Providing first aid article. First aid rules. First aid instructions

First aid is a set of urgent measures aimed at saving a person's life. An accident, a sharp attack of illness, poisoning - in these and other emergencies, competent first aid is needed.

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

The ability to provide first aid is an elementary but very important skill. He can save someone's life. Here are 10 basic first aid skills.

First aid algorithm

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

1. Make sure that when giving first aid you are not in danger and you do not endanger yourself.
2. Ensure the safety of the victim and others (for example, remove the victim from a burning car).
3. Check for signs of life (pulse, breathing, pupillary reaction to light) and consciousness in the victim. To check for breathing, you need to tilt the victim's head back, bend over to his mouth and nose and try to hear or feel breathing. To detect the pulse, it is necessary to attach the fingertips to the carotid artery of the victim. To assess consciousness, it is necessary (if possible) to take the victim by the shoulders, shake gently and ask a question.
4. Call specialists:, from the city - 03 (ambulance) or 01 (rescuers).
5. Provide emergency first aid. Depending on the situation, this may be:
   • restoration of airway patency;
   • cardiopulmonary resuscitation;
   • stop bleeding and other measures.
6. Provide the victim with physical and psychological comfort, wait for the arrival of specialists.

Artificial respiration

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

Typical situations requiring IVL:

• car accident;
• accident on the water
• electric shock and others.

There are various ways of IVL. Mouth-to-mouth and mouth-to-nose artificial respiration is considered the most effective in providing first aid to a non-specialist.

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

mouth-to-mouth artificial respiration technique

1. Ensure patency of the upper airway. Turn the head of the victim to one side and use your finger to remove mucus, blood, foreign objects from the oral cavity. Check the victim's nasal passages, clean them if necessary.
2. Tilt the victim's head back while holding the neck with one hand.
   

   Do not change the position of the head of the victim with a spinal injury!

3. Place a tissue, handkerchief, piece of cloth, or gauze over the victim's mouth to protect yourself from infections. Pinch the victim's nose with your thumb and forefinger. Inhale deeply, press your lips tightly against the victim's mouth. Exhale into the victim's lungs.
   

   The first 5–10 breaths should be fast (20–30 seconds), then 12–15 breaths per minute.

4. Watch the movement of the victim's chest. If the victim's chest rises when inhaling air, then you are doing everything right.

Indirect cardiac massage

If there is no pulse along with breathing, it is necessary to do an indirect heart massage.

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

Attention! It is impossible to carry out a closed heart massage in the presence of a pulse.

Chest Compression Technique

1. Lay the victim down on a flat, hard surface. Do not perform chest compressions on a bed or other soft surfaces.
2. Determine the location of the affected xiphoid process. The xiphoid process is the shortest and narrowest part of the sternum, its end.
3. Measure 2-4 cm upward from the xiphoid process - this is the point of compression.
4. Place the base of your palm on the compression point. In this case, the thumb should point either to the chin or to the stomach of the victim, depending on the location of the resuscitator. Place the other hand on top of one hand, fold your fingers into the lock. Pressing is carried out strictly with the base of the palm - your fingers should not come into contact with the victim's sternum.
5. Perform rhythmic chest thrusts strongly, smoothly, strictly vertically, with the weight of the upper half of your body. Frequency - 100-110 pressures per minute. In this case, the chest should bend by 3-4 cm.
   

   For infants, indirect heart massage is performed with the index and middle fingers of one hand. Teenagers - the palm of one hand.

If mechanical ventilation is performed simultaneously with closed heart massage, every two breaths should alternate with 30 chest compressions.

If, during resuscitation, the victim regains breathing or a pulse appears, stop first aid and lay the person on his side, putting his hand under his head. Keep an eye on his condition until paramedics arrive.

Heimlich maneuver

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

Signs of airway obstruction:

• Lack of complete breathing. If the windpipe is not completely blocked, the person coughs; if completely - holds on to the throat.
• Inability to speak.
• Blueness of the skin of the face, swelling of the vessels of the neck.

Airway clearance is most often performed using the Heimlich method.

1. Stand behind the victim.
2. Grab it with your hands, clasping them into a lock, just above the navel, under the costal arch.
3. Strongly press on the victim's abdomen, sharply bending your elbows.
   

   Do not apply pressure to the victim's chest, except for pregnant women who apply pressure to the lower chest.

4. Repeat this several times until the airways are clear.

If the victim has lost consciousness and fallen, lay him on his back, sit on his hips and with both hands press on the costal arches.

To remove foreign bodies from the child's respiratory tract, turn him on his stomach and pat 2-3 times between the shoulder blades. Be very careful. Even if the baby coughs quickly, see a doctor for a medical examination.

Bleeding

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

Stopping capillary bleeding is carried out by applying an aseptic bandage, and also, if the arms or legs are injured, by raising the limbs above the level of the body.

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

To stop arterial bleeding, the artery must be clamped.

Artery Clamping Technique: Firmly press the artery with your fingers or fist against the underlying bone formations.

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

If the bleeding does not stop after applying a tight bandage and pressing on the artery, apply a tourniquet. Remember that this is a last resort when other methods fail.

Technique for applying a hemostatic tourniquet

1. Apply a tourniquet to clothing or a soft pad just above the wound.
2. Tighten the tourniquet and check the pulsation of the vessels: the bleeding should stop, and the skin below the tourniquet should turn pale.
3. Put a bandage on the wound.
4. Record the exact time the tourniquet was applied.

A tourniquet can be applied to the limbs for a maximum of 1 hour. After its expiration, the tourniquet must be loosened for 10-15 minutes. If necessary, you can tighten again, but no more than 20 minutes.

fractures

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

Fracture First Aid Technique

1. Assess the severity of the victim's condition, determine the location of the fracture.
2. If there is bleeding, stop it.
3. Determine whether it is possible to move the victim before the arrival of specialists.
   

   Do not carry the victim and do not change his position in case of spinal injuries!

4. Ensure the immobility of the bone in the fracture area - perform immobilization. To do this, it is necessary to immobilize the joints located above and below the fracture.
5. Put on a tire. As a tire, you can use flat sticks, boards, rulers, rods, etc. The tire must be tightly, but not tightly fixed with bandages or plaster.

With a closed fracture, immobilization is performed over clothing. With an open fracture, you can not apply a splint to places where the bone protrudes outward.

burns

A burn is damage to body tissues caused by high temperatures or chemicals. Burns vary in degrees as well as types of damage. According to the last reason, burns are distinguished:

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

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

Then, in case of thermal burns, the affected area should be freed from clothing (gently, without tearing off, but cutting off the adhering tissue around the wound) and, for the purpose of disinfection and anesthesia, irrigate it with a water-alcohol solution (1/1) or vodka.

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

Then irrigate the wound with cold water, apply a sterile dressing and apply ice. Also, give the victim warm salted water.

To speed up the healing of minor burns, use sprays with dexpanthenol. If the burn covers an area of ​​more than one palm, be sure to consult a doctor.

Fainting

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

It is important to distinguish between ordinary and epileptic syncope. The first is usually preceded by nausea and dizziness.

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

Typical situations of fainting:

• fright,
• excitement,
• stuffiness and others.

If the person faints, put him in a comfortable horizontal position and provide fresh air (unbutton clothes, loosen belt, open windows and doors). Sprinkle cold water on the face of the victim, pat him on the cheeks. If you have a first-aid kit on hand, give a cotton swab moistened with ammonia to sniff.

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

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

Drowning and sunstroke

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

First aid for drowning

1. Remove the victim from the water.
   

   A drowning man grabs everything that comes to hand. Be careful: swim up to him from behind, hold him by the hair or armpits, keeping your face above the surface of the water.

2. Lay the victim on his knee with his head down.
3. Clear the oral cavity of foreign bodies (mucus, vomit, algae).
4. Check for signs of life.
5. In the absence of a pulse and breathing, immediately start mechanical ventilation and chest compressions.
6. After recovery of breathing and cardiac activity, lay the victim on his side, cover him and ensure comfort until the arrival of paramedics.

In the summer, sunstroke is also a danger. Sunstroke is a brain disorder caused by prolonged exposure to the sun.

Symptoms:

• headache,
• weakness,
• noise in ears,
• nausea,
• vomit.

If the victim is still exposed to the sun, his temperature rises, shortness of breath appears, sometimes he even loses consciousness.

Therefore, when providing first aid, first of all, it is necessary to transfer the victim to a cool, ventilated place. Then release him from clothes, loosen the belt, undress. Place a cold, wet towel on his head and neck. Let me smell the ammonia. Give artificial respiration if necessary.

In case of sunstroke, the victim should be given plenty of cool, slightly salted water (drink often, but in small sips).

Causes of frostbite - high humidity, frost, wind, immobility. Aggravates the condition of the victim, as a rule, alcohol intoxication.

Symptoms:

• feeling cold;
• tingling in the frost-bitten part of the body;
• then - numbness and loss of sensation.

First aid for frostbite

1. Keep the victim warm.
2. Take off any cold or wet clothing.
3. Do not rub the victim with snow or a cloth - this will only injure the skin.
4. Wrap the frostbitten area of ​​the body.
5. Give the victim hot sweet drink or hot food.

Poisoning

Poisoning is a disorder of the body's vital functions that has arisen due to the ingress of poison or toxin into it. Depending on the type of toxin, poisoning is distinguished:

• carbon monoxide,
• pesticides,
• alcohol
• drugs,
• food and others.

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

In addition, accidental or intentional drug poisoning and alcohol intoxication are common.

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

1. Rinse the victim's stomach. To do this, make him drink several glasses of salted water (for 1 liter - 10 g of salt and 5 g of soda). After 2-3 glasses, induce vomiting in the victim. Repeat these steps until the vomit is "clean".
   

   Gastric lavage is possible only if the victim is conscious.

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

What is First Aid?

First Medical Aid (FMA) is a set of measures aimed at saving lives, reducing suffering and reducing the negative consequences for the health of victims in emergencies. First aid can be provided by any person who is at the scene of an emergency and is able to provide it, before the arrival of emergency rescue and medical teams in the emergency zone.

An accident is a sudden event that caused significant material, environmental, or any other serious damage, but people were not injured.

A catastrophe is a sudden event that results in injury or death.

An emergency situation (ES) is a sudden event that resulted in the death of two or more people, three or more people were injured and are in serious condition.

An emergency zone is a territory where an emergency situation has arisen and where a danger to human life and health remains, until this danger is eliminated by the forces of emergency rescue teams.

Who can and who is obliged to provide First Aid?

Legal basis for the provision of First Medical Aid:

1. Article 41 of the Constitution of the Russian Federation – “everyone has the right to health care and medical care.” Therefore, everyone has the right to receive emergency medical care, including pre-medical care. Anyone who can provide such assistance has the right to provide it.

2. Article 39 of the Fundamentals of the Legislation of the Russian Federation on the Protection of the Health of Citizens, No. 5487-1 dated July 22, 1993 - “first medical aid should be provided without delay by medical institutions, regardless of territorial, departmental subordination and form of ownership, medical workers, as well as persons obliged to provide it in the form of first aid by law or special rule. The latter include employees of law enforcement agencies and departments (Ministry of Internal Affairs, FSB, FSO, Ministry of Emergency Situations, etc.), military personnel who find themselves in the emergency zone, as well as employees of organizations and enterprises where an emergency occurred.

3. Article 10, paragraph 13 of the Federal Law "On the Police" No. 1026-1 of April 18, 1991 - "police officers are obliged to take urgent measures in case of accidents, catastrophes, fires, natural disasters and other emergency events to save people and provide them with first aid medical care."

4. Federal Law “On the Internal Troops of the Ministry of Internal Affairs of the Russian Federation” No. 27-FZ of February 6, 1997 prescribes their participation “together with the internal affairs bodies in taking urgent measures to save people, protect property left unattended, ensure the protection of public order in emergency situations and other emergency circumstances, as well as in ensuring the state of emergency.” Article 25 of this Law obliges the servicemen of the internal troops, when using physical force, special means, weapons, military and special equipment, “to ensure the provision of first aid to persons who have received bodily injuries.”

5. Article 16 of the Law "On private detective and security activities in the Russian Federation" No. 2487-1 of March 11, 1992 also obliges employees of these structures to provide first aid.

6. Paragraphs 362-366 of the "Charter of the garrison and guard service of the Armed Forces of the Russian Federation", approved by Decree of the President of the Russian Federation No. 2140 of December 14, 1993 - "military units of the Armed Forces of the Russian Federation may be involved in eliminating the consequences of emergency circumstances or to provide assistance, including including the first medical, affected population.

7. Federal Law "On Civil Defense" No. 28-FZ of February 12, 1998, which sets the main tasks of civil defense and protection of the population "carrying out emergency rescue operations in the event of danger to the population during the conduct of hostilities or as a result of these actions, and also due to natural and man-made emergencies. Priority provision of the population affected by the conduct of hostilities or as a result of these actions, including medical care, including the provision of first aid. The law defines the circle of persons obliged to perform these tasks: “military formations specially designed to solve problems in the field of civil defense, organizationally united in civil defense troops, as well as emergency rescue formations and rescue services, as well as the Armed Forces of the Russian Federation, other troops and military formations.

8. Labor Code of the Russian Federation No. 197-FZ of December 30, 2001, as amended since October 2006. Federal Law "On the Fundamentals of Labor Protection in the Russian Federation" No. 181-FZ dated July 17, 1999 - "the employer is obliged to ensure that measures are taken to prevent accidents, preserve the life and health of employees in the event of such situations, including the provision of first aid to victims ".

Who can be trained in First Aid?

Article 19 of the Federal Law "On the protection of the population and territories from natural and man-made emergencies" No. 68-FZ of December 21, 1994 - "every citizen of the Russian Federation can and must learn first aid techniques, as well as improve their knowledge and practical skills in the specified area.

Article 33 of the Fundamentals of the Legislation of the Russian Federation on the Protection of the Health of Citizens - a citizen providing assistance cannot exceed his qualifications in the field of medical knowledge, that is, prescribe and use potent medications, perform complex medical manipulations that he does not own.

Is it possible to provide First Aid without the consent of the victim?

Article 33 of the Fundamentals of the Legislation of the Russian Federation on the Protection of the Health of Citizens enshrines the right of a citizen to refuse medical intervention. Providing assistance without the consent of the victim is allowed if: the victim has not reached the age of 14 and his legal adult representative is not nearby, the victim is unconscious, the victim suffers from diseases that pose a danger to others (for example, especially dangerous infections) or a severe mental disorder, the victim has committed socially dangerous act.

As a socially dangerous act, the refusal of the victim to receive medical care during an emergency can be regarded if these actions increase panic among other victims or otherwise impede the elimination of the medical consequences of an emergency.

What should a rescuer have in their pockets?

Simple but necessary items may be required to successfully and safely provide First Aid. A good rescuer, always and everywhere, should have with him:

Two pairs of medical rubber gloves - work safety, making drainage for the pleural cavity.

Two large bandages 7x14 or two dressing bags - stopping bleeding, dressings, immobilization, restoring the patency of the upper respiratory tract.

A high-quality folding knife or multitool - removing clothes from the victim, making tires and devices from improvised materials, well, for all occasions ...

A good LED flashlight - examination of the victim, diagnosis of life-threatening conditions, diagnosis of an upper respiratory tract burn.

A coil of wide adhesive tape or adhesive tape - fixing dressings and splints, fixing an occlusive dressing for pneumothorax, fixing pleural drainage.

Small notepad - record information and data about the victims.

With this simple arsenal, it will be easier to complete the task, it weighs nothing and takes up little space in the bag and pockets.

Diagnosis of shock in the absence of a sphygmomanometer (apparatus for measuring blood pressure).

It should be remembered: if there is a pulse on the peripheral arteries (radial artery) - systolic blood pressure is above 80 mm Hg. Art. (shock 1 degree). If there is a pulse on the main arteries (carotid, femoral arteries) - systolic blood pressure is above 40 mm Hg. Art. (shock 2 degrees). In shock 1 degree blood pressure (BP) 90\60 mm Hg. Art. and below. With shock of the 2nd degree, blood pressure is 70/40 mm. rt. Art. and below. With shock of the 3rd degree, blood pressure is 40\0 mm Hg. Art. or not defined.

It should be remembered that during the development of shock, there can be two phases: the erectile phase of shock (stage of excitation) - usually immediately after the moment of injury. The victim is excited, rushing about, rolling on the ground, screaming, swearing, loudly calling for help. The phase is very short. Then the torpid phase of shock develops (the stage of inhibition) - the victim lies quietly, does not call for help, depression of consciousness develops, signs of life-threatening bleeding are visible. Hence one of the basic rules: first of all, we pay attention to the “quiet” victims, and not those who loudly call for help!!! This is especially true for children: a crying child is the norm, a quiet and lethargic child is an alarm!!! The typical behavior of adult victims (especially representatives of courageous professions - military, policemen, rescuers, etc.) - lethargic, quiet, outwardly - minor visible injuries (ecchymosis - bruises, "bruises" and abrasions, minor wounds) try to refuse help: “I will lie down / sit here and everything will pass” - anxiety !!!

Fight shock.

a non-medical rescuer has a very limited arsenal of dealing with shock.

Stop bleeding, apply bandages to wounds, immobilize injured limbs.

Put the patient in the Trendelenburg position - raise the legs above the head (reception of "self-transfusion" of blood). Provides outflow of blood from the lower extremities to the brain. Nothing more can be done with bare hands.

If there are medicines, syringes, infusion systems (“droppers”) and a person who knows how to use them. If an emergency occurred in an area “far from civilization” and there is no possibility of a quick arrival of a doctor. In a hopeless situation and to save the life of the victim:

Anesthetize the victim. Use only central analgesics or narcotics. Promedol in syringe tubes (available from military personnel, in military field conditions, in IPP packs). Tramal - 100 (ampoules), nalbuphine (ampoules), butorphanol (ampoules) - analgesics of the central type, do not belong to narcotic drugs (specially registered, the circulation of which is controlled by law) - may be found in someone at the scene of an emergency. Ketorol (ampoules) does not belong to the central type of analgesics, but is quite effective. Introduce one ampoule of the above drugs intramuscularly or intravenously (preferably) to an adult, inject half an ampoule to children. Small children 0.1 milliliter per year of life, but not more than 0.5 milliliters. Ketorol is administered only intramuscularly. The introduction of drugs not of central analgesic action (Analgin, Nurofen, etc.) is ineffective. The introduction of drugs inside (tablets, capsules) is ineffective. But you can try if there is no other choice. If there are no syringes and there are only ampoules, the contents of the ampoule can be given to drink. Trying to use non-medical drugs is harmful, completely pointless and punishable by law. The substances that drug addicts use have almost no analgesic effect, but there are many other, extremely harmful features.

Intravenous administration of corticosteroid hormones. Prednisone or dexamethasone. Three - four ampoules for an adult, one - two for a child. The goal - the anti-shock effect of hormones ensures the stabilization of cell membranes, reduces the permeability of the walls of blood vessels, promotes the opening of the lumen of small peripheral vessels and the return to the bloodstream of that part of the blood that was deposited (retained) in the peripheral vessels against the background of the onset of centralization of blood circulation during shock.

Start intravenous fluid drip. All solutions for intravenous infusions (infusions) are divided into two groups: crystalloids (saline solutions) and colloids (blood substitutes).

Crystalloids include (most often found in ambulance packs, in various emergency packs, first aid kits and stocks): isotonic sodium chloride solution 0.9%, Disol, Trisol, Acesol, Lactasol, Quartasol, Stabizol.

Colloids include (the most common): Polyglucin, Reopoliglyukin, Gelatinol, solutions of hydroxyethyl starch (HAES) 6% and 10%.

Patients with craniocerebral injury and suspicion of it should not be dripped with 5% isotonic glucose solution - it increases the permeability of cerebral vessels, provokes the development of cerebral edema and fatal complications.

For successful relief of shock, colloids and crystalloids are administered in a 1:1 ratio.

Infusion always begins with the introduction of saline solutions! If you start with the introduction of colloids, you can get dangerous complications and damage to the kidneys! The only colloidal drug that can be started with is Voluven (4th generation HAES drug).

The volume of infusion is ten milliliters per kilogram of the patient's body weight in one hour. The total infusion volume is not more than thirty milliliters per kilogram of body weight for the entire infusion time. It is not recommended to significantly exceed this volume when providing assistance to a person without a medical education (to exceed slightly - it's okay). With a significant excess administration of solutions, pulmonary edema may occur - the so-called "Danang lung" (Danang Lung), a problem that the Americans faced during the Vietnam War, with massive assistance to wounded soldiers, medical instructors without a full medical education. The body weight of a newborn is 3.5 kg, a five-year-old child is 20 kg, a teenager is 40 kg, a thin woman is 50 kg, a full woman is 70 kg, a thin man is 80 kg, a large man is 100 kg (average values ​​​​by which the volume of infusion can be calculated).

We inject the first half a bottle of saline solution quickly (in a jet or very frequent drops), then we drip at a speed of one drop in two seconds (we count calmly one or two, at the expense of “two” - a drop drips). The next vial is a colloidal solution (if you have a choice, any 6% HAES solution). Next is a bottle of saline, then a bottle of colloidal solution. Standard bottles of 400 or 500 milliliters, there are bottles of 200 and 250 milliliters.

We remember that the use of any medicines by people without medical education is permissible only in exceptional cases, to save the life of the victim. When the isolation phase during an emergency is delayed for several hours and there is no possibility of a doctor arriving earlier. If any medications were used before the arrival of the doctor, write down / remember which and in what dose, the time of administration and report to the doctor upon his arrival at the emergency site.

Headbands.

Bandage "Cap". The most common neurosurgical dressing. Advantages - simple, securely fixes and evenly presses the dressing to the wound on the head, can be easily removed in one motion. Disadvantages - requires the assistance of a second rescuer or the victim (if he is conscious) when applying a bandage. Put a piece of bandage about 1 meter long on the patient's head over the dressing material (a napkin applied directly to the wound). Lower the ends of this segment down in front of the patient's ears (like the ears of a hat with earflaps). Ask the patient or a second rescuer to hold these ends taut. Apply two (!) circular fixing rounds along the line of the eyebrow - ear - large occipital protuberance. Bring the third round to a bandage segment, wrap it around it and draw it along the scalp, closer to the forehead, to the bandage segment at the opposite ear. Again wrap around a segment of the bandage and lead to the scalp, closer to the back of the head. Repeat until the entire scalp is covered with a bandage. Finish the bandage with two fixing rounds. Tie the ends of the fixing section of the bandage under the chin. To remove the bandage, simply untie the fixing segment and pull its ends up. There is a variation of this bandage - the “Hippocratic cap” - the overlay technique is similar, but without a fixing segment of the bandage. It stays very unreliable. Not applicable in emergency situations.

Bandage "Bridle". The second most common bandage. Reminds me of a motorcycle or hockey helmet. Allows you to securely fix the dressing in the parietal, temporal, zygomatic area, in the eye or ear area, fix the lower jaw. Universal, simple, reliable, does not require assistants when applying. The disadvantage is that it does not allow you to completely close the scalp. Impose two fixing rounds according to the usual rule. The third tour is carried out from the occipital side under the ear to the lower jaw (do not press the tour on the front surface of the neck!). Make several rounds from under the jaw to the scalp. Conduct a tour from under the jaw to the back of the head, apply two fixing tours. When conducting a tour from the occipital region, you can enter the ear or eye. The most versatile bandage for damage to the lateral area of ​​the head and face.

Eye and ear patch. Simple, low bandage consumption. Make two fixing rounds according to the usual rule. The third round is carried out from the back of the head, under the ear, on the cheek, on the eye. Apply the desired number of tours to the eye or ear. You can make a call to the second eye or ear. Make two fixing rounds.

Bandage on the back of the head. The disadvantage is that it passes along the front surface of the neck, it cannot be made pressing. Dignity - closes the occipital region and the back of the neck (!). Apply two fixing rounds, draw from the occipital region to the front surface of the neck, hold to the occipital region. Set the required number of rounds. Finish with two fixing rounds. It is used only if there is nothing else besides a bandage and napkins. The best way is to secure a thick layer of dressing with a cervical collar (for any neck injury, a collar is applied in any case!).

Bandages on the chest.

Spiral chest bandage with support. The simplest and most common. In addition to fixing the dressing, it serves to fix the occlusive dressing over the adhesive tape (with open pneumothorax) and for transport immobilization in case of multiple fractures of the ribs. Apply a long piece of bandage obliquely over the patient's shoulder girdle (like a witness's ribbon at a wedding). The ends of the segment in front and behind should go down to the middle of the patient's thigh. Apply a spiral bandage from the lower edge of the ribs to the armpits. Tie the ends of the long piece on the patient's other shoulder girdle.

Cross bandage on the chest. Fixes the dressing above the armpits on the chest or on the back. Fixes the dressing material in the area of ​​the mammary gland. Can be made one-sided or two-sided. Apply two fixing rounds along the lower edge of the ribs, hold the third round obliquely on the patient's shoulder girdle (like an officer's harness). On the back, you can draw a tour obliquely (in the manner of a harness), or you can draw it along the back of the neck back to the chest. Place a tour along the bottom edge of the ribs just above the previous one. Repeat the steps several times - as needed until the bandage is completed.

transport immobilization.

Transport immobilization is used for bone fractures, dislocations of bones, joint injuries, injuries of large vascular bundles and nerves, extensive soft tissue injuries and extensive burns, and frostbite. The goal is to reduce the suffering of the victim and prevent additional secondary injuries (for example, sharp bone fragments can damage blood vessels and nerves) during transportation. Transport immobilization plays a special role in assisting victims in emergencies: with a large number of severely injured, there is not enough time for a thorough examination of each individually, at the scene of an emergency, and some injuries can be “missed” and not noticed. Especially in unconscious victims. The transport immobilization allows to prevent the complications connected with it.

Signs of a broken bone:

Edema at the fracture site - bleeding from the vessels of the bone into the surrounding soft tissues.

Sharp pain on palpation (palpation).

Violation of the function of the limb - the patient can not make active movements of the limb.

Painful axial load on the limb - for example, a patient has a fracture of the lower third of the thigh - with a light tapping of the fingers on the heel from below, along the axis of the limb - there will be a sharp pain at the fracture site.

Shortening of a broken limb compared to a healthy one.

Visible deformity of the limb.

Pathological limb mobility (non-normal) at the fracture site.

Crepitus (crunching) of bone fragments on palpation of the fracture site.

With an open fracture - the presence of a wound at the fracture site (mandatory!), Visible bone fragments in the wound (optional!).

Signs of dislocation of the limb in the joint:

Swelling in the area of ​​the injured joint.

Sharp pain on palpation in the area of ​​the damaged joint.

Limb dysfunction. The patient cannot make active movements in the joint. When you try to move a limb, the limb in the damaged joint “springs”.

Shortening of the limb compared to healthy.

There is no visible deformity of the limb outside the joints.

There is no pathological mobility of the limb outside the joints.

There is no crepitus of bone fragments on palpation in the joint area.

For immobilization are used:

Shants' collar, Elansky's splint - immobilization of the cervical spine.

Shield - immobilization in case of spinal injury.

Transport tires - immobilization of limbs. The most common are Cramer's ladder splints, splints with traction for immobilization of the thigh - the Dieterichs splint, disposable cardboard splints (if used correctly, they are most convenient).

Tires made from improvised materials and household items.

Fixing bandages - eight-shaped on the joint, Deso, Velpo.

Autoimmobilization - fixing the injured arm to the body, the injured leg to the healthy leg. By itself - ineffective, but useful in combination with tires from improvised materials.

Basic principles of immobilization:

Fix the joint above the fracture site and all joints below the fracture site (for example, fracture of the lower leg - ankle and knee joint, hip fracture - ankle, knee and hip joint). This is due to the fact that the tendons of most muscles “spread” through the joint (for example, the muscle is on the forearm - the tendon is attached to the humerus, this is the meaning of the joint - the muscle has contracted, the joint is bent), if the movements in the joint are not turned off - immobilization ineffective. The tendons of individual muscles can "spread" through several joints.

The tire should cover the limb from three sides (usually the back, inner and outer surfaces) - otherwise the lateral displacement of bone fragments cannot be ruled out, it is on the side of the bone that large vessels and nerves usually pass. When immobilizing the lower leg, the rear splint should reach the lower back, while immobilizing the thigh, the rear splint should reach the shoulder joint. Fix the tires to each other in at least six places (if we fix them with improvised means, and not with a bandage)!

Limbs, if possible, give the usual "physiological" position (the arm is bent at a right angle, the leg is extended). But in any case, the position should be the least painful for the patient. During any manipulations with the injured limb, the assistant fixes bone fragments above and below the fracture site!!!

With closed fractures, it is necessary to carry out a slight and careful traction of the limb at the fracture site along the axial line - to eliminate the interposition (infringement) of soft tissues between bone fragments. Usually - the muscles tighten the bone fragments "towards each other."

In case of open fractures, bone fragments should not be set!!! After stopping the bleeding and applying an AC bandage (aseptic dressing), fix the limb in the position in which it was at the time the victim was found.

Do not attempt to remove clothing from the injured limb. With open fractures, the clothes from the victim are cut off. With closed fractures (if you are sure) - clothes can be left.

It is impossible to impose an iron ladder tire on a naked body. Be sure to put a soft bedding. Typically, such tires are pre-wrapped with bandages or sheathed with oilcloth.

Under the bends of the limb (places of the joints), be sure to place a soft roller - “pilot” (a roll of a bandage, a folded hat, a piece of cloth, a medical glove inflated with air, etc.) all over.

Model the length and shape of the tire according to a healthy limb (the left leg is broken - we try on the tire on the right leg, etc.)

With any shifting and moving the patient onto a stretcher, a separate assistant should hold the injured limb!!!

Cerebral symptoms.

With an injury or disease of the brain, there are typical "general" symptoms: headache, dizziness, nausea, vomiting. "Brain vomiting" often occurs suddenly, without previous nausea, vomiting is plentiful - "fountain", does not bring the patient a sense of relief (unlike vomiting with food poisoning and diseases of the gastrointestinal tract). A typical clinical example of "cerebral vomiting" is a manifestation of "seasickness" (however, with seasickness, vomiting is preceded by nausea, since the organ of balance in the middle ear, the organ of Corti, is irritated). In severe traumatic brain injury, there is a violation of consciousness. There are three degrees of oppression of consciousness: stupor - the patient "like a drunk", staggers when walking, answers questions inaccurately and with a delay ("inhibited"), stupor - consciousness is disturbed, the patient "sleeps", reacts to a loud cry, strong pain stimuli, answers questions with great difficulty, if he is "stirred up", coma - consciousness is completely lost, does not respond to stimuli, there may be a violation of vital functions - breathing and blood circulation. There are three degrees of coma depth according to the Glasgow scale (this is already diagnosed by a doctor). It is important to remember that the earlier consciousness is lost from the moment of injury, the more severe the injury and the worse the prognosis. Consciousness can be restored for a short time - the "light gap" - the later it is from the moment of injury and shorter, the worse the prognosis. With an intracranial hematoma, a brain tumor, any volumetric process in the cranial cavity, anisocoria is observed (different pupil sizes) - one pupil is very narrowed, the second is dilated. The pupil is constricted on the side of the lesion (the pupil should dilate on the side of the lesion, but there is an optic chiasm in the brain). In a patient with a prosthesis of one eye (and especially with severe alcohol intoxication), one can make a mistake in determining anisocoria. It should be remembered that with anisocoria, the reaction of the pupils to light is reduced, but preserved (in an eye prosthesis, of course, there can be no reaction to light).

Never try water, feed, give medicine to the victim with impaired consciousness!!!

meningeal symptoms.

Occur when the meninges are irritated by an inflammatory process, tumor, subarachnoid hemorrhage (!). Subarachnoid hemorrhage can occur with a closed craniocerebral injury. At the same time, cerebral symptoms (nausea, vomiting, impaired consciousness) may not be present at first. There will be severe unbearable headache and meningeal symptoms. Rigidity (stiffness of the occipital muscles) - the patient lies on his back, put one hand on his chest, put the other on the back of his head, try to bend his neck forward, touch his chest with his chin. It will not work to bend the neck, there will be severe pain in the back of the head. Moreover, if the legs were straightened, the patient would bend them at the knees - the upper symptom of Brudzinsky. Kernig's symptom - the patient lies on his back, legs are extended. One hand under the knee, the other to take the foot. Bend your leg at a right angle, then try to straighten it up. It will not be possible to straighten, there will be strong resistance. (A similar symptom - Lasègue's symptom - is observed with sciatica. But with Lasègue's symptom, there will be a sharp pain in the leg along the sciatic nerve and in the lower back). Lessage's suspension symptom - in children of the first year of life. If a normal child is taken under the armpits and shaken from side to side, a healthy child will scream and bend his legs to his stomach (in a position as if sitting on a chair). With Lessage's symptom, the child is lethargic, quiet, legs are straight, dangle and cross "like a rag doll." In children older than a year, meningeal symptoms are the same as in adults.

Patients may have other neurological symptoms, they are already diagnosed by a doctor. Diagnosis of mild neurological symptoms is extremely difficult in patients with alcohol or drug intoxication (the same category of patients often tries to refuse examination and hospitalization)! In the presence of cerebral or meningeal symptoms, the patient must be examined by a doctor and hospitalized in a hospital!

Types of shortness of breath.

Inspiratory - it is difficult for the patient to inhale. Increases with physical activity. The patient is pale, "puffs", tries to "breathe". At rest - characteristic of heart failure, inflammatory lung diseases (pneumonia). It can also happen in healthy people against the background of extreme physical activity (for example, a very long and fast run). A typical picture is an athlete after the finish.

Expiratory - it is difficult for the patient to exhale. It does not depend on physical activity. On exhalation, wheezing and whistling, audible at a distance. characteristic of an attack of bronchial asthma.

Mixed - it is difficult for the patient to both inhale and exhale. Increases against the background of minor physical activity, attempts to move. It is typical for trauma to the chest and organs of the chest cavity, a combination of heart failure and severe lung diseases.

Hemopericardium.

Hemopericardium or "cardiac tamponade" - bleeding into the pericardial cavity (the serous membrane surrounding the heart) and compression of the heart. Without help, it is fatal. Signs: a sharp tachycardia (140 beats per minute or more), a sharp cyanosis (cyanosis of the skin), a decrease in systolic blood pressure ("upper number") with normal or increased diastolic blood pressure ("lower figure"). Pulse pressure (the difference between systolic and diastolic blood pressure) can be 10 mm Hg. Art. (for example, 100 \ 90 mm Hg. Art.). Help - a puncture of the pericardium, is carried out by a resuscitator (the rescuer is not a doctor - he will not cope, knowledge of topographic anatomy is required).

"Catastrophe" in the abdominal cavity.

The organs of the abdominal cavity are covered with a serous membrane - the peritoneum. In case of injury or disease of the abdominal organs, symptoms of irritation of the peritoneum occur - peritoneal symptoms. In case of injury to the liver or spleen, severe internal bleeding occurs, but during the first hour there may be no symptoms from peritoneal irritation - only symptoms of acute hypoxia (significant blood loss). Any closed abdominal trauma is suspicious of damage to the liver or spleen within the first hour after the injury! When any hollow organ of the abdominal cavity is ruptured, the victim complains of very strong, “dagger” (as if stabbed) pain in the abdomen - irritation of the peritoneum by the contents of the hollow organ (stomach, intestines).

Hemoperitoneum.

Accumulation of blood between the sheets of peritoneum surrounding the intestinal loops. The abdomen is swollen, but soft (!). It can be asymmetrical - swollen at the bottom right (when the liver is injured) or bottom left (when the spleen is injured) - blood accumulates in the peritoneum of the corresponding section of the large intestine (ascending or descending). At the same time, in the place of swelling - dullness of percussion sound (a dull sound when tapping with fingers). Symptoms of peritoneal irritation may not be present or may not appear immediately (!).

Acute peritonitis.

Occurs with injury or rupture of hollow organs, perforated stomach ulcer, 12 duodenal ulcer, or inflammatory diseases of the abdominal organs. Diffuse peritonitis (a life-threatening condition for the patient) develops within six hours. Signs: the tongue is dry, often covered with a light coating, the patient is thirsty, constantly asks to drink (do not give drink !!!), the suffering facial expression is “Hippocratic mask” (Facies Hippocraticus), the stomach is swollen, board-like tense (flat and hard as a board ), expressed peritoneal symptoms (symptoms of irritation of the peritoneum). Symptom of Shchetkin-Blumberg - soreness when pressing on the abdomen with fingers. With a sharp release of the hand - the pain increases sharply, the patient "jumps", cries out. Symptom Mendel - pain with very light tapping with your fingertips on the abdomen. The symptom of Kullenkampf - with irritation of the peritoneum in the small pelvis (accumulation of blood in the small pelvis, rupture of the bladder, gynecological bleeding) - is similar to the symptom of Shchetkin-Blumberg, but we put our hand over the pubis, press down on the pubic bone, when pressed there is no pain, the hand does not resist meets, when the hand is released - a sharp pain. With a rupture of hollow organs, peritoneal symptoms will appear almost immediately after the injury.

Wounds.

Any injury to the chest or abdomen at the prehospital stage is regarded as penetrating! The border of a penetrating wound is in the cranial cavity - the dura mater, in the chest - the parietal pleura (lines the chest wall from the inside), in the abdominal cavity - the parietal sheet of the peritoneum (lines the anterior abdominal wall from the inside).

Primarily infected wound - the introduction of infection into the wound channel along with the injuring object. 100% guarantee of purulent-inflammatory complications in the absence of surgical care. With a strict theoretical approach, all wounds not inflicted in the operating room can be considered as primarily infected.

Asepsis - measures aimed at preventing infection from entering the wound.

Antiseptics - measures aimed at the destruction of the infection that has entered the wound.

Types of wounds:

Stab - applied with a sharp object. In the neck, chest, abdomen - 100% penetrating. The inlet is small, usually corresponding to the shape of the injuring object. It is always dangerous to injure deeply lying organs and tissues, the occurrence of internal bleeding.

Cut or chopped - a long, linear wound. Applied with a cutting object. The edges of a chopped wound - gape (diverge).

The bruised wound is of arbitrary shape. Inflicted with a blunt, crushing object. The edges of the wound are crushed.

Rupture - arbitrary shape. There is a significant tissue defect (“a piece of flesh” is torn out). Usually requires surgical treatment, does not heal on its own with a significant tissue defect.

Scalped wound - there is a defect in the skin, the skin is torn off by a "flap".

The bitten wound is of arbitrary shape. Corresponds to the shape of the jaws of the bitten. Always primary infection! Any bitten wound necessarily requires surgical treatment!

First aid- This is a type of medical care that includes a set of simple medical measures aimed at temporarily eliminating the causes that threaten the life of the affected person. First aid is performed at the site of injury by the injured themselves (self-help) or by other citizens (mutual assistance) who are nearby.

At bruises superficially located tissues and internal organs can be damaged.

dislocations

Stretching- damage to soft tissues (ligaments, muscles, tendons, nerves) under the influence of a force that does not violate their integrity.

Wound- mechanical damage to the body cover, often accompanied by a violation of the integrity of muscles, nerves, large vessels, bones, internal organs, cavities and joints.

Bleeding- an outpouring of blood from damaged blood vessels.

chemical burn- the result of exposure to tissues (skin, mucous membranes) of substances with a pronounced cauterizing property (strong acids, alkalis, salts of heavy metals, phosphorus).

Thermal burn- a type of injury that occurs when exposed to high temperature tissue of the body. A burn can be obtained from exposure to light radiation, flame, boiling water, steam, hot air, electric current (the nature of the agent causing the burn).

First aid

BASIC RULES FOR PROVIDING FIRST MEDICAL AID IN EMERGENCY CONDITIONS

First aid- these are the simplest urgent measures necessary to save the life and health of victims of injuries, accidents and sudden illnesses. It must be at the scene of the accident until the arrival of a doctor or the transfer of the victim to the hospital.

First aid is the beginning of the treatment of injuries, as it prevents complications such as shock, bleeding, infection, additional displacement of bone fragments and injury to large nerve trunks and blood vessels.

It should be remembered that the further state of health of the victim and even his life largely depends on the timeliness and quality of first aid. For some minor injuries, medical assistance to the victim may be limited to only the volume of first aid. However, for more serious injuries (fractures, dislocations, bleeding, damage to internal organs, etc.), first aid is the initial stage of treatment, since after it has been provided, the victim must be taken to a medical facility.

First aid is very important, but will never replace qualified (specialized) medical care. You should not try to treat the victim yourself, but after giving him first aid, you should immediately consult a doctor.

sprains, dislocations, bruises,

FRACTURES, RENDERING RULES

FIRST AID

Stretching

stretching- damage to soft tissues (ligaments, muscles, tendons, nerves) under the influence of a force that does not violate their integrity. Most often, the ligamentous apparatus of the joints is stretched with incorrect, sudden and abrupt movements. In more severe cases, a tear or complete rupture of the ligaments and joint capsule may occur. Signs: the appearance of sudden severe pain, swelling, impaired movement in the joints, hemorrhage into soft tissues. When feeling the place of stretching, pain is manifested.

First aid - providing rest to the victim, tight bandaging of the damaged joint, ensuring its mobility and reducing hemorrhage. Then you need to contact a traumatologist.

dislocations

Dislocation- this is a displacement of the articular ends of the bones, partially or completely violating their mutual contact.

Signs: the appearance of intense pain in the area of ​​the affected joint; dysfunction of the limb, manifested in the inability to produce active movements; forced position of the limb and deformation of the shape of the joint. Traumatic dislocations of the joints require immediate first aid. Timely reduced dislocation with proper subsequent treatment leads to a complete restoration of the impaired function of the limb.

First aid - fixation of the injured limb, the introduction of an anesthetic drug and the direction of the victim to a medical institution. Fixation of the limb is carried out with a bandage or hanging it on a scarf.

In case of dislocations of the joints of the lower limb, the victim is delivered to a medical institution in a supine position (on a stretcher) with pillows or soft objects placed under the limb (a folded blanket, jacket, sweater, etc.) and its mandatory fixation.

When providing first aid in unclear cases, when it is not possible to distinguish a dislocation from a fracture, the victim is treated as if he had a clear fracture of the bones.

bruises

At bruises superficially located tissues and internal organs can be damaged. Signs: pain, swelling, bruising.

First aid - applying a pressure bandage, cold, rest. Severe bruises of the chest or abdomen may be accompanied by damage to internal organs: lungs, liver, spleen, kidneys, pain and often internal bleeding. Cold is applied to the site of the bruise and the victim is urgently taken to a medical facility.

With head injuries, brain damage is possible: a bruise or a concussion. Signs: headaches, nausea, sometimes vomiting, consciousness is preserved. A concussion is accompanied by loss of consciousness, nausea and vomiting, severe headaches, dizziness.

First aid is the creation of complete rest for the affected person and the imposition of cold on the head.

fractures

fracture is a violation of the integrity of the bone.

There are two types of fractures: open and closed. Open fractures are characterized by the presence of a wound in the fracture area, and closed fractures are characterized by the absence of a violation of the integrity of the integument (skin, mucous membrane).

A fracture may be accompanied by complications: damage to the sharp ends of bone fragments of large blood vessels, which leads to external bleeding (in the presence of an open wound); INSERT INTO `temp_content` (`id`, `title`, `image`, `fulltext`, `smalltext`, `emptytext`, `date`, `somenumber`) VALUES INSERT INTO `temp_content` (`id`, `title`, `image`, `fulltext`, `smalltext`, `emptytext`, `date`, `somenumber`) VALUES damage to nerve trunks causing shock or paralysis; infection of the wound and the development of a purulent infection; damage to internal organs (brain, lungs, liver, kidneys, spleen, etc.).

Signs: severe pain, impaired motor function of the limb, a kind of bone crunch. In open fractures, bone fragments may be visible in the wound. Fractures of the limb bones are accompanied by their shortening and curvature at the fracture site. Damage to the ribs can make it difficult to breathe, when feeling at the fracture site, a crunch (crepitus) of the fragments of the rib is heard. Fractures of the pelvis and spine are often accompanied by urination disorders and movement disorders in the lower extremities. With fractures of the bones of the skull, there is often bleeding from the ears. In severe cases, fractures are accompanied by shock. Especially often shock develops in open fractures with arterial bleeding.

With skull fractures, nausea, vomiting, impaired consciousness, slowing of the pulse are observed, which are signs of a concussion (bruise) of the brain, bleeding from the nose and ears.

Pelvic fractures are accompanied by significant blood loss and, in 30% of cases, by the development of traumatic shock. This condition occurs due to the fact that large blood vessels and nerve trunks are damaged in the pelvic region. There are violations of urination and defecation, blood appears in the urine and feces.

Spinal fractures are one of the most serious injuries, often ending in death. Anatomically, the spinal column consists of vertebrae adjacent to each other, which are interconnected by intervertebral discs, articular processes and ligaments. The spinal cord is located in a special canal, which can also suffer in case of injury. Very dangerous injuries of the cervical spine, leading to serious disorders of the cardiovascular and respiratory systems.

First aid - ensuring immobility (transport immobilization) of the injured limb with tires or sticks, boards and other objects at hand.

If there are no objects for immobilization at hand, then you should bandage the injured arm to the body, and the injured leg to the healthy leg.

In case of a fracture of the spine, the victim is transported on a shield. With an open fracture, accompanied by profuse bleeding, a pressure aseptic (sterile) bandage is applied and, if necessary, a hemostatic tourniquet. It should be borne in mind that the application of the tourniquet is limited to the minimum possible period. The patient is given painkillers.

WOUNDS AND BLEEDING, RULES OF RENDERING

FIRST AID

Wounds

Wound- mechanical damage to the integument of the body, often accompanied by a violation of the integrity of muscles, nerves, large vessels, bones, internal organs, cavities and joints. Depending on the nature of the damage and the type of wounding object, cut, stab, chopped, bruised, crushed, gunshot, torn and bitten wounds are distinguished.

Wounds can be superficial or deep, which, in turn, can be non-penetrating and penetrating into the cranial cavity, chest, abdominal cavity. Penetrating wounds are especially dangerous.

Cut wounds usually gape, have even edges and bleed profusely. With such a wound, the surrounding tissues are slightly damaged.

Stab wounds are the result of penetration into the body of piercing objects. Stab wounds are often penetrating. The shape of the inlet and the wound channel depends on the type of wounding weapon and the depth of its penetration. Stab wounds are characterized by a deep channel and often significant damage to internal organs. It is not uncommon for internal bleeding in the body cavity and the development of infections.

Chopped wounds are characterized by deep tissue damage, wide gaping, bruising and concussion of surrounding tissues; bruised and lacerated wounds - a large number of mashed, bruised, blood-soaked tissues.

Gunshot wounds occur as a result of a bullet or shrapnel wound and can be through, when there are inlet and outlet wound openings, blind, when a bullet or shrapnel gets stuck in the tissues, and tangential, in which a bullet or shrapnel, flying along a tangent, damages the skin and soft tissues without getting stuck in them.

First aid - first of all, expose the wound; at the same time, outer clothing, depending on the nature of the wound, weather and local conditions, is removed or cut. First remove clothes from the healthy side, and then from the affected side. In the cold season, in order to avoid cooling, as well as in emergency cases, when providing first aid to a victim who is in serious condition, cut clothes in the wound area. It is impossible to tear off adhering clothes from the wound; it must be carefully cut with scissors. A bandage is applied to any wound, if possible aseptic. The means of applying an aseptic bandage in most cases is a medical dressing bag, and in its absence, a sterile bandage, cotton wool, in extreme cases, a clean cloth. If the wound is accompanied by significant bleeding, it is stopped by any suitable means.

With extensive soft tissue injuries, with bone fractures and injuries of large blood vessels and nerve trunks, it is necessary to immobilize the limb with special or improvised means. The victim is injected with an anesthetic, given antibiotics, and quickly taken to a medical facility.

Bleeding

Bleeding- an outpouring of blood from damaged blood vessels. It is one of the frequent and dangerous consequences of injuries, injuries and burns. Depending on the type of damaged vessel, arterial, venous and capillary bleeding is distinguished. Arterial bleeding occurs when the arteries are damaged and is the most dangerous.

Signs: from the wound a strong, pulsating stream of scarlet blood beats.

First aid is to lift the bleeding area, apply a pressure bandage, bend the limbs at the joint as much as possible and squeeze the vessels passing in this area with your fingers or a tourniquet.

The vessel should be pressed above the wound, at certain anatomical points, where the muscle mass is less pronounced, the vessel passes superficially and can be pressed against the underlying bone. It is better to squeeze with several fingers of one or both hands. A reliable way to temporarily stop arterial bleeding in the upper and lower extremities is the imposition of a hemostatic tourniquet or twist, i.e., circular tugging of the limb. In the absence of a tourniquet, any available material is used (rubber tube, trouser belt, scarf, rope, etc.).

The procedure for applying a hemostatic tourniquet

1. A tourniquet is applied in case of damage to the large arteries of the limbs above the wound, so that it completely compresses the artery.

2. The tourniquet is applied with a raised limb, placing a soft tissue under it (bandage, clothes, etc.), make several turns until the bleeding stops completely. The coils should lie close to each other so that folds of clothing do not fall between them. The ends of the tourniquet are securely fixed (tied or fastened with a chain and a hook). A properly applied tourniquet should stop bleeding and cause the peripheral pulse to disappear.

3. A note must be attached to the tourniquet indicating the time the tourniquet was applied.

4. The tourniquet is applied for no more than 1.4-2 hours, in the cold season - for 1 hour.

5. If necessary, a longer stay of the tourniquet on the limb is weakened for 5-10 minutes (until the blood supply to the limb is restored), pressing the damaged vessel with the fingers for this time. This can be repeated several times, while each time reducing the time between manipulations by 1.5-2 times compared to the previous one. The victim is immediately sent to a medical institution for the final stop of bleeding.

Venous bleeding occurs when the walls of the veins are damaged.

Signs: dark blood flows from the wound in a slow continuous stream. First aid is to raise the limb, bend it at the joint as much as possible, or apply a pressure bandage. With severe venous bleeding, they resort to pressing the vessel. The damaged vessel is pressed against the bone below the wound. This method is convenient in that it can be performed immediately and does not require any devices.

Capillary bleeding is the result of damage to the smallest blood vessels (capillaries). Signs: the wound surface bleeds. First aid is the application of a pressure bandage. A bandage (gauze) is applied to the bleeding area, you can use a clean handkerchief or white cloth.

INJURIES OF THE FACIAL PART OF THE HEAD, RULES

Oral injuries

In accidents, the oral cavity is often injured with damage to the teeth. First aid: if a person is unconscious and blood flows from his mouth, after wrapping a bandage, a clean handkerchief or a piece of clean cloth around his finger, raise his head by placing a small roller under it. If possible, keep blood from running down the back of the throat.

If the victim is conscious and does not have other serious injuries (concussion or contusion of the brain, damage to internal organs, internal bleeding, etc.), sit him down with his head tilted so that he can spit out blood.

If teeth are knocked out and the gum bleeds heavily, make a tampon out of a sterile bandage, put it on the site of the knocked out tooth and ask the victim to bite the tampon slightly (to avoid damage to the formed blood clot and resumption of bleeding). Usually after 5-10 minutes the bleeding stops. For the next two hours, food should be avoided. If necessary, moisten the mouth with a small amount of liquid (warm water, cold tea, etc.). During the day, consumed food and water should not be hot.

If, after carrying out the above measures, the bleeding does not stop (blood clotting indicators are individual for each person), you should consult a doctor in order to avoid significant blood loss.

Eye injury

Most often, eye injuries are caused by the ingress of foreign bodies (eyelash, midge, fragments of objects, etc.). In this case, the injured eye should not be rubbed, but should be kept closed, since during physical impact a foreign particle can get under the eyelid and cause pain. The foreign body may come out on its own with tears. If the mote is clearly visible, then try to remove it with the tip of a bandage, a clean handkerchief; if possible, put your eye under running water.

In the event of a chemical burn to the eye, flush with plenty of running water. If lime gets into the eye, it should be washed with vegetable oil.

In case of eye injury from branches in the forest, consult a doctor, and before that, cover your eye with a clean handkerchief. Remember to never rub your eyes with dirty hands. Do not wash stab and cut wounds of the eyes and eyelids with water.

First aid for foreign bodies in the nose, ear and respiratory tract

Foreign body in the nose

If a foreign body gets into the nose, do not try to remove it with your fingers, especially in young children, otherwise you will push it deeper. Ask an older child to blow his nose, after closing the nasal passage, free from a foreign body. If unsuccessful, contact your doctor as soon as possible; the earlier the foreign body is removed, the fewer complications during its removal.

Nose bleed

Causes - blow, picking your nose, fluctuations in atmospheric pressure and humidity, physical overexertion, overeating, stuffiness and overheating.

First aid: sit down, slightly tilting your head forward, let the blood drain (not for long). Do not tilt your head back, otherwise the blood will enter the stomach, which may cause vomiting. Squeeze the nose just above the nostrils for 5 minutes. While breathing through your mouth. Apply cold to the bridge of the nose and to the back of the head (wet handkerchief, snow, ice). Insert a cotton swab into your nose and lie down for a bit. Once the bleeding has stopped, carefully remove the swab. Avoid sudden movements, do not blow your nose.

Be sure to consult a doctor if the bleeding has not stopped, the bleeding was caused by a strong fall or head injury, the flowing blood is mixed with a clear liquid.

Foreign bodies in the ear

If a foreign body gets into the ear, it should not be removed with a sharp object that will cause more harm than the foreign body itself; if a living insect enters the ear, drip a little pure olive oil into the ear, which then (after tilting the ear) will flow out of it, and the insect will come out with it. Sometimes it is enough to turn the ear to a source of strong light: the insect may come out on its own. Never rinse your ear with water: if the foreign bodies are beans, peas or grains, they will swell and be difficult to remove. Seek medical attention if the foreign body cannot be removed from the ear.

Foreign bodies entering the respiratory tract

There is a sharp irritation followed by a reflex cough, as a result of which a foreign body can be thrown out. If this does not happen, it is necessary to provide first aid to the victim.

The victim is an adult: tilt him forward so that the head falls below the shoulders, hit the back (between the shoulder blades) with the palm of your hand several times, thereby causing a reflex cough. If the foreign body has come out of the pharynx and the respiratory function has recovered, the victim should be allowed to drink water in small sips.

If the above measures did not help and the victim is not breathing, try to put pressure on the stomach; while doing so, care must be taken not to damage vital organs. Grasp the victim with your hands, standing behind. Squeeze the fingers of one hand into a fist, press it to the stomach between the navel and chest, grab the fist with the other hand and pull both hands towards you and up, trying to squeeze out the air that is still there from the lungs and thereby push out the foreign body stuck in the airways.

Repeat manipulations 3-4 times. If the foreign body comes out, the victim will not be able to breathe for several seconds. During this time, remove the foreign body from the oral cavity.

The victim is a child under 7 years old: tap him on the back with one hand, hold his chest with the other. When assisting a child under one year old, it is necessary to put him face down on one hand and tap on the back with the fingers of the other hand. It is necessary to remove a foreign body from the child's mouth carefully, since it is possible that when inhaling it can again enter the respiratory tract.

The victim is unconscious, air can enter the lungs, bypassing the stuck object, due to the fact that the neck muscles are in a relaxed state. In this case, it is necessary to perform artificial respiration by the mouth-to-mouth method. If the result is negative, turn the victim face down, slipping your knee under his chest, knock on the back 3-4 times. If previous efforts have not been successful, then lay the victim on his back (while the head should be thrown back), rest with both hands on a point above the navel and press hard 3-4 times on the chest from the upper abdomen. If a foreign object appears in the victim's mouth, carefully remove it.

Seek medical attention if the foreign body cannot be removed.

RULES FOR THE TREATMENT OF WOUNDS AND THE APPLICATION OF STERILE BANDAGES

Rules for the treatment of wounds

After stopping the bleeding, the skin around the wound is treated with a solution of iodine, potassium permanganate, brilliant green, alcohol, vodka or cologne. With a cotton or gauze swab moistened with one of these liquids, the skin is lubricated from the edge of the wound from the outside. They should not be poured into a wound, as this will increase pain, damage the tissues inside the wound, and slow down the healing process. With a penetrating wound of the abdomen, you can not eat or drink. After treatment, the wound is closed with a sterile dressing.

In the absence of sterile material, gauze or a clean cloth can be used. Apply iodine to the area of ​​the dressing that will be in contact with the wound.

Rules for applying sterile dressings

Dressing for head and neck injuries

In case of head injuries, a bandage is applied to the wound using scarves, sterile wipes and an adhesive plaster. The choice of dressing type depends on the location and nature of the wound. A bandage in the form of a “cap” is applied to the wounds of the scalp, which is strengthened with a strip of bandage for the lower jaw. A piece up to 1 m in size is torn off from the bandage and placed in the middle over a sterile napkin covering the wound, on the crown area, the ends are lowered vertically down in front of the ears and held taut. A circular fixing turn is made around the head, then, having reached the tie, the bandage is wrapped around it and led obliquely to the back of the head. Alternating turns of the bandage through the back of the head and forehead, each time directing it more vertically, cover the entire scalp. After that, 2-3 circular turns strengthen the bandage. The ends are tied in a bow under the chin.

When the neck, larynx or occiput is injured, a cruciform bandage is applied. With circular turns, the bandage is first fixed around the head, and then above and behind the left ear it is lowered in an oblique direction down to the neck. Next, the bandage is led along the right side surface of the neck, the front surface is covered with it and returned to the back of the head, it is led above the right and left ear, the moves made are repeated. The bandage is fixed with the turns of the bandage around the head.

With extensive wounds of the head and their location in the face, a bandage is applied in the form of a "bridle". After 2-3 fixing circular moves through the forehead, the bandage is led along the back of the head to the neck and chin, several vertical moves are made through the chin and crown, then from under the chin the bandage is led along the back of the head.

A sling-like bandage is applied to the nose, forehead and chin. A sterile napkin or bandage is placed under the bandage on the wound surface.

The eye patch begins with a fixing move around the head, then the bandage is led from the back of the head under the right ear to the right eye or under the left ear to the left eye, and after that the turns of the bandage begin to alternate: one through the eye, the second around the head.

Bandages on the chest

A spiral or cruciform bandage is applied to the chest. For a spiral bandage, the end of the bandage about 1.5 m long is torn off, placed on a healthy shoulder girdle and left hanging obliquely on the chest. With a bandage, starting from the bottom from the back, bandage the chest with spiral turns. The loosely hanging ends of the bandage are tied. A cruciform bandage is applied from below in circular, fixing 2-3 turns of the bandage, then from the back on the right to the left shoulder girdle in a fixing circular motion, from below through the right shoulder girdle, again around the chest. The end of the bandage of the last circular move is fixed with a pin.

For penetrating wounds of the chest, an airtight bandage is applied to the wound, possibly using adhesive tape. Strips of the plaster, starting 1-2 cm above the wound, are glued to the skin in a tile-like manner, thus covering the entire wound surface. A sterile napkin or a sterile bandage is placed on the adhesive plaster in 3-4 layers, then a layer of cotton wool and tightly bandaged. Of particular danger are injuries accompanied by pneumothorax with significant bleeding. In this case, it is most advisable to close the wound with an airtight material (oilcloth, cellophane) and apply a bandage with a thickened layer of cotton wool or gauze.

Bandages on the stomach

A sterile bandage is applied to the upper abdomen, in which bandaging is carried out sequentially with turns from the bottom up.

On the lower part of the abdomen, a spike-shaped bandage is applied to the abdomen and inguinal region. It starts with rotations around the abdomen, then the bandage is rotated along the outer surface of the thigh and around it, then again rotations are made around the abdomen. Small non-penetrating wounds of the abdomen, boils are closed with a sticker using adhesive tape.

Bandages on the upper limbs, shoulder and forearm

Spiral, spike-shaped and cruciform bandages are usually applied to the upper limbs.

The spiral bandage on the finger begins with a turn around the wrist, then the bandage is led along the back of the hand to the nail phalanx and the bandage is spirally applied from the end to the base and the bandage is fixed on the wrist by reverse overlay along the back of the hand.

In case of damage to the palmar or dorsal surface of the hand, a cruciform bandage is applied, starting with a fixing overlay on the wrist, and then along the back of the hand on the palm.

A bandage is applied to the shoulder joint, starting from the healthy side from the armpit along the chest and the outer surface of the injured shoulder from behind through the armpit of the shoulder, along the back through the healthy armpit to the chest and, repeating the bandage moves, until the entire joint is covered, the end is fixed on the chest pin.

A bandage is applied to the elbow joint, starting with 2-3 bandages through the cubital fossa and then with spiral bandage moves, alternating them on the forearm and shoulder, ending in the cubital fossa

Bandage on the lower limbs

A bandage is applied to the heel area with the first stroke of the bandage through its most protruding part, then alternately above and below the first application of the bandage, and oblique and eight-shaped bandages are made for fixation.

An eight-shaped bandage is applied to the ankle joint. The first fixing turn of the bandage is made above the ankle, then down to the foot and around it, then the bandage is led along the back surface of the foot above the ankle and returned to the foot, then to the ankle, the end of the bandage is fixed with circular turns above the ankle.

A spiral bandage is applied to the lower leg and thigh in the same way as to the forearm and shoulder.

A bandage is applied to the knee joint, starting with a circular turn through the patella, and then the turns of the bandage go lower and higher, crossing in the popliteal fossa.

In the perineal region, a T-shaped bandage or bandage is applied with a scarf.

In case of traumatic amputation of the limb, first of all, the bleeding is stopped by applying a tourniquet or twist, and then, after introducing an analgesic, the stump is covered with a bandage. A cotton-gauze pad is placed on the wound, which is fixed alternately with circular and longitudinal turns of the bandage on the stump.

16.6. Syncope, prolonged pressure syndrome, traumatic shock, rules

FIRST AID

Fainting

Fainting- sudden short-term loss of consciousness, accompanied by a weakening of the heart and breathing. Occurs with rapidly developing anemia of the brain and lasts from a few seconds to 5-10 minutes or more.

Signs: fainting is expressed in sudden onset of dizziness, dizziness, weakness and loss of consciousness. Fainting is accompanied by blanching and cooling of the skin. Breathing is slow, shallow, weak and rare pulse (up to 40-50 beats per minute).

First aid - lay the victim on his back so that his head is slightly lowered and his legs are raised. To facilitate breathing, release the neck and chest from tight clothing; cover the victim with something warm, put a heating pad at the feet; rub whiskey with ammonia and give it a sniff; splash your face with cold water. With prolonged fainting, artificial respiration is indicated. After the victim has regained consciousness, give him hot coffee.

Long squeezing syndrome

With prolonged compression of the soft tissues of individual parts of the body, lower or upper limbs, a severe lesion can develop, called the syndrome of prolonged compression of the limbs or traumatic toxicosis. It is caused by the absorption of toxic substances into the blood, which are the decay products of damaged soft tissues.

Having found a person in the rubble, it is necessary to take measures to release him. The blockage is dismantled carefully, as it may collapse. The victim is removed only after he is completely released from compression. Then it is carefully examined. On the damaged part of the body, there may be abrasions and dents, repeating the outlines of the protruding parts of the crushed objects; the skin may be pale, sometimes cyanotic, cold to the touch. The injured limb 30-40 minutes after its release will begin to swell rapidly.

During traumatic toxicosis, three periods are distinguished: early, intermediate and late. In the early period, immediately after the injury and within 2 hours, the affected person is excited, consciousness is preserved, he tries to free himself from the blockage, asks for help. After staying in the blockage for more than 2 hours, an intermediate period begins. In the body, toxic phenomena are growing. Excitation passes, the victim becomes relatively calm, gives signals about himself, answers questions, can periodically fall into a drowsy state, dry mouth, thirst, and general weakness are noted.

In the later period, the general condition of the victim deteriorates sharply: agitation appears, an inadequate reaction to the environment, consciousness is disturbed, delirium, chills, vomiting occur, the pupils first strongly constrict and then expand, the pulse is weak and frequent. In severe cases, death occurs.

First aid - a sterile bandage is applied to wounds and abrasions. If the victim has cold, cyanotic, severely damaged limbs, a tourniquet is applied to them above the place of compression. This stops the absorption of toxic substances from crushed soft tissues into the bloodstream. The tourniquet is not applied very tightly so as not to completely disrupt the blood flow to the damaged limbs. In cases where the limbs are warm to the touch and not severely damaged, a tight bandage is applied to them. After applying a tourniquet or a tight bandage, an analgesic is injected with a syringe tube, and in its absence, 50 g of vodka is taken orally. Damaged limbs, even in the absence of fractures, are immobilized with splints or with the help of improvised means.

Showing hot tea, coffee, drinking plenty of water with the addition of baking soda, 2-4 g per reception (up to 20-40 g per day).

Soda helps to restore the acid-base balance of the internal environment of the body, and drinking plenty of water helps to eliminate toxic substances in the urine.

Victims with traumatic toxicosis are quickly and carefully delivered on a stretcher to a medical facility.

traumatic shock

traumatic shock- a life-threatening complication of severe injuries, characterized by a disorder in the activity of the central nervous system, blood circulation, metabolism and other vital functions. Shock can be caused by single or repeated injuries. Especially often, shock occurs with heavy bleeding, in winter - when the wounded person is cooled.

Depending on the time of onset of signs of shock, it can be primary and secondary. Primary shock occurs at the time of injury or shortly after it. Secondary shock can occur after helping the victim due to careless transportation or poor immobilization for fractures.

In the development of traumatic shock, two phases are distinguished - excitation and inhibition. The excitation phase develops immediately after injury as a response of the body to the strongest pain stimuli. At the same time, the victim shows anxiety, rushes about in pain, screams, asks for help. This phase is short (10-20 minutes). It is followed by deceleration, with full consciousness the victim does not ask for help, his vital functions are depressed: the body is cold, the face is pale, the pulse is weak, breathing is barely noticeable.

There are four degrees of traumatic shock: mild, moderate, severe shock and extremely severe shock.

First aid - lay the victim in the position of the legs above, head below. Eliminate the causes that cause respiratory failure (ensure the patency of the upper respiratory tract, fix the tongue when it retracts, clear the mouth, free the neck and chest from tight clothing, unfasten the trouser belt). Perform artificial respiration by mouth-to-mouth or mouth-to-nose methods. In case of penetrating wounds of the chest, immediately cover the wound with several sterile drapes, fixing them in the chest. Stop external bleeding. For arterial bleeding, apply a tourniquet, and for venous and capillary bleeding - pressure bandages. In case of cessation of cardiac activity, make an indirect massage

This is a complex 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 has first aid skills, at the place of receipt 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 provide assistance to a person who has been injured or suffering from a sudden attack of illness, until the arrival of qualified medical assistance, such as, for example, an ambulance team or delivery (by passing transport) of the injured (sick) to the nearest medical treatment facility . The time from the moment of injury, poisoning and other accidents to the moment of receiving first aid should be reduced as much as possible (Rule of the "golden hour").

This cannot be done!

If someone chokes, you can not knock him on the back.
The knife or any other object in the wound must not be removed.
In case of a burn - do not apply oil, cream, ointment. Pee on the burn.
If a person is cold - you can not give vodka or coffee.
Frostbite - you can not rub, you can not warm up before the arrival of doctors.
A dislocated arm - you can not set it yourself.
Broken bones - you can not combine the bones yourself, put a splint.
When bitten by a snake - you can not make an incision at the site of the bite, suck out the poison, pull the bitten limb with a tourniquet.
Fainting - no need to slap on the cheeks, bring ammonia to the nose and splash cold water in the face.
Bleeding from the nose - do not advise the victim to lay his head back or lie down, do not plug his nose with cotton.
With a heart attack - you can not give validol, corvalol

The legal side of first aid

Providing first aid is your RIGHT, not an obligation!
The exceptions are medical workers, rescuers, firefighters, police.
An unconscious person can be helped
If a person is conscious, it is necessary to ask (- help you?). If he refuses, you can't help. If a child under 14 years old is without relatives, you can provide, otherwise ask for consent from relatives.
If the victim is dangerous, it is better not to provide assistance.
Consent is not required for suicidal attempts
You must not exceed your qualifications: you must not give (prescribe) any medicines, you must not perform any medical manipulations (set dislocations, etc.)
There is an article about "Leaving at risk". It implies the responsibility of a CITIZEN who did not report the incident and walked past the victim.

Importance of First Aid

The task of first aid is to save the life of the victim by carrying out the simplest measures, reduce his suffering, prevent the development of possible complications, and alleviate the severity of the injury or illness.

First aid rules are simple and necessary knowledge for everyone that will help to provide immediate assistance to victims right at the scene. There are situations when knowledge of first aid has to be applied by the victim himself. According to statistics, up to 90% of the dead could have survived if timely and qualified first aid was provided in the first minutes after the incident.

However, in case of incorrect provision of first aid, you yourself can become the culprit of the tragedy, with all the ensuing consequences in accordance with the laws of the Russian Federation. Therefore, the first thing to do in case of an emergency is to call an ambulance or rescuers. Do not try to do serious interventions, medicines and surgical interventions are excluded, do only what is necessary to save a life, the doctors will take care of the rest. Assess your ability to provide first aid: you may be in serious danger.

General rules for first aid

First aid can be provided at the site of injury by the victim himself (self-help), his comrade (mutual assistance), sanitary combatants. First aid measures are: temporary stoppage of bleeding, application of a sterile bandage on the wound and burn surface, artificial respiration and indirect heart massage, administration of antidotes, administration of antibiotics, administration of painkillers (in case of shock), extinguishing burning clothing, transport immobilization, warming, shelter from heat and cold, putting on a gas mask, removing the affected from the infected area, partial sanitization.

The provision of first aid as soon as possible is of decisive importance for the further course and outcome of the lesion, and sometimes even saving lives. In case of severe bleeding, electric shock, drowning, cessation of cardiac activity and respiration, and in a number of other cases, first aid should be provided immediately.

When providing first aid, personal and improvised means are used. The standard means of providing first aid are dressings - bandages, medical dressing bags, large and small sterile dressings and napkins, cotton wool, etc. To stop bleeding, hemostatic tourniquets are used - tape and tubular, and for immobilization (immobilization) special tires - plywood , ladder, mesh, etc. When providing first aid, some medicines are used - a 5% alcohol solution of iodine in ampoules or in a vial, a 1-2% alcohol solution of brilliant green in a vial, validol tablets, valerian tincture, ammonia alcohol in ampoules, sodium bicarbonate (baking soda) in tablets or powder, vaseline, etc.

What can a person do between the discovery of the victim and the arrival of the ambulance? He can do no harm and make sure that the condition of the victim at the time the doctor appears does not worsen. As already mentioned, the program is based on a clear and understandable algorithm of behavior at the scene of the incident, which allows you to quickly assess the threats, dangers and the condition of the victim. A person who knows the algorithm does not waste time on empty thoughts and does not panic. At the subconscious level, simple actions are crammed in his head:

1. Examine the scene, make sure what threatens me and then what threatens the victim.
2. Examine the victim and try to understand if there is a threat to his life and if so, from what he can die right now.
3. Call specialists
4. Stay with the victim until the arrival of specialists, trying to maintain or improve his condition by available methods.
Exactly in that order and nothing else. Psychologically, this is quite difficult to understand - such a formulation of the question does not fit with all the concepts of duty, honor and conscience. And here it is very important to bring the listener to the understanding that by endangering his own life, he will not be able to save another as a result. And actions associated with a risk to life are the lot of specialists - firefighters, rescuers, etc.

The initial examination of the victim does not require deep medical knowledge. Here it is necessary to answer simple questions: does the victim have signs of life (consciousness, breathing, pulse), and does he have injuries from which he will die right now. For example, arterial or simply severe venous bleeding, injuries of the spine and base of the skull, open craniocerebral injuries. No - great! An ambulance is called and before it arrives, the victim is provided with psychological assistance - simple care for him. Talk, warm, sit comfortably. These seemingly simple actions are extremely effective in reducing the effects of shock, a condition whose seriousness is still underestimated.

If the condition of the victim is more serious, the rule is activated, which is formulated simply: “What we see, we fight with it.” No consciousness - fearless. We control breathing and pulse. No breathing - we start artificial ventilation of the lungs and so on. Everything is very simple, and after practicing on role-playing games, it is remembered to automatism.

Signs of life

The caregiver must be able to distinguish loss of consciousness from death. If minimal signs of life are found, it is necessary to immediately begin to provide first aid.

The signs of life are:

1. the presence of a heartbeat (it is determined by the hand or ear on the chest in the region of the left nipple);
2. the presence of a pulse on the arteries (it is determined on the neck - the carotid artery, in the area of ​​the wrist joint - the radial artery, in the groin - the femoral artery);
3. the presence of breathing (it is determined by the movement of the chest and abdomen, moistening the mirror attached to the nose and mouth of the victim, the movement of a piece of cotton wool or a bandage brought to the nostrils;
4. Presence of pupillary reaction to light. If you illuminate the eye with a beam of light (for example, a flashlight), then pupil constriction is observed - a positive reaction of the pupil. In daylight, this reaction can be checked as follows: for a while they close the eye with their hand, then quickly move the hand to the side, while constriction of the pupil is noticeable.
It should be remembered that the absence of a heartbeat, pulse, breathing and pupillary response to light does not mean that the victim is dead. A similar set of symptoms can also be observed in clinical death, when the victim also needs to be assisted in full.

Signs of death

First aid is pointless with obvious signs of death:

1.clouding and drying of the cornea of ​​the eye;
2. the presence of the "cat's eye" symptom - when the eye is squeezed, the pupil is deformed and resembles a cat's eye;
3. cooling of the body, the appearance of cadaveric spots and rigor mortis. Corpse spots of blue-violet or purple-red color appear on the skin when the corpse is on the back in the area of ​​the shoulder blades, lower back, and when it is on the stomach - on the face, neck, chest, stomach. Rigor mortis - this indisputable sign of death - begins to appear 2-4 hours after death.

First aid for bone fractures

A fracture is a break in the integrity of a bone. Fractures are divided into closed (without damage to the skin) and open, in which there is damage to the skin in the fracture zone.

Fractures come in a variety of forms: transverse, oblique, spiral, longitudinal.

A fracture is characterized by: a sharp pain that increases with any movement and load on the limb, a change in the position and shape of the limb, a violation of its function (inability to use the limb), the appearance of swelling and bruising in the fracture zone, shortening of the limb, pathological (abnormal) bone mobility.

The main first aid measures for bone fractures are:

1) the creation of immobility of the bones in the area of ​​the fracture;

2) carrying out measures aimed at combating shock or preventing it;

3) organization of the fastest delivery of the victim to a medical institution.

The rapid immobilization of the bones in the area of ​​the fracture - immobilization reduces pain and is the main point in the prevention of shock. Immobilization of the limb is achieved by the imposition of transport splints or splints made of improvised solid material. Splinting should be carried out directly at the scene of the incident and only after that the patient should be transported.

In case of an open fracture, an aseptic bandage must be applied before immobilization of the limb. When bleeding from a wound, methods of temporarily stopping bleeding should be applied (pressure bandage, tourniquet, etc.).

Immobilization of the lower extremity is more convenient to carry out with the help of the Dieterichs transport splint, Cramer's upper-staircase splint or pneumatic splint. If there are no transport tires, immobilization should be carried out using improvised tires from any materials at hand.

In the absence of auxiliary material, immobilization should be carried out by bandaging the injured limb to a healthy part of the body: the upper limb - to the body with a bandage or scarf, the lower - to a healthy leg.

When carrying out transport immobilization, the following rules must be observed:

1) tires must be securely fastened and fix the fracture area well;

2) the splint cannot be applied directly to a bare limb, the latter must first be covered with cotton wool or some kind of cloth;

3) creating immobility in the fracture zone, it is necessary to fix two joints above and below the fracture site (for example, in case of a fracture of the lower leg, the ankle and knee joints are fixed) in a position convenient for the patient and for transportation;

4) in case of hip fractures, all joints of the lower limb (knee, ankle, hip) should be fixed.

Prevention of shock and other general phenomena is largely ensured by properly performed fixation of damaged bones.

Skull and brain injuries

The greatest danger in case of bruises of the head is damage to the brain. Allocate damage to the brain: concussion, bruise (contusion), and squeezing.

Brain injury is characterized by general cerebral symptoms: dizziness, headache, nausea and vomiting.

The most common are concussions. The main symptoms: loss of consciousness (from several minutes to a day or more) and retrograde amnesia - the victim cannot remember the events that preceded the injury. With a bruise and compression of the brain, symptoms of a focal lesion appear: impaired speech, sensitivity, limb movements, facial expressions, etc.

The first aid is to create peace. The victim is given a horizontal position. To the head - an ice pack or a cloth moistened with cold water. If the victim is unconscious, it is necessary to clean the oral cavity from mucus, vomit, put him in a fixed-stabilized position.

Transportation of victims with head wounds, damage to the bones of the skull and brain should be carried out on a stretcher in the supine position. Transportation of victims in an unconscious state should be carried out in a position on their side. This provides good immobilization of the head and prevents the development of asphyxia from retraction of the tongue and aspiration of vomit.

Before transporting victims with damage to the jaws, the jaws should be immobilized: for fractures of the lower jaw - by applying a sling bandage, for fractures of the upper jaw - by inserting a strip of plywood or a ruler between the jaws and fixing it to the head.

spine fracture

A spinal fracture is an extremely severe injury. Its symptom is severe pain in the back at the slightest movement. It is strictly forbidden to put the victim with a suspected fracture of the spine on his feet. Create peace by laying it on a flat hard surface - a wooden shield, boards. The same items are used for transport immobilization. In the absence of a board and the unconscious state of the victim, transportation is the least dangerous on a stretcher in the prone position.

Pelvic fracture

A pelvic fracture is one of the most severe bone injuries, often accompanied by damage to internal organs and severe shock. The patient should be laid on a flat hard surface, legs bent at the knee and hip joints, hips slightly apart (frog position), under the knees put a tight roller from a pillow, blanket, coat, hay, etc. 25-30 cm high.

First aid for prolonged compression of the limbs

The syndrome occurs more often as a result of prolonged squeezing of the limb with a heavy object. Positional compression can be with a long (more than 6 hours) presence of the victim on a hard surface in one position. The syndrome can occur in victims with damage to bones, joints and internal organs.

There are three levels of severity:

1) extremely severe, for example, when squeezing both lower limbs for more than 6 hours;

2) moderate, when squeezing only the lower leg or forearm for 6 hours;

3) light, when squeezing small areas of the body for 3-6 hours.

Signs: the hand or leg is cold to the touch, pale with a bluish tinge, pain tactile sensitivity is sharply reduced or absent.

Later, swelling and unbearable pain appear; urine is lacquered red.

If the limb is not released from compression, then the general condition of the victim may be satisfactory. Release of a limb without a tourniquet can cause a sharp deterioration in the condition, with loss of consciousness, involuntary urination.

The main task of first aid for compression is the organization of measures to extract the victims from under the weights that have fallen on him. Immediately after release from weights, in order to prevent the entry of toxic decay products of damaged tissues of the limbs into the blood, tourniquets should be applied to the damaged limbs as close to the base as possible, as in stopping arterial bleeding, then the limbs should be covered with bubbles of ice, snow or a cloth moistened with cold water .

Injured limbs are immobilized with splints. The victims often at the time of injury develop a severe general condition - shock. To combat shock and to prevent it, the victim should be warmly covered, you can give some alcohol or hot coffee, tea. If possible, introduce cardiac agents or a drug (morphine, omnopon - 1 ml of a 1% solution). The victim is subject to immediate transportation to a medical facility in the supine position.

First aid in case of damage to the eye, ear. throat, nose

Mechanical damage to the eye can be superficial and penetrating. There are also blunt eye injuries - contusions, in which hemorrhages can be observed under the conjunctiva, in the anterior chamber and in the vitreous body. Pain is one of the main signs of injury.

With superficial damage to the cornea, photophobia and lacrimation are noted. A sign of penetrating injury is the relative softness of the eyeball. Emergency care consists in applying an aseptic bandage. In case of chemical burns, before applying a bandage, rinse the eye with plenty of water and immediately (within 15-20 minutes).

Ear damage can be superficial or deep. Deep usually occur with severe head injuries with fractures of the temporal bone. An aseptic bandage is applied to the damaged ear.

Injuries to the nose, often closed, are accompanied by epistaxis, nasal deformity, impaired nasal breathing, pain, up to the development of shock, swelling and hemorrhages in the nose and surrounding parts of the face. First aid is to stop the bleeding and apply a bandage.

Injuries of the larynx are always accompanied by a violation of the general condition. Shock may develop. There is pain when swallowing and talking, hoarseness or aphonia, shortness of breath, cough. The presence of emphysema and hemoptysis indicate damage to the mucous membrane of the larynx. First aid measures are aimed at combating shock and bleeding. The victim must be injected with an analgesic, if the skin is injured, apply an aseptic bandage, if hemoptysis - cold on the neck.

INSTRUCTIONS

FIRST AID

1. General Provisions

1.1. First aid is a set of measures aimed at restoring or preserving the life and health of the victim. It should be provided by someone who is next to the victim (mutual assistance), or the victim himself (self-help) before the arrival of a medical worker.

1.2. Responsibility for organizing training in providing first aid in a health-improving organization rests with the head and / or responsible officials.

1.3. In order for the first pre-medical aid to be effective, the health-improving organization must have:

First aid kits with a set of necessary medicines and medical supplies for first aid;

Posters depicting the methods of providing first aid to victims of accidents and performing artificial respiration and external heart massage.

1.4. The person providing assistance must know the main signs of a violation of the vital functions of the human body, as well as be able to free the victim from the action of dangerous and harmful factors, assess the condition of the victim, determine the sequence of first aid methods used, and, if necessary, use improvised means when providing assistance and transporting the victim.

1.5. The sequence of actions when providing first aid to the victim:

Elimination of the impact on the body of the victim of dangerous and harmful factors (release him from the action of electric current, extinguishing burning clothes, removing him from water, etc.);

Assessment of the condition of the victim;

Determining the nature of the injury that poses the greatest threat to the life of the victim, and the sequence of actions to save him;

Performing the necessary measures to save the victim in order of urgency (restoring the airway; performing artificial respiration, external heart massage; stopping bleeding; immobilizing the fracture site; applying a bandage, etc.);

Maintaining the basic vital functions of the victim until the arrival of medical personnel;

Calling an ambulance or doctor, or taking steps to transport the victim to the nearest medical facility.

1.6. If it is impossible to call medical personnel to the scene, it is necessary to ensure the transportation of the victim to the nearest medical organization. It is possible to transport the victim only with steady breathing and pulse.

1.7. In the case when the condition of the victim does not allow him to be transported, it is necessary to maintain his basic vital functions until the arrival of a medical worker.

2. Signs to determine the state of health of the victim

2.1. Signs by which you can quickly determine the state of health of the victim are as follows:

Consciousness: clear, absent, impaired (the victim is inhibited or agitated);

The color of the skin and visible mucous membranes (lips, eyes) : pink, bluish, pale.

Respiration: normal, absent, disturbed (irregular, shallow, wheezing);

Pulse on the carotid arteries: well defined (correct or irregular rhythm), poorly defined, absent;

Pupils: dilated, constricted.

3. A complex of resuscitation measures

If the victim has no consciousness, breathing, pulse, the skin is cyanotic, and the pupils are dilated, you should immediately begin to restore the vital functions of the body by performing artificial respiration and external heart massage. It is required to note the time of respiratory arrest and blood circulation in the victim, the time of the start of artificial respiration and external heart massage, as well as the duration of resuscitation and report this information to the arriving medical personnel.

3.1. Artificial respiration.

Artificial respiration is carried out in cases where the victim does not breathe or breathes very badly (rarely, convulsively, as if with a sob), and also if his breathing constantly worsens, regardless of what caused it: electric shock, poisoning, drowning, etc. d. The most effective method of artificial respiration is the "mouth-to-mouth" or "mouth-to-nose" method, since this ensures that a sufficient volume of air enters the victim's lungs.

The "mouth-to-mouth" or "mouth-to-nose" method is based on the use of air exhaled by the caregiver, which is forced into the victim's airways and is physiologically suitable for the victim to breathe. Air can be blown through gauze, a handkerchief, etc. This method of artificial respiration makes it easy to control the flow of air into the lungs of the victim by expanding the chest after blowing and its subsequent subsidence as a result of passive exhalation.

To carry out artificial respiration, the victim should be laid on his back, unfasten clothing that restricts breathing and ensure the patency of the upper respiratory tract, which, in the supine position when unconscious, is closed by a sunken tongue. In addition, there may be foreign contents in the oral cavity (vomit, sand, silt, grass, etc.), which must be removed with the index finger wrapped in a scarf (cloth) or bandage, turning the victim's head to one side.

After that, the assisting person is located on the side of the victim’s head, slips one hand under his neck, and with the palm of the other hand presses on his forehead, throwing his head back as much as possible. In this case, the root of the tongue rises and frees the entrance to the larynx, and the victim's mouth opens. The person providing assistance leans towards the victim’s face, takes a deep breath with his mouth open, then fully covers the victim’s open mouth with his lips and exhales vigorously, blowing air into his mouth with some effort; at the same time, he covers the nose of the victim with his cheek or fingers of the hand located on the forehead. In this case, it is imperative to observe the chest of the victim, which should rise. As soon as the chest has risen, the air injection is stopped, the assisting person raises his head, and the victim passively exhales. In order for the exhalation to be deeper, you can gently press the hand on the chest to help the air out of the lungs of the victim.

If the victim has a well-defined pulse and only artificial respiration is necessary, then the interval between artificial breaths should be 5 s, which corresponds to a respiratory rate of 12 times per minute.

In addition to expanding the chest, a good indicator of the effectiveness of artificial respiration can be the pinking of the skin and mucous membranes, as well as the exit of the victim from an unconscious state and the appearance of independent breathing.

When performing artificial respiration, the assisting person must ensure that the blown air enters the lungs, and not into the victim's stomach. When air enters the stomach, as evidenced by bloating "under the spoon", gently press the palm of your hand on the stomach between the sternum and navel. This may cause vomiting, so it is necessary to turn the head and shoulders of the victim to the side (preferably to the left) to clear his mouth and throat.

If the jaws of the victim are tightly clenched and it is not possible to open the mouth, artificial respiration should be carried out according to the "mouth to nose" method.

Young children are blown into the mouth and nose at the same time. The smaller the child, the less air he needs to inhale and the more often it should be blown in comparison with an adult (up to 15-18 times per minute).

When the first weak breaths appear in the victim, an artificial breath should be timed to the moment he begins to breathe independently.

Cease artificial respiration after the victim recovers sufficiently deep and rhythmic spontaneous breathing.

It is impossible to refuse to help the victim and consider him dead in the absence of such signs of life as breathing or pulse. Only a medical professional has the right to make a conclusion about the death of the victim.

3.2. External cardiac massage.

An indication for an external heart massage is cardiac arrest, which is characterized by a combination of the following symptoms: pallor or cyanosis of the skin, loss of consciousness, no pulse in the carotid arteries, cessation of breathing or convulsive, incorrect breaths. In case of cardiac arrest, without wasting a second, the victim must be laid on a flat, rigid base: a bench, a floor, in extreme cases, put a board under his back.

If assistance is provided by one person, he is located on the side of the victim and, bending over, makes two quick vigorous blows (according to the “mouth-to-mouth” or “mouth-to-nose” method), then unbends, remaining on the same side of the victim, palm puts one hand on the lower half of the sternum (stepping back two fingers higher from its lower edge), and raises the fingers. He puts the palm of the second hand on top of the first across or along and presses, helping by tilting his body. When pressing, the arms should be straightened at the elbow joints.

Pressing should be done in quick bursts so as to displace the sternum by 4-5 cm, the duration of pressure is not more than 0.5 s, the interval between individual pressures is not more than 0.5 s.

In pauses, the hands are not removed from the sternum (if two people provide assistance), the fingers remain raised, the arms are fully extended at the elbow joints.

If the revival is performed by one person, then for every two deep blows (breaths), he makes 15 pressures on the sternum, then again makes two blows and again repeats 15 pressures, etc. At least 60 pressures and 12 blows must be done per minute, t i.e. perform 72 manipulations, so the pace of resuscitation should be high.

Experience shows that most of the time is spent on artificial respiration. You can not delay the blowing: as soon as the chest of the victim has expanded, it must be stopped.

With the correct performance of external heart massage, each pressure on the sternum causes a pulse to appear in the arteries.

The caregivers should periodically monitor the correctness and effectiveness of external cardiac massage by the appearance of a pulse on the carotid or femoral arteries. When carrying out resuscitation by one person, he should interrupt the heart massage for 2-3 seconds every 2 minutes. to determine the pulse on the carotid artery.

If two people are involved in resuscitation, then the pulse on the carotid artery is controlled by the one who conducts artificial respiration. The appearance of a pulse during a massage break indicates the restoration of the activity of the heart (the presence of blood circulation). At the same time, heart massage should be immediately stopped, but artificial respiration should be continued until stable independent breathing appears. In the absence of a pulse, it is necessary to continue to massage the heart.

Artificial respiration and external cardiac massage should be carried out until the patient is restored to stable independent breathing and heart activity or until he is transferred to medical personnel.

A prolonged absence of a pulse with the appearance of other signs of revitalization of the body (spontaneous breathing, constriction of the pupils, attempts by the victim to move his arms and legs, etc.) is a sign of cardiac fibrillation. In these cases, it is necessary to continue to give artificial respiration and heart massage to the victim before transferring him to medical personnel.

4. First aid for various types of damage to the child's body

4.1. Wound .

When providing first aid in case of injury, the following rules must be strictly observed.

It is forbidden:

Rinse the wound with water or some medicinal substance, cover it with powder and lubricate with ointments, as this prevents the wound from healing, causes suppuration and contributes to the entry of dirt into it from the surface of the skin;

It is impossible to remove sand, earth, etc. from the wound, since it is impossible to remove everything that pollutes the wound;

Remove blood clots, clothing, etc. from the wound, as this can cause severe bleeding;

Cover wounds with duct tape or cobwebs to prevent tetanus infection.

Need:

Helper wash hands or smear fingers with iodine;

Carefully remove dirt from the skin around the wound, the cleaned area of ​​the skin should be smeared with iodine;

Open the dressing bag in the first aid kit in accordance with the instructions printed on its wrapper.

When applying a dressing, do not touch with your hands that part of it that should be applied directly to the wound.

If for some reason there was no dressing bag, a clean handkerchief, cloth, etc. can be used for dressing). Do not apply cotton wool directly to the wound. On the place of the tissue that is applied directly to the wound, drip iodine to get a spot larger than the wound, and then put the tissue on the wound;

Contact a medical organization as soon as possible, especially if the wound is contaminated with earth.

4.2. Bleeding .

4.2.1. internal bleeding.

Internal bleeding is recognized by the appearance of the victim (he turns pale; sticky sweat appears on the skin; breathing is frequent, intermittent, the pulse is frequent, of weak filling).

Need:

Lay down the victim or give him a semi-sitting position;

Provide complete peace;

Apply "cold" to the intended site of bleeding;

Call a doctor or healthcare professional immediately.

It is forbidden:

Give the victim to drink if there is a suspicion of damage to the abdominal organs.

4.2.2. External bleeding.

Need:

a) with mild bleeding:

Lubricate the skin around the wound with iodine;

Apply a dressing, cotton wool to the wound and bandage it tightly;

Without removing the applied dressing, apply additional layers of gauze, cotton wool on top of it and bandage it tightly if bleeding continues;

b) with heavy bleeding:

Depending on the site of injury, for a quick stop, press the arteries to the underlying bone above the wound in the blood flow in the most effective places (temporal artery; occipital artery; carotid artery; subclavian artery; axillary artery; brachial artery; radial artery; ulnar artery; femoral artery; femoral artery in the middle of the thigh; popliteal artery; dorsal artery of the foot; posterior tibial artery);

In case of severe bleeding from a wounded limb, bend it in the joint above the wound site, if there is no fracture of this limb. Put a lump of cotton wool, gauze, etc. into the hole formed during bending, bend the joint to failure and fix the bend of the joint with a belt, scarf and other materials;

In case of severe bleeding from a wounded limb, apply a tourniquet above the wound (closer to the body), wrapping the limb at the site of the tourniquet application with a soft pad (gauze, scarf, etc.). Previously, the bleeding vessel should be pressed with fingers to the underlying bone. The tourniquet is applied correctly, if the pulsation of the vessel below the place of its application is not determined, the limb turns pale. The tourniquet can be applied by stretching (elastic special tourniquet) and twisting (tie, twisted scarf, towel);

Take the injured person with a tourniquet to a medical facility as soon as possible.

It is forbidden:

Tighten the tourniquet too tightly, as you can damage the muscles, pinch the nerve fibers and cause paralysis of the limb;

Apply tourniquet to warm time more than 2 hours, and in the cold - more than 1 hour, since there is a danger of tissue necrosis. If there is a need to leave the tourniquet longer, then you need to remove it for 10-15 minutes, after pressing the vessel with your finger above the bleeding site, and then apply it again to new skin areas.

4.3. Electric shock.

Need:

As soon as possible, release the victim from the action of electric current;

Take measures to separate the victim from current-carrying parts, if there is no possibility of a quick shutdown of the electrical installation. To do this, you can: use any dry, non-conductive object (stick, board, rope, etc.); pull the victim away from current-carrying parts by his personal clothing, if it is dry and lags behind the body; cut the wire with an ax with a dry wooden handle; use an object that conducts electric current, wrapping it in the place of contact with the hands of the rescuer with dry cloth, felt, etc.;

Remove the victim from the danger zone at a distance of at least 8 m from the current-carrying part (wire);

In accordance with the condition of the victim, provide first aid, including resuscitation (artificial respiration and chest compressions). Regardless of the subjective well-being of the victim, deliver him to a medical facility.

It is forbidden:

Forget about personal safety measures when assisting a victim of electric current. With extreme caution, you need to move in the area where the current-carrying part (wire, etc.) lies on the ground. It is necessary to move in the zone of spreading of the earth fault current using protective equipment for isolation from the ground (dielectric protective equipment, dry boards, etc.) or without the use of protective equipment, moving the feet on the ground and not tearing them one from the other.

4.4. Fractures, dislocations, bruises, sprains .

4.4.1. For fractures,:

Provide the victim with immobilization (creation of rest) of the broken bone;

With open fractures, stop bleeding, apply a sterile bandage;

Apply a tire (standard or made from improvised material - plywood, boards, sticks, etc.). If there are no objects with which to immobilize the fracture site, it is bandaged to a healthy part of the body (an injured arm to the chest, an injured leg to a healthy one, etc.);

With a closed fracture, leave a thin layer of clothing at the splint site. Remove the remaining layers of clothing or shoes without aggravating the position of the victim (for example, cut);

Apply cold to the fracture site to reduce pain;

Deliver the victim to a medical institution, creating a calm position of the damaged body part during transportation and transfer to medical personnel.

It is forbidden:

Remove clothes and shoes from the victim in a natural way, if this leads to additional physical impact (squeezing, pressing) on ​​the fracture site.

4.4.2. When dislocated, you need:

Ensure complete immobility of the damaged part with a tire (standard or made from improvised material);

Deliver the victim to a medical facility with immobilization.

It is forbidden:

Try to correct the dislocation yourself. This should only be done by a medical professional.

4.4.3. For injuries, you need:

Create peace for a bruised place;

Apply "cold" to the site of injury;

Apply a tight bandage.

It is forbidden:

Lubricate the bruised area with iodine, rub and apply a warm compress.

4.4.4. When stretching ligaments, you need:

Bandage the injured limb tightly and provide it with peace;

Apply "cold" to the injury site;

Create conditions for blood circulation (raise the injured leg, hang the injured arm on a scarf to the neck).

It is forbidden:

Carry out procedures that can lead to heating of the injured area.

4.4.5. With a skull fracture(signs: bleeding from the ears and mouth, unconsciousness) and concussion (signs: headache, nausea, vomiting, loss of consciousness) need:

Eliminate the harmful effects of the situation (frost, heat, being on the carriageway, etc.);

Move the victim in compliance with the rules of safe transportation to a comfortable place;

Lay the victim on his back, in case of vomiting, turn his head to one side;

Fix the head on both sides with rollers from clothes;

When suffocation occurs due to tongue retraction, push the lower jaw forward and maintain it in this position;

If there is a wound, apply a tight sterile bandage;

Put "cold";

Ensure complete rest until the doctor arrives;

Provide qualified medical assistance as soon as possible (call medical workers, provide appropriate transportation).

It is forbidden:

Give the victim any medication on their own;

Talk to the victim;

Allow the victim to get up and move around.

4.4.6. In case of spinal injury(signs: sharp pain in the spine, inability to bend the back and turn) need:

Carefully, without lifting the victim, slip a wide board and other object similar in function under his back or turn the victim face down and strictly ensure that his torso does not bend in any position (to avoid damage to the spinal cord);

Eliminate any load on the muscles of the spine;

Provide complete peace.

It is forbidden:

Turn the victim on his side, plant, put on his feet;

Lay on a soft, elastic bedding.

4.5. For burns you need:

For burns of the 1st degree (redness and soreness of the skin), cut the clothes and shoes at the burnt place and carefully remove them, moisten the burnt place with alcohol, a weak solution of potassium permanganate, and other cooling and disinfecting lotions, then contact a medical institution;

For burns of the II, III and IV degrees (blisters, necrosis of the skin and deep-lying tissues), apply a dry sterile bandage, wrap the affected area of ​​the skin in a clean cloth, sheet, etc., seek medical help. If the burnt pieces of clothing are stuck to the burned skin, apply a sterile bandage over them;

If the victim shows signs of shock, immediately give him 20 drops of valerian tincture or another similar remedy to drink;

In case of eye burns, make cold lotions from a solution of boric acid (half a teaspoon of acid in a glass of water);

In case of a chemical burn, wash the affected area with water, treat it with neutralizing solutions: in case of an acid burn, a solution of baking soda (1 teaspoon per glass of water); for alkali burns - a solution of boric acid (1 teaspoon per glass of water) or a solution of acetic acid (table vinegar, half diluted with water).

It is forbidden:

Touch the burned areas of the skin with your hands or lubricate them with ointments, fats, and other means;

Open bubbles;

Remove substances, materials, dirt, mastic, clothing, etc. adhering to the burned area.

4.6. For heat and sunstroke:

Quickly move the victim to a cool place;

Lay on your back, placing a bundle under your head (you can use clothes);

Unfasten or remove tight clothing;

Moisten the head and chest with cold water;

Apply cold lotions to the surface of the skin, where many vessels are concentrated (forehead, parietal region, etc.);

If the person is conscious, give cold tea, cold salted water to drink;

If breathing is disturbed and there is no pulse, perform artificial respiration and external heart massage;

Provide peace;

Call an ambulance or take the victim to a medical facility (depending on the state of health).

It is forbidden:

4.7. For food poisoning:

Give the victim to drink at least 3-4 glasses of water and a pink solution of potassium permanganate, followed by vomiting;

Repeat gastric lavage several times;

Give the victim activated charcoal;

Drink warm tea, put to bed, cover warmer (until the arrival of medical personnel);

In case of violation of breathing and blood circulation, start artificial respiration and external heart massage.

It is forbidden:

Leave the victim unattended until the ambulance arrives and takes him to a medical organization.

4.8. For frostbite, you need:

In case of slight freezing, immediately rub and heat the chilled area to eliminate vasospasm (excluding the possibility of damage to the skin, its injury);

In case of loss of sensitivity, whitening of the skin, do not allow rapid warming of supercooled areas of the body when the victim is in the room, use heat-insulating dressings (cotton-gauze, woolen, etc.) on the affected integuments;

Ensure the immobility of supercooled hands, feet, body body (for this you can resort to splinting);

Leave the heat-insulating bandage until a feeling of heat appears and the sensitivity of the supercooled skin is restored, then give hot sweet tea to drink;

In case of general hypothermia, the victim should be urgently delivered to the nearest medical institution without removing heat-insulating dressings and means (in particular, you should not remove icy shoes, you can only wrap your feet with a padded jacket, etc.).

It is forbidden:

Tear or pierce the formed blisters, as this threatens to fester.

4.9. When hit by foreign bodies in organs and tissues need contact a healthcare professional or healthcare organization.

You can remove a foreign body yourself only if there is sufficient confidence that this can be done easily, completely and without serious consequences.

4.10. When drowning a person, you need:

Act thoughtfully, calmly and carefully;

The person providing assistance must not only swim and dive well himself, but also know the methods of transporting the victim, be able to free himself from his seizures;

Urgently call an ambulance or a doctor;

If possible, quickly clean the mouth and throat (open the mouth, remove the trapped sand, carefully pull out the tongue and fix it to the chin with a bandage or scarf, the ends of which are tied at the back of the head);

Remove water from the respiratory tract (put the victim on his knee with his stomach, head and legs hang down; beat on the back);

If, after removing the water, the victim is unconscious, there is no pulse on the carotid arteries, does not breathe, start artificial respiration and external heart massage. Carry out until complete recovery of breathing or stop when there are obvious signs of death, which the doctor must ascertain;

When restoring breathing and consciousness, wrap, warm, drink hot strong coffee, tea (give an adult 1-2 tablespoons of vodka);

Ensure complete rest until the doctor arrives.

It is forbidden:

Until the doctor arrives, leave the victim alone (without attention) even with a clear visible improvement in well-being.

4.11. When bitten.

4.11.1. For snake bites and poisonous insects,:

Suck the poison out of the wound as soon as possible (this procedure is not dangerous for the caregiver);

Restrict the victim's mobility to slow the spread of the poison;

Provide plenty of fluids;

Deliver the victim to a medical organization. Transport only in the supine position.

It is forbidden:

Apply a tourniquet to the bitten limb;

Cauterize the bite site;

Make incisions for better discharge of poison;

Give the victim alcohol.

4.11.2. For animal bites:

Lubricate the skin around the bite (scratch) with iodine;

Apply a sterile bandage;

Send the victim to a medical organization for vaccination against rabies.

4.11.3. When bitten or stung by insects (bees, wasps, etc.), you need to:

Remove sting;

Put "cold" in place of the edema;

Give the victim a large amount of drink;

In case of allergic reactions to insect venom, give the victim 1-2 tablets of diphenhydramine and 20-25 drops of cordiamine, cover the victim with warm heating pads and urgently deliver to a medical organization;

In case of respiratory failure and cardiac arrest, perform artificial respiration and external heart massage.

It is forbidden:

The victim should take alcohol, as it promotes vascular permeability, the poison lingers in the cells, swelling increases.