First aid measures carried out. Instructions for first aid

Appendix N 1. List of conditions for which first aid is provided* Appendix N 2. List of first aid measures

Order of the Ministry of Health and Social Development of the Russian Federation
dated May 4, 2012 N 477n
"On approval of the list of conditions for which first aid is provided and the list of measures to provide first aid"

With changes and additions from:

In accordance with Article 31 of the Federal Law of November 21, 2011 N 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation” (Collected Legislation of the Russian Federation, 2011, N 48, Art. 6724) I order:

2. Recognize the order of the Ministry of Health and Social Development of the Russian Federation dated May 17, 2010 N 353n “On First Aid” (registered by the Ministry of Justice of the Russian Federation on July 12, 2010 N 17768) as invalid.

The conditions for which first aid is provided, as well as the measures taken during this, are determined.

Thus, assistance is provided for various injuries, poisoning, frostbite, burns, external bleeding, unconsciousness, etc.

It has been established how the person providing assistance should behave.

In particular, he must assess the threat to his own life, the victims and those around him. The victim must be removed from hard-to-reach places, examined, and determined whether he is conscious. It is necessary to call an ambulance and other special services.

A number of special events are planned. These include cardiopulmonary resuscitation, stopping external bleeding, and measures to restore airway patency.

First aid is a set of urgent measures aimed at saving a person’s life. An accident, a sudden attack of illness, poisoning - in these and other emergency situations, competent first aid is necessary.

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 near the victim at a critical moment. For some categories of citizens, providing first aid is an official duty. We are talking about police officers, traffic police and the Ministry of Emergency Situations, military personnel, and firefighters.

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

First aid algorithm

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

Make sure that when providing first aid you are not in danger and you are not putting yourself in danger.
Ensure the safety of the victim and others (for example, remove the victim from a burning car).
Check the victim for signs of life (pulse, breathing, reaction of pupils to light) and consciousness. To check breathing, you need to tilt the victim's head back, lean towards his mouth and nose and try to hear or feel breathing. To detect the pulse, you need to place your fingertips on the victim’s carotid artery. To assess consciousness, it is necessary (if possible) to take the victim by the shoulders, gently shake him and ask a question.
Call specialists: from the city - 03 (ambulance) or 01 (rescue).
Provide emergency first aid. Depending on the situation, this could be:
- restoration of airway patency;
- cardiopulmonary resuscitation;
- stopping bleeding and other measures.
Provide the victim with physical and psychological comfort and wait for specialists to arrive.

Artificial respiration

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

Typical situations requiring mechanical ventilation:

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

There are various methods of mechanical ventilation. The most effective means of providing first aid to a non-specialist are mouth-to-mouth and mouth-to-nose artificial respiration.

If, upon examination of the victim, natural breathing is not detected, artificial ventilation of the lungs must be performed immediately.

Mouth-to-mouth artificial respiration technique

Ensure patency of the upper respiratory tract. Turn the victim's head to the side and use your finger to remove mucus, blood, and foreign objects from the mouth. Check the victim's nasal passages and clear them if necessary.
Tilt the victim's head back, holding the neck with one hand.
Do not change the position of the victim’s head if there is a spinal injury!
Place a napkin, 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 index finger. Take a deep breath and press your lips firmly against the victim's mouth. Exhale into the victim's lungs.
The first 5–10 exhalations should be quick (in 20–30 seconds), then 12–15 exhalations per minute.
Observe the movement of the victim's chest. If the victim's chest rises when he inhales air, then you are doing everything right.

Indirect cardiac massage

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

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

Attention! You cannot perform a closed cardiac massage if there is a pulse.

Indirect cardiac massage technique

Place the victim on a flat, hard surface. Chest compressions should not be performed on beds or other soft surfaces.
Determine the location of the affected xiphoid process. The xiphoid process is the shortest and narrowest part of the sternum, its end.
Measure 2-4 cm up from the xiphoid process - this is the point of compression.
Place the heel 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 person performing resuscitation. Place your other palm on top of one hand, clasping your fingers. Pressure is applied strictly with the base of the palm - your fingers should not touch the victim’s sternum.
Perform rhythmic chest thrusts strongly, smoothly, strictly vertically, using 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 cardiac massage is performed with the index and middle finger of one hand. For teenagers - with the palm of one hand.

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

If during resuscitation measures the victim regains breathing or has a pulse, stop providing first aid and place the person on his side with his palm under his head. Monitor his condition until paramedics arrive.

Heimlich maneuver

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

Signs of a blocked airway:

Lack of full breathing. If the windpipe is not completely blocked, the person coughs; if completely, he holds on to the throat.
Inability to speak.
Blue discoloration of facial skin, swelling of neck vessels.

Airway clearance is most often carried out using the Heimlich method.

Stand behind the victim.
Grasp it with your hands, clasping them together, just above the navel, under the costal arch.
Press firmly on the victim's abdomen while sharply bending your elbows.
Do not squeeze the victim's chest, with the exception of pregnant women, for whom pressure is applied to the lower chest.
Repeat the dose 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 press on the costal arches with both hands.

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

Bleeding

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

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

In case of venous bleeding, a pressure bandage is applied. To do this, wound tamponade 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 compressed 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: Press the artery firmly with your fingers or fist against the underlying bone formation.

The arteries are easily accessible for palpation, so this method is very effective. However, it requires physical strength from the first aider.

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

Technique for applying a hemostatic tourniquet

Apply a tourniquet to clothing or soft padding just above the wound.
Tighten the tourniquet and check the pulsation of the blood vessels: the bleeding should stop and the skin below the tourniquet should turn pale.
Apply a bandage to the wound.
Record the exact time the tourniquet is applied.

The tourniquet can be applied to the limbs for a maximum of 1 hour. After it expires, the tourniquet must be loosened for 10–15 minutes. If necessary, you can tighten it again, but no more than 20 minutes.

Fractures

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

First aid technique for fracture

Assess the severity of the victim’s condition and determine the location of the fracture.
If there is bleeding, stop it.
Determine whether the victim can be moved before specialists arrive.
Do not carry the victim or change his position if there is a spinal injury!
Ensure the bone immobility in the fracture area - perform immobilization. To do this, it is necessary to immobilize the joints located above and below the fracture.
Apply a splint. You can use flat sticks, boards, rulers, rods, etc. as a tire. The splint must be secured tightly, but not tightly, with bandages or plaster.

With a closed fracture, immobilization is performed over clothing. In case of an open fracture, do 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 severity as well as types of damage. According to the latter basis, 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 (carefully, without tearing it off, but cutting off the adhering tissue around the wound) and for the purpose of disinfection and pain relief, irrigate it with a water-alcohol solution (1/1) or vodka.

Do not use oil-based ointments and fatty creams - fats and oils do not reduce pain, do not disinfect the burn, or promote healing.

Afterwards, irrigate the wound with cold water, apply a sterile bandage and apply cold. 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 larger than one palm, be sure to consult a doctor.

Fainting

Fainting is a sudden loss of consciousness caused by a temporary disruption of cerebral blood flow. In other words, this is a signal from the brain that it does not have enough oxygen.

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

A pre-fainting state is characterized by the fact that a person rolls his eyes, breaks out in a cold sweat, his pulse weakens, and his limbs become cold.

Typical situations of fainting:

fright,
excitement,
stuffiness and others.

If a person faints, give him a comfortable horizontal position and provide fresh air (unfasten clothes, loosen belt, open windows and doors). Spray the victim's face with cold water and pat his cheeks. If you have a first aid kit on hand, give a cotton swab soaked in ammonia a sniff.

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

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

Drowning and sunstroke

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

First aid for drowning

Remove the victim from the water.
A drowning man grabs whatever he can get his hands on. Be careful: swim up to him from behind, hold him by the hair or armpits, keeping your face above the surface of the water.
Place the victim with his stomach on his knee so that his head is down.
Clean the oral cavity of foreign bodies (mucus, vomit, algae).
Check for signs of life.
If there is no pulse or breathing, immediately begin mechanical ventilation and chest compressions.
After breathing and cardiac function have been restored, place the victim on his side, cover him and keep him comfortable until paramedics arrive.

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

Symptoms:

headache,
weakness,
tinnitus,
nausea,
vomit.

If the victim continues to remain in the sun, his temperature rises, shortness of breath appears, and sometimes he even loses consciousness.

Therefore, when providing first aid, it is first necessary to move the victim to a cool, ventilated place. Then free him from his clothes, loosen the belt, and take him off. Place a cold, wet towel on his head and neck. Give it a sniff of ammonia. Give artificial respiration if necessary.

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

The causes of frostbite are high humidity, frost, wind, and immobile position. Alcohol intoxication usually aggravates the victim's condition.

Symptoms:

feeling cold;
tingling in the frostbitten part of the body;
then - numbness and loss of sensitivity.

First aid for frostbite

Keep the victim warm.
Remove frozen or wet clothing.
Do not rub the victim with snow or cloth - this will only injure the skin.
Wrap up the frostbitten area of your body.
Give the victim a hot sweet drink or hot food.

Poisoning

Poisoning is a disorder of the body's functioning that occurs due to the ingestion of a poison or toxin. Depending on the type of toxin, poisoning is distinguished:

carbon monoxide,
pesticides,
alcohol,
medications,
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 carbon 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, as well as alcohol intoxication, are common.

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

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 clear.
Gastric lavage is only possible if the victim is conscious.
Dissolve 10–20 tablets of activated carbon in a glass of water and give it to the victim to drink.
Wait for the specialists to arrive.

Persons obliged to provide first aid in accordance with federal law or with a special rule and having appropriate training, as well as drivers of vehicles and other persons with appropriate training and (or) skills, provide first aid (before providing medical assistance) to citizens when accidents, injuries, poisoning and other conditions and diseases that threaten their life and health when they are in certain conditions.

List of first aid measures:

1. Measures to assess the situation and ensure safe conditions for providing first aid:

1) identification of threatening factors for one’s own life and health;

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

3) elimination of threatening factors for life and health;

4) cessation of the effect of damaging factors on the victim;

5) assessment of the number of victims;

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

7) moving the victim.

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

3. Determination of the presence of consciousness in the victim.

4. First aid measures to restore airway patency and determine signs of life in the victim:

2) extension of the lower jaw;

3) determining the presence of breathing using hearing, vision and touch;

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

5. First aid measures to perform cardiopulmonary resuscitation until signs of life appear:

1) hand pressure on the victim’s sternum;

2) artificial respiration "Mouth to mouth";

3) artificial respiration "Mouth to nose";

4) artificial respiration using an artificial respiration device<В соответствии с утвержденными требованиями к комплектации изделиями медицинского назначения аптечек (укладок, наборов, комплектов) для оказания первой помощи>.

6. First aid measures to maintain airway patency:

1) giving a stable lateral position;

3) extension of the lower jaw.

7. First aid measures for a general examination of the victim and temporary stopping of external bleeding:

1) general examination of the victim for the presence of bleeding;

2) finger pressure of the artery;

3) application of a tourniquet;

4) maximum flexion of the limb at the joint;

5) direct pressure on the wound;

6) applying a pressure bandage.

8. Measures for a detailed examination of the victim in order to identify signs of injuries, poisoning and other conditions that threaten his life and health, and to provide first aid if these conditions are identified:

1) conducting a head examination;

2) performing a neck examination;

3) performing a breast examination;

4) performing a back examination;

5) conducting an examination of the abdomen and pelvis;

6) conducting an examination of the limbs;

7) application of bandages for injuries to various areas of the body, including occlusive (sealing) for injuries to the chest;

8) carrying out immobilization (using improvised means, autoimmobilization, using medical devices<В соответствии с утвержденными требованиями к комплектации изделиями медицинского назначения аптечек (укладок, наборов, комплектов) для оказания первой помощи.>);

9) fixation of the cervical spine (manually, with improvised means, using medical devices<В соответствии с утвержденными требованиями к комплектации изделиями медицинского назначения аптечек (укладок, наборов, комплектов) для оказания первой помощи.>);

10) stopping the victim from exposure to hazardous chemicals (gastric lavage by drinking water and inducing vomiting, removing from the damaged surface and washing the damaged surface with running water);

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

12) thermal insulation against frostbite and other effects of exposure to low temperatures.

9. Giving the victim an optimal body position.

10. Monitoring the victim’s condition (consciousness, breathing, blood circulation) and providing psychological support.

11. Transfer of the victim to an ambulance team and other special services, whose employees are required to provide first aid in accordance with federal law or with a special rule.

(Appendix No. 2 to the order of the Ministry of Health and Social Development of the Russian Federation dated May 4, 2012 No. 477n)

First aid- a set of urgent, simple measures aimed at restoring or preserving the life and health of the victim, carried out at the scene of injury mainly in the form of self- and mutual assistance, as well as by members of rescue teams using standard and improvised means.

The list of conditions and measures for providing first aid was approved by order of the Ministry of Health and Social Development of the Russian Federation dated May 4, 2012 No. 477n (as amended on November 7, 2012) “On approval of the list of conditions for which first aid is provided and the list of measures for providing first aid.”

List of states

1. Lack of consciousness.

2. Stopping breathing and blood circulation.

3. External bleeding.

4. Foreign bodies of the upper respiratory tract.

5. Injuries to various areas of the body.

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

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

8. Poisoning.

First aid measures include:

1. Measures to assess the situation and ensure safe conditions for providing first aid:

Identification of threatening factors for one’s own life and health;

Identification of threatening factors for the life and health of the victim;

Elimination of threatening factors for life and health;

Termination of the effect of damaging factors on the victim;

Estimation of the number of victims;

Removing the victim from a vehicle or other hard-to-reach places;

Relocation of the victim.

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

3. Determination of the presence of consciousness in the victim.

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

Advancement of the lower jaw;

Determining the presence of breathing using hearing, vision and touch;

Determining the presence of blood circulation, checking the pulse in the main arteries.

5. Measures to carry out cardiopulmonary resuscitation until signs of life appear:

Hand pressure on the victim’s sternum;

Artificial respiration "mouth to mouth";

Artificial respiration "from mouth to nose";

Artificial respiration using a breathing device.

6. Measures to maintain airway patency:

Giving a stable lateral position;

Throwing back the head with lifting the chin;

Advancement of the lower jaw.

7. Measures for a general examination of the victim and temporary stopping of external bleeding:

General examination of the victim for bleeding;

Finger pressure of the artery;

Application of a tourniquet;

Maximum flexion of the limb at the joint;

Direct pressure on the wound;

Applying a pressure bandage.

Carrying out a head examination;

Carrying out a neck examination;

Conducting a breast examination;

Carrying out a back examination;

Conducting an examination of the abdomen and pelvis;

Conducting an examination of the limbs;

Application of bandages for injuries to various areas of the body, including occlusive (sealing) for wounds of the chest;

Carrying out immobilization (using improvised means, autoimmobilization, using medical products);

Fixation of the cervical spine (manually, with improvised means, using medical devices);

Stopping the victim from exposure to hazardous chemicals (gastric lavage by drinking water and inducing vomiting, removing from the damaged surface and rinsing the damaged surface with running water);

Local cooling for injuries, thermal burns and other effects of high temperatures or thermal radiation;

Thermal insulation against frostbite and other effects of low temperatures.

9. Giving the victim an optimal body position.

10. Monitoring the victim’s condition (consciousness, breathing, blood circulation) and providing psychological support.

11. Transfer of the victim to an ambulance team and other special services, whose employees are required to provide first aid in accordance with federal law or with a special rule.

One of the most important conditions for providing first aid The victim is aware of its urgency: the faster it is provided, the greater the hope for a favorable outcome. Therefore, such assistance can and should be provided in a timely manner by those who are close to the victim.

The first aid provider must know:

The main signs of a violation of the vital functions of the human body;

General principles, rules and techniques for providing first aid in relation to the nature of the injury;

Basic methods of carrying and evacuating victims.

The signs by which you can quickly determine the condition of the victim are as follows:

Consciousness: clear, absent or impaired;

Breathing: normal, absent or impaired;

Pulse on the carotid arteries: determined (the rhythm is correct or incorrect) or not determined;

Pupils: narrow or wide.

With certain knowledge and skills, a first aid provider is able to quickly assess the condition of the victim and decide in what volume and order assistance should be provided.

1. Measures to assess the situation and ensure safe conditions for providing first aid:

1) identification of threatening factors for one’s own life and health;

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

3) elimination of threatening factors for life and health;

4) cessation of the effect of damaging factors on the victim;

5) assessment of the number of victims;

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

7) moving the victim.

2. Calling emergency medical services and other special services, whose employees are required to provide first aid in accordance with federal law or special rule .

3. Determining whether the victim is conscious.

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

2) extension of the lower jaw;

3) determining the presence of breathing using hearing, vision and touch;

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

5. Measures to perform cardiopulmonary resuscitation until signs of life appear:

1) hand pressure on the victim’s sternum;

2) artificial respiration "Mouth to mouth";

3) artificial respiration "Mouth to nose";

4) artificial respiration using an artificial respiration device

6. Measures to maintain airway patency:

1) giving a stable lateral position;

3) extension of the lower jaw.

7. Measures for a general examination of the victim and temporary stopping of external bleeding:

1) general examination of the victim for the presence of bleeding;

2) finger pressure of the artery;

3) application of a tourniquet;

4) maximum flexion of the limb at the joint;

5) direct pressure on the wound;

6) applying a pressure bandage.

1) conducting a head examination;

2) performing a neck examination;

3) performing a breast examination;

4) performing a back examination;

5) conducting an examination of the abdomen and pelvis;

6) conducting an examination of the limbs;

7) application of bandages for injuries to various areas of the body, including occlusive (sealing) for injuries to the chest;

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

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

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

12) thermal insulation against frostbite and other effects of exposure to low temperatures.

9. Giving the victim an optimal body position.

10. Monitoring the victim’s condition (consciousness, breathing, blood circulation) and providing psychological support.

11. Transfer of the victim to an emergency medical team or other special services, whose employees are required to provide first aid in accordance with federal law or a special rule.

General principles of first aid reflect the most important requirements that must be taken into account when providing first aid to victims in various situations:

First aid actions should be determined by the actual situation;

The safety of first responders must be ensured;

It is necessary to use available means to provide the best possible first aid;

Providing first aid must be combined with simultaneous preparation for evacuation;

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

List of first aid measures in a specific situation depends on the damaging factors, affecting a person, and injuries received.

In disasters with a predominance of mechanical (dynamic) damaging factors First aid measures include:

ª extracting victims from under the rubble, destroyed shelters, shelters;

ª finding out whether the victim is alive;

ª giving a physiologically advantageous position to the victim;

ª restoration of airway patency and mechanical ventilation;

ª closed (indirect) cardiac massage;

ª temporary stop of external bleeding by all available methods;

ª administration of painkillers using a syringe tube;

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

ª immobilization of limbs for bone fractures and soft tissue crushing;

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

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

In the lesions with a predominance of thermal factors , in addition to the activities listed above, the following are held:

ª extinguishing burning clothes;

ª application of an aseptic dressing;

ª covering the victim with a clean sheet;

ª warming the victim and giving painkillers.

In case of disasters involving the release of hazardous substances into the environment First aid is carried out:

ª protection of the respiratory system, vision and skin from the direct effects of hazardous chemicals by using personal protective equipment, cotton-gauze bandages, covering the face with wet gauze, a scarf, a towel, etc.;

ª administration of an antidote;

ª prompt removal of the affected person from the infection zone;

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

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

ª removal of respiratory protection;

ª giving optimal body position;

ª ensuring access to fresh air;

ª if AOXV gets into the stomach, drink plenty of fluids to lavage the stomach using a tubeless method, using sorbents;

ª monitoring victims until medical assistance arrives.

In case of radiation accidents first aid includes:

ª carrying out measures to stop the entry of radioactive substances into the body with inhaled air, water, food (use of personal protective equipment, cotton-gauze bandages, etc.);

ª cessation of external exposure of those affected by their rapid evacuation outside the territory contaminated with radioactive substances or to collective protective equipment;

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

ª partial sanitary treatment of exposed skin areas;

ª removal of radioactive substances from clothing and shoes.

In case of mass infectious diseases in foci of bacteriological (biological) infection, first aid includes:

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

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

ª use of emergency nonspecific prophylaxis;

ª carrying out partial or complete special processing.

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

Primary pre-hospital health care (first aid) - type of medical care, the activities of which complement first aid. It turns out to be by paramedics (paramedic or nurse) at the site of the lesion or in the immediate vicinity of the site of the lesion using standard medical equipment.

Her purpose:

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

ª protection of wounds from secondary infection ;

ª monitoring the correctness of first aid and correcting its deficiencies;

ª prevention of the development of subsequent complications;

ª preparing the injured for further evacuation.

The optimal period for providing first aid is up to 2 hours from the moment of injury.

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

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

ª performing cardiopulmonary resuscitation;

ª infusion of infusion agents;

ª administration of painkillers and cardiovascular drugs;

ª administration and ingestion of antibiotics, anti-inflammatory, sedatives, anticonvulsants and antiemetic drugs;

ª introduction of sorbents, antidotes, etc.;

ª monitoring the correct application of tourniquets, bandages and splints and, if necessary, correcting and supplementing them using standard equipment;

ª application of aseptic and occlusive dressings.

Medical personnel providing first aid also monitor the correctness of first aid.

Primary (emergency) medical care - type of medical care, including a complex of treatment and preventive measures performed by doctors of emergency medical teams, medical and nursing teams and general practitioners, as a rule, at the prehospital stage of medical evacuation(a medical aid station deployed by medical and nursing teams, in an outpatient clinic, health center of the facility or other nearby health care facility).

Its main tasks - combating life-threatening phenomena(asphyxia, bleeding, shock, convulsions, etc.), prevention of complications(in particular, wound infections, etc.) and preparing the injured for further evacuation. The optimal time for providing assistance for emergency indications is 3 hours, in full - 6 hours (for injuries and burns).

When a significant number of injured people enter the medical evacuation stage, a situation is created where it is not possible to provide full first aid to all those in need in a timely manner (within the acceptable time frame).

Given this situation, measures primary (emergency) medical care are divided into 2 groups:

ª urgent measures;

ª activities that may be forced to be postponed or provided at the next stage.

To urgent measures include:

Ø elimination of asphyxia :

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

Air duct insertion;

Tongue fixation;

Cutting off or suturing hanging flaps of the soft palate and lateral parts of the pharynx;

Tracheostomy according to indications;

Artificial pulmonary ventilation (ALV);

Application of an occlusive dressing for open pneumothorax;

Puncture of the pleural cavity or thoracentesis for tension pneumothorax;

Ø stopping external bleeding :

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

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

Monitoring the correctness and appropriateness of applying a tourniquet;

Application of a tourniquet if indicated;

Ø carrying out anti-shock measures :

Transfusion of blood substitutes in case of significant bleeding;

Conducting novocaine blockades;

Administration of painkillers and cardiovascular drugs;

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

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

Ø carrying out measures aimed at eliminating the desorption of chemicals from clothing and allowing to remove the gas mask from the affected persons coming from the source of chemical damage;

Ø administration of antidotes, use of anticonvulsants, bronchodilators and antiemetics;

Ø degassing of the wound when it is contaminated with persistent chemicals;

Ø gastric lavage using a tube in case of chemical or radioactive substances entering the stomach;

Ø use of antitoxic serum for poisoning with bacterial toxins and nonspecific prevention of infectious diseases .

For events that may be postponed, include:

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

Ø changing the dressing if the wound is contaminated with radioactive substances;

Ø carrying out novocaine blockades for moderate injuries;

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

Ø prescribing various symptomatic remedies for conditions that do not pose a threat to the life of the affected person .

Specialized medical care- the final form of medical care, is exhaustive. It is provided specialist doctors(neurosurgeons, traumatologists, ophthalmologists, etc.) with special diagnostic and treatment equipment in specialized medical institutions. Profiling of medical institutions can be carried out by giving them specialized medical care teams with appropriate medical equipment. The optimal period for providing specialized medical care is 24-72 hours from the moment of injury.

In general terms, the first 3 types of medical care ( first, primary (emergency) pre-medical, medical health care ) decide similar tasks , namely:

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

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

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

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

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

Thus, volume of medical care both at the source of damage and at the stages of medical evacuation is not constant and can change depending on the situation.

If, under specific conditions, all measures of a given type of medical care are carried out, then it is considered that volume of medical care full.

If, in relation to a certain group of those affected at the source of the lesion and at the stage of medical evacuation, it is not possible to carry out certain treatment and preventive measures, it provides for the refusal to carry out measures that can be delayed, and usually includes the implementation of emergency measures, then volume of medical care called abbreviated.

Depending on the type and scale of the emergency, the number of people affected and the nature of their injuries, the availability of medical forces and means, the state of territorial and departmental healthcare, the distance from the emergency area of hospital-type medical institutions capable of providing the full scope of specialized medical care and their capabilities, different can be accepted medical care options injured in emergency situations:

Providing those affected, before their evacuation to hospital-type medical institutions, with only first or primary (ambulance) pre-medical health care;

Providing victims with primary (emergency) medical care before their evacuation to hospital-type medical institutions;

Providing specialized medical care to the injured before their evacuation to hospital-type medical institutions and emergency measures.

Before the evacuation of the injured to hospital-type medical institutions in all cases must be fulfilled measures to eliminate current life-threatening conditions, prevent various severe complications and ensure transportation without significant deterioration of their condition .