Sovereignty Module: Heal the Wounded
Heal the Wounded
Complete Medical Knowledge: Diagnosis, Treatment, and Surgery Without Modern Infrastructure
Complete Medical Knowledge: Diagnosis, Treatment, and Surgery Without Modern Infrastructure
When hospitals are gone, medical knowledge saves lives. This campaign covers diagnosis, wound care, infection control, herbal pharmacy, and emergency surgery.
Chapter 1: Vital Signs and Assessment
| Vital Sign | Normal Range (Adult) | Concerning | Critical | How to Measure |
|---|---|---|---|---|
| Heart rate | 60-100 bpm | <50 or >120 | <40 or >150 | Radial pulse, 15 sec × 4 |
| Respiratory rate | 12-20 breaths/min | <10 or >24 | <8 or >30 | Watch chest rise, 30 sec × 2 |
| Temperature | 97.8-99.1°F (36.5-37.3°C) | >100.4°F (38°C) | >104°F (40°C) | Thermometer or touch assessment |
| Blood pressure | 120/80 mmHg | >140/90 or <90/60 | >180/120 or <80/50 | Cuff + stethoscope |
| Consciousness (AVPU) | Alert | Responds to Voice | Responds to Pain / Unresponsive | Verbal + physical stimulus |
| Skin color | Pink (varies by ethnicity) | Pale, flushed, or mottled | Blue (cyanotic) or gray | Visual inspection (nail beds, lips) |
| Capillary refill | <2 seconds | 2-4 seconds | >4 seconds | Press nail bed, release, count |
Chapter 2: Wound Care
| Wound Type | Treatment | Closure Method | Infection Risk | Healing Time |
|---|---|---|---|---|
| Clean cut (sharp edge) | Irrigate, close, dress | Sutures, butterfly strips, or glue | Low | 7-14 days |
| Laceration (torn) | Irrigate thoroughly, debride | Loose sutures or open healing | Moderate | 14-21 days |
| Puncture (deep, narrow) | DO NOT close. Irrigate, pack open | Leave open (drain from inside out) | High | 21-30 days |
| Abrasion (road rash) | Clean, remove debris, moist dressing | No closure needed | Low-moderate | 7-14 days |
| Burn (1st degree) | Cool water 20 min, aloe, cover | No closure | Low | 7-14 days |
| Burn (2nd degree) | Cool water, don't pop blisters, silver if available | No closure, moist dressing | Moderate | 14-28 days |
| Burn (3rd degree) | Cool, cover, EVACUATE if possible | Requires grafting | Very high | Months |
| Animal bite | Irrigate aggressively (rabies risk), antibiotics | Leave open or loose closure | Very high | 14-21 days |
CRITICAL RULE: Dirty wounds, bites, and punctures = LEAVE OPEN. Closing a contaminated wound traps bacteria inside = abscess or sepsis.
Chapter 3: Infection Recognition and Treatment
| Sign | Meaning | Action Required |
|---|---|---|
| Redness spreading from wound | Cellulitis (skin infection) | Antibiotics (oral). Mark edge with pen, monitor spread. |
| Red streaks toward heart | Lymphangitis (spreading fast) | URGENT. Antibiotics immediately. Elevate limb. |
| Pus (yellow/green discharge) | Abscess forming | Open and drain. Pack with clean gauze. Antibiotics. |
| Fever + wound changes | Systemic infection beginning | Oral antibiotics. Monitor closely. |
| High fever + confusion + rapid heart rate | Sepsis (life-threatening) | IV antibiotics if available. This is an emergency. |
| Gas/crepitus in tissue around wound | Gas gangrene | EMERGENCY. Surgical debridement. Will be fatal without intervention. |
| Black tissue around wound | Necrosis (dead tissue) | Debride (cut away dead tissue). May need amputation if spreading. |
Chapter 4: Herbal Antibiotics and Medicines
| Plant/Substance | Action | Preparation | Use | Effectiveness |
|---|---|---|---|---|
| Honey (raw, unprocessed) | Antibacterial, wound healing | Apply directly to wound | Wound dressing, burns | Very high (proven) |
| Garlic | Antibacterial, antifungal | Crush, apply poultice or eat raw | Infection, respiratory | Moderate-high |
| Echinacea | Immune stimulant | Tea or tincture (root) | Early infection, prevention | Moderate |
| Yarrow | Styptic (stops bleeding), antiseptic | Crush leaves, apply to wound | Bleeding wounds | High (hemostatic) |
| Plantain (broadleaf) | Anti-inflammatory, drawing | Chew leaf, apply as poultice | Bites, stings, splinters | Moderate |
| Willow bark | Pain relief (contains salicin/aspirin) | Tea (inner bark) | Pain, fever, inflammation | Moderate-high |
| Thyme | Antiseptic (thymol) | Strong tea as wound wash | Wound irrigation | Moderate |
| Oregon grape root | Antibiotic (berberine) | Tincture or strong tea | Infection (internal + external) | Moderate-high |
| Comfrey | Bone healing, tissue repair | Poultice (leaf/root) | Fractures, sprains, wounds | High (external only) |
| Activated charcoal | Poison absorption | Powder in water | Poisoning, GI issues | Very high (specific use) |
Chapter 5: Fracture Management
| Fracture Type | Signs | Treatment | Immobilization | Healing Time |
|---|---|---|---|---|
| Closed (simple) | Pain, swelling, deformity, can't use | Splint in position of comfort | Rigid splint + padding | 6-12 weeks |
| Open (compound) | Bone visible through skin | Cover wound, splint, antibiotics | Splint + wound care | 8-16 weeks |
| Colles (wrist) | Dinner fork deformity | Reduce (pull/align), splint | Forearm splint, wrist neutral | 6-8 weeks |
| Femur (thigh) | Severe pain, shortened leg | Traction splint (CRITICAL) | Traction + full leg immobilization | 12-16 weeks |
| Rib | Pain with breathing, point tender | Bind loosely, pain control | DO NOT wrap tightly (prevents breathing) | 4-6 weeks |
| Spine (suspected) | Mechanism + midline tenderness | DO NOT MOVE. Log roll only. | Full spinal immobilization | Variable |
Splinting rules: Immobilize joint ABOVE and BELOW fracture. Pad all bony prominences. Check circulation (pulse, sensation, color) distal to splint every 2 hours. Loosen if swelling increases.
Chapter 6: Emergency Procedures
| Procedure | Indication | Technique | Risk | Training Level |
|---|---|---|---|---|
| Tourniquet | Life-threatening limb bleeding | 2-3 inches above wound, tighten until bleeding stops | Limb loss if >6 hours | Basic |
| Chest seal | Penetrating chest wound (sucking) | Occlusive dressing, taped on 3 sides | Tension pneumothorax | Basic |
| Needle decompression | Tension pneumothorax | 14ga needle, 2nd intercostal space, midclavicular | Lung puncture | Advanced |
| Cricothyrotomy | Complete airway obstruction | Incision through cricothyroid membrane | Bleeding, false passage | Advanced |
| Wound closure (suturing) | Clean lacerations >6 hours old | Simple interrupted sutures, 5mm apart | Infection if contaminated | Intermediate |
| Abscess drainage | Fluctuant abscess | Incise at point of maximal fluctuance, pack open | Incomplete drainage | Intermediate |
| Dislocated shoulder reduction | Anterior shoulder dislocation | External rotation method or Cunningham technique | Fracture if forced | Intermediate |
| Dental extraction | Infected/broken tooth | Loosen with elevator, extract with forceps | Jaw fracture, bleeding | Intermediate |
Reference Card
- ABCs: Airway → Breathing → Circulation. Always in this order. Fix life threats first.
- Bleeding: Direct pressure first (10 minutes continuous). Tourniquet for life-threatening limb bleeding.
- Infection prevention: clean hands, clean water irrigation, clean dressings. Honey on wounds (proven antibacterial).
- Dirty wounds STAY OPEN. Never close a bite, puncture, or contaminated wound. Let it drain.
- Fractures: splint it where it lies. Immobilize joint above and below. Check circulation every 2 hours.
- Fever: willow bark tea (natural aspirin). Cool cloths. Hydrate. Fever >104°F = emergency cooling.
- Dehydration: oral rehydration solution = 1 liter water + 6 teaspoons sugar + 1/2 teaspoon salt. Sip constantly.
- When in doubt: keep patient warm, hydrated, clean, and still. Most injuries heal if you prevent infection and shock.
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