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First aid. Presentation for the lesson "providing first aid" Presentation on the topic of primary care
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First aid
First aid is a set of simple medical measures using medicines performed by a medical professional (doctor, paramedic, nurse (nurse) or, as in some countries, paramedic) or a person who does not have a medical education, but who has the skills to provide first aid , at the site of injury and / or the occurrence of any acute or exacerbation of a chronic disease in the order of self-help and mutual assistance, as well as participants in emergency rescue operations using standard and improvised means. The main purpose of first aid is to help a person injured or suffering from a sudden onset of illness until qualified medical assistance arrives.
First aid for: Poisoning Bleeding Fainting Burns Frostbite Electrical injury Convulsions Sudden death Dislocations and fractures Sunstroke Heatstroke Drowning
Poisoning: Poisoning or intoxication develops as a result of exposure to various toxic substances on the body. Most often, these substances are used in everyday life and enter the human body. Symptoms of poisoning will depend on the nature of the chemical (alkalis, acids, food toxins) and how it enters the body (through the mouth, skin, blood). Depending on this, the algorithm for providing first aid to the victim will be determined. Signs of poisoning are: nausea, vomiting, pain in the stomach and intestines, diarrhea, dysfunction of the cardiovascular system, psychomotor agitation or lethargy. The patient may experience tachycardia, pallor of the skin, possibly a state of collapse. In the absence of timely assistance, the patient may experience renal failure, which is manifested by a delay or complete cessation of urination. In case of poisoning with corrosive substances (acids, alkalis), burns can be seen on the mucous membrane of the mouth and lips. In case of poisoning with poisons acting on the central nervous system, respiratory failure is possible up to its complete cessation.
First aid for poisoning: Gastric lavage. Regardless of the nature of the chemical or toxic substance, its quantity and time of entry into the body, assistance should begin with gastric lavage with a large amount (3-4 liters) of water at room temperature to clean lavage water. To do this, you must ask the patient to drink as much lukewarm, slightly salty water as possible at one time and induce vomiting by pressing your fingers on the root of the tongue. You must repeat this manipulation 2-3 times, after which give the patient 2-3 tablespoons of mashed activated charcoal and a laxative. If you know that your patient has been poisoned by acid, in no case should you try to neutralize the effect of these substances with alkali (for example, soda solution) and vice versa. Rapidly released gases can cause a rupture in the wall of the stomach and the contents will pour into the abdominal cavity.
Bleeding. Arterial venous
Signs of arterial bleeding: When an artery is damaged, blood is bright scarlet and spurts from the wound. Given that arterial blood flows from the heart to the periphery, bleeding can be stopped by pinching the damaged vessel above the injury site. You can clamp the artery only by pressing it against the bone.
Help with arterial bleeding: A tourniquet can be applied for no more than 2 hours in summer and 1 hour in winter, so a note must be placed under the tourniquet, which will indicate the time the tourniquet is applied. Finger pressure. For an emergency stop of bleeding, it is necessary to press the artery against the bone with your fingers or, if it is the femoral artery, with your fist. However, you will not be able to hold your fingers with such effort for a long time, so while you are holding the artery with your fingers, someone urgently needs to find a rubber arterial tourniquet, gauze wipes and cotton wool. Application of an arterial tourniquet. At the site of finger pressing, it is necessary to apply several rounds of an arterial tourniquet, placing gauze napkins and cotton wool under it. The correct application of the tourniquet is evidenced by the cessation of bleeding from the wound (after the first round of the tightened tourniquet) and the absence of pulsation below the site of the tourniquet. A loose tourniquet will only increase bleeding.
Signs of venous bleeding: If the blood is dark red and comes from a wound in a slow or weakly pulsating jet in time with breathing, your patient has venous bleeding, which is life-threatening due to both rapid blood loss and the possibility of an air embolism. Venous bleeding is possible with rupture of blood vessels in the nasal mucosa or varicose veins of the lower extremities. Nosebleeds caused by taking aspirin, increased blood pressure, may not stop for a long time and require hospitalization of the patient. First aid for any venous bleeding involves the imposition of a pressure bandage, cold and elevated position.
Help with venous bleeding: The imposition of a pressure bandage and exposure to cold. A pressure bandage is applied below the wound as venous blood rises from the peripheral vessels to the heart. Such a pressure bandage consists of several sterile gauze pads or an unwound bandage, on which a tourniquet or elastic bandage is applied. The correctness of the application of the venous tourniquet is evidenced by the stoppage of bleeding, but the preservation of the pulsation below the place of pressing. On top of the bandage in the projection to the source of bleeding, it is good to apply an ice pack or a heating pad filled with cold water. Do not forget that after 30-40 minutes the cold must be removed for 10 minutes in order to restore the general blood flow in this area. If bleeding occurs from a limb, it should be given an elevated position. In case of nosebleeds, the wing of the nose is pressed against its septum, it is good to first introduce a ball of cotton wool moistened with 3% hydrogen peroxide into the nasal passage. Cold is applied to the area of the bridge of the nose or the back of the head for 3-4 minutes with breaks of 3-4 minutes until the bleeding stops. It is not necessary to throw back the head, because the blood will drain down the back of the throat.
Signs of capillary bleeding: Slow bleeding from the entire surface of the wound is an indicator of capillary bleeding. With all the seeming harmlessness of such a wound, stopping such bleeding presents great difficulties if the patient suffers from poor blood clotting (hemophilia).
Help with capillary bleeding: The imposition of a pressure bandage. If your first aid kit has a hemostatic sponge, it should be applied to the wound, and then a pressure bandage should be applied. If there is no such sponge, then several layers of gauze napkins are applied to the wound, which are fixed with a pressure bandage. In any case, if the wound is on a limb, it should be given an elevated position and provided with rest and cold (ice pack).
Fainting. Causes of fainting: Sudden short-term loss of consciousness (fainting) can occur for various reasons. Syncope is based on oxygen starvation of the brain. Loss of consciousness is often preceded by bouts of dizziness, weakness, nausea. The patient falls or slowly sinks to the ground. His face turns pale, the pupils become narrow, but the reaction to light remains alive (when a light source is brought to the eyes, the pupils narrow). Arterial pressure is reduced, the pulse is weak filling. In the horizontal position of the patient, fainting, as a rule, quickly stops, consciousness returns, the cheeks turn pink, the patient takes a deep breath and opens his eyes.
Help with fainting: If possible, lay the patient on his back, lifting his legs. If it is impossible to put the patient down (on the street, in transport), seat him and ask him to lower his head below the knees or to the level of the knees. All tight parts of clothing must be unbuttoned and fresh air must be provided. Rub or spray cold water on the skin of the face and neck. Bring a cotton swab with ammonia to the nose of the patient, rub her temples. It often happens that after a faint, a person is embarrassed by the attention of a large number of people and refuses further help. You should insist that the patient is not left unaccompanied in the near future, because fainting may recur.
Burns. Types of burns: depending on the damaging factor, they are divided into thermal (hot liquid, flame, hot metal), electrical and chemical. According to the depth of the lesion, 4 degrees are distinguished. The area of burns is roughly determined using the rule of nines and the rule of palms. The area of the palm of an adult is about 1% of the area of the body. According to the rule of nines, large parts of the body make up 9 or 18% of the body surface area. For example, the surface of the head and neck, the surface of the hand make up 9% each, the surface of the leg, the front surface of the torso - 18% each. Burns are considered severe if the total damage surface is more than 10%.
Help for burns: Fig. help with chemical burns. Your first step should be aimed at stopping the damaging effect of the thermal agent. Burning clothes must either be torn off or a blanket thrown over them. Then you must cut off (do not take off!) your clothes and throw them off. To quickly cool the skin with thermal burns, it is best to douse it with cold water. Apply dry sterile dressings to burn wounds and urgently hospitalize the patient.
Frostbite. Frostbite occurs at ambient temperatures below 0 °C. Frostbite occurs most frequently in the fingers, somewhat less frequently in the ears, nose, cheeks, and feet. With severe frostbite and cooling of the body, shortness of breath, tachycardia, and a drop in blood pressure are possible. In the initial period of frostbite, the skin of the damaged area is pale, cold, insensitive. The victim feels numb. As you warm up, severe pain appears and visible tissue damage develops, depending on the degree of frostbite: I degree - cyanotic skin, with a purple tint; II degree - skin blisters filled with a clear liquid; III degree - the skin is blue-purple, edema appears, the blisters are filled with bloody fluid, skin necrosis develops; IV degree - necrosis of the skin and underlying tissues to the full depth, down to the bones, a week later - wet or dry gangrene.
Help with frostbite: It is necessary to warm the frostbitten area. Specific methods depend on the situation. Take the victim to the room. If you have the opportunity, warm the frostbitten area in a bath of water, the temperature of which is gradually increased from 36 to 40 ° C over 15 minutes. At the same time, massage the limb from the periphery to the center. After 30 minutes, wipe the skin dry and treat with alcohol, apply dry sterile dressings with a thick layer of cotton wool on the outside. In case of frostbite of the face and ears, rub them with a clean hand or a soft cloth until they turn pink, treat with alcohol and vaseline oil. You can not use snow for grinding. It will cause damage to the surface layer of the skin. It is necessary to warm the patient by drinking hot tea and wrapping him in a blanket. If frostbite is accompanied by blistering and necrosis, be sure to hospitalize the patient.
Electrical injury. Signs of exposure to electric current: Electric current has local and general effects. Locally in the zone of action of the current, a burn occurs without surrounding redness and pain. The general reaction in mild cases is expressed in fright, excitement or lethargy, palpitations, arrhythmias. In severe electrical injury, the functions of the brain, heart, and respiration are disrupted, up to their termination and death.
Help in case of electric shock: Release the victim from the current source - push the electrical wire away from the victim with a dry wooden stick (mop handle, rolling pin), rubber mat or other insulating materials. Remember your own safety measures! If the heartbeat is preserved, and there is no breathing, start artificial ventilation of the lungs (mouth to mouth or mouth to nose). In the absence of a heartbeat, start an indirect heart massage in combination with artificial ventilation of the lungs (2 breaths for 15 shocks). As a rule, you can start the heart by delivering a strong blow to the middle of the sternum and continuing the external heart massage. An indicator of the correct massage of the heart will be pulse shocks on the carotid artery, constriction of the pupils and the appearance of spontaneous breathing.
Seizures. epileptic status. . An epileptic seizure can occur either suddenly or after warning signs. These can be various disturbances of perception (visual, sound, olfactory sensations), palpitations, intestinal peristalsis, speech and mental precursors, etc. The causes of epileptic seizures can be brain injuries, tumors, acute disorders of cerebral circulation, eclampsia of pregnant women. Losing consciousness, the patient falls and lets out a sharp cry. The head is thrown back, trismus develops, the arms are bent, the fingers are clenched into fists, the legs are unbent. The chest freezes in the position of maximum exhalation. Then twitching of arms, legs, tongue begins, which at this time bites, the head periodically turns to the sides. Foam is released from the mouth, involuntary urination, defecation occur. This continues for up to 2 minutes. After that, the patient calms down. His consciousness is absent, the muscles are relaxed, there are automatic movements. Breathing from convulsive becomes quiet, calm. There comes a deep sleep, after half an hour is replaced by a superficial, light, lasting up to several hours.
Help with epileptic convulsions: Outside the walls of the hospital Your help should be, first of all, in preventing injury to the patient. If you managed to notice the harbingers of a seizure, support the patient so that he does not fall on his back, from the full extent of his growth. Try to smoothly lower it to the floor, placing any soft object under your head (jacket, slippers, bag). At the next stage, you should try to unclench his teeth and insert between them (from the side) some hard object wrapped in a cloth (a spoon wrapped in a towel, a bandage folded in half, not unwound, etc.). This will prevent you from biting your tongue. After the end of the seizure, when the patient falls asleep, in no case do not wake him up, he should wake up on his own.
Sudden death. Signs and causes of sudden death: Sudden death is accompanied by the following undeniable signs: 1. Lack of consciousness. 2. Lack of spontaneous breathing. 3. Absence of pulsation in the central arteries (carotid, femoral). 4. Pupil dilation and lack of reaction to light. The causes of sudden death can be: 1. electric shock; 2. heart rhythm disturbances (with coronary heart disease, myocarditis, heart defects); 3. hemorrhage in the brain with aneurysms or atherosclerosis of blood vessels, especially against the background of high blood pressure; 4.massive blood loss due to rupture of an aneurysm of the aorta or other large vessels; 5.anaphylactic shock; 6.asphyxia, entry of a foreign body into the trachea.
Help for sudden death: Resuscitation should begin immediately, and even better - without allowing a complete stop of cardiac activity and breathing. If the cause of death was asphyxia or drowning, free the oral cavity from objects that interfere with breathing. Lay the patient on a hard, flat surface, loosen tight clothing. Stand on the side of the patient and put one palm on the lower third of the sternum - in the center. Place the other hand perpendicular to the back of the first. Start strong pushes with your hands at a frequency of 60 - 70 per minute. In this case, the sternum should be displaced by at least 4-6 cm towards the spine. The effectiveness of the massage is controlled by the passage of the pulse wave through the carotid artery. After 15 compressions, put your mouth through the handkerchief to the patient's mouth, tightly clasping it with your lips and pinching his nose, and make 2 vigorous exhalations. The patient's chest should rise. Then continue the heart massage. If you have an assistant, then he can perform a heart massage (4-5 shocks), and you can perform artificial ventilation of the lungs (2 exhalations). The effectiveness of resuscitation is confirmed by the appearance of independent contractions of the heart (pulse on the carotid artery) and constriction of the pupil. If breathing occurs, resuscitation can be stopped and the patient urgently hospitalized. In the absence of favorable signs, resuscitation is carried out for 30 minutes, after which the heart massage and ventilation of the lungs are stopped.
Dislocations and fractures. Dislocations are called persistent displacement of the articular parts of the articulating bones, accompanied by damage to the articular bag. Signs of dislocation are: 1. change in the shape of the joint; 2. uncharacteristic position of the limb; 3.pain; 4.spring fixation of the limb when trying to give it a physiological position; 5. dysfunction of the joint.
Help with dislocation: Since any, even a slight movement of a limb causes unbearable pain, first of all, you must fix the limb in the position in which it was, providing it with peace at the stage of hospitalization. For this, transport tires, special bandages or any available means are used. To immobilize the upper limb, you can use a scarf, the narrow ends of which are tied through the neck. In case of dislocation of the lower limb, tires or boards are placed under it and from the sides and the limb is bandaged to them. In case of dislocation of the fingers of the hand, the entire hand is immobilized to any flat solid surface. In the area of the joints between the tire and the limb, a layer of cotton wool is laid. In case of dislocation of the lower jaw, a sling-like bandage is brought under it (reminiscent of a bandage worn on the hand by the attendants), the ends of which are tied in a cross way at the back of the head.
Fractures. Fractures are called damage to the bone with a violation of its integrity. Fractures can be closed (without damage to the skin) and open (with damage to the skin). Bone fractures are also possible. The signs of a fracture are: 1. deformation of the limb at the site of the fracture; 2. impossibility of limb movement; 3. limb shortening; 4. crackling of bone fragments under the skin; 5. pain during axial tapping (along the bone); 6. with a fracture of the pelvic bones - the inability to tear off the leg from the surface on which the patient lies. The main signs of bruises and fractures - pain, swelling, hematoma, impossibility of movement - coincide. You should be guided by the sensation of crunching in the area of the fracture and pain during axial load. The last symptom is checked with a slight tapping along the axis of the limb. In this case, there is a sharp pain at the site of the fracture.
Help with fractures: In closed fractures, just like in dislocations, it is necessary to ensure the immobilization of the limb and rest. Use assistive devices. In case of fractures of the hip and shoulder bones, tires are applied, capturing three joints (ankle, knee, femoral and wrist, elbow and shoulder). In other cases, two joints are fixed - above and below the fracture site. In no case should you try to match the bone fragments - this can cause bleeding. With open fractures, you will have two tasks: to stop the bleeding and immobilize the limb. If you see that blood is pouring out in a pulsating stream (arterial bleeding), a tourniquet should be applied above the bleeding site. After stopping the bleeding, apply an aseptic (sterile) bandage to the wound area and immobilize. If the blood is poured out in a uniform stream, apply a pressure aseptic bandage and immobilize.
Sunstroke. Sunstroke - overheating as a result of prolonged exposure to the sun and direct exposure to sunlight on the head. Signs of sunstroke: Increased body temperature. Redness of the skin. Increased perspiration. Increased heart rate and respiration. Headache, weakness. Noise in ears. Nausea, vomiting. loss of consciousness, convulsions. Often skin burns
Help with sunstroke: The victim should immediately lie down with his head elevated in a shady place or a cool room. The victim must be removed from clothing, laid down and wrapped in wet sheets or towels. Place an ice or cold water bladder or cold compress on the victim's head. When overheating, it is important first of all to cool the head, since in this case the central nervous system is especially affected. You can not immerse the victim in cold water, as reflex cardiac arrest is possible. Cooling should be carried out gradually, avoiding large temperature differences. Give the victim a plentiful cold drink (water, tea, coffee, juice). In the presence of burns, it is necessary to lubricate the affected skin with petroleum jelly, do not open the blisters, apply a dry sterile bandage and contact a medical institution.
Heatstroke. Heat stroke is a pathological condition caused by a general sharp overheating of the body as a result of exposure to external thermal factors. Causes - a violation of thermoregulation that occurs under the influence of excess heat from the environment. Overheating of the body is facilitated by conditions that impede heat transfer: High humidity and stillness of the air. Physical stress. Enhanced nutrition. Prolonged wearing of clothing made of synthetic, leather or rubberized fabric in conditions of elevated ambient temperature. Insufficient fluid intake. The symptoms of heat stroke are exactly the same as those of sunstroke.
Drowning. Drowning is a death or terminal condition resulting from the penetration of water (less often other liquids and bulk materials) into the lungs and airways. Causes of Drowning Drowning occurs for a variety of reasons. Often people drown, neglecting elementary precautions (do not swim behind the buoys, do not swim while intoxicated, do not swim in questionable reservoirs, do not swim in a storm). When drowning, the fear factor plays a big role. So, often those who do not know how to swim, who accidentally find themselves in the water at great depths, begin to randomly paddle with their arms and legs, shouting "Save me, I'm drowning!". Thus, they release air from the lungs and inevitably sink into the water. Drowning can also occur among diving enthusiasts. Sometimes it is even more dangerous than simple drowning, especially if you dive alone. Often the drowning of scuba divers is accompanied by the so-called "Decompression Sickness".
Help with drowning:
Types of drownings. There are several types of drowning: true ("aspiration", "wet"), false ("asphyctic", "dry", "spastic"), syncope ("reflex") and mixed. "Wet" drowning - occurs when a large amount of liquid enters the airways and lungs. As a rule, this happens to those people who fight to the last for their lives. Occurs on average in 20% of cases. "Dry" drowning occurs when there is a spasm of the glottis and, as a result, fluid does not penetrate into the lungs. It occurs on average in 35% of cases. Syncopal drowning occurs with reflex cardiac arrest due to vasospasm. In this case, the victim, as a rule, immediately goes to the bottom. It occurs on average in 10% of cases. The mixed type of drowning is characterized by the presence of signs of both "wet" and "dry" types. Occurs on average in 20% of cases. The proverb “The salvation of the drowning is the work of the drowning themselves” is not without meaning. In a critical situation, the most important thing is not to get confused. When you get into the water, you need to soberly assess the situation, calm down and swim to the shore.
Thank you for your attention
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OBJ lesson. modern requirements. Part-1 GBOU secondary school No. 280 named after. M.Yu.Lermontov Admiralteysky district. Prepared by: teacher-organizer of OBZH Soloshenko S.M. St. Petersburg - 2013slide 2
Lesson plan: List of conditions for which first aid is provided; List of first aid measures;
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Order of the Ministry of Health and Social Development of Russia No. 477n of 05/04/2012 On approval of the list of conditions under which first aid is provided, and the list of first aid measures. Registered with the Ministry of Justice of the Russian Federation on May 16, 2012 Registration number 24183
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List of conditions under which first aid is provided 1. Lack of consciousness.
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List of conditions under which first aid is provided 2. Respiratory and circulatory arrest.
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List of conditions under which first aid is provided 3. External bleeding.
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List of conditions under which first aid is provided 4. Foreign bodies of the upper respiratory tract.
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List of conditions under which first aid is provided 5. Injuries to various areas of the body.
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List of conditions in which first aid is provided 6. Burns, effects of exposure to high temperatures, thermal radiation
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List of conditions under which first aid is provided 7. Frostbite and other effects of exposure to low temperatures.
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In accordance with Part 1 of Article 31 of the Federal Law of November 21, 2011 No. 323-FZ “On the Fundamentals of Protecting the Health of Citizens in the Russian Federation”, first aid before medical assistance is provided to citizens in case of accidents, injuries, poisoning and other conditions and diseases, threatening their life and health, by persons who are obliged to provide first aid in accordance with federal law or with a special rule and have appropriate training, including employees of the internal affairs bodies of the Russian Federation, employees, military personnel and employees of the State Fire Service, rescuers of emergency rescue teams and emergency services. In accordance with Part 4 of Article 31 of the Federal Law of November 21, 2011 No. 323-FZ, drivers of vehicles and other persons have the right to provide first aid if they have the appropriate training and (or) skills.
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Measures to assess the situation and ensure safe conditions for first aid: 1) identification of threatening factors for one's own life and health; 2) determination of threatening factors for the life and health of the victim; 3) elimination of threatening factors for life and health; 4) termination of the effect of damaging factors on the victim; 5) assessment of the number of victims; 6) removal of the victim from the vehicle or other hard-to-reach places; 7) movement of the victim.
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2. Calling an ambulance, other special services, whose employees are required to provide first aid in accordance with federal law or with a special rule.
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4. Measures to restore the patency of the respiratory tract and determine the signs of life in the victim: 1) tilting the head back with a chin lift; 2) extension of the lower jaw; 3) determining the presence of breathing with the help of hearing, sight and touch; 4) determination of the presence of blood circulation, checking the pulse on the main arteries.
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5. Measures for conducting cardiopulmonary resuscitation before the appearance of signs of life: 1) pressure with hands on the chest of the victim; 2) artificial respiration "Mouth to mouth"; 3) artificial respiration "Mouth to nose"; 4) artificial respiration using a device for artificial respiration
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6. Measures to maintain airway patency: 1) giving a stable lateral position; 2) head tilt with chin lift; 3) extension of the lower jaw.
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7. Measures for a general examination of the victim and a temporary stop of external bleeding: 1) a general examination of the victim for the presence of bleeding; 2) digital pressure of the artery; 3) application of a tourniquet; 4) maximum flexion of the limb in the joint; 5) direct pressure on the wound; 6) applying a pressure bandage.
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8. Measures for a detailed examination of the victim in order to identify signs of injuries, poisoning and other conditions that threaten his life and health, and to provide first aid in case of detection of these conditions: 1) examination of the head; 2) examination of the neck; 3) conducting a breast examination; 4) examination of the back; 5) examination of the abdomen and pelvis; 6) examination of the limbs; 7) applying bandages for injuries of various areas of the body, including occlusive (sealing) for chest wounds; 8) carrying out immobilization (using improvised means, auto-immobilization, using medical devices);
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Description of the presentation Presentation FIRST AID with pictures by slides
The goals of first aid are 1. to save a person's life, 2. to improve the condition and prevent its deterioration, 3. to protect the victim.
ALGORITHM OF ACTION IN EMERGENCIES 1. Assessment of the situation and ensuring safety 2. Examination of the victim and first aid 3. Calling specialists
1. SITUATION ASSESSMENT AND SECURITY MAINTENANCE Try to determine: what happened? Is there a threat to you and the victims? how many injured? Can anyone be called in to help?
2. EXAMINATION OF THE INJURED Primary examination 1. Consciousness 2. Breathing If the victim is breathing, he must be brought to the lateral safe (recovery) position. If the victim is not breathing, cardiopulmonary resuscitation is necessary. 3. Bleeding
3. CALLING SPECIALISTS Numbers 01, 02, 03 When calling, you must report: Nature of the accident Number of victims Sex and approximate age of the victim Condition of the victim Address
GENERAL FIRST AID RULES Remain calm. Figure out what happened. Reassure the victim. Talk to the victim and try to understand what happened, provide PR Help the victim to a comfortable position. Call an ambulance. Monitoring the condition and vital signs Do no harm.
Stop external bleeding Direct pressure on the wound. Elevation of the injured limb. Applying a pressure bandage. Pressing the artery
INTERNAL BLEEDING Signs and symptoms fast, weak (thready) pulse, restlessness and anxiety, weakness, pale, wet, cold skin, thirst, dizziness. bleeding from natural openings - ears, nose, mouth, vagina, anus, urethra.
First Aid for Internal Bleeding Help the casualty into a comfortable position. At the slightest suspicion of internal bleeding, call an ambulance. Cover the victim with a blanket, coat, or something else to protect them from the cold. Apply cold compresses to the injury site Do not allow the victim to move. Do not give the victim food or drink. Control the level of consciousness, breathing and pulse.
BLEEDING FROM THE NOSE First Aid Have the casualty sit down. Tilt your head slightly forward. Put cold on the bridge of the nose and the back of the head. Ask the victim to breathe through their mouth and pinch their nostrils for a few minutes. After a few minutes, it is necessary to open the nose, if the bleeding continues, pinch the nostrils again. Call an ambulance if: bleeding does not stop within 30 minutes, the victim has high blood pressure.
INJURIES First Aid Elevate the injury. Keep the injured body part immobile. Apply cold compresses or ice packs to the injury site. Apply an elastic bandage to the injured area. Heat can be applied 2-3 days after the bruise. In case of serious injury, please consult a doctor.
WOUNDS Minor wounds Gently wash the wound with soap and water, apply wound dressing, bandage or pad the wound. Dangerous wounds (wound larger than 2-2.5 cm) stop bleeding, apply a bandage, call an ambulance or advise a doctor.
FOREIGN BODY IN WOUND First Aid Stop bleeding. Do not remove the foreign body. Immobilize the foreign body with dressings. Call an ambulance or send the victim to the hospital. institution.
AMPUTATION First Aid 1. Take care of the victim first and stop the bleeding. 2. Save the amputated part Wrap the amputated part in sterile gauze or a clean cloth. Put it in a plastic bag. Place the bag in a container filled with cold water. It is advisable to add pieces of ice to the water. Do not place the amputated part directly on ice, do not allow it to come into contact with water, do not rinse or process it. 3. Call an ambulance or send the victim to the hospital.
SYNDROME OF LONG-TERM COMPRESSION. First aid First of all, free the head and upper body of the victim from under the blockage, clean the mouth and nose from foreign bodies. Apply sterile dressings to wounds and abrasions. After release from crushing objects, bandage the injured limb tightly, starting from the hand or foot. Immobilize the limb as for fractures. Around the entire limb, lay bags of ice or snow (if they are not available, with a cloth moistened with cold water). Call an ambulance or take the victim to a hospital immediately.
SYNDROME OF LONG-TERM COMPRESSION. Signs and symptoms of rapidly increasing edema, pain, in dents, which are smoothed out with the development of edema, blisters with transparent or bloody contents, pulsation of the vessels of the extremities weakens. the extremity becomes cold, the victim cannot move it, when you try to bend or straighten the injured limb, there is a sharp pain, loss of sensitivity.
LIMB INJURIES Sprained and torn muscles, tendons and ligaments Signs and symptoms Pain that gets worse with movement, swelling, bruising (bruising).
LIMB INJURIES Sprained and torn muscles, tendons, and ligaments First Aid Apply cold to the injured area, then apply a tight bandage. You can use an elastic band. Raise the injured body part. Get complete rest. Apply cold for the first 2 days, after which heat can be applied. If a rupture is suspected, or if pain and swelling persist, advise the victim to seek medical attention.
Dislocation and fracture Signs and symptoms Pain that sharply increases when trying to change the position of the injured part of the body, swelling at the site of injury, the inability to move the limb, a specific crunch at the time of injury or "crunch" of bone fragments when moving or touching, deformity of the limb at the fracture site, unnatural position of the limb and its curvature in an unusual place; shortening of the limb.
Dislocation and Fracture First Aid Rest. For closed injuries, apply ice to the damaged area. For open injuries, stop bleeding using the artery pressure method. Apply a sterile dressing. And immobilize the injured limb. Call an ambulance.
CHEST INJURIES Signs and symptoms pain aggravated by movement, inhalation, exhalation, as well as coughing or sneezing, hemoptysis, rapid and shallow breathing, with pneumothorax - whistling and hissing of air seeping through the wound, bubbling blood in the wound, a sharp deterioration in the condition of the wounded, squelching, smacking sounds can be heard that occur both during inhalation and exhalation.
CHEST INJURIES First Aid Place the casualty in a semi-sitting position, leaning towards the injury and apply a support bandage, tying the arm to the torso to immobilize the ribs. Call an ambulance. With an open pneumothorax, it is necessary to apply an airtight tight bandage to the chest wound. To do this, close the wound with a sterile napkin, cover it with polyethylene or other air-tight material and bandage it.
ABDOMINAL INJURIES First Aid Lay the victim down. If the victim has a longitudinal wound of the abdomen, put him on his back with straight legs. If the wound is transverse and with closed injuries, put the victim on his back, bending his knees to reduce stress on the wound. For closed injuries, apply ice to the injured area. Put a bandage on the wound. If the victim begins to cough or vomit, hold the bandage. Call an ambulance.
ABDOMINAL INJURIES First aid If internal organs, such as part of the intestine, are visible, first cover the wound with a clean, damp cloth, then with polyethylene, and then apply a wide bandage loosely. Cover the top with a blanket or towel. Do not push or touch internal organs
FRACTURES OF THE PELVIC BONES Signs and symptoms change in the shape of the pelvis, the inability to stand, walk, lift the leg, swelling and sharp pain in the area of the fracture, hemorrhage, half-bent and slightly spread legs ("frog position").
FRACTURES OF THE PELVIC BONES First Aid Immobilize the legs in the position in which they are. To do this, under the knees and around the pelvis and legs, place dense thick rollers, folded blankets, and clothes. Fix the position of the legs with a wide bandage. Apply cold compresses to the pelvic area. Call an ambulance. If you are forced to transport the victim yourself, then do it with the utmost care.
SPINE INJURIES Signs and symptoms pain, touch, tenderness, spinal deformity, swelling and bleeding, loss of sensation.
SPINE INJURIES First aid If the victim is conscious, it is necessary to fix the head in line with the body. Place folded blankets or objects around the head and entire body, support the head of the victim with your hands. If the victim is unconscious, check for breathing and, if breathing is present, move him to a safe position, trying to keep his head and body in line.
HEAD INJURIES First Aid Lay the casualty on their back in a position with their shoulders and head elevated. Call an ambulance. For closed injuries, apply ice to the head. For open wounds, stop bleeding. If bleeding from the ear, cover the ear with a bandage and turn the head to the injured side to drain the fluid.
BURNS Thermal Chemical Electrical Radiation Superficial Partially penetrating Deep
BURNS First Aid Cool the burned area with water for 10 to 20 minutes. Remove watches, bracelets, belts, necklaces or rings. Cover the burn with a dressing, a clean plastic bag, or a clean cloth. Do not remove clothing that has stuck to the skin. Do not open the blister and. Do not use any oils, ointments or lotions. etc.
BURNS and a victim with burns is hospitalized: with deep burns, with partially penetrating burns, if their area is more than 10%, with chemical, radiation and electrical burns, with eye burns (including flash and electric arc), with burns of the mouth and throat. Victims of burns should consult a doctor: - for burns, partially penetrating burns, if their area is more than 1%, but less than 9%.
HEAT AND SUN STROKE Signs and symptoms high body temperature (40 o C and above), thirst, reddened, hot and dry skin, rapid breathing, rapid pulse, headache. convulsions, hallucinations, loss of consciousness.
HEAT STROKE AND SUN STROKE First aid Move victim to a cool area. Remove tight clothing. Wrap the victim with a damp sheet, wet his clothes, turn on the fan. Apply cold compresses to the head, and in the neck, armpits and groin, apply ice packs wrapped with meteria. Drink it with mineral or ordinary cold water. Call an ambulance. Do not give the victim alcoholic or caffeinated drinks.
Frostbite Signs and symptoms At the time of frostbite and in the cold, tingling, tingling, numbness. the skin becomes white or yellow, feels very cold to the touch, loss of sensation seems waxy, numbness of the frostbitten area. After warming With superficial frostbite, burning, tingling, itching, redness With deep frostbite, swelling, blisters, the skin is bluish-purple, dead blackened, sensitivity is not restored.
Frostbite First Aid Move victim to a warm place. Remove wet or restrictive shoes and clothing, and jewelry. Give the victim plenty of warm and sweet drinks. Gradually warm up the frostbitten part of your body. Dry gently and cover the affected area with a dry, sterile dressing. Call an ambulance or take the victim to a hospital.
Frostbite When helping with frostbite, it is unacceptable to: rub the frostbite, especially with snow or ice; to warm a frostbitten place too quickly, for example, by an open fire or by placing it immediately in hot water; give the victim alcohol; open blisters; thaw a frostbitten place if there is a danger that this part of the body will freeze again.
HYPCOOLING (HYPOTHERMIA) Signs and symptoms shivering, in more severe hypothermia no shivering, apathy and drowsiness, blurred consciousness, slurred speech, pale, bluish skin, disorientation, weak and slow pulse, slow and shallow breathing, impaired consciousness
HYPOCOOLING (HYPOTHERMIA) First aid Move the victim to a warm, wind-protected place, Remove frozen and wet clothing from him. Wrap him in a warm blanket or clothing. If the casualty is conscious and can swallow, give him a warm, decaffeinated drink. In the area of the neck, armpits and groin, apply heating pads wrapped in cloth. Call an ambulance.
HYPOCOOLING (HYPOTHERMIA) When assisting with hypothermia, it is unacceptable: to allow the victim to make active movements. massaging and rubbing the body of the victim, placing the victim in a hot bath, giving the victim alcohol, as it negatively affects blood circulation.
TRANSPORTATION OF VICTIMS. The victim should be carried only if the arrival of medical assistance at the scene is not possible If the victim must be immediately removed from dangerous conditions. If first aid is not available at the scene
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1. Injury - violation of the integrity of the tissue under the influence of external factors. Injuries can be mechanical, physical, chemical, biochemical, mental. A bruise is a mechanical violation of soft tissues without damage to the skin, pain, swelling, bruising, and accumulation of blood appear at the site of the bruise. When the chest is bruised, breathing is disturbed. Bruising of the abdomen can lead to rupture of the liver, spleen, intestines, internal bleeding. A head injury causes a head injury. Wounds - damage to body tissues due to mechanical impact, accompanied by a violation of the integrity of the skin and mucous membranes. There are stab, bruised, cut, gunshot, bitten wounds. They are accompanied by bleeding, pain, impaired function of the damaged organ, and may be complicated by infection. First aid. In the presence of arterial bleeding, take measures to temporarily stop it. Remove pieces of clothing, large foreign bodies from the wound. Cut the hair around the wound with scissors. Treat the skin around the wound with alcohol and brilliant green (1% solution of brilliant green). Apply a cotton-gauze bandage from an individual package (you can put several sterile napkins on the wound, cover them with sterile cotton and bandage). To strengthen the bandages on the head, it is convenient to use a mesh bandage. In case of extensive deep wounds, it is necessary to ensure the rest of the injured limb: hang the arm on a scarf or bandage it to the body, immobilize the leg with a transport splint. Bandages on the torso and abdomen are best done according to the type of bandages-stickers (napkins should be strengthened with a bandage or adhesive tape). In case of severe pain, inject 1-2 ml of a 2% solution of promedol intramuscularly or non-narcotic painkillers (tramal, etc.).
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2. Fainting - a sudden short-term loss of consciousness. Manifested by a sharp pallor of the skin. eyes wander and close; victim falls; pupils constrict, then dilate, do not react to light. The limbs are cold to the touch, the skin is covered with sticky sweat, the pulse is rare, weak; breathing is rare, superficial. The attack lasts from a few seconds to 1-2 mimes, followed by a quick and complete recovery of consciousness. First aid. Lay the victim on his back with his head slightly thrown back, unbutton the collar, and provide access to fresh air. Bring a cotton swab moistened with ammonia to the nose, spray your face with cold water, warm your feet or rub them.
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3. Collapse - a severe, life-threatening condition, characterized by a sharp decrease in arterial and venous pressure, depression of the central nervous system. Collapse can occur with a sharp blood loss, lack of oxygen, malnutrition, injuries, poisoning. With collapse, the skin turns pale, covered with a sticky cold sweat, the limbs become marbled blue, the veins subside and become indistinguishable under the skin. Eyes sunken, facial features sharpened. Blood pressure drops sharply, the pulse is barely palpable or absent. Breathing is rapid, shallow, sometimes intermittent. Involuntary urination and bowel movements may occur. The patient is lethargic, consciousness is darkened, and sometimes completely absent. First aid. Lay the victim on his back without a pillow, raise the lower part of the body and legs slightly, give him a sniff of ammonia. Apply heating pads to the extremities, while maintaining consciousness, give the victim strong hot tea. Urgent hospitalization is required.
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4. Coma - an unconscious state when there are no reactions to external stimuli (verbal, painful effects, etc.). The causes of coma can be different (impaired cerebral circulation, damage to the liver, kidneys, poisoning, trauma). Traumatic coma can occur with severe concussion. Unconsciousness lasts from a few minutes to 24 hours or longer. On examination, pallor of the face, slow pulse, vomiting, impaired or absent breathing, involuntary urination are noted, with a bruise of the brain, paralysis is added to this. First aid. Free the airways from mucus, vomit, foreign bodies. Carry out artificial respiration by mouth-to-mouth, mouth-to-nose methods. Urgent hospitalization is necessary.
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5. Bleeding - outpouring (outflow) of blood from blood vessels in violation of the integrity of their walls. Bleeding can be traumatic, caused by damage to blood vessels, and non-traumatic, associated with the destruction of blood vessels by some disease process. Depending on the type of damaged blood vessels, bleeding can be arterial, venous, capillary and mixed. With arterial bleeding, the outflowing blood has a bright red color, beats with a strong pulsating jet. With venous bleeding, the blood is darker and abundantly discharged from the wound in a continuous stream. With capillary bleeding, blood is released evenly over the entire surface of the wound (like from a sponge). Mixed bleeding is characterized by signs of arterial and venous bleeding. The victim with acute blood loss is pale, covered with cold sweat, lethargic, complains of dizziness, there is a darkening before the eyes when lifting the head, dry mouth. The pulse is frequent, small filling.
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First aid. With bleeding The main way, often saving the life of the victim, is to temporarily stop the bleeding. The easiest way is to digitally press the artery along, that is, not in the wound area, but higher in accessible places near the bone or under it. Press the temporal artery with the first (thumb) finger in front of the auricle in case of bleeding from head wounds. Press the mandibular artery against the angle of the lower jaw in case of bleeding from a wound on the face. Press the common carotid artery on the anterior surface outside of the larynx. Finger pressure should be made towards the spine, while the carotid artery is pressed against the transverse process of the sixth cervical vertebra. Press the subclavian artery in the fossa above the clavicle to the first rib. In case of bleeding from a wound in the area of the shoulder joint and shoulder girdle, press the axillary artery against the head of the humerus along the anterior edge of hair growth in the armpit. Press the brachial artery against the humerus on the inside of the biceps muscle if the bleeding originated from wounds in the middle and lower third of the shoulder, forearm and hand. Press the radial artery against the underlying bone in the wrist area near the thumb in case of bleeding from wounds of the hand. Press the femoral artery in the groin area in case of bleeding from wounds in the thigh area. Pressing to produce in the inguinal region in the middle of the distance between the pubis and the protrusion of the ilium. Press the popliteal artery in the region of the popliteal fossa in case of bleeding from wounds of the lower leg and foot. Press the arteries of the dorsum of the foot against the underlying bone in case of bleeding from a wound on the foot. Finger pressure makes it possible to stop bleeding almost instantly. But even a strong person cannot continue it for more than 10-15 minutes, as his hands get tired, and the pressure weakens. In this regard, this technique is important, mainly because it allows you to buy some time for other ways to stop bleeding.
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Finger pressing of the artery in case of bleeding from wounds of the forearm and shoulder Stopping bleeding by maximum fixed flexion of the limb
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In case of arterial bleeding from the vessels of the upper and lower extremities, pressing the arteries can be done in a different way: in case of bleeding from the arteries of the forearm, put two packs of bandages into the elbow bend and bend the arm as much as possible in the elbow joint; do the same for the arteries of the lower leg and foot - put two packs of bandages into the popliteal region and bend the leg as much as possible in the joint. After pressing the arteries, proceed to the imposition of a hemostatic tourniquet. It consists of a thick rubber tube or tape 1.0-1.5 m long, with a hook attached to one end and a metal chain to the other. In order not to damage the skin, the tourniquet must be applied over clothing or the place of application of the tourniquet should be wrapped several times with a bandage, towel, etc. Stretch the rubber tourniquet, attach it to the limb in this form and, without loosening the tension, wrap it around it several times so that skin folds do not get between them. Fasten the ends of the bundle with a chain and a hook. In the absence of a rubber tourniquet, use improvised materials, for example, a rubber tube, a waist belt, a tie, a bandage, a handkerchief. At the same time, drag the limb like a tourniquet, or make a twist with a stick. The use of thin or hard objects (rope, wire can cause damage to tissues, nerves, so it is not recommended to use them. If the tourniquet is applied correctly, bleeding immediately stops and the skin of the limb turns pale. The degree of compression of the limb can be determined by the pulse on any artery below the tourniquet ; the disappearance of the pulse indicates that the artery is compressed. Leave the tourniquet on the limb for 2 hours (and in winter outdoors - for 1.0-1.5 hours), since with prolonged compression, necrosis of the limb below the tourniquet may occur. Attach to the tourniquet a sheet of paper indicating the time of its application.In cases where more than 2 hours have passed, and the victim for some reason has not yet been delivered to a medical facility, the tourniquet should be removed for a short time.This should be done together: one should apply finger pressure to the artery above tourniquet, another slowly, so that the blood flow does not push out the thrombus formed in the artery, dissolve the tourniquet for 3-5 minutes and apply it again, but slightly above the previous place. The victim, who is put on a tourniquet, must be observed. If the tourniquet is applied weakly, then the artery is not completely clamped, and bleeding continues. Since at the same time the veins are clamped with a tourniquet, the limb is filled with blood, the pressure in the vessels increases, and the bleeding may even intensify; the skin of the limb due to the overflow of the veins with blood will become cyanotic. If the limb is squeezed too hard with a tourniquet, the underlying tissues, including nerves, are damaged, and paralysis of the limb may occur. The tourniquet should be tightened only until the bleeding stops, but no more. Arterial bleeding from the arteries of the hand and foot does not require the mandatory application of a tourniquet. It is enough to tightly bandage a pack of sterile bandage or a tight roller of sterile wipes to the wound site and give the limb an elevated position. The tourniquet is used only for extensive multiple wounds and crush injuries of the hand or foot. Bleeding from the digital arteries should be stopped with a tight pressure bandage. In case of any bleeding, especially when a limb is injured, it is necessary to give it a sublime
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6. Fracture - a sudden violation of the integrity of the bone. Fractures are open and closed. Open fractures are fractures in which there is a wound in the fracture zone and the fracture area communicates with the external environment. They can be life-threatening due to the frequent development of shock, blood loss, infection. First aid. Apply a sterile bandage to the wound in the area of the fracture. Enter an anesthetic. It is strictly forbidden to set the fingers into the wound of bone fragments. For heavy bleeding, apply a tourniquet. Transport the victim to the hospital on a stretcher in the supine position. Immobilization of the forearm with a splint Closed fractures are fractures in which there is no wound in the fracture zone. Characteristic external signs of closed fractures are a violation of straightness and the appearance of a “step” at the fracture site. Abnormal mobility, pain, crunching of fragments, swelling are noted. First aid. should be performed over clothing).
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7. Injury to the skull The fixed bones of the skull protect the brain from injury People who have had a head (or spinal) injury may have significant physical or neurological impairments such as paralysis, speech problems, memory problems, and psychiatric problems. Many victims remain disabled for life. Timely and correct first aid can prevent some of the consequences of head and spinal injuries, leading to death or disability. Fixed bones of the skull protect the brain from damage 1 - skull; 2 - brain
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The main types of dressings on the head area 1 - cap; 2 - cap; 3 - on one eye; 4 - on both eyes; 5 - on the ear (Neapolitan bandage); 6 - eight-shaped bandage on the occipital region and neck; 7 - on the chin and lower jaw (bridle); 8 - bandage with a mesh-ribbed bandage; Hippocratic cap: 9 - beginning; 10 - general view; 11 - on the nose; 12 - on the chin; 13 - on the parietal region; 14 - on the back of the head; 15 - contour bandage on the cheek.
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Fractures of the calvaria can be closed or open. Local manifestations - a hematoma in the scalp, a wound with an open injury, other changes detected by palpation. There may be disturbances of consciousness from a short-term loss of consciousness to coma, depending on the degree of damage, which can lead to respiratory failure. First aid. If the victim is conscious and in a satisfactory condition, then he should be laid on his back on a stretcher without a pillow. Put a bandage on the head wound. In an unconscious state, the victim should be placed on a stretcher on his back in a half-turn position, for which a roller of outerwear should be placed under one side of the body. Turn your head to the side, if possible to the left, so that in the event of vomiting, the vomit does not enter the respiratory tract, but flows out. Loosen all constricting clothing. If the victim has dentures and glasses, then remove them. In case of acute respiratory failure, perform artificial respiration. Fracture of the base of the skull. In the early period, bleeding from the ears, nosebleeds, dizziness, headaches, and loss of consciousness are noted. In a later period, hemorrhages appear in the eye sockets, outflow of cerebrospinal fluid from the nose and ears. First aid. Lay the victim on his back, free the airways from mucus, vomit, in case of respiratory failure, perform artificial respiration; in case of discharge of blood and cerebrospinal fluid from the ears and nose, tamponate for a short period of time; urgently hospitalize. A concussion develops mainly with a closed craniocerebral injury. It is manifested by loss of consciousness of varying duration, from a few moments to several minutes. After leaving the unconscious state, headache, nausea, and sometimes vomiting are noted, the victim almost always does not remember the circumstances that preceded the injury, and the very moment of it. Characterized by blanching or redness of the face, increased heart rate, general weakness. A brain contusion is characterized by a prolonged loss of consciousness (over 1-2 hours) and is possible with closed and open traumatic brain injury. In severe cases, the bruise may interfere with breathing and cardiovascular activity. First aid. Put the victim on a stretcher, even with the shortest loss of consciousness. In case of an open craniocerebral injury that caused a concussion or a bruise, apply a bandage to the wound. In case of cardiac arrest, breathing, perform an indirect heart massage, artificial respiration using the “mouth-to-mouth”, “mouth-to-nose” method, or use special devices.
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8. Wounds of the soft tissues of the face are accompanied by a divergence of the edges of the wound, bleeding, pain, impaired functions of opening the mouth, speech, and breathing. Soft tissue injuries can be complicated by shock, blood loss. First aid. Apply a pressure bandage, locally - cold. In case of bleeding, temporarily stop it by pressing large arteries with fingers.
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9. Fracture of the lower jaw. Victims complain of pain at the site of injury, aggravated by speech, opening of the mouth, inability to close the teeth. Often, a fracture of the lower jaw is accompanied by a short-term loss of consciousness. First aid. In order to anesthetize the victim, subcutaneously inject 1 ml of a 2% solution of promedol or other painkillers. Create rest for the damaged organ using a chin, sling or standard transport bandage.
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10. Bruising of the eye 10. Bruising of the eye can be direct - occur when a traumatic object hits the eye directly, and indirect - due to concussion of the body, facial skeleton. Signs of a bruised eyeball are pain, swelling of the eyelids, decreased visual acuity. First aid. Put on a bandage. Eyelid injuries occur as a result of exposure to cutting or stabbing objects, blows with blunt objects. Signs of injury are the presence of a wound of various sizes and shapes, bleeding from it, swelling of the eyelid, a change in its color. First aid. Treat wounds with 1% solution of brilliant green, apply a bandage. Penetrating eye injury. These include damage to the integrity of the membranes of the eyeball. Penetrating wounds can be caused by cutting or stabbing objects, a fragment in the eye. Wounds are characterized by pain, photophobia, lacrimation. First aid. Drop into the eye a 30% sodium solution or a 0.25% solution of chloramphenicol. Apply a sterile bandage.
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11. Signs and symptoms of a penetrating wound of the chest: - shortness of breath; - bleeding from an open chest wound; - suction sound coming from the wound with each breath; - severe pain in the area of the wound; - obvious deformity characteristic of a fracture; - hemoptysis. Pneumothorax - accumulation of air in the pleural cavity. There are closed and open pneumothorax. Closed pneumothorax is a complication of chest trauma and is a sign of lung rupture. Rupture of the lungs occurs as a result of direct injury by fragments of the rib or as a result of hitting the ground when falling from a height. Through a gap in the lungs, air enters the pleural cavity, resulting in a collapse of the lung and turning it off from breathing. The victim catches air with his mouth, shortness of breath is expressed, the skin is pale with a bluish tint, the pulse is quickened. A bullet that has penetrated into the lungs or chest cavity around the lung opens up access to air: 1 - air leaving the lung fills the space around the lung; 2 - air entering from the outside fills the space in the lung region; 3 - a bullet that penetrated the chest
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First aid. Inject 2 ml of a 50% solution of analgin intramuscularly or other painkillers, give the victim an elevated position with a raised head, if possible, inhale oxygen. Hospitalize urgently. With an open pneumothorax, there is a gaping wound of the chest wall, as a result of which the pleural cavity communicates with the external environment. The lung collapses and goes out of breath. The general condition of the victim is severe. The skin is bluish in color, shortness of breath is pronounced, the victim tries to hold the wound with his hand. With each breath, air enters the wound with a “squish”. First aid. - to give an elevated position to the victim; - ask the victim to take a deep breath; - cover the wound with a bandage that does not allow air to pass through, such as a piece of plastic bag or plastic wrap. If this is not at hand, take a folded piece of cloth or something from clothing; - fix the bandage with adhesive tape, leaving one edge open (due to this, air will not enter the wound when inhaling, but will be able to exit when exhaling); - in case of a gunshot wound, be sure to check the place where the bullet could exit. If a second hole is found, provide assistance as described above.
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12. If spinal injuries are suspected, carefully, two or three of them, transfer the victim to his back on a stretcher (preferably on a shield), lay his head on a tight roller made of clothes, or on a rubber circle and fix it with a wide bandage to the shield. If necessary, carry out artificial respiration. While waiting for the arrival of an ambulance, observe the following rules: - if possible, keep the victim's head and spine motionless; - immobilize the victim's head on both sides in the position in which he was found; - maintain airway patency; - monitor the level of consciousness and breathing; - if necessary, stop external bleeding; - maintain normal body temperature of the victim; - if the victim is wearing a protective helmet, do not remove it. Remove it only if the victim is not breathing. 1 - spinal cord 2 - spinal column
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13. Fractures of the pelvic bones are observed when the pelvic ring is injured. Multiple fractures of the pelvic bones are severe injuries, with massive internal blood loss. - often with damage to the urethra and bladder, the development of traumatic shock. The victim complains of pain in the sacrum and perineum. Pressing on the symphysis pubis and iliac bones is painful. The victim cannot raise the straight leg and, bending it at the knee joint, drags the foot. In severe shock, an unconscious state, a fracture of the pelvic bones can be determined by the presence of a defect in the womb area, an upward displacement of any half of the pelvis. deformities of the pelvic bones, shortening of the hip. First aid. Lay the victim on a stretcher on his back with a roller under his knees. Spread your knees to the sides (the "frog" position). Give any pain reliever.
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14. Fractures of the clavicle occur when falling on an outstretched arm, shoulder joint. Characterized by deformation of the clavicle, abnormal mobility, swelling, crunch of fragments. You decide to apply a supportive and fixative dressing. Position the arm and the kerchief accordingly: - place the forearm of the injured side across the chest so that the fingers point towards the opposite shoulder; - apply a straightened bandage over the forearm and hand; - the bandage should cover the elbow and shoulder; - supporting the forearm, wrap the lower end of the bandage under the hand, forearm and
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Position the arm and the kerchief accordingly: - place the forearm of the injured side across the chest so that the fingers point towards the opposite shoulder; - apply a straightened bandage over the forearm and hand; - the bandage should cover the elbow and shoulder; - supporting the forearm, wrap the lower end of the bandage under the hand, forearm and elbow.
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Apply a fixing bandage: - stretch the bandage from the elbow of the injured side around the body, securing it well; - tie the ends of the bandage on the opposite side under the healthy arm.
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15. Shoulder dislocations Shoulder dislocations are observed when falling on an outstretched and retracted arm. The hand of the victim is laid aside. Trying to lower it causes a sharp pain. The injured shoulder is elongated compared to the healthy shoulder. First aid. Usually, the victims themselves find a position in which the pain decreases - they raise and support the arm with a healthy hand. No need to try to forcibly lower your hand. During immobilization, put a large cotton-gauze roller into the armpit and bandage the arm to the body. Hang the hand and forearm on a scarf. Enter 2 ml of a 50% solution of analgin or other painkillers.
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16. Fracture Fractures of the upper end of the humerus. Causes of damage - falls on the elbow, on the area of the shoulder joint. Victims note a sharp pain in the shoulder joint. The arm, bent at the elbow and pressed to the body, is supported by a healthy arm. The shoulder joint is enlarged in volume, there is a sharp pain during probing and careful movements, a crunch of fragments. First aid. Hang the hand on a scarf, in case of severe pain - fix it to the body with a bandage. Enter 2 ml of a 50% solution of analgin or other painkillers. Fractures of the middle third of the shoulder are the result of both indirect trauma (falling on the elbow, sharp twisting of the shoulder) and direct trauma (hit on the shoulder). Characterized by shortening and deformation of the shoulder, abnormal mobility at the fracture site, the crunch of fragments. First aid. Immobilize the fracture with a splint. Apply a splint from a healthy shoulder blade to the base of the fingers. Bend the arm at a right angle at the elbow joint. Enter 2 ml of a 50% solution of analgin or other painkillers. The fracture is not always obvious. Fractures include a split or crack in the bone, as well as its complete break.
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Fractures of the bones of the forearm. A fracture of both bones, and one (ulnar or radial) is possible. A fracture of one bone may be accompanied by a dislocation of another. With fractures of both bones, deformity of the forearm, abnormal mobility, pain, and a crunch of fragments are noted. First aid. Immobilize the forearm with a splint, applying it from the lower third of the shoulder to the base of the fingers. Bend the arm at the elbow joint at a right angle. Enter an anesthetic. Fractures of the bones of the hand occur most often as a result of a direct blow. Deformation, swelling, pain are observed. the crunch of fragments. First aid. Put a tightly folded cotton-gauze roller or a small ball into the palm, fix the forearm and hand to the splint that runs from the ends of the fingers to the middle of the forearm.
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Hip fractures. Fracture of the femoral neck may result from a minor injury (fall from height) in the elderly; in young people, it can occur when a car hits, falls from a height. These same causes can also cause a fracture of the femur. The victim has severe pain in the hip joint, the leg is turned outward, swelling quickly appears. An attempt to lift the leg causes severe pain at the fracture site. The hip can be shortened, abnormal mobility, fragments crunch are observed. First aid. Enter an anesthetic. Apply a Dieterichs splint or, in its absence, apply two splints: a long one - from the armpit to the outer ankle and a short one - from the crotch to the inner ankle. Place the foot at a 90° angle
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Fractures of the leg. More often there is a fracture of both bones of the lower leg, less often only one. The causes of damage are a strong blow to the shin, the fall of heavy objects on the leg, a sharp rotation of the shin with a fixed foot. Deformities and shortening of the lower leg, abnormal mobility, pain, crunch of fragments are noted. The victim cannot raise his leg on his own. First aid. Apply a splint from the upper third of the thigh to the end of the toes. Enter an anesthetic.
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17. Burns Burns are the result of exposure to high temperatures (thermal burns), strong acids and alkalis (chemical burns), electric current, ionizing radiation. Thermal burns. There are three degrees of burns: mild, moderate and severe. First-degree burn (superficial) Affects only the top layer of the skin. The skin becomes red and dry, usually painful. (Sunburn is most common with excessive sun exposure without cover.) Such burns usually heal within 5-6 days without leaving scars. Second-degree burn Damage to both layers of the skin - the epidermis and dermis. The skin becomes reddened, blistered (yellow-watery formations) that may break open, making the skin wet. Increase in pain. Healing is usually in 3-4 weeks, scarring is possible.
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Third degree burn Destroys both layers of skin and tissue - nerves, blood vessels, fat, muscle and bone. The skin looks charred (black) or waxy white (yellow-brown) and tissue dies (necrosis). These burns are usually less painful, as they damage the nerve endings of the skin. Extensive burns due to fluid loss lead to a state of shock. Possibly an infection. Rough scars remain on the body, skin grafting is often required. Fourth Degree Burn Charring of tissue and underlying bones. The victims show signs of incipient or already existing shock. Danger - shock, cessation of functioning of organs, amputation, infection. Notes: - children tend to suffer burns more severely than adults, even if the exposure temperature was not so high; - powder or ointment should not be applied to burn wounds (treatment of these wounds should be carried out only by a doctor when he has an idea of the degree of damage. Extensive burns are complicated by burn shock, during which the victim rushes about in pain, seeks to escape, is poorly oriented in place and environment. Excitation is replaced by prostration, lethargy.Inhalation of hot air, steam, smoke can cause burns of the respiratory tract, swelling of the larynx, respiratory failure.This leads to hypoxia (impaired oxygen delivery to body tissues).
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First aid for burns. With a limited thermal burn, you should immediately start cooling the burn site with tap water for 10-15 minutes. After that, apply a clean, preferably sterile bandage to the burn area. To reduce pain, use painkillers (analgin, amidopyrine, etc.). With extensive burns, after applying bandages, give the victim hot tea to drink. Give an anesthetic and, wrapping it warmly, urgently deliver it to a medical institution. If transportation is delayed or takes a long time, then the victim should be given an alkaline-salt mixture (1 teaspoon of table salt and 1/2 teaspoon of baking soda dissolved in 2 glasses of water) to drink. In the first 6 hours after the burn, the victim should receive at least 2 glasses of solution within an hour. Do not pop blisters, as the integrity of the skin protects against infection. If the blisters burst, treat the injured area as you would a wound: wash with soap and water and apply a sterile dressing. Watch for signs and symptoms of infection. If you suspect a burn to the airways or lungs, constantly monitor breathing (with a burn, the airways may swell, causing respiratory failure in the victim). Remove rings, watches and other items from the affected person until swelling appears. Remember that when providing assistance, you can not: - touch the burned area with anything other than sterile or clean swab dressings, use cotton wool and remove clothes from the burned area; - tear off clothes stuck to the burn area; - treat the wound with third-degree burns; - open burn blisters; - use fat, alcohol or ointment for severe burns.
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18. Hypothermia Hypothermia is a general hypothermia of the body, when the body is unable to compensate for the loss of heat. Frostbite occurs with prolonged exposure to cold on any part of the body. The effect of cold on the whole body causes a general cooling. With frostbite on the affected areas, the skin becomes cold, pale bluish in color, there is no sensitivity. With general cooling, the victim is lethargic, indifferent, the skin is pale, cold, the pulse is rare, the body temperature is less than 36.5°C. When exposed to cold, the body narrows the blood vessels located close to the skin, and warm blood rushes deep into the body. Thus, heat output through the skin is reduced and normal body temperature is maintained. If this mechanism is not able to maintain a constant body temperature, the person begins to chill, as a result of which additional heat is generated due to muscle activity. Hypothermia occurs due to hypothermia of the whole organism in violation of the process of thermoregulation. In hypothermia, body temperature drops below 35°C, causing cardiac arrhythmia and eventually cardiac arrest. Death is coming. If the casualty shows both signs of frostbite and hypothermia, treat as if hypothermia were treated first, as this condition can lead to death if the person is not immediately rewarmed. But even in this case, frostbite should not be ignored, which, if severe, can lead to amputation of the damaged part of the body. First aid. Bring the victim to a warm room, remove shoes and gloves. First, rub the frostbitten limb with a dry cloth, then place it in a basin with warm (32-34.5 ° C) water. Within 10 minutes, bring the temperature to 40.5 ° C. When sensitivity and blood circulation are restored, wipe the limb dry, wipe it with a 33% alcohol solution, apply an aseptic or clean bandage (you can wear clean ironed socks or gloves). With general cooling of the victim, it is necessary to cover it warmly, cover it with heating pads, and give hot tea to drink.
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19. Poisoning Poisoning occurs when a toxic substance enters the body. This substance can be a drug or any chemical taken by a person intentionally or accidentally. Poisoning is the third most common cause of accidental death in Russia. Mostly they are unintentional. Both children and adults are victims of poisoning. A poison is any substance that, when ingested, causes poisoning, disease, or death. One of the common sources of food poisoning can be foods contaminated with some microbes that release very strong toxins. This is, first of all, a botulinum stick. Poisoning occurs when eating canned food. After the onset, which is usual for any food poisoning (vomiting, diarrhea, abdominal pain), after a few hours, vision is weakened, speech and swallowing are disturbed. Food poisoning caused by staph toxins is widespread. These bacteria multiply on various food products (cream cakes, dairy products, smoked meats, pâtés). First aid. Rinse the affected stomach: give 5-6 glasses of warm water or a weak solution of baking soda to drink; irritating the root of the tongue with a finger, induce vomiting; repeat this procedure several times. After washing, give strong tea. Then send the victim to a medical facility. - as a result of an injection (bite, sting) Poison can enter the body in four ways: - through the digestive tract - through the respiratory tract - through the skin
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Chemical poisoning Acid poisoning (80% solution of acetic, hydrochloric, carbolic, oxalic acids) and caustic alkalis (caustic soda, ammonia) often occur. Immediately after acid or alkali enters the body, severe pain appears in the mouth, pharynx, and respiratory tract. A burn of the mucous membrane causes severe swelling, copious salivation, and a sharp pain makes it impossible for the victim to swallow. During inhalation, saliva along with air can flow into the airways, making breathing difficult and causing suffocation. First aid. Immediately remove saliva and mucus from the victim's mouth. Having screwed a piece of gauze, a handkerchief or a napkin onto a teaspoon, wipe the oral cavity. If there are signs of suffocation, perform artificial respiration. Quite often, the victims vomit, sometimes with an admixture of blood. It is strictly forbidden to wash the stomach on your own in such cases, as this can increase vomiting, lead to the ingress of acids and alkalis into the respiratory tract. The victim can be given to drink 2-3 glasses of water, preferably with ice. Do not try to "neutralize" toxic liquids. In case of poisoning with other chemicals (chlorinated hydrocarbon, aniline dye, etc.), before the arrival of a doctor, it is necessary to induce vomiting in the victim and rinse the stomach with water if he is conscious. Lay the victim in an unconscious state without a pillow on his stomach, turn his head to the side. When the tongue is retracted, as well as with convulsions in an unconscious state, when the jaws are tightly closed and prevent normal breathing, carefully tilt your head back and push the lower jaw forward and up.
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Poisoning with potent poisons Symptoms of poisoning depend on their predominant effect on certain organs and systems of the body. When exposed to the nervous system, convulsions, drowsiness, difficulty in movement, impaired consciousness, impaired pulse and breathing may occur. When exposed to the digestive system, there are sharp pains in the abdomen, nausea, vomiting, diarrhea: on the heart - a feeling of "fading" - a violation of its rhythm, a change in blood pressure. First aid. Urgently induce vomiting. First, give the victim to drink 1-2 glasses of warm water. Repeat this procedure 5-6 times, then apply adsorbing substances - 3-4 tablets of activated charcoal. Then a laxative is recommended. When excited, put a cold compress on the victim's head and try to keep him in bed. If necessary, perform artificial respiration and chest compressions. Massage should be continued until the full restoration of cardiac activity, the appearance of distinct heartbeats and pulse. Send the victim to a medical facility. Gaseous or inhaled toxic substances enter the body when inhaled. These include gases and vapours, such as carbon monoxide, nitrous oxide ("laughing gas"), and industrial substances such as chlorine, various adhesives, dyes and cleaning solvents. First aid for poisoning with gaseous toxins: - make sure that the scene is not dangerous; - isolate the victim from exposure to gases or vapors. In this case, you need to take the victim to fresh air and call an ambulance. Monitor airways, breathing, and pulse, and administer first aid if necessary. Help the casualty into a comfortable position until the ambulance arrives. When there is a danger of contact with a poisonous substance, wear protective clothing, regardless of whether you are at work or at home. To prevent poisoning, follow all warnings on safety labels, labels, and posters, and follow the necessary precautions.
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20. Sunstroke Sunstroke is a severe morbid condition of the body as a result of overheating of the head by direct sunlight. The victim has nausea, vomiting, nosebleeds, possibly visual disturbances, increased pulse and respiration, in some cases unconsciousness, respiratory and cardiac arrest. Similar symptoms are observed with extensive sunburns, with signs of a first-degree burn appearing. Sunstroke can cause pain in the occipital region. First aid. Move the victim to a cool room or shade, take off his clothes, put cold on his head and in the heart area, give a plentiful salt drink. In severe forms, start artificial respiration and chest compressions. Send, if necessary, the victim to a medical facility.
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21. Drowning Drowning is the filling of the airways with liquid or liquid masses. Signs of drowning are the release of foam from the mouth, respiratory and cardiac arrest, blue skin, dilated pupils. First aid. Clean the oral cavity: laying the victim on the rescuer's thigh so. so that the head of the victim hangs down to the ground, pressing vigorously on the chest and back, remove water from the stomach and lungs; After that, they immediately begin to carry out artificial respiration. Method using belts, straps, towels, etc.: According to the "one-two" count, the victim is lifted - a breath occurs; on the count of "three-four" they lower him to the ground; on the account "five-six" - a pause, there is an exhalation To restore cardiac activity simultaneously with artificial respiration, an indirect heart massage is necessary. Every 5-6 clicks on the heart area, air is blown through the mouth or nose of the victim. This is done until the full restoration of breathing and heartbeat. After normalization of breathing and cardiac activity, the victim should be warmed, covered and taken to a medical center.
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22. Electrical injury 27. Electrical injury - damage to the body by electric current. Electrical injuries are local (burns) and general. Local electrical injury is a consequence of the impact on a part of the body current as a result of a short circuit. General electrical injury occurs with the direct action of electric current, from the moment it passes through the body. With a general lesion, convulsive contraction of muscles, depression of cardiac activity, and respiratory failure are characteristic. A lightning strike, along with the listed signs of a general electrical injury, causes hearing loss, speech impairment, and the appearance of dark blue spots on the skin. First aid. Immediately release the victim from the action of the current: turn off the switch, discard the electrical wire, cut it. During the initial examination, watch closely for signs of respiratory failure or sudden cardiac arrest. Start artificial respiration and chest compressions. During the secondary inspection, don't forget to inspect the exit wound: always look for two burns. Apply a sterile dressing to the burn site. Send the victim to a medical facility.
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23. Foreign body A foreign body is an object that enters the body from outside and lingers in tissues, organs, cavities. A foreign body in the eye can be located on the inner surface of the eyelids and the cornea of the eye or intrude into the cornea. First aid. Do not rub the eye, pull the eyelid by the eyelashes, remove the foreign body with a moistened corner of a clean napkin, handkerchief. When a foreign body is introduced into the cornea of the eye, assistance should be provided in a medical institution. There are two types of foreign body in the ear: an insect or an object. First aid. If an insect gets into the ear, drip 3-5 drops of vegetable oil (water) into the ear canal, put the victim in 1-2 minutes on the sore ear; the foreign body must come out with fluid. Remove a foreign body from the nose by blowing out; if this procedure fails, then consult a doctor. A foreign body that has entered the respiratory tract can lead to their complete blockage and suffocation. Choking occurs when food or a foreign object enters the trachea instead of the esophagus (see diagram on the right).
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First aid. Allow the victim to clear his throat: strongly bend his torso forward, apply several intense blows with the palm between the shoulder blades. Grab the victim with your hands around the waist, press 4-5 times in the middle of the abdomen. In case of a negative result, immediately deliver the victim to a medical institution. Assistance with complete obstruction of the respiratory tract to an unconscious adult or child - tilt the head of the victim and raise his chin; - to determine the presence of breathing, use visual, auditory and tactile control for 5 seconds; if the victim is not breathing: - pinch the victim's nostrils, tightly wrap your lips around his mouth; - make 2 full breaths; - Watch your chest rise to make sure air is getting into your lungs. Make 5 pushes in the stomach: - sit astride the hips of the victim; - place the base of the palm just above the navel so that the fingers of the hand are directed towards the head of the victim; - put the second hand on top of the first; - 5 times press on the victim's stomach with quick upward jerking movements. First aid for obvious signs of strangulation. For a child older than one year, first aid for suffocation is provided in the same way as for an adult. The only significant difference is that this assistance must be commensurate with the weight and size of the child. The rest of the procedures are the same. Start pushing into the abdomen: - grab the victim's waist; - clench your hand into a fist; - press the fist from the side of the thumb to the middle part of the abdomen just above the navel and below the tip of the victim's sternum; - grasp the fist with the palm of the other hand; - with a quick upward push, press your fist into the victim's stomach; - each push is made separately in an attempt to remove a foreign object. Continue pushing into the abdomen until: - the foreign body is removed; - the victim will not begin to breathe or cough hard; - the victim will lose consciousness (in this case, put the victim on his back, instruct to call an ambulance and immediately start:
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If the air does not pass into the lungs, try to remove the foreign object from the victim's mouth with a bent finger: - with the thumb of one hand, press the victim's tongue to the lower jaw and slightly push it out; - slide your finger down from the cheek to the base of the tongue in a sliding motion. Be careful not to push the foreign body deeper into the throat; - try to grab the foreign body with your finger and remove it from the mouth. Then do mouth-to-mouth breaths. A foreign body from the esophagus is removed in a medical institution. The victim should not be given food or water. 1- normal route of passage of food; 2 - food that has entered the trachea with air
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Time is of the essence in life-threatening emergencies. If the brain does not receive oxygen within a few minutes after breathing stops, irreversible brain damage or death will occur: 0 minutes - breathing has stopped, the heart will soon stop; 4-6 minutes - possible brain damage; 6-10 minutes - probable brain damage; more than 10 minutes - irreversible brain damage The need for artificial respiration occurs in cases where breathing is absent or disturbed to such an extent that it threatens the life of the victim. Artificial respiration is an urgent first aid measure for drowning, suffocation, electric shock, heat and sunstroke, and some poisoning. In the case of clinical death, that is, in the absence of spontaneous breathing and heartbeat, artificial respiration is carried out simultaneously with a heart massage. The duration of artificial respiration depends on the severity of respiratory disorders, and it should continue until fully spontaneous breathing is restored. At the first signs of death, for example, cadaveric spots, artificial respiration should be stopped. The best method of artificial respiration, of course, is to connect special devices (respirators) to the victim's airways, which can blow up to 1000-1500 ml of fresh air to the victim for each breath. But non-specialists, of course, do not have such devices at hand. The old methods of artificial respiration (Sylvester, Schaeffer, etc.), which are based on various methods of chest compression, are not effective enough, because, firstly, they do not ensure the release of the airways from the sunken tongue, and secondly, with their With help, no more than 200-250 ml of air enters the lungs for 1 breath. Currently, the most effective methods of artificial respiration are recognized as blowing from mouth to mouth and from mouth to nose. The rescuer forcefully exhales air from their lungs into the victim's lungs, temporarily becoming a "respirator". Of course, this is not the fresh air with 21% oxygen that we breathe. However, as studies by resuscitators have shown, the air exhaled by a healthy person still contains 16-17% oxygen, which is enough to carry out full-fledged artificial respiration, especially in extreme conditions. So, if the victim does not have his own respiratory movements, then you must immediately begin artificial respiration! If there is any doubt whether the victim is breathing or not, then one should, without hesitation, begin to "breathe for him" and not waste precious minutes looking for a mirror, applying it to his mouth, etc. In order to blow "the air of his exhalation" into the lungs of the victim, the rescuer is forced to touch his face with his lips. From hygienic and ethical considerations, the following technique can be considered the most rational, consisting of several operations: 1) take a handkerchief or any other piece of fabric (preferably gauze); 2) bite through a hole in the middle of the gauze; 3) expand it with your fingers up to 2-3 cm; 4) put a tissue with a hole on the nose or mouth of the victim (depending on the choice of artificial respiration method); 5) press your lips tightly against the face of the victim through gauze, and carry out blowing through the hole in it.
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24. Artificial respiration from mouth to mouth. The savior stands on the side of the victim's head (preferably on the left). If the victim lies on the floor, then you have to kneel. Quickly cleans the mouth and throat of the victim from vomit. If the jaws of the victim are tightly compressed, then pushes them apart. Then, putting one hand on the forehead of the victim, and the other on the back of the head, he overbends (that is, throws back) the head of the victim, while the mouth, as a rule, opens. The rescuer takes a deep breath, slightly delays his exhalation and, bending down to the victim, completely seals the area of \u200b\u200bhis mouth with his lips, creating, as it were, an air-tight dome over the victim's mouth opening. In this case, the nostrils of the victim must be closed with the thumb and forefinger of the hand lying on his forehead, or covered with his cheek, which is much more difficult to do. Lack of tightness is a common mistake in artificial respiration. In this case, air leakage through the nose or corners of the mouth of the victim nullifies all the efforts of the rescuer. After sealing, the rescuer makes a quick, strong exhalation, blowing air into the airways and lungs of the victim. Exhalation should last about 1 s and reach 1.0-1.5 liters in volume in order to cause sufficient stimulation of the respiratory center. In this case, it is necessary to continuously monitor whether the chest of the victim rises well during artificial inspiration. If the amplitude of such respiratory movements is insufficient, then the volume of air blown in is small or the tongue sinks. After the end of the exhalation, the rescuer unbends and releases the victim's mouth, in no case stopping the overextension of his head, otherwise the tongue will sink and there will be no full-fledged independent exhalation. The exhalation of the victim should last about 2 s, in any case it is better that it be twice as long as the inhalation. In a pause before the next breath, the rescuer needs to take 1-2 small ordinary breaths “for himself”. The cycle is repeated at a frequency of 10-12 per minute. If a large amount of air enters not into the lungs, but into the stomach, the swelling of the latter will make it difficult to save the victim. Therefore, it is advisable to periodically release his stomach from the air, pressing on the epigastric (pituitary) region.
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25. Artificial respiration from mouth to nose is carried out if the victim has clenched teeth or has an injury to the lips or jaws. The rescuer, putting one hand on the forehead of the victim, and the other on his chin, hyperextends his head and at the same time presses his lower jaw to the upper one. With the fingers of the hand supporting the chin, he should press the upper lip, thereby sealing the mouth of the victim. After a deep breath, the rescuer covers the victim's nose with his lips, creating the same air-tight dome. Then the rescuer makes a strong blowing of air through the nostrils (1.0-1.5 l), while watching the movement of the victim's chest. After the end of artificial inhalation, it is necessary to release not only the nose, but also the victim's mouth: the soft palate can prevent air from escaping through the nose, and then there will be no exhalation at all when the mouth is closed. It is necessary with such an exhalation to keep the head overbent (that is, thrown back), otherwise the sunken tongue will interfere with exhalation. The duration of the exhalation is about 2 s. In a pause, the rescuer makes 1-2 small breaths-exhalations "for himself". Artificial respiration should be carried out without interruption for more than 3-4 seconds, until fully spontaneous breathing is restored or until a doctor appears and gives other instructions. It is necessary to continuously check the effectiveness of artificial respiration (good inflation of the chest of the victim, absence of bloating, gradual pinking of the skin of the face). You should constantly ensure that vomit does not appear in the mouth and nasopharynx, and if this happens, then before the next breath, a finger wrapped in a cloth should be cleared through the mouth of the victim's airways. As artificial respiration is carried out, the rescuer may feel dizzy due to a lack of carbon dioxide in his body. Therefore, it is better that two rescuers perform air blowing, changing after 2-3 minutes. If this is not possible, then every 2-3 minutes the breaths should be reduced to 4-5 per minute, so that during this period the level of carbon dioxide in the blood and brain rises in the person who performs artificial respiration. When carrying out artificial respiration in a victim with respiratory arrest, it is necessary to check every minute whether he has also experienced cardiac arrest. To do this, use two fingers to feel the pulse on the neck in the triangle between the windpipe (laryngeal cartilage, which is sometimes called the Adam's apple) and the sternocleidomastoid (sternocleidomastoid) muscle. The rescuer places two fingers on the lateral surface of the laryngeal cartilage, after which he "slips" them into the hollow between the cartilage and the sternocleidomastoid muscle. It is in the depths of this triangle that the carotid artery should pulsate. If there is no pulsation of the carotid artery, an indirect heart massage should be started immediately, combining it with artificial respiration. If you miss the moment of cardiac arrest and only artificial respiration is performed on the victim for 1-2 minutes, then, as a rule, it will not be possible to save him.
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26. Features of artificial respiration in children To restore breathing in children under 1 year old, artificial ventilation of the lungs is carried out according to the "mouth to mouth and nose" method, in children over 1 year old - according to the "mouth to mouth" method. Both methods are carried out in the position of the child on the back, for children under 1 year old, a low roller (folded blanket) is placed under the back or the upper part of the body is slightly raised with the hand brought under the back, the child's head is thrown back. The rescuer takes a breath (shallow!), hermetically covers the mouth and nose of the child or (in children over 1 year old) only the mouth and blows air into the respiratory tract of the child, the volume of which should be the smaller, the younger the child (for example, in a newborn from equal 30-40 ml). With a sufficient volume of air blown in and getting into the lungs (and not the stomach), chest movements appear. When you have finished blowing, you need to make sure that the chest is lowering. Blowing an excessively large volume of air for a child can lead to serious consequences - rupture of the alveoli of the lung tissue and air escaping into the pleural cavity. The frequency of inspirations should correspond to the age-related frequency of respiratory movements, which decreases with age. On average, the respiratory rate in 1 min is in newborns and children up to 4 months. life - 40, at 4-6 months. - 40-35, at 7 months. -2 years - 35-30, at 2-4 years - 30-25, at 4-6 years - about 25, at 6-12 years - 22-20. at 12-15 years old - 20-18.
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27. Cardiac massage is a mechanical effect on the heart after it has stopped in order to restore activity and maintain continuous blood flow until the heart resumes its work. Indications for cardiac massage are all cases of cardiac arrest. Signs of sudden cardiac arrest - a sharp pallor, loss of consciousness, the disappearance of the pulse in the carotid arteries, cessation of breathing or the appearance of rare. convulsive breaths, dilated pupils. There are two main types of heart massage: indirect, or external (closed), and direct, or internal (open). Find the correct position for the hands: - feel for the indentation on the lower edge of the sternum with your fingers and keep your two fingers in this place; - put the base of the palm of the other hand on the sternum above the place where the fingers are located; - remove the fingers from the recess and place the palm of the first hand on top of the other hand; - Do not touch your chest with your fingers. When carrying out pressure, the rescuer's shoulders should be above his palms!
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28. Indirect massage Indirect heart massage is based on the fact that when you press the chest from front to back, the heart, located between the sternum and spine, is compressed so much that blood from its cavities enters the vessels. After the cessation of pressure, the heart expands and venous blood enters its cavity. Each person should own an indirect heart massage. In cardiac arrest, it should be started as soon as possible. It is most effective when started immediately after cardiac arrest. For this, the victim is laid on a flat hard surface - the ground, floor, board (on a soft surface, for example, a bed, heart massage cannot be performed). The rescuer stands to the left or right of the victim, puts his palm on his chest so that the base of the palm is located at the lower end of the sternum. On top of this palm he places another to increase pressure and with strong, sharp movements, helping himself with the whole weight of the body. performs fast rhythmic shocks with a frequency of once per second. In this case, the sternum should bend by 3-4 cm, and with a wide chest - by 5-6 cm. To facilitate the flow of venous blood to the heart, the victim's legs are given an elevated position. When conducting an indirect massage, observe the following rules: - when applying pressure, the rescuer's shoulders should be above his palms; - pressure on the sternum is carried out to a depth of 4-5 cm; - Approximately 15 compressions should be done in 10 seconds (from 80 to 100 compressions per minute); - to produce pressure smoothly in a vertical straight line, constantly holding hands on the sternum; - do not make swinging movements during the procedure (this reduces the effectiveness of pressure and wastes your strength in vain); - before starting the next pressure, let the chest rise to its original position. The technique of indirect heart massage in children depends on the age of the child. For children under 1 year old, it is enough to press on the sternum with one or two fingers. To do this, the rescuer lays the child on his back with his head to himself, covers the child so that the thumbs are located on the front surface of the chest, and their ends are on the lower third of the sternum, the rest of the fingers are placed under the back. For children over the age of 1 year and up to 7 years, heart massage is performed, standing on the side, with the base of one hand, and older children - with both hands (as adults). During the massage, the chest should bend down by 1.0-1.5 cm in newborns, by 2.0-2.5 cm in children 1-12 months old. , by 3-4 cm - in children older than 1 year. The number of pressures on the sternum for 1 min should correspond to the average age-related pulse rate, which is 140 in a newborn, and 6 months in children. - 130-135, 1 year - 120-125, 2 years -110-115, Zlet - 105-110, 4 years - 100-105, 5 years - 100, 6 years - 90-95, 7 years - 85-90 , 8-9 years old - 80-85, 10-12 years old - 80, 13-15 years old - 75 beats per 1 minute. An indirect heart massage must be combined with artificial respiration. They are more convenient for two people. In this case, one of the rescuers makes one blowing of air into the lungs, then the other makes five pressures on the chest. An indirect heart massage is a simple and effective measure that allows you to save the life of the injured, and is used in first aid. The success achieved with indirect massage is determined by the constriction of the pupils, the appearance of an independent pulse and breathing. This massage should be carried out before the arrival of the doctor.
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29. Injections There are several ways to administer drugs. Seriously ill patients are most often administered parenterally (bypassing the gastrointestinal tract), that is, subcutaneously, intramuscularly, intravenously using a syringe with a needle. These methods make it possible to quickly obtain the desired therapeutic effect, ensure accurate dosing of the drug, and create its maximum concentration at the injection site. Injections and infusions are carried out in compliance with the rules of asepsis and antisepsis, that is, with a sterile syringe and needle, after careful treatment of the hands of the person making the injection and the skin of the victim at the site of its upcoming puncture. The syringe is the simplest pump suitable for injection and suction. Its main components are a hollow cylinder and a piston, which must fit snugly against the inner surface of the cylinder, sliding freely along it, but not letting air and liquid through. The cylinder - glass, metal and plastic (in disposable syringes) can be of various capacities. At one end, it passes into a drawn tip or cone in the form of a funnel for a needle attachment; the other end remains open or has a removable cap with a hole for the piston rod. The piston is mounted on a rod on which there is a handle. Checking the syringe for leaks is carried out as follows: close the cylinder body with the second and third fingers of the left hand (in which the syringe is held), and move the piston down with the right, then release it. If the piston quickly returned to its original position, the syringe is sealed.
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Before use, syringes and needles must be sterilized (disinfected). At home, it is carried out by boiling in a fire or electric disinfection boiler (sterilizer). Mechanically cleaned and washed syringes are disassembled, wrapped with gauze and placed on the sterilizer mesh. Needles are also placed here (at least two for each syringe), tweezers, mesh hooks to ensure sterile conditions for assembling the syringe. Distilled or boiled water is poured into the sterilizer so that it completely covers the syringes. Duration of sterilization by boiling - 45 minutes from the moment of boiling water. After that, remove the lid of the boiler and put it with the inner surface up. With sterile tweezers, hooks are taken out of the sterilizer, with their help they lift the mesh with syringes and needles and place it obliquely on the sterilizer. A cylinder, a piston and two needles are placed on the inside of the sterilizer lid with sterile tweezers, after which the syringe cylinder is grabbed with sterile tweezers and transferred to the left hand. Then, with the same tweezers, they take the piston by the handle and insert it into the cylinder. With sterile tweezers, grasp the needle by the sleeve (after removing the mandrin from it) and put it on the needle of the syringe with rotational movements. To check the patency of the needle, air is passed through the needle by moving the piston inside the cylinder. Before you draw a drug into a syringe, you must carefully read its name on the ampoule or vial and clarify the method of administration. For each injection, 2 needles are needed: one for taking the drug solution into the syringe, the other directly for injection. A narrow part of the ampoule is filed with a nail file or an emery cutter, then the neck of the ampoule is treated with a cotton ball moistened with alcohol (in case the needle touches the outer surface of the ampoule when taking the drug) and break it off. The medicine is taken from the ampoule by sucking it into the cavity of the syringe. To do this, an opened ampoule is taken in the left hand, and a needle is inserted into it with the right. put on a syringe and, slowly pulling back the piston, draw up the required amount of solution, which can be determined by the divisions marked on the cylinder wall. The needle with which the solution was taken is removed, and an injection needle is put on the needle cone. The syringe is placed vertically with the needle up and air is carefully removed from it.
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The choice of site for subcutaneous injection depends on the thickness of the subcutaneous tissue. The most convenient areas are the outer surface of the thigh, shoulder, subscapular region. The skin at the site of the upcoming injection is carefully treated with ethyl alcohol (an alcohol solution of iodine can also be used). The thumb and forefinger of the left hand collect the skin and subcutaneous tissue into a fold. There are two ways to hold a syringe and give an injection. First way. The syringe barrel is held by the first, third and fourth fingers, the second finger lies on the needle sleeve, the fifth on the piston. The injection is made at the base of the fold from the bottom up, at an angle of 30 ° to the surface of the body. After that, the syringe is intercepted with the left hand, the rim of the cylinder is held with the second and third fingers of the right hand, and the piston handle is pressed with the first finger. Then, with the right hand, a cotton ball moistened with ethyl alcohol is applied to the injection site and the needle is quickly removed. The injection site is lightly massaged. The second way. The filled syringe is held vertically with the needle down. The fifth finger lies on the needle sleeve, the second on the piston. Quickly inserting the needle, the second finger is moved to the piston handle and, pressing on it, the drug is injected, after which the needle is removed. With any method of subcutaneous injection, the cut of the needle should be directed upwards, and the needle should be inserted approximately 2/3 of the length. To achieve a faster effect when administering drugs, as well as for parenteral administration of poorly absorbable drugs, an intramuscular injection is performed. The injection site is chosen in such a way that there is a sufficient muscle layer in this area and there is no accidental injury to large nerves and blood vessels. Intramuscular injections are most often made in the gluteal region - in its upper outer part (quadrant). Use long needles (60 mm) with a large diameter (0.8-1.0 mm). The syringe is held in the right hand with the needle down, perpendicular to the surface of the body, while the second finger is located on the piston, and the fifth on the needle sleeve. The skin is pulled with the fingers of the left hand, the needle is quickly inserted to a depth of 5-6 cm, the piston is pulled up to prevent the needle from entering the vessel, and only then the drug is slowly injected. Remove the needle quickly, in one motion. The injection site is treated with a cotton ball moistened with ethyl alcohol. Areas of the human body where subcutaneous or intramuscular injections should not be made
slide 51
For intravenous injection, one of the veins of the elbow bend is most often used. Injections are made in the position of the victim sitting or lying down, the unbent arm is placed on the table, with the elbow up. A tourniquet is applied to the shoulder so as to compress only superficial veins and not block the flow of arterial blood. The pulse on the radial artery should be well defined. To speed up the swelling of the veins, the victim is asked to vigorously bend the fingers of the hand, while the veins of the forearm fill up and become clearly visible. The skin of the elbow is treated with a cotton ball moistened with ethyl alcohol. Then, with the fingers of the right hand, they take a syringe connected to the needle, and with two fingers of the left hand they pull the skin and fix the vein. Holding the needle at a 45° angle, pierce the skin and advance the needle along the course of the vein. Then the angle of inclination of the needle is reduced and the wall of the vein is pierced, after which the needle is advanced almost horizontally in the vein somewhat forward. When a needle enters a vein, blood appears in the syringe. If the needle does not enter the vein, then when the piston is pulled up, blood will not flow into the syringe. When taking blood from a vein, the tourniquet is not removed until the end of the procedure. With intravenous injection, the tourniquet is removed and, slowly pressing on the piston, the drug is injected into the vein. Constantly monitor that air bubbles do not enter the vein from the syringe and that the solution does not enter the subcutaneous tissue. Prevention of post-injection complications. The main cause of complications are errors made when performing injections. The most common violations of the rules of asepsis, as a result of which purulent complications may develop. Therefore, before injection, you need to check the integrity of the vial or ampoule, make sure that the label is sterile. Use only a sterile syringe and needle. Ampoules with medicines, bottle caps - wipe thoroughly with ethyl alcohol before use. Hands must be thoroughly washed and also treated with ethyl alcohol. If there is a seal or redness of the skin at the injection site, you need to make a warming water compress, put a heating pad. .Another cause of complications is a violation of the rules for administering drugs. If the needle is not chosen correctly, then excessive trauma to the tissues occurs, a hematoma, a seal are formed. With a sharp movement, the needle may break and part of it will remain in the tissues. Before injection, the needle should be carefully examined, especially at the junction of the rod with the cannula, where fracture is most likely. Therefore, the entire needle should never be dipped into the tissue. If there is such a complication, then you need to remove it as soon as possible.
slide 52
30. EXAMINATION OF THE INJURED Being in a passive position, the victim is motionless, cannot independently change the adopted position, the head and limbs hang down. Such a situation occurs in an unconscious state. The victim takes a forced position to alleviate a serious condition, relieve pain; for example, with damage to the lungs, pleura, he is forced to lie on the affected side. The victim takes the supine position mainly with severe pain in the abdomen; with kidney damage, some victims keep the leg (from the side of the lesion) bent at the hip and knee joint, as this relieves pain. The main indicators of the vital activity of the organism are the preserved respiration and cardiac activity.
slide 53
31. SIGNS OF LIFE The signs of life are: - Presence of preserved breathing. It is determined by the movement of the chest and abdomen, the fogging of a mirror applied to the nose and mouth, the movement of a ball of cotton wool or a bandage brought to the nostrils: - the presence of cardiac activity. It is determined by probing the pulse - jerky, periodic oscillations of the walls of peripheral vessels. You can determine the pulse on the radial artery, located under the skin between the styloid process of the radius and the tendon of the internal radial muscle. In cases where it is impossible to examine the pulse on the radial artery, it is determined either on the carotid or temporal artery, or on the legs (on the dorsal artery of the foot and posterior tibial artery). Usually, the pulse rate in a healthy person is 60-75 beats / min, the pulse rhythm is correct, uniform, the filling is good (it is judged by squeezing the artery with fingers with different strengths). The pulse quickens in case of insufficiency of cardiac activity as a result of injuries, with blood loss, during pain. A significant decrease in the pulse occurs in severe conditions (craniocerebral injury): - the presence of a pupillary reaction to light. It is determined by directing a beam of light from any source to the eye; constriction of the pupil indicates a positive reaction. In daylight, this reaction is checked as follows: close the eye with a hand for 2-3 minutes, then quickly remove the hand; if the pupils narrow, then this indicates the preservation of the functions of the brain. The absence of all of the above is a signal for immediate resuscitation (artificial respiration, chest compressions) until signs of life are restored. Resuscitation of the victim becomes inappropriate 20-25 minutes after the start of resuscitation, provided there are no signs of life.
slide 54
32. SIGNS OF DEATH The onset of biological death - the irreversible cessation of the body's vital activity - is preceded by agony and clinical death. Agony is characterized by a darkened consciousness, lack of a pulse, respiratory distress, which becomes irregular, superficial, convulsive, and a decrease in blood pressure. The skin becomes cold, with a pale or bluish tint. After the agony comes clinical death. Clinical death is a condition in which there are no main signs of life - heartbeat and respiration, but irreversible changes in the body have not yet developed. Clinical death lasts 5-8 minutes. This period must be used to provide resuscitation. After this time, biological death occurs. Signs of death are: - no breathing; - no heartbeat; - lack of sensitivity to pain and thermal stimuli; - decrease in body temperature; - clouding and drying of the cornea of the eye; - absence of gag reflex; - cadaveric spots of blue-violet or purple-red color on the skin of the face, chest, abdomen; - rigor mortis, which manifests itself 2-4 hours after death. The final decision on the death of the victim is made in accordance with the procedure established by law.
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