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The Inside Scoop on RICE for Injuries

The Inside Scoop on RICE for Injuries | The Survival Doctor

by James Hubbard, MD, MPH

I love acronyms. They’re such great memory tricks. They saved me on many a test in medical school. And many of them I remember to this day. Needless to say, I use them when I can. RICE is one I use the most.

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Exposed Bone: Treatment for an Open Fracture


by James Hubbard, M.D., M.P.H.

I hope you never see one, but an open fracture, also called a compound fracture, is a broken bone that’s exposed to the air. Proper treatment for an open fracture is essential.

Open fractures are easy to diagnose and pretty dramatic if the bone is sticking out of the skin, or there’s a big cut with a broken bone exposed. But it’s not always that simple. What if you broke a bone and there’s a cut nearby? Could the bone have punctured the skin and then gone back in? The answer is yes.

And if exposed to bacteria, bones can get infected. Infections in open fractures are very hard to cure. You can lose a limb, or your life. Oral antibiotics often don’t work. So you need try your best to prevent the bone from ever becoming infected.


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What Do Distal and Proximal Mean?

Distal means further away, and proximal means closer to. In the picture, the left side of the wound (represented as being closed with duct tape) is distal to the heart, and the right side is proximal to the heart.

Distal means farthest away, and proximal means closest to. In the picture, the left side of the wound (represented as being closed with duct tape) is distal to the heart, and the right side is proximal to the heart.

by James Hubbard, M.D., M.P.H.

In medical terminology, distal and proximal, or distally and proximally, describe anatomical locations.

Proximal means closest to, and distal means farthest away.

With reference to a wound on an arm, distal to the wound would be past the wound toward the fingers. Proximal to the wound would be from the wound toward the shoulder.

On the leg, the toes are the most distal, the hip the most proximal.

The knee is proximal to the ankle; the elbow is proximal to the wrist. Get it?

With reference to blood vessels, distal would be furthest from the heart. Proximal closest.

If it’s not clear, please ask in the comments section below.

Arteries Vs. Veins: How to Tell the Difference and Stop the Bleeding


Arteries flow away from the heart (red). Veins flow back toward it (blue).

by James Hubbard, M.D., M.P.H.

When trying to stop a cut from bleeding, you need to know how to tell the difference between a bleeding vein and a bleeding artery.

Memorize this saying: Arteries spurt. Veins don’t.

Arteries carry oxygen-rich blood from the heart to tissue. Veins drain the blood back to the heart to resupply it with oxygen.

Arteries pump. Veins dump.

Step 1: Apply pressure.

  • Use gauze or a clean cloth. If you don’t have anything else, use a gloved hand. If it’s yourself, as a last resort, use your bare hand. If it’s others, beware you could be exposing yourself to a blood-borne disease. Stuff a gash with a cloth (the cleanest you have) or gauze, and hold pressure. A shirt will do.

Step 2: Determine whether it’s an artery or vein.

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