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housekeeping: if you want to request an injury or wound for me to cover, please do it here! https://twitter.com/nenyanaryavilya/status/1298455452792041473?s=20
I will be trying to organize these roughly by mdzs canon timeline
I'm gonna write up each injury as a batch of tweets, and adding them to the thread all at once
I will be trying to organize these roughly by mdzs canon timeline
I'm gonna write up each injury as a batch of tweets, and adding them to the thread all at once
A DISCLAIMER: this thread is going to be talking in modern, western terms about modern, western medicine, wound care, emergency care and wound theory. for verisimilitude, please research/ask about traditional chinese medicine, daoist medical/meditative practices, etc
SOURCES:
my personal experiences as an EMT
Emergency Transportation of the Sick and Injured (2019)
The Emergency Medicine Trauma Handbook (2020)
Emergency Medicine: A Comprehensive Study Guide (2020)
(i’m just using the most recent ones as references i have learned this stuff)
my personal experiences as an EMT
Emergency Transportation of the Sick and Injured (2019)
The Emergency Medicine Trauma Handbook (2020)
Emergency Medicine: A Comprehensive Study Guide (2020)
(i’m just using the most recent ones as references i have learned this stuff)
OKAY LETS START.
feel free to QRT or reply! I will respond to any questions when i’m done!
feel free to QRT or reply! I will respond to any questions when i’m done!
MENG YAO’S STAB WOUND (Qinghe)
this is a chest wound! based on the % of the blade that went into meng yao’s chest, he probably has a lacerated and/or collapsed lung. (it is also AWFULLY close to his heart but he didn't die on the spot, so)
this is a chest wound! based on the % of the blade that went into meng yao’s chest, he probably has a lacerated and/or collapsed lung. (it is also AWFULLY close to his heart but he didn't die on the spot, so)
now, for our purposes, we aren’t going to consider spitting blood a clinically significant symptom, because everyone spits blood all the time, but irl bloody sputum & a chest wound is Bad News Bears. it means there's probably blood in the lungs.
to treat a wound like this:
you need to expose the wound, then examine it. you would check how badly it’s bleeding, and to see if there are bubbles around the wound (showing air is escaping into the pleural space).
you need to expose the wound, then examine it. you would check how badly it’s bleeding, and to see if there are bubbles around the wound (showing air is escaping into the pleural space).
to dress the wound, you would want to try and put a non-breathable bandage: waxed fabric or thin leather could work in this setting? don't do that irl.
you would seal it on 3 sides. this lets air escape without letting air enter the chest.
you would seal it on 3 sides. this lets air escape without letting air enter the chest.
irl, he would immediately need oxygen and to have a one-way valve installed to decrease chest pressure, and possibly surgery to repair the injured lung, but as this is ~xianxia, please presume healing is quick enough that stabilization in the field is good enough
LAN WANGJI'S LEG INJURY
i am going to lump together treatment for the open wound (which he receives in the xuanwu cave) and the broken (what i assume is) tibia he receives at the burning of yunshen
i am going to lump together treatment for the open wound (which he receives in the xuanwu cave) and the broken (what i assume is) tibia he receives at the burning of yunshen
first, stop the bleeding, clean and dress the wound. it does not seem to be bleeding badly, so washing it with soap and water would be sufficient. even just clean water would be good. Rubbing alcohol is… not a thing, but hard liquor would help in an absolute pinch.
you can bind the wound with a simple, clean, absorbent dressing. his fracture does not seem to be exposed or angulated, so there's not really too much of a concern wrt putting a little pressure on the injury, but too much and you could make the break worse
ABSOLUTE BASICS OF SPLINTING: when you’re trying to splint a long bone (any of ur big ol limb bones) you want to immobilize the joints ABOVE and BELOW the injury. so wwx that lil dinky stick is doing FUCK ALL except getting dirt in the wound.
SO. you need 2 sticks that are at least mid-thigh for lwj, and four lengths of cloth ties or soft rope. rough rope could cut off circulation, which is not what we want.
position the leg out straight with the foot pointed up and the bindings under the leg. place one stick on the inside of the leg, and one on the outside. they should extend a few inches below the end of the foot.
tie the sticks together around the leg:
above the knee
below the injury (above the ankle)
at the top of the thigh
around the foot, supporting it in the functional position (if there's nerve damage, you want him to be able to walk)
above the knee
below the injury (above the ankle)
at the top of the thigh
around the foot, supporting it in the functional position (if there's nerve damage, you want him to be able to walk)
"but this would keep him immobile and then he couldn't fight the xuanwu" this is a wound care thread not a combat tactics thread. shoo.
WEI WUXIAN'S (INFECTED) BURN
This is gonna be a septic shock treatment more than anything -- but the burn injury is to the upper left chest, about 2.5% body surface area
This is gonna be a septic shock treatment more than anything -- but the burn injury is to the upper left chest, about 2.5% body surface area
TO CARE FOR A BURN:
stop the burning process!!!! this usually means removing whatever is causing the burn.
cover it with a clean, dry, loose-fitting dressing. since the burn is on the chest, you would want to make sure the tight skin isn't restricting his breath.
stop the burning process!!!! this usually means removing whatever is causing the burn.
cover it with a clean, dry, loose-fitting dressing. since the burn is on the chest, you would want to make sure the tight skin isn't restricting his breath.
give fluids! burns are dehydrating.
so, lan wangji pulls him out of the lake, and he's febrile and barely alert. congrats, u probably have *drumrolll* SEPSIS
so, lan wangji pulls him out of the lake, and he's febrile and barely alert. congrats, u probably have *drumrolll* SEPSIS
sepsis is what happens when you get an infection and your body starts shutting down! sepsis =/= septic shock, but septic shock is caused by sepsis.
when lan wangji took his pulse here, he probably noticed that he was tachycardic, or had a very high pulse rate >
when lan wangji took his pulse here, he probably noticed that he was tachycardic, or had a very high pulse rate >
and he may have noticed that while he was feverish, his arms and legs were cool or cold. these are super bad signs.
shock is what happens when your heart, for some reason, cannot get enough oxygen in your blood to circulate throughout your body.
shock is what happens when your heart, for some reason, cannot get enough oxygen in your blood to circulate throughout your body.
when this happens, the main thing you need to do is get the person oxygen and try and correct whatever is causing the problem -- in this case, the infection.
if this were real life, and wwx's condition degenerated as fast as it did in that cave, he would have died long before>
if this were real life, and wwx's condition degenerated as fast as it did in that cave, he would have died long before>
jiang cheng and the crew came to rescue him. but, this is ~xianxia! so lwj can use his spiritual power to help sustain wwx and promote recovery. it's ok, you guys, oxygen is for losers who don't have jindan
OH. ONE THING LWJ COULD DO FOR HIM -- he doesn't have a spinal injury, so lwj could elevate his feet >= 12in above his heart. this is called the trendelenburg position, and helps you if you're hypotensive.
(seriously guys if you even SUSPECT a spinal injury don't do this irl)
(seriously guys if you even SUSPECT a spinal injury don't do this irl)
MELTED CORE/CORE DESTROYED
This... doesn't have a direct real-world analogue, like the other ones do, but from what I can tell it's basically like taking a sledgehammer to your immune system.
This... doesn't have a direct real-world analogue, like the other ones do, but from what I can tell it's basically like taking a sledgehammer to your immune system.
Unlike the other entries here, this one is about long-term care and management. A cultivator with no core is now, essentially, immunosuppressed.
An immunosuppressed person can and will fall ill extremely easily. They lack the natural defenses against small doses of things like>
An immunosuppressed person can and will fall ill extremely easily. They lack the natural defenses against small doses of things like>
viruses and bacteria, which means what would normally be a cold or mild flu for a regular person, or an "off day" for a regular cultivator, could be devastating or deadly to them.
They will get tired more easily. They will not be able to travel many days without rest, go >
They will get tired more easily. They will not be able to travel many days without rest, go >
long periods without food, or practice any dangerous techniques. If they are injured, the injury will heal far more slowly than even a regular non-cultivator's would.
As far as cultivation methods -- a coreless cultivator is actually *more* likely to take damage from>
As far as cultivation methods -- a coreless cultivator is actually *more* likely to take damage from>
a dangerous technique (like the nie sect sabers) or a forbidden one (like modao). They lack the spiritual defense system to avoid things like qi deviation.
JIANG CHENG'S BROKEN ARM
okie we're back to real-world injuries, this time an upper extremity fracture, yippee!
okie we're back to real-world injuries, this time an upper extremity fracture, yippee!
SO originally i legitimately thought this was a radius/ulna fracture but when i watched the clip again it seems to be a humerus fracture!
it's time for our ABCs --
A
Bone
Coming out through the skin is very bad
it's time for our ABCs --
A
Bone
Coming out through the skin is very bad
SO YOU'VE GOT AN OPEN ANGULATED FRACTURE
this is when a bone breaks through the skin. your body knows very well where your bones are Meant to be, and it will Not be happy that it is on the Outside. angulated fractures hurt like a BITCH
this is when a bone breaks through the skin. your body knows very well where your bones are Meant to be, and it will Not be happy that it is on the Outside. angulated fractures hurt like a BITCH
step one is, as always, control the bleeding. Jiang Cheng is bleeding pretty bad here, but he's not shocky or spraying blood, which means he probably didn't hit an artery. Controlling venous bleeding is always way easier: direct pressure usually does the trick.
to get the bone back Where Bones Go, you'll probably need to apply manual traction. this is going to hurt like a bitch too, but once it's done, it will make the injury FAR more bearable.
lightly grasp the hand of the injured arm, and let his body weight gently pull the bone>
lightly grasp the hand of the injured arm, and let his body weight gently pull the bone>
back into place. In EMS, we're given two shots at this -- if it doesn't go back the second time, we splint it the way it is and let a doctor handle it.
Once the bone has been reangulated, you want to do something similar to what we did for lwj in the xuanwu cave.
Get a stick or board >= jiang cheng's upper arm. bind it above the injury, then below. place the arm in a sling -- a wrist cuff is good here, to keep from disturbing>
Get a stick or board >= jiang cheng's upper arm. bind it above the injury, then below. place the arm in a sling -- a wrist cuff is good here, to keep from disturbing>
the splint -- and then use a swath to bind it against his body, immobilizing the elbow and shoulder.
WEI WUXIAN'S ABDOMINAL WOUND
The other half of this fight! This is (obviously) an abdominal wound. It doesn't seem deep, but it is long, and your abdomen is all soft and squishy and gets hurt Real Easy
The other half of this fight! This is (obviously) an abdominal wound. It doesn't seem deep, but it is long, and your abdomen is all soft and squishy and gets hurt Real Easy
(why did this one take so long? bc ems does Not handle abdominal wound closure. that is way above our pay grade. I was reading the med student textbook to check)
So! It seems like this is a laceration, probably >1/2 in (2cm) deep and about 9in(22cm) long. luckily, that's probably not going to sever through the abdominal wall! which is good. it's going to damage the muscle tissue though which is not good
luckily, wwx lives with a doctor!! so she can perform the necessary steps of -
checking the wound thoroughly to see how deep it is, and if there might be underlying damage to the structures of the abdomen
wound debridement (cleaning the wound edges)
sutures! she would probably>
checking the wound thoroughly to see how deep it is, and if there might be underlying damage to the structures of the abdomen
wound debridement (cleaning the wound edges)
sutures! she would probably>
use a horizontal mattress closure? is my guess? please anyone who actually has sutured an abdominal wound correct me if I am wrong.
but remember! wwx doesn't have a core, so wen qing is also going to have to consistently monitor the wound, change the dressings and make>
but remember! wwx doesn't have a core, so wen qing is also going to have to consistently monitor the wound, change the dressings and make>
sure there's no signs of infection. wwx is very susceptible to complications in his weakened state.
THE HUNDRED HOLES CURSE
trypophobia cw
yeah this just Sounds gross. anyway, it's multiple small, painful lesions that manifest on the skin and refuse to heal properly.
trypophobia cw
yeah this just Sounds gross. anyway, it's multiple small, painful lesions that manifest on the skin and refuse to heal properly.
since this can't be cured without the caster's permission (or death), let's talk management:
to prevent infection, you would want to keep the wounds covered with a dry sterile dressing, changed once daily. you would need to check the wounds regularly for any signs of infection>
to prevent infection, you would want to keep the wounds covered with a dry sterile dressing, changed once daily. you would need to check the wounds regularly for any signs of infection>
and clean them thoroughly to prevent the same. There isn't much more to say here; the lesions seem very shallow.
The other step would be pain management, using natural analgesics to help manage the discomfort associated with the curse.
The other step would be pain management, using natural analgesics to help manage the discomfort associated with the curse.
I'm not going to add wound care for injuries like jiang yanli's, or jin zixuan's, because they're clearly fatal -- I think jiang yanli was stabbed directly in the heart, and jin zixuan straight up doesn't have a heart anymore, since wen ning wrecked his shit
which brings us to!!!
BACKLASH FROM YOUR WMD, LEADING YOUR ARMY OF THE UNDEAD TO TEAR YOU LIMB FROM LIMB AS A HORRIBLE SACRIFICE TO YOUR OWN HUBRIS
bruh you just die. thats it u are just gonna die. dont make zombies next time idk what to tell you
okay!! that's it for tonight folks!
tomorrow evening we will pick up with lwj's whip injuries, and the wen iron brand part two
tomorrow evening we will pick up with lwj's whip injuries, and the wen iron brand part two
