Measures to assess the situation of first aid. Sidorov P.I.

HIGHER PROFESSIONAL EDUCATION

"KRASNOYARSK STATE MEDICAL UNIVERSITY"

NAMED AFTER PROFESSOR V.F. VOYNO-YASENETSKY "

MINISTRIES OF HEALTH AND SOCIAL DEVELOPMENT

RUSSIAN FEDERATION

PHARMACEUTICAL COLLEGE

Specialty Pharmacy

Qualification Pharmacist

TO THEORETICAL ACTIVITIES

Approved at the meeting of the CMC

Protocol No. …………….

"___" ____________ 2012

Chairman of the CMC "General Professional Disciplines"

………… Donguzova E.E.

Compiled by:

………… Shumkova V.A.

Krasnoyarsk

Lecture number 1

Topic “The concept of first aid.

Aseptic and antiseptic. "

1. General concepts of first aid. Types of first aid.

2. Activities that includes first aid

3. General principles of first aid.

4. Identification of signs of life and signs of death.

5. Basic concepts of aseptic and antiseptic.

6. Chemical antiseptics. Biological antiseptics.

7. Sterilization.

General concepts of first aid.

Types of first aid.

First aid   - a set of emergency medical measures taken suddenly to a sick or injured person at the scene of the incident and during the period of its delivery to a medical facility.

The primary goal of first aid: assisting a person until qualified assistance arrives.

Distinguish the following types of first aid:

1) the first medical unskilled assistance (it is provided by a non-medical worker, often without the necessary funds and medicines);

2) the first medical qualified (pre-medical) help provided by a medical worker (not a doctor);

3) the first medical aid provided by a doctor who has at his disposal the necessary medicines and tools.

Activities that includes first aid.

The first medical (pre-medical) help includes 3 groups of events:

1) an immediate cessation of the influence of external damaging factors and its removal from the unfavorable conditions in which it has fallen (extraction from water, removal from a gas-polluted room, etc.).

2) First aid to the injured depending on the nature and type of injury, accident or sudden illness.

3) Calling medical specialists and organizing the speedy delivery (transportation) of a sick or injured person to a medical institution.

The activities of the first group are first aid in general. She is often provided in the manner of mutual and self-help.

The second group of activities is medical care. It can be provided by medical workers or persons who have studied the main signs of damage and special first-aid methods.

Of great importance is the quickest delivery of the victim to a medical institution. Transporting a sick or injured person should be quick and correct, i.e. in the safest position for him, in accordance with the nature of the disease or type of injury.

First aid measures (scope) also include: examining the scene of the accident, evacuation from the danger zone, temporarily stopping bleeding, preventing and controlling shock, resuscitation, applying a sterile dressing to a wound, transport immobilization, etc.

Everyone should know how to provide first aid   one who needs it. This is not about a full medical understanding of various difficulties associated with various types of diseases.

But with the most common types of symptoms of diseases, injuries, burns and other injuries - you just need to be able to provide first aid.

First aid

We bring to your attention a brief guide from the field. With the help of simple instructions and graphic images, it will be easy for you to remember how to help someone who is on the verge of life and death.

Of course, after one reading, it will be difficult for you to remember all the nuances. After all, first aid has its own specifics.

However, re-reading this post at least once in a certain period of time, we can confidently say that you will be a trained lifeguard in all cases described below.

If you are not reading this article for educational purposes, but in order to use the tips in specific circumstances, use the content to quickly jump to the desired item.

First aid

First aid is the only way you can help those in need. We, as in all textbooks, cite standard cases as examples.

An educated individual simply needs to know these rules.

  Bleeding

Common bleeding issues

If a person looks pale, feels chills and dizziness, what is it?

This means that he is plunged into a state of shock. Urgently call an ambulance crew.

Is it possible to get some kind of infection in contact with the patient’s blood?

If possible, it is better to avoid such contact. It is advisable to use medical gloves, plastic bags or ask the victim, if possible, to heal himself a wound.

Do I need to wash the wound?

You can rinse with minor cuts and abrasions. In the case of severe bleeding, this should not be done, since by washing away the clotted blood, you will only increase the bleeding.

What to do if there is a foreign object inside the wound?

Do not remove it from the wound, as this will aggravate the situation. Instead, put a tight bandage around the subject.

  Fractures

  Dislocations and sprains

How to identify dislocations or sprains? First, the patient feels pain. Secondly, there is swelling (bruising) around the joint or along the muscle. If the joint is injured, it will be difficult to make movements.

Rest and convince the patient not to move the injured part. Do not try to straighten it yourself either.

Apply an ice pack wrapped in a towel to the injured area for no more than 20 minutes.

If necessary, give the victim an anesthetic.

Contact a trauma center to get an x-ray. If the patient is not able to walk at all, or if the pain is too acute, call for medical help.

  First aid for burns

First, cool the burned area under a stream of cold water for at least 10 minutes.

Always seek medical attention if a child is injured in a burn. Moreover, if the burnt area is covered with blisters or with the naked eye, internal tissues are visible.

Do not touch anything that adheres to the burned area. In no case do not lubricate the burn with oil, as it retains heat, and this will only do harm.

Do not use ice to cool the burn: it can damage the skin.

  Airway obstruction

  Heart attack

How to identify a heart attack? First of all, it is accompanied by pressing pain behind the sternum. Point discomfort is felt in the arms, neck, jaw, back or stomach.

Breathing becomes frequent and intermittent, and the heartbeat is rapid and not rhythmic. In addition, there is a weak and rapid pulse in the limbs, cold and profuse sweat, nausea, and sometimes vomiting.

Urgently call an ambulance, as the bill goes on minutes. If possible, measure blood pressure, heart rate, and heart rate.

If the patient has no allergies, give him aspirin. The tablet needs to be chewed. However, before doing this, make sure that the patient does not have any medications prescribed by your doctor.

Provide the patient with the most comfortable position. It is important to calm and reassure him while waiting for a doctor, since such attacks are sometimes accompanied by a panic feeling.

  Stroke

Identifying the symptoms of a stroke is easy enough. Sudden weakness or numbness in any limb, impaired speech and its understanding, dizziness, impaired coordination of movements, sharp headache or fainting - all this indicates a likely stroke.

Lay the patient on high pillows, slipping them under the shoulders, shoulder blades and head, and call an ambulance.

Provide fresh air in the room by opening a window. Open your shirt collar, loosen a tight belt, and remove any tight clothing. Then measure the pressure.

If there are signs of vomiting reflexes - turn the patient's head on its side. Try to calmly talk and encourage him while waiting for the doctor.

  Heatstroke

Heat stroke is determined by the following symptoms: there is no sweating, sometimes body temperature rises to 40 ° C, hot skin looks pale, blood pressure decreases, and the pulse becomes weak. There may be convulsions, vomiting, diarrhea, and loss of consciousness.

Move the patient to the most cool place, provide an influx of fresh air and call for medical help.

Remove excess and unfasten tight clothing. Wrap your body in a damp and cool cloth. If this is not possible, put towels dipped in cold water on your head, neck and groin.

It is advisable that the patient drink cool mineral or ordinary, slightly salted water.

If necessary, continue to cool the body by applying ice or cold items wrapped in cloth to your wrists, elbows, groin, neck and armpits.

  Hypothermia

As a rule, with hypothermia, a person is pale and cold to the touch. He may not experience trembling, but his respiratory rate is slow and his body temperature is below 35 degrees Celsius.

Call an ambulance and move the patient to a warm room, wrapping him in a blanket. Have a hot drink, but no caffeine or alcohol. Tea is best. Offer junk food.

If you find signs of frostbite, that is, loss of sensitivity, whitening of the skin or tingling, do not rub the affected areas with snow, oil or petroleum jelly.
  This can seriously injure the skin. Just wrap these sections in several layers.

  Head injury

In case of head injuries, you must first stop the blood. Then firmly press a sterile napkin to the wound and hold it with your fingers until the bleeding stops completely. Next, cold is applied to the head.

Call an ambulance and monitor for heart rate, breathing, and pupil response to light. If these signs of life do not exist, immediately begin cardiopulmonary resuscitation ().

After restoring breathing and cardiac activity, give the victim a stable lateral position. Cover and warm it.

  Drowning

What if you see a drowned man? First of all, make sure that nothing is threatening you, and then remove it from the water.

Lay it on your knee with your stomach and let the water naturally out of the airways.

Clean your mouth of foreign objects (mucus, vomit, etc.) and call an ambulance immediately.

Determine the presence of a pulse on the carotid artery, the reaction of the pupils to light and spontaneous breathing. If not, start cardiopulmonary resuscitation.

If signs of life appear, turn the person on his side, cover and warm him.

If there is a suspicion of a fracture of the spine, the drowned man should be pulled out of the water on a board or shield.
  In the absence of a pulse on the carotid artery, it is unacceptable to lose time on removing water from the lungs and stomach.
  Get started right away. They must be carried out, even if the victim stayed under water for more than 20 minutes.

  Bites

The bites of insects and snakes are different, respectively, and first aid for them.

Insect bites

Carefully inspect the bite site. If a sting is found, carefully pull it out. Then attach ice or a cold compress to this place.

If a person has developed an allergy or anaphylactic reaction, call an ambulance.

Snake bites

If a person was bitten by a poisonous snake - immediately call an ambulance. Then inspect the bite site. You can attach ice to it.

If possible, keep the affected part of the body below the heart. Try to reassure the person. Do not let him walk unless this is absolutely necessary.

In no case do not incise the site of the bite, and do not try to suck the poison yourself.
In snake venom poisoning, the following symptoms are characteristic: nausea, vomiting, tingling sensation in the body, shock, coma or paralysis.

You should know that with any movement of the body, the poison begins to penetrate into the tissues of the body much more actively. Therefore, before the arrival of physicians, the patient is strongly recommended maximum rest.

  Loss of consciousness

What is first aid for loss of consciousness? First of all, do not panic.

Turn the patient on his side so that he does not choke on possible vomiting. Next, his head should be thrown back so that the tongue moves forward and does not block the airways.

Call an ambulance. Listen to if the victim is breathing. If not, start cardiopulmonary resuscitation.

  Cardiopulmonary resuscitation

  Artificial respiration

Find out in what order you need to carry out mechanical ventilation.

1. With a circular motion of fingers wrapped in gauze or a scarf, remove mucus, blood, and foreign objects from the victim’s oral cavity.
2. Throw back your head: raise your chin while holding the cervical spine. You should be aware that if you suspect a fracture of the cervical spine, you should not throw your head back.
3. Pinch the patient’s nose with the thumb and forefinger. Then take a deep breath and exhale gently into the victim's mouth. Give 2-3 seconds to passively exhale air. Take a new breath. Repeat the procedure every 5-6 seconds.

If you notice that the patient began to breathe, still continue to blow air with his breath. Continue this until a deep independent breathing is restored.

  Heart massage

Locate the xiphoid process as shown. Determine the compression point two transverse fingers above the xiphoid process, strictly in the center of the vertical axis. Put the base of the palm on the compression point.

  Compression point

Compression is carried out strictly vertically along the line connecting the sternum to the spine. Perform the procedure with the weight of the upper half of your body, doing it smoothly, without sudden movements.

The depth of the punching of the chest should be at least 3-4 cm. Perform about 80-100 pressures per minute.

Alternate 2 “breaths” of mechanical ventilation (mechanical ventilation) with 15 pressures.

Babies are massaged with the palmar surfaces of the second and third fingers. Adolescents - the palm of one hand.

In adults, the emphasis is on the base of the palms, the thumb is directed to the victim’s head or feet. The fingers should be raised and not touching the chest.

During cardiopulmonary resuscitation, monitor for signs of life. This will determine the success of resuscitation.

First aid- This is an extremely important thing in our life. No one knows at what unexpected moment these skills can come in handy.

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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) moving 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. 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) applying 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) 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) carrying out immobilization (with the help of 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.

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.

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 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.

Primary pre-medical care (ambulance) - type of medical care, the activities of which complement first aid. It turns out to be average medical workers (paramedic or nurse) in the lesion focus or in the immediate vicinity of the lesion site using standard medical equipment.

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 is up to 2 hours from the moment of defeat.

Primary (ambulance) pre-medical health care   includes the following events (according to indications):

ª artificial ventilation of the lungs by introducing an S-shaped tube — an air duct or an apparatus of the “AMBU” type;

ª cardiopulmonary resuscitation;

ª infusion of infusion funds;

ª the introduction of painkillers and cardiovascular drugs;

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

ª the introduction of sorbents, antidotes, etc .;

ª checking the correctness of the application of tourniquets, dressings and tires and, if necessary, correcting and supplementing them using time cards;

ª application of aseptic and occlusive dressings.

Medical personnel providing first aid, in addition, monitors the correctness of first aid.

Primary (ambulance) medical care - type of medical care, including a set of medical and preventive measures performed by doctors of ambulance crews, medical and nursing teams and general practitioners, usually, at the prehospital stage of medical evacuation   (a medical care center deployed by medical and nursing teams, in an outpatient clinic, a facility health center or other nearby healthcare facility).

Her main tasks - dealing with life-threatening injuries   (asphyxiation, bleeding, shock, cramps, etc.), complication prevention   (in particular, wound infection, etc.) and preparation of the affected for further evacuation. The optimal time for rendering assistance according to urgent indications is 3 hours, in full - 6 hours (for injuries and burns).

Upon receipt of a significant number of affected people at the stage of medical evacuation, 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 this situation, events primary (emergency) medical health care   divided into 2 groups:

ª urgent events;

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

For urgent eventsrelate:

Ø asphyxiation :

Suction of mucus, vomit and blood from the upper respiratory tract;

Introduction of the duct;

Tongue fixation;

Clipping or hemming of the hanging flaps of the soft palate and lateral pharynx;

Tracheostomy according to indications;

Artificial ventilation of the lungs (IVL);

Applying an occlusive dressing with open pneumothorax;

Puncture of the pleural cavity or thoracocentesis with intense pneumothorax;

Ø stop external bleeding :

Stitching a vessel in a wound or applying a clamp to a bleeding vessel;

Tight tamponade of the wound and the application of a pressure bandage;

Control the correctness and appropriateness of applying a tourniquet;

Applying a tourniquet if indicated;

Ø anti-shock measures :

Transfusion of blood substitutes with significant bleeding;

Carrying out novocaine blockades;

The introduction of painkillers and cardiovascular agents;

Ø cutting off a limb hanging on a soft tissue flap ;

Ø catheterization or capillary puncture of the bladder with urinary retention;

Ø carrying out activities aimed at eliminating the desorption of chemicals 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 wound degassing when contaminated with persistent chemicals;

Ø gastric lavage with a probe in case of chemical or radioactive substances entering the stomach;

Ø the use of antitoxic serum for poisoning with bacterial toxins and non-specific prevention of infectious diseases .

For events that may be delayed,relate:

Ø elimination of the shortcomings of the first and primary pre-medical health care (correction of dressings, improvement of transport immobilization);

Ø dressing change due to contamination of the wound with radioactive substances;

Ø novocaine blockade in case of moderate injuries;

Ø antibiotic injections and tetanus prophylaxis for open injuries and burns;

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

Specialized Medical Assistance- The final form of medical care is comprehensive. She is being provided narrow specialists   (neurosurgeons, traumatologists, ophthalmologists, etc.) who have special diagnostic and treatment equipment in specialized medical institutions. Profiling medical facilities   can be done by giving them specialized medical teamswith appropriate medical equipment. The optimal period for the provision of specialized medical care is 24-72 hours from the moment of defeat.

In general terms, the first 3 types of medical care ( first, primary (ambulance) pre-medical, medical medical and sanitary ) 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:

Providing only the first or primary (emergency) pre-medical health care to the affected before evacuation to hospital-type medical facilities;

Providing affected people before their evacuation to medical facilities of the hospital type and primary (emergency) medical health care;

Providing affected people before their evacuation to hospital-type medical facilities and emergency 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 .

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 station, where the affected are allocated, who need sanitary treatment (with infection of the skin and clothing of RV that exceeds 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 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), as much as possible reducing 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:

1. To be convinced that at first aid nothing threatens you and you do not endanger yourself.
2. Ensure the safety of the victim and others (for example, remove the victim from a burning vehicle).
3. 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.
4. Call specialists: from the city - 03 (ambulance) or 01 (rescuers).
5. Provide emergency first aid. Depending on the situation, this may be:
   • restoration of airway patency;
   • cardiopulmonary resuscitation;
   • stopping bleeding and other events.
6. 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

1. 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.
2. 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!

3. 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.

4. 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

1. Place the victim on a flat hard surface. On the bed and other soft surfaces, chest compression is prohibited.
2. Determine the location of the affected xiphoid process. The xiphoid process is the shortest and narrowest part of the sternum, its end.
3. Measure 2–4 cm upwards from the xiphoid process - this is the compression point.
4. 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.
5. 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.

1. Stand behind the victim.
2. Wrap his arms around him, locking them into a lock, just above the navel, under the edge of the arch.
3. 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.

4. 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

1. Place a tourniquet on clothing or a soft lining just above the wound.
2. Tighten the tourniquet and check the pulsation of the vessels: bleeding should stop, and the skin below the tourniquet should turn pale.
3. Put a bandage on the wound.
4. 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

1. Assess the severity of the condition of the victim, determine the location of the fracture.
2. If bleeding occurs, stop it.
3. 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!

4. 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.
5. 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 ensure an influx of fresh air (unfasten clothing, loosen 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

1. 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.

2. Put the victim on his knee so that his head is below.
3. Clean the oral cavity of foreign bodies (mucus, vomit, algae).
4. Check for signs of life.
5. If there is no pulse or breathing, immediately start mechanical ventilation and indirect heart massage.
6. After restoring breathing and cardiac activity, lay the victim on one side, cover him and provide comfort until the doctors arrive.

In the summer, sunstroke is also a danger. 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

1. Put the victim in heat.
2. Remove frozen or wet clothes from it.
3. Do not rub the victim with snow or cloth - this will only injure your skin.
4. Wrap a frostbitten area of \u200b\u200bthe body.
5. 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 advised 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:

1. 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.

2. Dissolve 10–20 tablets of activated charcoal in a glass of water, let the victim drink it.
3. Wait for the arrival of specialists.