại đến trung tâm kiểm soát chất độc (the Poison Control Center), hay đi bệnh viện khi có bất kỳ triệu chứng nghiêm trọng ǵ

2) BỌ VE CẮN (TICK BITES)

Những người sống vùng rừng cây hay đồng cỏ, hay những người dành thời gian vui chơi giải trí ở những khu vực này th́ dễ bị bọ ve cắn . Loài côn trùng nho nhỏ này sống bằng cách hút máu các loài động vật có vú (mammals) thí dụ như hươu nai (deer), loài gậm nhấm (rodents), thỏ (rabbits) và có thể truyền bệnh từ động vật sang người .

Việc sơ cứu (first aid) những vết bọ ve cắn bao gồm loại bỏ con bọ ve đang bu bám ngay lập tức để tránh những phản ứng từ vết cắn và giảm thiểu tối đa các loại bệnh nhiễm trùng do bọ ve gây ra thí dụ bệnh Lyme, bệnh nóng sốt Colorado bọ ve (Colorado tick fever), bệnh nóng sốt được phát hiện ở núi đá (Rocky Mountain Spotted fever)

Để tháo bỏ con bọ ve bu bám trên người , hăy làm như sau:
1. Dùng cây nhíp (tweezers) hay cây kẹp nhỏ nhỏ cong cong hay thẳng thẳng (small curl or flat forcepts) kẹp lấy đầu con bọ ve và càng cận sát nơi da đang bị con bọ ve cắn càng tốt, rồi nhẹ nhàng kéo ra, đừng bóp nát hay xoay vặn con bọ ve

2. Rửa vùng bị bọ ve cắn bằng xà pḥng / xà bông và nước.

3. Bôi thuốc Antihistamine hoặc loại 1% hydrocortisone cream (loại kem chứa 1% chất hydrocortisone)


Cần phải có sự chăm sóc y tế chuyên nghiệp , nếu con bọ ve cắn quá sâu và bạn không thể tháo gỡ nó ra được, hoặc bạn đang ở trong khu vực được thông báo là có nhiều nguy cơ bị bệnh lyme, hoặc bạn có triệu chứng nóng sốt hay triệu chứng cảm cúm , hoặc bạn có trải nghiệm bắp thịt trở lên suy nhược, tê liệt (paralysis) , hoặc nổi vết tṛn đỏ trên da gọi là "phát ban mắt ḅ" (the bull's eye rash) là đặc chưng của bệnh Lyme .

CẢNH BÁO !!!
Đừng bao giờ bôi petroleum jelly (vaseline), rượu cồn ( alcohol ) ahy ammonia lên con bọ ve - chúng sẽ cắn chặt sâu vào da hơn. Nếu bạn đang ở trong vùng cảnh báo có nhiều nguy cơ bệnh Lyme mà bị bọ ve cắn, bạn nhất định phải phone báo bác sĩ để được tư vấn và ngay lập tức được chăm sóc và điều tri bao gồm việc sử dụng thuốc kháng sinh
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Old 05-27-2019   #1141
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Surgeons multitask major operations


“Your surgeon may be doing someone else’s surgery at the same time as yours. We’re talking about complex, long, highly skilled operations that are scheduled completely concurrently, so your surgeon is not present for half of yours or more. Many of us have been concerned about this for decades. Ask about it beforehand
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Old 05-27-2019   #1142
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Electronic paperwork annoys us

Most of us hate electronic medical records systems. We don’t like that we have to click off boxes instead of focusing on the patient. The choices they give us to click on don’t give the doctors a real understanding of what we’re doing. A lot of things get missed.” —Karen Higgins, RN. When doctors are filling out by hand,
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Our priorities have changed



“Because Medicare has put more emphasis on the results of patient satisfaction surveys, hospitals are pushing us to emphasize customer service. It makes me worry we will do what we can to make people happy in place of what we should. To say that you need to focus on getting this person’s dinner right even though your other patient needs his chemo hung—that’s not right.” —Theresa Brown, RN
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Signs Your Doctor Is a Keeper (And 5 Signs They’re Not!)



Charlotte Hilton Andersen




How does your doc stack up?




Keep your doc if: She’s experienced in your particular problem







When it comes to getting quality medical care, experience is the most important factor, says David Norris, CEO of MD Insider, a company that evaluates physicians based on their performance data. Whether you are managing a lifelong condition like diabetes or need a specific treatment like knee surgery, a doctor who specializes in that particular thing is worth their weight in gold, he says. And forget all those fancy plaques on the wall; Norris says their data found no correlation between attending a top-tier, expensive medical school and medical proficiency. “Ultimately it comes down to how many times they’ve done [something], whether it’s diagnosing or surgery or whatever,” he says. “The more they’ve done it, for the most part, the better they are at it.” Here are the secrets to finding the best doctors, according to other doctors.
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Old 05-27-2019   #1145
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Ditch your doc if: She has a lot of repeat customers


Ideally, doctors are there to help you get better. While there are some conditions that won’t and just need to be monitored, most of the time you can expect to see at least some improvement. “One of the biggest indicators a doctor isn’t a good one is the number of times a patient has to be readmitted or has to have the procedure or treatment repeated,” Norris says
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Old 05-27-2019   #1146
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Keep your doc (even if he has terrible online reviews): As long as you like him

Google may be the first resource you turn to when looking for a good doctor but that may be the least reliable way to find one, Norris says. His company has analyzed hundreds of thousands of online reviews and matched them with the doctor’s actual performance data. Their conclusion? “We’ve found absolutely no correlation between patient reviews, like those found on sites like Yelp!, and medical proficiency,” he explains. “People who’ve had negative experiences are more likely to leave reviews and they’ll often complain about things that have no relevance to their medical care, like bathrooms or parking spaces.” So forget what everyone else online is saying—the only opinion that should matter is yours.
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Old 05-27-2019   #1147
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Ditch your doc if: He’s just “nice”





Bedside manner is a great bonus but rapport isn’t the most important thing when it comes to getting the best medical care, especially with specialists. “Being a good doctor doesn’t mean they’re a nice doctor,” Norris says, “but in the end you’re better off with the surgeon who is technically better than the one who’s nicer.” If your doc happens to be nice and well-skilled, you’ve found a true winner. But don’t just stay with someone because you bond over golf scores
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Old 05-27-2019   #1148
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Keep your doc if: She is open about her failures

Transparency is one of the attributes patients find most reassuring in their healthcare providers, but one of the hardest to find, according to Norris. “Honesty and transparency build trust, which leads to better patient outcomes,” he says. One example? Many doctors will advertise that they perform a particular procedure or treat a specific condition, he says, but far fewer will provide evidence of how many times they’ve done it or treated it and how it has worked out. You definitely want a doc in the latter camp, even if it shows they’re not perfect.
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Old 05-27-2019   #1149
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Ditch your doc if: She’s always ordering tests

Getting every test under the sun may make you feel like your doctor is proactive but that sense of security comes with a price—literally. “Contrary to popular belief, more testing does not generally result in better outcomes,” Norris says. “Often [tests are ordered] because they have a financial tie-back or other business reason for doing so, like the doctor owns a stake in a certain company or has just purchased an expensive new machine.”
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Old 05-27-2019   #1150
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Keep your doc if: He tells you “no” sometimes

Doctors are vulnerable to peer pressure too and this is even more true in the age of the internet. Some doctors are so afraid of negative online reviews or of making a patient upset that they’ll allow the patient to bully them into doing something they don’t feel is best. For instance, many patients want antibiotics for cold and flu symptoms even though tons of research has shown they’re not effective and can worsen the antibiotic-resistance crisis. But some doctors will give in to these demands just to placate a patient. This doesn’t mean you shouldn’t ask questions or make concerns known but rather that your demands shouldn’t trump his expertise. A doctor who truly cares about you won’t be afraid to tell you when something isn’t in your best interest.
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Old 05-27-2019   #1151
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Ditch your doc if: He’s in and out in two minutes

The average person has to wait nearly half an hour in the office before seeing their doctor and then the average appointment lasts less than 15 minutes. Even worse, a separate study found that patients were only allowed to speak for a mere 12 seconds before being interrupted. But just because this is the standard doesn’t mean you should settle for it. This revolving door mentality leaves patients frustrated and, more often that not, with a prescription, rather than feeling heard and getting advice about lifestyle changes that could help them more than a pill. A good doctor will respect your schedule, take the time to listen to you, and let you finish your sentences
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Old 05-27-2019   #1152
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Keep your doc if: He’s accessible




We live in a 24/7 world and being confined to office hours can mean inconvenience at best and a serious problem missed at worst. Many doctors are now offering alternate scheduling (like weekend hours), call lines, online test results, and e-mail access to help patients get the care they need it when they need it. These 21st-century conveniences aren’t necessarily a dealbreaker but they sure do make things easier
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Old 05-27-2019   #1153
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Ditch your doc if: He won’t refer you for a second opinion

“Forty percent of patients are misdiagnosed initially,” Norris says. Medicine isn’t an exact science and it’s easy to make mistakes. One of the best ways to avoid this is to have a second (or third) pair of eyes on the patient. A good doctor will encourage you to seek out more information and other medical opinions. Don’t trust a doc who tells you they are the only ones with the answers and you shouldn’t question them.
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Old 05-27-2019   #1154
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Keep your doc if: She updates her skills

Medicine as a profession is constantly changing, with new information, research, technology, and treatments emerging all the time. Good doctors will stay abreast of developments in their field and be willing to learn more about new techniques
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Old 05-28-2019   #1155
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People take too many drugs

Two out of every three patients who visit a doctor leave with at least one prescription for medication, according to the Institute for Safe Medication Practices. “Drugs are an easy solution,” says Feldman, “but there are other solutions.” Here are things you need to know right now about taking too many medications.
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Old 05-28-2019   #1156
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Did you know I can save you a trip to the doctor?



At our in-store clinic, I can treat your child’s ear infection, do a sports physical, diagnose head lice, and more
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Old 05-28-2019   #1157
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High health-care costs aren’t lining my pockets

Even though pharmacists counsel patients every day, the federal government does not recognize us as health-care providers. That makes it very difficult for us to get reimbursed by insurance companies and government programs for the clinical services we provide.
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Old 05-28-2019   #1158
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Ask me if I can fill your prescriptions for Fido too

As long as the same drug is also prescribed for humans, I typically charge less than your vet—and I can even add chicken flavor to make it taste better. Learn the secrets your veterinarian won’t tell you.
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Old 05-28-2019   #1159
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If you’re paying out of pocket for your drugs, shop around

Your generic medication may cost as much as ten times more at some pharmacies than at others, according to a Consumer Reports survey. Check first with GoodRx, a free app that compares local drug prices.
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Old 05-28-2019   #1160
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Consider paying with cash

Even if you have insurance, always ask me whether your prescription will cost less if you pay with cash. Sometimes the cash price is less than your insurance co-pay.
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