{"id":2588,"date":"2020-07-21T14:27:38","date_gmt":"2020-07-21T18:27:38","guid":{"rendered":"http:\/\/wordpress.world.dan.org\/?post_type=dan_health_resources&#038;p=2588"},"modified":"2020-09-18T10:00:37","modified_gmt":"2020-09-18T14:00:37","slug":"appendix","status":"publish","type":"dan_health_resources","link":"https:\/\/world.dan.org\/fr\/health-medicine\/health-resource\/dive-medical-reference-books\/hazardous-marine-life\/appendix\/","title":{"rendered":"Chapitre 4 : Annexe"},"content":{"rendered":"<p class=\"has-medium-font-size\"><strong><em>\u201cSafety is a consequence of education.\u201d<\/em><\/strong><\/p>\n\n\n\n<p>Le Divers Alert Network encourage les plongeurs de tous les niveaux de certification \u00e0 suivre une formation aux premiers secours afin d'\u00eatre pr\u00eats \u00e0 r\u00e9agir en cas de blessures en plong\u00e9e, y compris celles li\u00e9es \u00e0 la vie marine. Le chapitre suivant d\u00e9taille certaines des techniques de premiers secours et des traitements mentionn\u00e9s dans le livre, notamment la thermolyse, les antivenins et la technique d'immobilisation par pression. Toutefois, il est important de souligner que la lecture et la compr\u00e9hension de ces documents ne remplacent pas la formation aux premiers secours.<\/p>\n\n\n\n<p>Si vous n'avez pas re\u00e7u de formation officielle, DAN vous recommande vivement de trouver un instructeur qualifi\u00e9. Pour trouver un instructeur de premiers secours en cas de blessures caus\u00e9es par des esp\u00e8ces marines dangereuses, visitez le site Web du <a href=\"https:\/\/apps.world.dan.org\/instructor-directory\/\"><strong>Annuaire des instructeurs DAN<\/strong><\/a>.<\/p>\n\n\n\n<p>Dans ce chapitre, vous apprendrez ce qui suit :<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><a href=\"#thermolysis\">Thermolyse<\/a><\/li><li><a href=\"#antivenoms\">Antivenins<\/a><\/li><li><a href=\"#pit\">Technique d'immobilisation par pression<\/a><\/li><\/ul>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<hr class=\"wp-block-separator\"\/>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"thermolysis\">Thermolyse<\/h2>\n\n\n\n<p>La thermolyse d\u00e9crit l'utilisation de la chaleur pour d\u00e9composer des substances (thermo signifiant temp\u00e9rature, et lyse signifiant d\u00e9composition ou destruction). Pour ce faire, on immerge souvent la zone affect\u00e9e dans de l'eau chaude. <\/p>\n\n\n\n<p>Proteins are essential organic compounds that perform a vast array of functions within living organisms. Most life forms live in temperatures below 122\u00b0F (50\u00b0C).<\/p>\n\n\n\n<p>Au-del\u00e0 de cette temp\u00e9rature, leurs prot\u00e9ines subissent un d\u00e9pliage irr\u00e9versible de leur structure biomol\u00e9culaire tridimensionnelle. Ce processus, appel\u00e9 d\u00e9naturation des prot\u00e9ines, a des cons\u00e9quences n\u00e9fastes sur leur fonction. L'application de chaleur peut d\u00e9naturer les venins qui sont compos\u00e9s de prot\u00e9ines, \u00e9liminant ainsi leur effet ou r\u00e9duisant leur puissance.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Technique<\/h3>\n\n\n\n<p>The standard recommendations for toxin denaturation as a first aid measure call for immersing the affected area in hot freshwater with an upper limit of 113\u00b0F (45\u00b0C) for 30 to 90 minutes. This may work reasonably well when the toxin inoculation is skin deep, like a jellyfish sting, but will be less effective when toxins have been inoculated by means of deeper puncture wounds, as is the case of lionfish spines. Though quick reasoning could call for increasing the temperature, applying higher temperatures at skin level in an attempt to reach the desired temperature at a deeper level poses an unacceptable risk of burning the skin. In addition, vasodilatation caused by exposure to elevated temperatures may expedite the onset of absorption and of systemic effects.<\/p>\n\n\n\n<p>Chaque cas est unique et n\u00e9cessite une estimation de la profondeur \u00e0 laquelle le venin a \u00e9t\u00e9 inject\u00e9 ; pour les inoculations superficielles, l'application de chaleur peut \u00eatre utile pour g\u00e9rer la douleur et d\u00e9naturer les toxines, alors que pour les inoculations plus profondes, la chaleur ne sert qu'\u00e0 g\u00e9rer la douleur.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Consid\u00e9rations sur les risques<\/h3>\n\n\n\n<p>If you attempt to use thermolysis as a first aid measure, minimize the risk of local tissue damage to the injured diver by testing the water on yourself first on the same area that the diver is injured. Use the hottest temperatures you can tolerate and avoid scalding. Do not rely on the victim\u2019s assessment, as intense pain may impair his ability to evaluate temperature tolerability.<\/p>\n\n\n\n<div style=\"height:25px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<hr class=\"wp-block-separator\"\/>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"antivenoms\">Antivenin (Antivenin, Antivenene)<\/h2>\n\n\n\n<p><em>L'antivenin est un produit biologique utilis\u00e9 dans le traitement des morsures ou des piq\u00fbres venimeuses (\u00e0 ne pas confondre avec l'antidote). Bien que cela soit rare, les plongeurs amateurs peuvent \u00eatre victimes d'une piq\u00fbre venimeuse caus\u00e9e par certains organismes marins, tels que le poisson-pierre ou la m\u00e9duse-bo\u00eete, ce qui n\u00e9cessite l'utilisation d'un antivenin. Les morsures venimeuses, comme celles des serpents de mer, sont encore plus rares.<\/em><\/p>\n\n\n\n<div class=\"wp-block-image is-style-default\"><figure class=\"alignright size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"256\" height=\"362\" src=\"https:\/\/world.dan.org\/wp-content\/uploads\/2020\/07\/antivenom-bottle-syringe-186421251-DAN-256x362-1.jpg\" alt=\"\" class=\"wp-image-11791\" srcset=\"https:\/\/world.dan.org\/wp-content\/uploads\/2020\/07\/antivenom-bottle-syringe-186421251-DAN-256x362-1.jpg 256w, https:\/\/world.dan.org\/wp-content\/uploads\/2020\/07\/antivenom-bottle-syringe-186421251-DAN-256x362-1-255x360.jpg 255w, https:\/\/world.dan.org\/wp-content\/uploads\/2020\/07\/antivenom-bottle-syringe-186421251-DAN-256x362-1-8x12.jpg 8w\" sizes=\"auto, (max-width: 256px) 100vw, 256px\" \/><\/figure><\/div>\n\n\n\n<h3 class=\"wp-block-heading\">Qu'est-ce que l'antivenin ?<\/h3>\n\n\n\n<p>Antivenoms are blood-derived biological products developed by injecting an animal\u2014typically a horse, goat or sheep\u2014with sublethal doses of venom. The animal will gradually develop antibodies against the venom, which can then be extracted from its blood as a serum to be administered to humans. Like most blood-derived products, antivenoms require an unbroken cold chain (proper refrigeration from production through storage until administration).<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Risques Consid\u00e9rations<\/h3>\n\n\n\n<p>Bien qu'elle ne soit g\u00e9n\u00e9ralement pas une pr\u00e9occupation pour les premiers intervenants, l'administration d'antivenins n'est pas sans risque. L'administration intraveineuse de s\u00e9rums d'animaux peut provoquer un choc anaphylactique chez les personnes sensibles.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Qu'en est-il des auto-injecteurs d'antivenin ?<\/h3>\n\n\n\n<p>Occasionally, DAN is asked about autoinjectors for antivenoms. Conceptually, these antivenom autoinjectors would work similarly to the way epinephrine autoinjectors (like EpiPen\u00ae) work for intramuscular administration. Though it is certainly a compelling idea, antivenoms are much more complex blood-derived products than epinephrine. As such, they have a much shorter shelf life and require an unbroken cold chain. In addition, antivenoms are administered intravenously, a skill which is beyond first aid responders. These limiting factors make this idea relatively impractical for field operation.<\/p>\n\n\n\n<div style=\"height:25px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<hr class=\"wp-block-separator\"\/>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"pit\">Technique d'immobilisation par pression<\/h2>\n\n\n\n<p><em>La technique d'immobilisation par pression est une technique de premiers secours destin\u00e9e \u00e0 contenir le venin dans la zone mordue et \u00e0 l'emp\u00eacher de passer dans la circulation centrale, o\u00f9 le venin pourrait affecter les organes vitaux. La technique consiste \u00e0 exercer une pression pour emp\u00eacher le drainage lymphatique et une immobilisation pour emp\u00eacher le retour veineux (retour du sang vers le c\u0153ur) caus\u00e9 par l'action de pompage des muscles squelettiques.<\/em><\/p>\n\n\n\n<div class=\"wp-block-image is-style-default\"><figure class=\"aligncenter size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"500\" src=\"https:\/\/world.dan.org\/wp-content\/uploads\/2020\/07\/pressure-immobilization-technique-IMG_8512-DAN-800x500-1.jpg\" alt=\"\" class=\"wp-image-11792\" srcset=\"https:\/\/world.dan.org\/wp-content\/uploads\/2020\/07\/pressure-immobilization-technique-IMG_8512-DAN-800x500-1.jpg 800w, https:\/\/world.dan.org\/wp-content\/uploads\/2020\/07\/pressure-immobilization-technique-IMG_8512-DAN-800x500-1-360x225.jpg 360w, https:\/\/world.dan.org\/wp-content\/uploads\/2020\/07\/pressure-immobilization-technique-IMG_8512-DAN-800x500-1-768x480.jpg 768w, https:\/\/world.dan.org\/wp-content\/uploads\/2020\/07\/pressure-immobilization-technique-IMG_8512-DAN-800x500-1-18x12.jpg 18w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\" \/><\/figure><\/div>\n\n\n\n<h3 class=\"wp-block-heading\">Technique<\/h3>\n\n\n\n<p>Utilisez un bandage \u00e9lastique et une attelle pour exercer une pression et une immobilisation appropri\u00e9es. Un tissu non \u00e9lastique n'est pas id\u00e9al car il est difficile d'obtenir une pression optimale.<\/p>\n\n\n\n<ol class=\"wp-block-list\"><li>Commencez \u00e0 bander quelques centim\u00e8tres au-dessus du point de morsure (entre la morsure et le c\u0153ur).<\/li><li>Enroulez le bandage autour du membre en faisant des tours qui se chevauchent, en remontant le long du membre puis en redescendant au-del\u00e0 du point de morsure.<\/li><li>L'enveloppe doit \u00eatre suffisamment serr\u00e9e pour exercer une pression, mais vous devez conserver une sensibilit\u00e9 et une couleur normales, ainsi qu'un pouls palpable.<\/li><li>Utilisez une attelle ou un substitut appropri\u00e9 pour immobiliser le membre.<\/li><li>Si possible, maintenez les extr\u00e9mit\u00e9s sup\u00e9rieures \u00e0 l'aide d'une \u00e9charpe.<\/li><\/ol>\n\n\n\n<div style=\"height:25px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>","protected":false},"excerpt":{"rendered":"<p>&#8220;Safety is a consequence of education.&#8221; Divers Alert Network encourages divers from all levels of certification to get first aid training so they are prepared to respond to diving injuries, [&hellip;]<\/p>\n","protected":false},"featured_media":11789,"parent":2543,"menu_order":22,"template":"","dan_health_resource_types":[405],"class_list":["post-2588","dan_health_resources","type-dan_health_resources","status-publish","has-post-thumbnail","hentry","dan_health_resource_types-dive-medical-reference-books"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.0 (Yoast SEO v27.3) - 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