First aid measures should be considered. First Aid List

Date of: 19.07.2019

First aid -it is a complex of simple medical measures performed at the site of injury or illness in the order of self-help or mutual assistance, as well as by participants in rescue operations, in the next 30 minutes, and when breathing stops, it takes 5-8 minutes.

MAIN GOAL - a)Elimination of the impact of a damaging factor;

b) Saving the life of an affected or sick person with sudden illnesses (with the help of PHC measures);

c) Evacuation from the affected area.

OPTIMAL PERIOD OF PROVISION PMP -up to 30 minutes after injury, with respiratory arrest - up to 5-8 minutes.

VALUE OF PMP- according to the WHO, 20% of those killed in peacetime as a result of accidents could have been saved if medical assistance had been provided to them at the scene in a timely and high-quality manner.

therefore every person must know and be able to provide first aid to victims (in emergency situations, at work, at home).

This is in line with the international slogan of Civil Defense:

WARN - SAVE - HELP

The main types of lesions in the emergency

First aid measures vary depending on the type of lesion:

Injuries, bone fractures, bleeding

Thermal and chemical burns

Radiation damage

Acute chemical poisoning

Psycho-emotional disorders

Massive Infectious Diseases

Subcooling, overheating

Electric shock Combined lesions (mechanical-thermal, radiation-mechanical, etc.)

Drowning

Combined lesions (mechanical-thermal, radiation-mechanical, etc.)

Main PMP events:

Removing the victim from the rubble, shelters, shelters

Extinguishing burning clothes

The introduction of painkillers with a syringe tube or a disposable syringe

Elimination of asphyxia by releasing the upper respiratory tract

Artificial ventilation

Temporary stop external bleeding by all available means

Applying an aseptic dressing to the wound and burn surface

Immobilization of a damaged limb with tires, the simplest means adapted

Indirect cardiac massage

The simplest anti-shock measures (rest, warming, cooling protection, warm drink)

Putting on a gas mask while in contaminated area

The introduction of antidotes (antidotes) affected by toxic substances

Partial sanitation

Giving medicines from an individual AI-2 first-aid kit

Removal to places of loading on vehicles

Evacuation of the affected

Medical sorting and evacuation of victims

Medical Sort -this is a method of distributing the affected into groups (categories) on the basis of need for homogeneous treatment, prophylactic and evacuation measures, depending on the specific situation. Its purpose is to ensure the timely provision of medical care to the affected and their further evacuation.

The sorting of the wounded was first applied by N.I. Pirogov during the Crimean War (1853-1856gg.) During the defense of Sevastopol. The basis of the proposals of N.I. Pie medical sorting were three signs:

Medical

Evacuation

Danger of the wounded to others

SORTING TYPES

Depending on the tasks solved in the sorting process, it is customary to distinguish two types of medical sorting:

INTERNAL POINT SORTINGcarried out in order to distribute the affected into groups depending on the nature and severity of the lesion in order to establish the priority of medical care and determine the functional department of this stage of medical evacuation or medical institution where assistance should be provided.

EVACUATION AND TRANSPORT SORTcarried out in order to distribute the affected into homogeneous groups according to the order of evacuation, type of transport (automobile, railway, aviation, etc.), position on the transport (lying, sitting) and addressing the issue of location (evacuation destination) taking into account the location, nature and severity of the lesion . These issues are resolved based on diagnosis and prognosis.

Medical Sortusually based on data:

External examination of the affected (patients);

Survey of the affected;

Familiarization with medical records (if available);

The use of simple research methods;

The simplest diagnostic equipment ( dosimetric devices, PHR-MV, etc.)

Medical sorting of those affected in the focus of mass destruction during the provision of first aid is carried out by the medical and nursing teams and ambulance teams in order to distinguish the following groups of victims:

First Aid or Secondary Needs First Aid

Those in need of removal or removal in the first or second stage, lying or sitting

Walkers who can follow on their own or with outside help.

First of all, they need help in the focus of mass destruction and in the removal of children from it:

Affected with unstoppable external or internal bleeding

In shock

Asphyxia

With prolonged squeezing syndrome

Convulsive

Unconscious

With penetrating wound to the chest or abdomen

Experienced by the influence of damaging factors that aggravate the defeat (burning clothing, the presence of ADHD or OM in open parts of the body, etc.).

Medical sorting of victims during the first medical aid at the first stage of medical evacuation is carried out mainly in order to:

Identification of victims who are dangerous to others and needing urgent medical, preventive and special measures

Identification of those in need of emergency first aid for referral to appropriate functional departments

Preparing for further evacuation.

Medical sorting begins at the distribution post, where the affected, those in need of sanitary treatment (with infection of the skin and clothing of RV exceeding the acceptable levels, in the presence of infection with SDYAV, OV and BS) and subject to referral to the site of partial special treatment, as well as infectious patients, are allocated and patients with severe psychomotor agitation, who need isolation. The rest of the injured are sent to the admission department or to the sorting platform, if it is organized, highlighting the streams of stretchers and walking patients. The distribution of those affected by such functional units of the stage as the special treatment department, sorting and evacuation, surgical dressing or hospital is very important.

AT RECEPTION AND SORTING OFFICE(at the sorting site) stand out:

Affected patients, whose medical care should be provided according to emergency indications in the dressing room or operating room, anti-shock (in the presence of external or internal bleeding, open or valvular pneumothorax, asphyxia, severe shock or collapse, with incomplete traumatic amputation of the limb, with a pronounced clinic of traumatic toxicosis, etc. .). The number of victims in need of urgent hostile assistance may be 20-25% of the total number received.

Non-transportable injured to be treated in the hospital ward, as well as women in labor. Non-transportable (after surgical interventions, victims who have developed an anaerobic infection, convulsive condition, etc.) can make up 10-12% of patients. Upon admission, those affected from the chemical lesion focus will need 10-15% in emergency resuscitation measures, and up to 40-60% of patients will need hospitalization.

Affected people, whose medical care may be delayed until they are admitted to a medical institution. In the reception and sorting department, in preparation for the evacuation of those in need, bandages can be bandaged, immobilization corrected, prophylactic and medication administered subcutaneously and by mouth, the primary reaction to radiation is stopped, etc.

Affected, subject to outpatient treatment.

Affected, in need of care and reduction of suffering (agonizing).

In the sorting and evacuation department (at the sorting site or in reception rooms), it is necessary to provide separate placement of stretchers and walking patients. If possible, stretcher patients should be placed on a stretcher, on bedding material in rows, ensuring a good approach to them. If several rooms are used for the sorting and evacuation department, it is advisable to fill them in affected. It is possible to place incoming injured at the same time in all rooms, while sorting teams sort them in turn, and the nurse-dispatcher regulates the placement of incoming injured in these rooms and sends them sorted to other departments.

The capacity of the premises of the sorting and operational department should allow at the same time accommodate at least 25-30% of the total number of affected, which determines the throughput of the stage.

Vehicles with injured persons should be brought as close as possible to the places of unloading of injured persons in the sorting and operational premises (to window openings on the first floors of buildings, directly to doorways of entry entrances to the premises), minimizing the transportation of affected persons by orderlies and accelerating their unloading.

First aid is a set of urgent measures aimed at saving a person’s life. Accident, a sharp attack of the disease, poisoning - in these and other emergency situations, competent first aid is needed.

According to the law, first aid is not medical - it is provided before the doctors arrive or the victim is taken to the hospital. First aid can be provided by anyone at a critical moment near the victim. For some categories of citizens, first aid is a duty. We are talking about the police, the traffic police and the Ministry of Emergency Situations, military personnel, firefighters.

The ability to provide first aid is an elementary, but very important skill. In he can save someone's life. We present to your attention 10 basic first aid skills.

First Aid Algorithm

In order not to get confused and correctly provide first aid, it is important to observe the following sequence of actions:

To be convinced that at first aid nothing threatens you and you do not endanger yourself.
Ensure the safety of the victim and others (for example, remove the victim from a burning vehicle).
Check if the victim has signs of life (pulse, breathing, pupil reaction to light) and consciousness. To check breathing, it is necessary to throw back the victim’s head, bend to his mouth and nose and try to hear or feel the breath. To detect the pulse, it is necessary to attach the fingertips to the victim's carotid artery. To assess consciousness, it is necessary (if possible) to take the victim by the shoulders, gently shake and ask any question.
Call specialists: from the city - 03 (ambulance) or 01 (rescuers).
Provide emergency first aid. Depending on the situation, this may be:
- restoration of airway patency;
- cardiopulmonary resuscitation;
- stopping bleeding and other events.
To provide physical and psychological comfort to the victim, wait for the arrival of specialists.

Artificial respiration

Artificial ventilation of the lungs (IVL) is the introduction of air (or oxygen) into the respiratory tract of a person in order to restore natural ventilation of the lungs. Refers to elementary resuscitation measures.

Typical situations requiring mechanical ventilation:

car accident;
water accident;
electric shock and others.

There are various methods of mechanical ventilation. The most effective in providing first aid to a layman is artificial respiration of the mouth to mouth and mouth to nose.

If during the examination of the victim natural breathing is not detected, it is necessary to immediately carry out artificial ventilation of the lungs.

Mouth-to-mouth resuscitation technique

Ensure patency of the upper respiratory tract. Turn the victim’s head to the side and use your finger to remove mucus, blood, and foreign objects from the oral cavity. Check the nasal passages of the victim, clean them if necessary.
Throw back the victim’s head while holding his neck with one hand.
Do not change the position of the head of the victim with a spinal injury!
Place a tissue, handkerchief, piece of cloth or gauze on the victim’s mouth to protect against infection. Pinch the victim’s nose with the thumb and forefinger. Take a deep breath, press your lips firmly against the victim’s mouth. Exhale into the victim's lungs.
The first 5–10 exhalations should be fast (in 20–30 seconds), then 12–15 exhalations per minute.
Watch the movement of the chest of the victim. If the victim’s chest rises when you inhale the air, then you are doing everything right.

Indirect cardiac massage

If there is no pulse with breathing, an indirect heart massage is necessary.

Indirect (closed) heart massage, or chest compression, is the compression of the heart muscles between the sternum and the spine in order to maintain a person’s blood circulation during cardiac arrest. Refers to elementary resuscitation measures.

Attention! Do not use a closed heart massage in the presence of a pulse.

Indirect Heart Massage Technique

Place the victim on a flat hard surface. On the bed and other soft surfaces, chest compression is prohibited.
Determine the location of the affected xiphoid process. The xiphoid process is the shortest and narrowest part of the sternum, its end.
Measure 2–4 cm upwards from the xiphoid process - this is the compression point.
Put the base of the palm on the compression point. In this case, the thumb should indicate either the chin or the stomach of the victim, depending on the location of the resuscitator. Put the other hand on top of one hand, fold your fingers into the lock. Pressure is carried out strictly by the base of the palm - your fingers should not touch the sternum of the victim.
Exercise rhythmic thrusts of the chest strongly, smoothly, strictly upright, with the weight of the upper half of your body. Frequency - 100–110 pressures per minute. In this case, the chest should bend 3-4 cm.
Infants are given indirect heart massage with the index and middle fingers of one hand. Adolescents - the palm of one hand.

If mechanical ventilation is performed simultaneously with a closed heart massage, every two breaths should alternate with 30 pressures on the chest.

If during the resuscitation measures the victim has breathing or a pulse appears, stop providing first aid and lay the person on his side with his palm under his head. Monitor his condition until the arrival of doctors.

Reception of Heimlich

When food or foreign bodies get into the trachea, it becomes clogged (fully or partially) - the person suffocates.

Signs of airway obstruction:

Lack of full breathing. If the respiratory throat is not completely blocked, the person coughs; if fully - holds on to the throat.
Inability to speak.
Blue skin, swelling of the vessels of the neck.

The cleaning of the respiratory tract is most often carried out according to the Heimlich method.

Stand behind the victim.
Wrap his arms around him, locking them into a lock, just above the navel, under the edge of the arch.
Press firmly on the victim’s stomach, abruptly bending your elbows.
Do not squeeze the victim’s chest, except for pregnant women who are under pressure in the lower chest.
Repeat this several times until the airways are clear.

If the victim lost consciousness and fell, put him on his back, sit on his hips and with both hands push on the edge arches.

To remove foreign bodies from the respiratory tract of a child, it is necessary to turn him on his stomach and pat 2-3 times between the shoulder blades. Be very careful. Even if the baby clears his throat quickly, consult a doctor for a medical examination.

Bleeding

Stopping bleeding is a measure aimed at stopping blood loss. When providing first aid, we are talking about stopping external bleeding. Depending on the type of vessel, capillary, venous and arterial bleeding is distinguished.

Stopping capillary bleeding is carried out by applying an aseptic dressing, as well as, if injured arms or legs, raising the limbs above the level of the body.

With venous bleeding, a pressure bandage is applied. To do this, the wound tamponade is performed: gauze is applied to the wound, several layers of cotton wool are laid on top of it (if there is no cotton wool, a clean towel), it is tightly bandaged. The veins squeezed by such a bandage quickly clot, and the bleeding stops. If the pressure dressing gets wet, press it firmly with your palm.

To stop arterial bleeding, the artery must be pinched.

Artery clamping technique: firmly press the artery with your fingers or fist to the underlying bones.

Arteries are easily accessible for palpation, so this method is very effective. However, he requires physical assistance from the first aid provider.

If bleeding does not stop after applying a tight bandage and pressing the artery, apply a tourniquet. Remember that this is an extreme measure when other methods do not help.

The technique of applying a hemostatic tourniquet

Place a tourniquet on clothing or a soft lining just above the wound.
Tighten the tourniquet and check the pulsation of the vessels: bleeding should stop, and the skin below the tourniquet should turn pale.
Put a bandage on the wound.
Record the exact time when the tourniquet is applied.

A tourniquet on the limbs can be applied for a maximum of 1 hour. After its expiration, the tourniquet must be loosened for 10-15 minutes. If necessary, you can tighten again, but not more than 20 minutes.

Fractures

Fracture - a violation of the integrity of the bone. Fracture is accompanied by severe pain, sometimes - fainting or shock, bleeding. There are open and closed fractures. The first is accompanied by a soft tissue wound, bone fragments are sometimes visible in the wound.

First Aid Technique for Fracture

Assess the severity of the condition of the victim, determine the location of the fracture.
If bleeding occurs, stop it.
Determine whether it is possible to move the victim before the arrival of specialists.
Do not transfer the victim and do not change his position in case of spinal injuries!
Ensure the immobility of the bone in the fracture area - immobilize. For this, it is necessary to immobilize the joints located above and below the fracture.
Put on the tire. As a tire, you can use flat sticks, boards, rulers, rods and more. The tire must be tightly, but not tightly fixed with bandages or a band-aid.

With a closed fracture, immobilization is performed on top of clothing. With an open fracture, the tire should not be applied to places where the bone protrudes outward.

Burns

A burn is damage to body tissues under the influence of high temperatures or chemicals. Burns vary in degree as well as type of damage. For the last reason, burns are distinguished:

thermal (flame, hot liquid, steam, hot objects);
chemical (alkalis, acids);
electric;
radiation (light and ionizing radiation);
combined.

In case of burns, the first thing to do is to eliminate the effect of the damaging factor (fire, electric current, boiling water and so on).

Then, in case of thermal burns, the affected area should be freed from clothing (gently, not tearing off, but cutting off adherent tissue around the wound) and, in order to disinfect and anesthetize, irrigate it with water-alcohol solution (1/1) or vodka.

Do not use ointments and greasy creams - fats and oils do not reduce pain, do not disinfect burns and do not promote healing.

After irrigating the wound with cold water, apply a sterile dressing and apply cold. In addition, give the victim warm, salted water.

To accelerate the healing of light burns, use dexpanthenol sprays. If the burn covers an area of \u200b\u200bmore than one palm, be sure to consult a doctor.

Fainting

Fainting is a sudden loss of consciousness due to a temporary impairment of cerebral blood flow. In other words, it is a signal from the brain that it lacks oxygen.

It is important to distinguish between normal and epileptic syncope. The first, as a rule, is preceded by nausea and dizziness.

A fainting state is characterized by the fact that a person rolls his eyes, becomes covered with cold sweat, his pulse weakens, his limbs get colder.

Typical fainting situations:

fright
excitement,
stuffiness and others.

If a person faints, give him a comfortable horizontal position and provide an influx of fresh air (unfasten clothing, loosen the belt, open windows and doors). Sprinkle cold water on the victim's face, pat him on the cheeks. If you have first-aid kits on hand, let them smell a cotton swab moistened with ammonia.

If consciousness does not return 3-5 minutes, immediately call an ambulance.

When the victim comes to his senses, give him strong tea or coffee.

Drowning and sunstroke

Drowning is the penetration of water into the lungs and airways, which can lead to death.

First aid for drowning

Remove victim from water.
A drowning man grabs at everything that comes to hand. Be careful: swim towards it from behind, hold by the hair or armpits, keeping your face above the surface of the water.
Put the victim on his knee so that his head is below.
Clean the oral cavity of foreign bodies (mucus, vomit, algae).
Check for signs of life.
If there is no pulse or breathing, immediately start mechanical ventilation and indirect heart massage.
After restoring breathing and cardiac activity, lay the victim on one side, cover him and provide comfort until the doctors arrive.

In the summer, sunstrokes are also dangerous. Sunstroke is a brain disorder caused by prolonged exposure to the sun.

Symptoms

headache,
weakness,
noise in ears,
nausea,
vomiting

If the victim still remains in the sun, his temperature rises, shortness of breath appears, sometimes he even faints.

Therefore, when providing first aid, first of all, it is necessary to transfer the victim to a cool, ventilated place. Then free it from clothes, loosen the belt, develop it. Put a cold, wet towel on his head and neck. Let ammonia smell. If necessary, take artificial respiration.

In case of sunstroke, it is necessary to drink plentifully with cool, slightly salted water (often, but in small sips).

Causes of frostbite - high humidity, frost, wind, stationary position. The aggravated condition of the victim, as a rule, is alcohol intoxication.

Symptoms

feeling of cold;
tingling in the frosty part of the body;
then numbness and loss of sensation.

First aid for frostbite

Put the victim in heat.
Remove frozen or wet clothes from it.
Do not rub the victim with snow or cloth - this will only injure your skin.
Wrap a frostbitten area of \u200b\u200bthe body.
Give the victim a hot, sweet drink or hot food.

Poisoning

Poisoning is a disorder of the body that occurs due to the ingress of poison or toxin into it. Depending on the type of toxin, poisoning is distinguished:

carbon monoxide
pesticides
alcohol
medicines
food and others.

First aid measures depend on the nature of the poisoning. The most common food poisoning is accompanied by nausea, vomiting, diarrhea and stomach pain. In this case, the victim is recommended to take 3-5 grams of activated charcoal every 15 minutes for an hour, drink plenty of water, refrain from eating and be sure to consult a doctor.

In addition, accidental or deliberate poisoning with drugs, as well as alcohol intoxication are common.

In these cases, first aid consists of the following steps:

Flush the affected stomach. To do this, make him drink several glasses of salted water (for 1 liter - 10 g of salt and 5 g of soda). After 2-3 glasses, induce vomiting of the victim. Repeat these steps until the vomit is clean.
Gastric lavage is only possible if the victim is conscious.
Dissolve 10–20 tablets of activated charcoal in a glass of water, let the victim drink it.
Wait for the arrival of specialists.

1. Measures to assess the situation and ensure a safe environment for first aid:

1) the definition of threats to their own lives and health;

2) determination of threatening factors for the life and health of the victim;

3) the elimination of threats to life and health;

4) the cessation of damaging factors on the victim;

5) estimate the number of victims;

6) removing the victim from the vehicle or other hard-to-reach places;

7) the movement of the victim.

Call an ambulance, other special services whose employees are required to provide first aid.

Determination of the presence of consciousness in the victim.

4. Measures to restore the airway and determine the signs of life in the victim:

2) extension of the lower jaw;

3) determination of the presence of breathing through hearing, vision and touch;

4) determining the presence of blood circulation, checking the pulse on the main arteries.

5. Activities for cardiopulmonary resuscitation before the onset of signs of life:

1) pressure on the sternum of the victim with his hands;

2) mouth-to-mouth artificial respiration;

3) artificial respiration "Mouth to nose";

4) artificial respiration using a device for artificial respiration

6. Measures to maintain airway patency:

1) giving a stable lateral position;

3) extension of the lower jaw.

7. Arrangements for a survey of the victim and a temporary stop of external bleeding:

1) a survey of the victim for bleeding;

2) digital pressure of the artery;

3) applying a tourniquet;

4) maximum flexion of the limb in the joint;

5) direct pressure on the wound;

6) the imposition of a pressure bandage.

8. Arrangements for a detailed examination of the victim in order to identify signs of injury, poisoning and other conditions that threaten his life and health, and to provide first aid in case of detection of these conditions:

1-6) examination of the head, neck, chest, back, abdomen, pelvis, limbs;

7) applying dressings for injuries of various areas of the body, including occlusal (sealing) for injuring the chest;

8) immobilization (using improvised means, autoimmobilization, using medical devices);

9) fixation of the cervical spine (manually, improvised means, using medical devices);

10) the cessation of exposure to hazardous chemicals on the victim (washing the stomach by taking water and inducing vomiting, removing from the damaged surface and washing the damaged surface with running water);

11) local cooling during injuries, thermal burns and other effects of high temperatures or thermal radiation;

12) thermal insulation during frostbite and other effects of low temperatures.

Giving the victim an optimal body position.

Monitoring the condition of the victim (consciousness, breathing, blood circulation) and the provision of psychological support.

Transfer of the injured ambulance crew to other special services whose employees are required to provide first aid in accordance with federal law or with a special rule.

General principles of first aid reflect the most important requirements that should be considered when providing first aid to victims in various situations:

First aid measures should be determined by the actual situation;

It is necessary to ensure the safety of those who provide first aid;

It is necessary to use improvised means to provide the maximum possible first aid;

First aid should be combined with simultaneous preparation for evacuation;

It is necessary to constantly monitor the victims before and during their evacuation to medical facilities.

First Aid List in a specific setting depends on the damaging factorsacting on a person and damage.

In catastrophes with a predominance of mechanical (dynamic) damaging factors first aid measures include:

ª recovery of victims from the rubble, destroyed shelters, shelters;

ª finding out if the victim is alive;

ª giving a physiologically favorable position to the victim;

ª restoration of airway patency and mechanical ventilation;

ª closed (indirect) heart massage;

ª temporary stop external bleeding with all available methods;

ª the introduction of painkillers using a syringe tube;

ª applying an aseptic dressing to a wound or burn surface and an occlusive dressing for penetrating wounds of the chest using a sterile rubberized shell of an individual dressing pack (PPI);

ª immobilization of limbs in case of bone fractures and crushing of soft tissues;

ª fixing the body to the shield or board in case of spinal injuries;

ª giving plenty of warm drink (in the absence of vomiting and trauma to the abdominal organs) with the addition of 1 tsp of baking soda and 1 tsp of salt in 1 liter of liquid.

In the lesions with the predominance of the action of thermal factors In addition to the above activities,

ª extinguishing burning clothes;

ª application of an aseptic dressing;

ª covering the victim with a clean sheet;

ª warming the victim and giving painkillers.

In case of disasters with the release into the environment of AOKHV in first aid order:

ª protection of respiratory organs, eyesight and skin from the direct effects of AOHB through the use of personal protective equipment, cotton-gauze dressings, covering your face with wet gauze, a scarf, a towel, etc .;

ª introduction of an antidote;

ª speedy removal of the affected from the infection zone;

ª partial sanitization of exposed parts of the body (washing with running water and soap, 2% solution of baking soda);

ª partial special processing of clothes, shoes, protective equipment, etc .;

ª removal of respiratory protection;

ª giving optimal body position;

ª providing access to fresh air;

ª when AOHB enters the stomach - a plentiful drink for the purpose of washing the stomach with a non-probe method, sorbents;

ª monitoring of victims before the arrival of medical care.

In case of radiation accidents first aid includes:

ª measures to stop the flow of radioactive substances into the body with inhaled air, water, food (use of personal protective equipment, cotton gauze dressings, etc.);

ª termination of external exposure of the affected by their quickest evacuation outside the territory contaminated with radioactive substances or in collective protective equipment;

ª the use of means of prevention and relief of the primary reaction from the first-aid kit of individual AI-2;

ª partial sanitization of exposed skin;

ª removal of radioactive substances from clothes and shoes.

With massive infectious diseases in the foci of bacteriological (biological) infection, first aid includes:

ª the use of improvised and (or) time personal protective equipment;

ª active detection and isolation of feverish patients suspected of an infectious disease;

ª use of emergency non-specific prophylaxis;

ª partial or complete special processing.

When providing first aid, the means included in the individual first-aid kit, sanitary bag: painkillers, radioprotectors, antidotes, antibiotics, etc. will be used.

First aid - A set of medical measures aimed at maintaining the vital functions of the affected body, preventing serious complications and preparing for evacuation.

It turns out to be paramedical personnel - paramedics, obstetricians, nurses using time sheets of property.

Her appointment :

ª the fight against life-threatening disorders (asphyxia, bleeding, shock, etc.);

ª protection of wounds from secondary infection ;

ª monitoring the accuracy of first aid and correcting its shortcomings;

ª prevention of subsequent complications;

ª preparation of the affected for further evacuation.

The optimal period for the provision of first-aid medical care is the first 20-30 minutes after receiving the lesion (Platinum half an hour). Real time of arrival of the ambulance brigade of the medical assistant or object formation (medical unit, medical center).

In addition to first aid, first aid includes:

Ø - ensuring the personal safety of personnel;

Ø - conducting an initial examination of the victim;

Ø - control of the correctness of first aid;

Ø - suction of blood, mucus and vomit in their upper respiratory tract using a manual aspirator;

Ø - introduction of the oral, nasal duct, (S-shaped tube, combi tube);

Ø - cricothyroid puncture with persistent obstruction of the upper respiratory tract;

Ø - conicotomy performed by an experienced paramedic using a conicotome;

Ø - artificial ventilation of the lungs with a manual breathing apparatus of the "AMBU" type;

Ø - conducting an indirect heart massage;

Ø - control of stopping external bleeding, additional use of personnel;

Ø - venous access using a peripheral catheter (diameter - not less than 1.0 mm);

Ø - conducting adequate infusion therapy with crystalloid solutions;

Ø - the introduction of painkillers and cardiovascular drugs;

Ø - the introduction and ingestion of antibiotics, anti-inflammatory, sedatives, anticonvulsants and antiemetics;

Ø - carrying out infusion and detoxification therapy with severe hemodynamic disorders and intoxications;

Ø - reception of sorbents, antidotes, etc .;

Ø - respiratory support;

Ø - control of dressings and, if necessary, their correction;

Ø - improvement of transport immobilization;

Ø - warming the victims;

Ø - upon receipt of victims from foci that are dangerous to others (radiation, chemical, biological) - decontamination (partial sanitation).

First aid - a complex of treatment and preventive measures carried out by doctors of ambulance crews, medical and nursing teams and general practitioners at the first stage of medical evacuation in order to eliminate the effects of the lesion directly threatening the life of the affected person, preventing the development of dangerous complications (asphyxia, shock, wound infection) or reducing their severity and preparing the affected for further evacuation.

The optimal time for first aid is 30 minutes - 1 hour (Golden hour of disaster medicine) after receiving a lesion. The provision of this type of assistance is necessarily carried out simultaneously with medical sorting.

Upon admission to the prehospital stage of a significant number of those affected, a situation is created where it is not possible to timely (within the acceptable time frame) provide all those in need with first aid in full. Given these circumstances, the first medical care activities are divided according to the urgency of rendering into two groups:

Ø urgent events ;

Ø events that may be delayed or rendered in the next step .

Urgent measures include activities that must be performed at the first stage of medical evacuation, where first aid is provided. Failure to do so will result in a severe death or a high probability of a serious complication.

Urgent Activities:

Ø elimination of all types of asphyxia (suction of mucus, blood and vomit from the upper respiratory tract, tracheo - and conicotomies, insertion of the duct, flashing and fixing of the tongue, cutting off or suturing hanging flaps of the soft palate and lateral pharynx, conicotomy or tracheostomy according to indications, application occlusal dressing with open pneumothorax, puncture of the pleural cavity or thoracocentesis with intense pneumothorax, mechanical ventilation);

Ø temporary stop of external bleeding (applying a clamp to a bleeding vessel, flashing the vessel in the wound, tight wound tamponade);

Ø complex of anti-shock measures (blood transfusion, novocaine blockade, the introduction of painkillers and cardiovascular drugs);

Ø cutting off a segment of a limb hanging on a flap of soft tissues with incomplete detachments;

Ø catheterization (capillary puncture) of the bladder with urinary retention;

Ø carrying out decontamination measures aimed at eliminating the desorption of toxic substances from clothes and allowing to remove the gas mask from the affected ones coming from the focus of chemical damage;

Ø the introduction of antidotes, the use of anticonvulsants, bronchodilators and antiemetics;

Ø degassing (decontamination) of the wound when contaminated with persistent chemical (radioactive) substances with changing dressings;

Ø probe gastric lavage in case chemical (radioactive) substances enter the stomach;

Ø use of antitoxic serum for poisoning with bacterial toxins and non-specific prophylaxis of infectious diseases;

Ø tetanus prophylaxis for open injuries and burns;

Ø analgesia;

Ø transport immobilization by service means.

Delayed events:

Ø elimination of the shortcomings of the first medical and first aid (correction of dressings, improvement of transport immobilization) not threatening the development of shock;

Ø novocaine blockade in case of moderate injuries without shock;

Ø antibiotic injections;

Ø administration of tranquilizers and antipsychotics;

Ø the appointment of various symptomatic agents in conditions that do not pose a threat to the life of the affected person.

Reducing the volume of first aid is carried out due to the refusal to carry out activities of the second group.

In emergency situations, when there is a massive amount of sanitary losses and when the stage of medical evacuation, intended for first aid, is overfilled, at this stage the assistance will be provided in the amount of pre-medical.

Depending on the actual conditions of the situation and the capabilities of the medical staff, in some cases, at the first stage of medical evacuation, the provision of first medical aid can be combined with the use of qualified medical care.

Qualified Medical Assistance - A set of treatment and preventive measures aimed at eliminating the severe, life-threatening consequences of injuries, injuries and diseases, preventing the development of probable complications and preparing for the intended evacuation.

It turns out at the second stage (hospital) by specialist doctors of a wide profile - surgeons, therapists (respectively qualified surgical and qualified therapeutic medical care ) in medical organizations and institutions with the aim of saving life affected, eliminating the effects of lesions, preventing the development of complications, combating already developed complications.

Emergency qualified assistance It turns out, as a rule, with lesions that pose a direct threat to life in the coming hours. With their untimely implementation, the probability of death or extremely serious complications significantly increases. When restoring the vital functions of the affected, emergency surgery is the main resuscitation measure and is carried out immediately without preoperative preparation. Operations are preceded only by intubation of the trachea, the connection of a ventilator and catheterization of the subclavian or femoral vein.

Allocate three volumes qualified surgical care .

1. For health reasons - carried out with a large flow of victims; it includes only emergency operations and anti-shock measures.

2. Abbreviated - includes the implementation of emergency and urgent surgical interventions, anti-shock measures. In catastrophes with mass casualties, as well as in a special period (local wars and armed conflicts), the reduced amount of assistance is the most typical.

3. Full - includes the implementation of emergency, urgent and deferred operations, anti-shock measures. Its implementation is an exception, it is carried out only with a significant delay in evacuation.

Events qualified therapeutic assistance divided into urgent events and activities that may be delayed.

Specialized Medical Assistance- a set of treatment and preventive measures performed by specialist doctors in specialized medical institutions or departments with special treatment and diagnostic equipment and equipment. Profiling medical facilities can be done by giving them specialized medical teamswith appropriate medical equipment.

In general terms, the first 3 types of medical care ( first, first aid, first medical ) decide similar tasks , namely:

ª elimination of phenomena that threaten the life of the affected or sick at the moment;

ª carrying out activities that eliminate and reduce the possibility of the occurrence (development) of serious complications;

ª the implementation of measures to ensure the evacuation of the affected and sick without significant deterioration of their condition.

However, differences in the qualifications of the personnel providing these types of medical care, equipment used and working conditions determine significant differences in the list of activities.

Within the framework of each type of medical care, in accordance with specific medical and tactical conditions, a specific list of medical and preventive measures is envisaged. This list is volume of medical care - a set of medical and preventive measures of a certain type of medical care performed at the stages of medical evacuation or in medical institutions in accordance with the emerging general and medical situation .

In this way, volume of medical care and in the lesion focus, and at the stages of medical evacuation is not constant and may vary depending on the situation.

If in specific conditions all the measures of this type of medical care are performed, then it is considered that volume of medical care full.

If, with respect to a certain group of people affected in the lesion focus and at the stage of medical evacuation, it is not possible to carry out certain medical and preventive measures, provides for the refusal to carry out activities that may be delayed, and usually includes the implementation of emergency measures, then volume of medical care called abridged.

Depending on the type and scale of the emergency, the number of people affected and the nature of the lesions they have, the availability of medical forces and facilities, the state of territorial and departmental health care, the removal of hospital-type medical facilities from the emergency area that are capable of performing the full amount of specialized medical care and their capabilities, various can be taken medical care options affected by emergency:

Provision of only first or pre-medical medical care to the affected person before their evacuation to hospital-type medical facilities;

Providing affected before evacuation to hospital-type medical facilities and first medical aid;

Providing affected people before their evacuation to medical facilities of the hospital type and emergency measures of qualified medical care.

Before the evacuation of the affected to hospital facilities in all cases must be performed measures to eliminate life-threatening conditions at the moment, prevent various serious complications and ensure transportation without significantly worsening their condition .

Announcement of events of St. Petersburg State Budgetary Institution "Center for Physical Culture, Sports and Health of the Admiralteysky District of St. Petersburg" from November 7 to 20

The audit organization in carrying out the above activities should be guided by the rules (standards) of audit activity.

MINISTRY OF HEALTH AND SOCIAL DEVELOPMENT OF THE RUSSIAN FEDERATION

ORDER

On approval of the list of conditions in which first aid is provided and the list of first aid measures

Document as amended:
(Russian newspaper, N 303, 12/31/2012).
____________________________________________________________________

In accordance with Article 31 of the Federal Law of November 21, 2011 N 323-ФЗ "On the Basics of Protecting the Health of Citizens in the Russian Federation" (Collected Legislation of the Russian Federation, 2011, N 48, Article 6724)

i order:

1. Approve:

a list of conditions in which first aid is provided, according to Appendix N 1;

list of first aid measures in accordance with Appendix N 2.

2. To invalidate the order of the Ministry of Health and Social Development of the Russian Federation of May 17, 2010 N 353н "On First Aid" (registered by the Ministry of Justice of the Russian Federation on July 12, 2010 N 17768).

The Minister
T. Golikova

Registered
in the Ministry of Justice
Russian Federation
May 16, 2012
registration N 24183

Appendix N 1. List of conditions in which first aid is provided

Appendix N 1

________________
* In accordance with Part 1 of Article 31 of the Federal Law of November 21, 2011 N 323-ФЗ "On the Basics of Protecting the Health of Citizens in the Russian Federation" (Collection of Legislation of the Russian Federation, 2011, N 48, Article 6724) (hereinafter - the Federal Law of November 21, 2011 N 323-ФЗ) first aid is provided to citizens in the event of accidents, injuries, poisoning and other conditions and diseases that threaten their life and health, by persons obliged to provide first aid in accordance with federal law or with special the rule and have the appropriate training, including members of the Interior of the Russian Federation, employees, military personnel and employees of the State Fire Service, rescue workers rescue units and emergency services. In accordance with Part 4 of Article 31 of the Federal Law of November 21, 2011 N 323-ФЗ, drivers of vehicles and other persons are entitled to provide first aid if they have the appropriate training and (or) skills.

1. Lack of consciousness.

2. Stop breathing and blood circulation.

3. External bleeding.

4. Foreign bodies of the upper respiratory tract.

5. Injuries to various areas of the body.

6. Burns, effects of exposure to high temperatures, thermal radiation.

7. Frostbite and other effects of exposure to low temperatures.

8. Poisoning.

Appendix N 2. List of first aid measures

Appendix N 2

1. Measures to assess the situation and ensure a safe environment for first aid:

1) the definition of threats to their own lives and health;

2) determination of threatening factors for the life and health of the victim;

3) the elimination of threats to life and health;

4) the cessation of damaging factors on the victim;

5) estimate the number of victims;

6) removing the victim from the vehicle or other hard-to-reach places;

7) the movement of the victim.

2. Call ambulance, other special services whose employees are required to provide first aid in accordance with federal law or with a special rule.

3. Determining the presence of consciousness in the victim.

4. Measures to restore the airway and determine the signs of life in the victim:

2) extension of the lower jaw;

3) determination of the presence of breathing through hearing, vision and touch;

4) determining the presence of blood circulation, checking the pulse on the main arteries.

5. Activities for cardiopulmonary resuscitation before the signs of life:

1) pressure on the sternum of the victim with his hands;

2) mouth-to-mouth artificial respiration;

3) artificial respiration "Mouth to nose";

4) artificial respiration using a device for artificial respiration *.
________________

by order of the Ministry of Health of Russia of November 7, 2012 N 586н.

6. Measures to maintain airway patency:

1) giving a stable lateral position;

3) extension of the lower jaw.

7. Measures for a survey of the victim and a temporary stop of external bleeding:

1) a survey of the victim for bleeding;

2) digital pressure of the artery;

3) applying a tourniquet;

4) maximum flexion of the limb in the joint;

5) direct pressure on the wound;

6) the imposition of a pressure bandage.

1) conducting a head examination;

2) examination of the neck;

3) examination of the chest;

4) examination of the back;

5) examination of the abdomen and pelvis;

6) examination of the limbs;

7) applying dressings for injuries of various areas of the body, including occlusal (sealing) for injuring the chest;

8) immobilization (using improvised means, autoimmobilization, using medical devices *);
________________
* In accordance with the approved requirements for completing medical products of first-aid kits (packs, sets, kits) for first aid.
(Footnote as amended, entered into force on January 11, 2013 by order of the Ministry of Health of Russia of November 7, 2012 N 586н.

9) fixation of the cervical spine (manually, improvised means, using medical devices *);
________________
* In accordance with the approved requirements for completing medical products of first-aid kits (packs, sets, kits) for first aid.
(Footnote as amended, entered into force on January 11, 2013 by order of the Ministry of Health of Russia of November 7, 2012 N 586н.

11) local cooling during injuries, thermal burns and other effects of high temperatures or thermal radiation;

12) thermal insulation during frostbite and other effects of low temperatures.

9. Giving the victim an optimal body position.

10. Monitoring the condition of the victim (consciousness, breathing, blood circulation) and the provision of psychological support.

11. Transfer of the injured ambulance crew to other special services whose employees are required to provide first aid in accordance with federal law or with a special rule.

Edition of the document taking into account
changes and additions prepared
JSC "Codex"