Emergency medical care for emergency conditions. Lecture: first aid in emergency conditions

IN Everyday life: at work, at home, during outdoor recreation, unforeseen situations happen and injuries occur. In such situations, it is important not to be confused by those around you and to help the victim. In what order is emergency first aid provided? health care(PMP), everyone should know, because a person’s life may depend on knowledge and skills.

What is first aid

A set of emergency measures for primary care is aimed at saving lives and alleviating the condition of the victim in case of accidents or sudden illnesses. Such measures are carried out at the scene of the incident by the victim or surrounding persons. From the quality of timely delivery emergency assistance The further condition of the victim greatly depends.

To save the victim, a first aid kit is used, which should be at work, in educational institutions, in cars. In case of its absence, available materials are used. An individual first aid kit includes the following equipment:

Materials for assistance: arterial tourniquet, bandage, cotton wool, splints for limb immobilization.
Medications: antiseptics, validol, ammonia, soda tablets, Vaseline and others.

Types of first aid

Depending on the type of qualifications of medical personnel and the location of emergency medical measures, the assistance to the victim is classified:

First aid. Unskilled workers provide assistance at the scene until the ambulance arrives.
First aid. Provided by a medical professional (nurse, paramedic) at the scene of the incident, at a paramedic-midwife station, or in an ambulance.
First medical aid. Provided by doctors necessary tools in the ambulance, emergency room, and emergency rooms.
Qualified medical care. Carried out in a hospital setting medical institution.
Specialized medical care. Doctors provide a range of medical services in specialized medical institutions.

First aid rules

What does a first aid provider need to know? In case of accidents, it is important for those around you not to get confused and to quickly and coordinately carry out the necessary measures. To do this, one person must issue commands or perform all actions independently. The first aid algorithm depends on the type of injury, but there are general rules behavior. The rescuer needs:

Make sure that he is not in danger and begin to take the necessary measures.
Perform all actions carefully so as not to worsen the patient's condition.
Assess the situation around the victim; if he is not in danger, do not touch him until examined by a specialist. If there is a threat, it is necessary to remove it from the affected area.
Call an ambulance.
Check the victim's pulse, breathing, and pupillary response.
Take measures to restore and maintain vital functions before the specialist arrives.
Provide protection to the victim from cold and rain.

Ways to provide assistance

The choice of necessary measures depends on the condition of the victim and the type of injury. To restore vital functions, there is a complex of resuscitation measures:

Artificial respiration. Produced at sudden stop breathing. Before carrying out the procedure, it is necessary to clear the mouth and nose of mucus, blood, and trapped objects, apply gauze bandage or a piece of cloth over the victim’s mouth (to prevent infection) and tilt his head back. After pinching the patient's nose with the thumb and forefinger, quickly exhale mouth to mouth. Correct artificial respiration is indicated by the movement of the victim's chest.
Indirect cardiac massage. Done in the absence of a pulse. It is necessary to lay the victim on a hard, flat surface. The heel of the palm of one hand of the rescuer is placed just above the narrowest part of the victim’s sternum and covered with the other hand, the fingers are raised and quick push pressure is applied to the chest. Cardiac massage is combined with artificial respiration - two mouth-to-mouth exhalations alternate with 15 pressures.
Application of a tourniquet. It is produced to stop external bleeding in wounds that are accompanied by vascular damage. A tourniquet is applied to the limb above the wound, and a soft bandage is placed under it. If there is no official means, stop arterial bleeding You can use a tie or scarf. Be sure to record the time the tourniquet was applied and attach it to the victim’s clothing.

Stages

After an incident, first aid includes the following steps:

Elimination of the source of injury (power outage, removal of rubble) and evacuation of the victim from the danger zone. Surrounding persons render.
Carrying out measures to restore the vital functions of the injured or sick person. Persons with the necessary skills can perform artificial respiration, stop bleeding, and perform cardiac massage.
Transporting the victim. Mostly carried out by ambulance in the presence of a medical professional. He must provide correct position patient on a stretcher and on the way, to prevent complications.

How to provide first aid

During rendering up to medical care It is important to follow the sequence of actions. Things to remember:

Providing first aid to victims should begin with resuscitation measures - artificial respiration and cardiac massage.
If there are signs of poisoning, induce vomiting with a large volume of water and allow it to be taken Activated carbon.
In case of fainting, the victim is given ammonia to smell.
In case of extensive injuries or burns, you should be given an analgesic to prevent shock.

For fractures

There are cases when fractures are accompanied by injuries and damage to the arteries. When providing primary care to a victim, the following sequence of actions must be followed:

stop bleeding by applying a tourniquet;
disinfect and bandage the wound with a sterile bandage;
immobilize the injured limb with a splint or improvised material.

For dislocations and sprains

In the presence of sprain or damage to tissues (ligaments), the following is observed: swelling of the joint, pain, hemorrhage. The victim needs:

fix the damaged area by applying a bandage using a bandage or improvised materials;
apply cold to the sore spot.

When a dislocation occurs, the bones are displaced and the following is observed: pain, joint deformation, restriction motor functions. The patient undergoes limb immobilization:

When a shoulder or shoulder is dislocated elbow joint the hand is suspended on a scarf or bandaged to the body.
A splint is applied to the lower limb.

For burns

There are radiation, thermal, chemical, and electrical burns. Before treating the damaged area, you need to:

free from clothes;
Trim the stuck fabric, but do not tear it off.

In case of damage by chemicals, first wash off the remaining chemical from the damaged surface with water, and then neutralize: acid - baking soda, alkali - acetic acid. After neutralization of chemicals or in case of a thermal burn, apply sterile bandage using a dressing medical package after the events:

disinfection of lesions with alcohol;
site irrigation cold water.

When the airways are blocked

When foreign objects enter the trachea, a person begins to choke, cough, and turn blue. In such a situation you need:

Stand behind the victim, clasp him with your arms at the level of the middle of the abdomen and sharply bend the limbs. It is necessary to repeat the steps before resuming normal breathing.
In case of fainting, you need to put the victim on his back, sit on his hips and press on the lower costal arches.
The child should be placed on his stomach and gently patted between the shoulder blades.

In case of a heart attack

A heart attack can be identified by the presence of symptoms: pressing (burning) pain in the left side chest or shortness of breath, weakness and sweating. In such cases, the procedure is as follows:

call a doctor;
open the window;
put the patient in bed and raise his head;
Give acetylsalicylic acid to chew and nitroglycerin under the tongue.

For stroke

The onset of a stroke is indicated by: headache, speech and vision disturbances, loss of balance, crooked smile. If such symptoms are detected, the victim should be provided with primary care in the following sequence:

call a doctor;
calm the patient;
give him a reclining position;
If you are vomiting, turn your head to the side.
loosen clothes;
provide a flow of fresh air;

In case of heatstroke

Overheating of the body is accompanied by: increased temperature, redness of the skin, headache, nausea, vomiting, increased heart rate. In such a situation, first aid to victims is carried out in the following order:

move a person into the shadows or cool room;
loosen tight clothing;
apply cold compresses to different parts of the body;
Drink cold water constantly.

In case of hypothermia

The following signs indicate the onset of hypothermia: blueness of the nasolabial triangle, pallor skin, chills, drowsiness, apathy, weakness. The patient must be gradually warmed up. To do this you need:

change into dry, warm clothes or cover with a blanket, if possible give a heating pad;
give hot sweet tea and warm food.

For head injury

Due to a head injury, a concussion (closed craniocerebral injury) is possible. The victim experiences headache, dizziness, nausea, vomiting, sometimes loss of consciousness, impaired breathing and cardiac function. A skull fracture can cause brain damage from bone fragments. A sign of this condition is: discharge of clear fluid from the nose or ear, bruises under the eyes. In case of a head injury, the actions should be as follows:

Check pulse and breathing and, if absent, carry out resuscitation measures.
Provide the victim with rest while lying on his back with his head turned to the side.
If there are wounds, they must be disinfected and carefully bandaged.
Transport the victim in a supine position.

Video

Introduction

Anaphylactic shock

Arterial hypotension

Angina pectoris

Myocardial infarction

Bronchial asthma

Comatose states

Hepatic coma. Vomiting "Coffee Grounds"

Convulsions

Poisoning

Defeat electric shock

Renal colic

List of sources used

Urgent state (from Latin urgens, emergency) is a condition that poses a threat to the life of the patient/injured and requires urgent (within minutes-hours, not days) medical and evacuation measures.

Primary requirements

1. Preparedness to provide emergency medical care in the proper amount.

Completeness of equipment, tools and medicines. Medical personnel must master the necessary manipulations, be able to work with equipment, know the doses, indications and contraindications for the use of basic medicines. You need to become familiar with the operation of the equipment and read reference books in advance, and not in an emergency situation.

2. Simultaneity of diagnostic and therapeutic measures.

For example, a patient with a coma unknown origin thiamine, glucose and naloxone are sequentially administered intravenously for therapeutic and diagnostic purposes.

Glucose - initial dose 80 ml of 40% solution. If the reason comatose state- hypoglycemic coma, the patient will regain consciousness. In all other cases, glucose will be absorbed as an energy product.

Thiamine - 100 mg (2 ml of 5% thiamine chloride solution) for the prevention of acute Wernicke encephalopathy (a potentially fatal complication of alcoholic coma).

Naloxone - 0.01 mg/kg in case of opiate poisoning.

3. Focus primarily on the clinical situation

In most cases, lack of time and insufficient information about the patient do not allow us to formulate a nosological diagnosis and treatment is essentially symptomatic and/or syndromic. It is important to keep pre-worked algorithms in your head and be able to pay attention to the most important details necessary for diagnosis and emergency care.

4. Remember your own safety

The patient may be infected (HIV, hepatitis, tuberculosis, etc.). The place where it turns out urgent Care, - dangerous (toxic substances, radiation, criminal conflicts, etc.) Incorrect behavior or errors in providing emergency care may be grounds for prosecution.

What are the main reasons for the development anaphylactic shock?

It's life threatening acute manifestation allergic reaction. More often develops in response to parenteral administration medicines, such as penicillin, sulfonamides, serums, vaccines, protein preparations, X-ray contrast agents, etc., and also appears during provocative tests with pollen and less often food allergens. Anaphylactic shock may occur from insect bites.

The clinical picture of anaphylactic shock is characterized by rapid development - a few seconds or minutes after contact with the allergen. There is depression of consciousness, falling blood pressure, convulsions and involuntary urination appear. The fulminant course of anaphylactic shock ends in death. For most, the disease begins with the appearance of a feeling of heat, skin hyperemia, fear of death, excitement or, conversely, depression, headache, chest pain, suffocation. Sometimes swelling of the larynx develops like Quincke's edema with stridorous breathing, itchy skin, rashes, rhinorrhea, dry hacking cough. Blood pressure drops sharply, the pulse becomes thready, and may be pronounced hemorrhagic syndrome with petechial eruptions.

How to provide emergency care to a patient?

The administration of medications or other allergens should be stopped and a tourniquet should be applied proximal to the allergen injection site. Help must be provided on the spot; for this purpose, it is necessary to lay the patient down and fix the tongue to prevent asphyxia. Inject 0.5 ml of 0.1% adrenaline solution subcutaneously at the site of allergen injection (or at the site of the bite) and 1 ml of 0.1% adrenaline solution intravenously. If blood pressure remains low, the injection of adrenaline solution should be repeated after 10-15 minutes. Great importance Corticosteroids are used to bring patients out of anaphylactic shock. Prednisolone should be administered into a vein at a dose of 75-150 mg or more; dexamethasone - 4-20 mg; hydrocortisone - 150-300 mg; If it is not possible to inject corticosteroids into a vein, they can be administered intramuscularly. Administer antihistamines: pipolfen - 2-4 ml of a 2.5% solution subcutaneously, suprastin - 2-4 ml of a 2% solution or diphenhydramine - 5 ml of a 1% solution. For asphyxia and suffocation, administer 10-20 ml of a 2.4% solution of aminophylline intravenously, alupent - 1-2 ml of a 0.05% solution, and isadrin - 2 ml of a 0.5% solution subcutaneously. If signs of heart failure appear, administer corglicon - 1 ml of 0.06% solution in isotonic sodium chloride solution, lasix (furosemide) 40-60 mg intravenously in a rapid stream in isotonic sodium chloride solution. If allergic reaction developed on the administration of penicillin, administer 1,000,000 units of penicillinase in 2 ml of isotonic sodium chloride solution. The administration of sodium bicarbonate (200 ml of 4% solution) and anti-shock fluids is indicated. If necessary, resuscitation measures are carried out, including closed cardiac massage, artificial respiration, and bronchial intubation. For laryngeal edema, tracheostomy is indicated.

What are the clinical manifestations arterial hypotension?

With arterial hypotension, there is a dull, pressing headache, sometimes paroxysmal throbbing pain, accompanied by nausea and vomiting. During a headache attack, patients are pale, the pulse is weak, and blood pressure drops to 90/60 mmHg. Art. and below.

2 ml of a 20% caffeine solution or 1 ml of a 5% ephedrine solution are administered. No hospitalization required.

What is characteristic of heart pain caused by angina pectoris?

The most important point in the treatment of angina pectoris is the relief of painful attacks. A painful attack during angina pectoris is characterized by compressive pain behind the sternum, which can occur either after physical activity(angina pectoris) or at rest (angina pectoris at rest). The pain lasts for several minutes and is relieved by taking nitroglycerin.

To relieve an attack, the use of nitroglycerin is indicated (2-3 drops of a 1% alcohol solution or in tablets of 0.0005 g). The drug must be absorbed into the oral mucosa, so it should be placed under the tongue. Nitroglycerin causes vasodilation of the upper half of the body and coronary vessels. If nitroglycerin is effective, the pain goes away within 2-3 minutes. If the pain does not disappear a few minutes after taking the drug, you can take it again.

For severe, prolonged pain, 1 ml of a 1% morphine solution with 20 ml of a 40% glucose solution can be administered intravenously. The infusion is done slowly. Considering that a severe prolonged attack of angina pectoris can be the onset of myocardial infarction, in cases where intravenous administration of narcotic analgesics is required, 5000-10000 units of heparin should be administered intravenously along with morphine (in the same syringe) to prevent thrombosis.

An analgesic effect is achieved by intramuscular injection of 2 ml of a 50% analgin solution. Sometimes its use allows you to reduce the dose of injected narcotic analgesics, since analgin enhances their effect. Sometimes a good analgesic effect is obtained by applying mustard plasters to the heart area. Skin irritation causes reflex expansion coronary arteries and improves blood supply to the myocardium.

What are the main causes of myocardial infarction?

Myocardial infarction is necrosis of a section of the heart muscle that develops as a result of a disruption in its blood supply. Immediate cause Myocardial infarction is the closure of the lumen of the coronary arteries or narrowing by an atherosclerotic plaque or thrombus.

The main symptom of a heart attack is severe compressive pain behind the sternum on the left. The pain radiates to the left shoulder blade, arm, and shoulder. Repeated repeated administration of nitroglycerin during a heart attack does not relieve pain; it can last for hours, and sometimes for days.

Emergency assistance in acute stage a heart attack involves, first of all, relieving a painful attack. If preliminary repeated intake of nitroglycerin (0.0005 g per tablet or 2-3 drops of 1% alcohol solution) did not relieve the pain, it is necessary to administer promedol (1 ml of 2% solution), pantopon (1 ml of 2% solution) or morphine (1 ml of 1% solution) subcutaneously along with 0.5 ml of 0.1% atropine solution and 2 ml of cordiamine . If subcutaneous administration of narcotic analgesics does not have an analgesic effect, you should resort to intravenous infusion of 1 ml of morphine with 20 ml of 40% glucose solution. Sometimes anginal pain can be relieved only with the help of anesthesia with nitrous oxide mixed with oxygen in a ratio of 4:1, and after the pain stops - 1:1. In recent years, to relieve pain and prevent shock, fentanyl 2 ml of a 0.005% solution has been used intravenously with 20 ml of saline. Together with fentanyl, 2 ml of a 0.25% solution of droperidol is usually administered; This combination enhances the pain-relieving effect of fentanyl and makes it last longer. The use of fentanyl soon after administration of morphine is undesirable due to the risk of respiratory arrest.

The complex of emergency measures in the acute stage of myocardial infarction includes the use of drugs against acute vascular and heart failure and direct-acting anticoagulants. With a slight decrease in blood pressure, sometimes cordiamine, caffeine, and camphor administered subcutaneously are sufficient. A significant drop in blood pressure (below 90/60 mm Hg), the threat of collapse requires the use of more powerful means- 1 ml of 1% mesatone solution or 0.5-1 ml of 0.2% norepinephrine solution subcutaneously. If collapse persists, these drugs should be re-administered every 1-2 hours. In these cases, intramuscular injections are also indicated. steroid hormones(30 mg of prednisolone or 50 mg of hydrocortisone), helping to normalize vascular tone and blood pressure.

What are the general characteristics of an asthma attack?

The main manifestation of bronchial asthma is an attack of suffocation with dry wheezing audible from a distance. Often an attack of atonic bronchial asthma is preceded by a prodromal period in the form of rhinitis, itching in the nasopharynx, dry cough, and a feeling of pressure in the chest. An attack of atonic bronchial asthma usually occurs upon contact with an allergen and quickly ends when such contact is stopped.

If there is no effect, administer glucocorticoids intravenously: 125-250 mg of hydrocortisone or 60-90 mg of prednisolone.

What are the manifestations and causes of collapse?

Collapse is an acute vascular failure, which is manifested by a sharp decrease in blood pressure and peripheral circulation disorder. The most common cause of collapse is massive blood loss, trauma, myocardial infarction, poisoning, acute infections, etc. Collapse can be the direct cause of death of the patient.

The patient's appearance is characteristic: pointed facial features, sunken eyes, pale gray skin color, small beads of sweat, cold bluish extremities. The patient lies motionless, lethargic, lethargic, and less often restless; breathing is rapid, shallow, pulse is frequent, small, soft. Blood pressure drops: the degree of its decrease characterizes the severity of the collapse.

The severity of symptoms depends on the nature of the underlying disease. Thus, during acute blood loss, the pallor of the skin and visible mucous membranes is striking; with myocardial infarction, one can often notice bluishness of the facial skin, acrocyanosis, etc.

In case of collapse, the patient must be placed in a horizontal position (pillows removed from under the head) and heating pads placed on the limbs. Call a doctor immediately. Before his arrival, the patient must be given cardiovascular drugs (cordiamin, caffeine) subcutaneously. As prescribed by the doctor, a set of measures is carried out depending on the cause of the collapse: hemostatic therapy and blood transfusion for blood loss, administration of cardiac glycosides and painkillers for myocardial infarction, etc.

What is a coma?

Coma is an unconscious state with profound impairment of reflexes and lack of response to stimulation.

The general and main symptom of a coma of any origin is a deep loss of consciousness caused by damage to vital parts of the brain.

Coma can occur suddenly in the midst of relative well-being. Acute development is typical for cerebral coma during stroke, hypoglycemic coma. However, in many cases, a comatose state, complicating the course of the disease, develops gradually (with diabetic, uremic, hepatic coma and many other comatose states). In these cases, coma, a deep loss of consciousness, is preceded by a precoma stage. Against the background of increasing exacerbation of the symptoms of the underlying disease, signs of damage to the central nervous system in the form of stupor, lethargy, indifference, confusion of consciousness with periodic clarifications. However, during this period, patients retain the ability to respond to severe irritation, with a delay, monosyllabically, but still answer a loudly asked question, they retain their pupillary, corneal and swallowing reflexes. Knowing the symptoms of a precomatous state is especially important, since it is often timely provision assistance during this period of illness prevents the development of coma and saves the life of the patient.

Hepatic coma. Vomiting "Coffee Grounds"

When examining the skin, it should be taken into account that with uremia, thrombosis of cerebral vessels, and anemia, the skin is pale. At alcoholic coma, cerebral hemorrhage, the face is usually hyperemic. Pink coloration of the skin is characteristic of coma due to carbon monoxide poisoning. Yellowness of the skin is usually observed when hepatic coma. Determining the moisture content of the skin of a patient in a coma is important. Moist, sweaty skin is characteristic of a hypoglycemic coma. In a diabetic coma, the skin is always dry. Traces of old scratching on the skin can be noted in patients with diabetic, hepatic and uremic coma. Fresh boils, as well as skin scars from old boils found in comatose patients, suggest diabetes mellitus.

The study of skin turgor is of particular importance. In some diseases accompanied by dehydration of the body and leading to the development of coma, there is a significant decrease in skin turgor. This symptom is especially pronounced in diabetic coma. A similar decrease in the turgor of the eyeballs in diabetic coma makes them soft, which is easily determined by palpation.

Treatment of coma depends on the nature of the underlying disease. In a diabetic coma, the patient is administered insulin subcutaneously and intravenously, sodium bicarbonate, and saline as prescribed by the doctor.

Hypoglycemic coma is preceded by a feeling of hunger, weakness and trembling throughout the body. Before the doctor arrives, the patient is given sugar or sweet tea. 20-40 ml of 40% glucose solution is injected into a vein.

In uremic coma, therapeutic measures are aimed at reducing intoxication. For this purpose, the stomach is washed, a cleansing enema is given, an isotonic sodium chloride solution and a 5% glucose solution are injected dripwise.

In case of hepatic coma, glucose solutions, steroid hormones, and vitamins are administered dropwise as prescribed by the doctor.

What is the pathogenesis and main causes of fainting?

Fainting is a sudden short-term loss of consciousness with weakening of the cardiac and respiratory systems. Fainting is mild form acute vascular brain failure and is caused by anemia of the brain; occurs more often in women. Fainting may result from mental trauma, at the sight of blood, painful irritation, during a long stay in a stuffy room, during intoxication and infectious diseases.

The severity of fainting may vary. Fainting is usually characterized by sudden occurrence slight fogging of consciousness in combination with non-systemic dizziness, ringing in the ears, nausea, yawning, increased intestinal motility. Objectively, sharp pallor of the skin, coldness of the hands and feet, beads of sweat on the face, and dilated pupils are noted. The pulse is weak, blood pressure is reduced. The attack lasts several seconds.

In a more severe case of fainting, complete loss of consciousness occurs with switching off muscle tone, the patient slowly settles down. At the height of fainting, there are no deep reflexes, the pulse is barely palpable, blood pressure is low, breathing is shallow. The attack lasts several tens of seconds, and is then followed by a rapid and complete restoration of consciousness without amnesia.

Convulsive syncope is characterized by the addition of convulsions to the picture of syncope. In rare cases, drooling, involuntary urination and defecation are observed. The unconscious state sometimes lasts several minutes.

After fainting they persist general weakness, nausea, unpleasant feeling in the stomach.

The patient should be laid on his back with his head slightly lowered, the collar should be unbuttoned, fresh air should be provided, a cotton swab moistened with ammonia should be brought to the nose, and the face should be sprayed with cold water. For a more persistent fainting condition, 1 ml of a 10% solution of caffeine or 2 ml of cordiamine should be injected subcutaneously; ephedrine can be used - 1 ml of a 5% solution, mesaton - 1 ml of a 1% solution, norepinephrine - 1 ml of a 0.2% solution.

The patient should be examined by a doctor.

What are the hallmarks of a seizure in epilepsy?

One of the most common and dangerous species convulsive conditions is a generalized convulsive seizure, which is observed in epilepsy. In most cases, patients with epilepsy, a few minutes before its onset, note the so-called aura (harbinger), which is manifested by increased irritability, palpitations, a feeling of heat, dizziness, chills, a feeling of fear, the perception of unpleasant odors, sounds, etc. Then the patient suddenly loses consciousness falls. At the beginning of the first phase (in the first seconds) of the seizure, he often emits a loud cry.

When providing first aid to a patient, first of all, it is necessary to prevent possible bruises of the head, arms, legs during a fall and convulsions, for which a pillow is placed under the patient’s head, arms and legs are held. To prevent asphyxia, it is necessary to unfasten the collar. A hard object, such as a spoon wrapped in a napkin, must be inserted between the patient’s teeth to prevent tongue bite. To avoid inhaling saliva, the patient's head should be turned to the side.

A dangerous complication of epilepsy that threatens the patient’s life is status epilepticus, in which convulsive seizures follow one after another, so that consciousness does not clear. Status epilepticus is an indication for urgent hospitalization of the patient in the neurological department of the hospital.

For status epilepticus, emergency care consists of prescribing an enema with chloral hydrate (2.0 g per 50 ml of water), intravenous administration 10 ml of a 25% solution of magnesium sulfate and 10 ml of a 40% glucose solution, intramuscular injection of 2-3 ml of a 2.5% solution of aminazine, intravenous infusion of 20 mg of diazepam (seduxen) dissolved in 10 ml of a 40% glucose solution. For ongoing seizures, 5-10 ml of a 10% hexenal solution is administered slowly intravenously. A spinal puncture is performed to remove 10-15 ml of solution.

A seizure in hysteria is significantly different from an epileptic seizure. It develops most often after any experiences associated with grief, resentment, fear, and, as a rule, in the presence of relatives or strangers. The patient may fall, but usually does not cause serious injury to himself, consciousness is preserved, there is no tongue biting or involuntary urination. The eyelids are tightly compressed, the eyeballs are turned upward. The reaction of the pupils to light is preserved. The patient responds correctly to painful stimuli. Convulsions are in the nature of purposeful movements (for example, the patient raises his arms, as if protecting his head from blows). Movements can be chaotic. The patient waves his arms and grimaces. Duration hysterical attack- 15-20 minutes, less often - several hours. The seizure ends quickly. The patient returns to his normal state and feels relief. There is no state of stupor or drowsiness. Unlike an epileptic seizure, a hysterical seizure never develops during sleep.

When providing assistance to a patient with a hysterical attack, it is necessary to remove all those present from the room where the patient is located. Talking to the patient calmly, but in an imperative tone, they convince him of the absence of a dangerous disease and instill in him the idea of a speedy recovery. To relieve a hysterical attack, sedatives are widely used: sodium bromide, valerian tincture, motherwort herb decoction.

What are the general characteristics of poisonings?

Poisoning is a pathological condition caused by the effects of poisons on the body. The causes of poisoning may be poor quality food products and poisonous plants, various chemicals used in everyday life and at work, medications, etc. Poisons have a local and general effect on the body, which depends on the nature of the poison and the route of its entry into the body.

For all acute poisonings, emergency care should pursue the following goals: 1) removing the poison from the body as quickly as possible; 2) neutralization of the poison remaining in the body with the help of antidotes (antidotes); 3) combating breathing and circulatory disorders.

If poison enters the mouth, immediate gastric lavage is necessary, which is carried out where the poisoning occurred (at home, at work); It is advisable to cleanse the intestines, for which they give a laxative and give an enema.

If poison gets on the skin or mucous membranes, the poison must be removed immediately mechanically. For detoxification, as prescribed by a doctor, solutions of glucose, sodium chloride, hemodez, polyglucin, etc. are administered subcutaneously and intravenously. If necessary, so-called forced diuresis is used: 3-5 liters of liquid and fast-acting diuretics are simultaneously administered. To neutralize the poison, specific antidotes are used (unithiol, methylene blue, etc.) depending on the nature of the poisoning. Oxygen is used to restore respiratory and circulatory function. cardiovascular drugs, respiratory analeptics, artificial respiration, including hardware.

What is the pathogenesis of the effect of current on the body and the causes of injury?

Electric shock with voltages above 50 V causes thermal and electrolytic effects. Most often, damage occurs as a result of non-compliance with safety precautions when working with electrical devices, both at home and at work.

First of all, the victim is released from contact with electric current (if this has not been done earlier). Turn off the power source, and if this is not possible, then remove the broken wire with a dry wooden stick. If the person providing assistance is wearing rubber boots and rubber gloves, then you can pull the victim away from the electrical wire. If breathing stops, artificial respiration is performed, cardiac and cardiovascular drugs are administered (0.1% adrenaline solution - 1 ml, cordiamine - 2 ml, 10% caffeine solution - 1 ml subcutaneously), drugs that stimulate breathing (1% lobeline solution - 1 ml intravenously slowly or intramuscularly). Apply a sterile bandage to the electrical burn wound.

The patient is transported on a stretcher to the burn or surgical department.

What are the causes of renal colic?

Renal colic develops when there is a sudden obstruction to the outflow of urine from the renal pelvis. Most often, renal colic develops as a result of the movement of a stone or the passage of a conglomerate of dense crystals through the ureter, as well as due to a violation of the patency of the ureter due to kinking or inflammatory processes.

The attack begins suddenly. Most often it is caused physical stress, but can also occur in the midst of complete rest, at night during sleep, often after drinking heavily. The pain is cutting with periods of calm and exacerbation. Patients behave restlessly, rushing about in bed in search of a position that would ease their suffering. An attack of renal colic often becomes protracted and, with short remissions, can last for several days in a row. As a rule, pain begins in the lumbar region and spreads to the hypochondrium and abdomen and, most importantly, along the ureter to the side Bladder, scrotum in men, labia in women, on the thighs. In many cases, the intensity of pain is greater in the abdomen or at the level of the genital organs than in the kidney area. The pain is usually accompanied by an increased urge to urinate and a cutting pain in the urethra.

Long-term renal colic may be accompanied by an increase in blood pressure, and with pyelonephritis - an increase in temperature.

First aid is usually limited to thermal procedures - a heating pad, a hot bath, which are supplemented by taking antispasmodic and painkillers from a home medicine cabinet (usually available to a patient with frequent attacks of renal colic): Avisan - 0.5-1 g, Cystenal - 10-20 drops, papaverine - 0.04 g, baralgin - 1 tablet. Atropine and narcotic analgesics are administered as prescribed by the doctor.

1. Evdokimov N.M. Providing first pre-medical aid.-M., 2001

2. Small medical encyclopedia t. 1,2,3 M., 1986

3. First medical aid: reference book M., 2001

GAPOU TO "Tobolsk" Medical College them. V. Soldatova"

METHODOLOGICAL DEVELOPMENT

practical lesson

PM 04, PM 07 "Performing work in one or more worker professions, employee positions"

MDK "Technology for the provision of medical services"

TOPIC: "Providing first aid for various conditions"

Teacher: Fedorova O.A.,

Cherkashina A.N., Zhelnina S.V.

Tobolsk, 2016

Glossary

A fracture is a complete or partial disruption of the integrity of a bone that occurs as a result of external mechanical action. A closed fracture, the integrity of the skin is not broken. An open fracture, the integrity of the skin above or near the site of deformation of the fracture is damaged. Wounds, damage to soft tissues in which the integrity of the skin is damaged. Scalped wounds, exfoliation of areas of the skin, subcutaneous tissue. Wounds, lacerations, defects. irregular shape with many angles, the wound has different depths with damage to the skin, subcutaneous tissue, muscles Thermal burn this is an injury that occurs under the influence of high temperature on the tissues of the body. Fainting, a sudden short-term loss of consciousness with weakening of the activity of the cardiac and respiratory systems. Convulsions; involuntary muscle contraction. Electrical trauma; this is damage caused by the action of an electric current on the body. Poisoning; a pathological condition that develops when poison enters the body;

Relevance

Emergency conditions that threaten the life and health of the patient require urgent measures at all stages of medical care. These conditions arise due to the development of shock, acute blood loss, respiratory distress, circulatory disorders, coma, which are caused by acute diseases internal organs, traumatic injuries, poisonings and accidents.

The most important place in providing assistance to those suddenly ill and injured as a result of natural and man-made emergencies in peacetime is to carry out adequate pre-hospital measures. As evidenced by the data of domestic and foreign specialists, a significant number of patients and victims of emergencies could have been saved subject to timely and effective provision of care at the prehospital stage.

Currently, the importance of first aid in the treatment of emergency conditions has increased enormously. The ability of nursing staff to assess the severity of the patient’s condition and identify priority problems is necessary to provide effective pre-medical care, which can greatly influence the further course and prognosis of the disease. A medical professional is required not only to have knowledge, but also to be able to quickly provide assistance, since confusion and inability to collect oneself can even aggravate the situation.

Thus, mastering the techniques of providing emergency medical care at the prehospital stage to sick and injured people, as well as improving practical skills, is an important and urgent task.

Modern principles emergency medical care

In world practice, a universal scheme for providing assistance to victims at the prehospital stage has been adopted.

The main stages of this scheme are:

1.Immediate initiation of emergency life-sustaining measures in the event of emergency conditions.

2.Organizing arrival at the scene of an incident qualified specialists V as soon as possible, performing certain emergency medical care measures during transport of the patient to the hospital.

.The fastest possible hospitalization to a specialized medical institution that has qualified medical personnel and is equipped with the necessary equipment.

Measures to be taken in case of emergency conditions

Treatment and evacuation measures carried out during the provision of emergency care should be divided into a number of interrelated stages - pre-hospital, hospital and first medical aid.

At the prehospital stage, first, pre-medical and first medical aid is provided.

The most important factor when providing emergency care is the time factor. The best treatment results for victims and patients are achieved when the period from the onset of an emergency to the time of provision of qualified assistance does not exceed 1 hour.

A preliminary assessment of the severity of the patient’s condition will help to avoid panic and fuss during subsequent actions, will make it possible to make more balanced and rational decisions in extreme situations, as well as measures for emergency evacuation of the victim from the danger zone.

After this, it is necessary to begin identifying the signs of the most life-threatening conditions that can lead to the death of the victim in the coming minutes:

· clinical death;

· coma;

· arterial bleeding;

· neck injuries;

· chest injuries.

Those providing assistance to victims in an emergency must strictly adhere to the algorithm shown in Diagram 1.

Scheme 1. Procedure for providing assistance in case of emergency

Providing first aid in case of emergency

There are 4 basic principles of first aid that should be followed:

.Inspection of the scene of the incident. Ensure safety when providing assistance.

2.Initial examination of the victim and provision of first aid for conditions life-threatening.

.Call a doctor or ambulance.

.Secondary examination of the victim and, if necessary, assistance in identifying other injuries and illnesses.

Before providing assistance to victims, find out:

· Is the scene of the incident dangerous?

· What happened;

· Number of patients and victims;

· Are those around you able to help?

Of particular importance is anything that could threaten your safety and the safety of others: exposed electrical wires, falling debris, intense traffic, fire, smoke, harmful fumes. If you are in any danger, do not approach the victim. Immediately call the appropriate rescue service or police for professional assistance.

Always look for other victims and, if necessary, ask others to assist you in providing assistance.

As soon as you approach the conscious victim, try to calm him down, then in a friendly tone:

· find out from the victim what happened;

· explain that you are a healthcare professional;

· offer assistance, obtain the victim’s consent to provide assistance;

· explain what action you are going to take.

Before you begin providing emergency medical care, you should obtain the victim's permission to do so. A conscious victim has the right to refuse your service. If he is unconscious, we can assume that you have obtained his consent to carry out emergency measures.

Bleeding

There are external and internal bleeding.

There are two types of bleeding: arterial and venous.

Arterial bleeding.The most dangerous bleeding is from injuries to large arteries - femoral, brachial, carotid. Death can occur in a matter of minutes.

Signs of arterial injury:arterial blood “gushes”, the color of the blood is bright red, the pulsation of the blood coincides with the heartbeat.

Signs of venous bleeding:venous blood flows out slowly, evenly, the blood is of a darker shade.

Methods to stop bleeding:

1.Finger pressure.

2.Tight bandage.

.Maximum limb flexion.

.Application of a tourniquet.

.Applying a clamp to a damaged vessel in a wound.

.Wound tamponade.

If possible, use a sterile dressing (or clean cloth) to apply a pressure bandage, apply it directly to the wound (to avoid eye injury and depression of the cranial vault).

Any movement of the limb stimulates blood flow in it. In addition, when blood vessels are damaged, blood clotting processes are disrupted. Any movements cause additional damage to blood vessels. Splinting the limbs can reduce bleeding. In this case, air tires, or any type of tire, are ideal.

When applying a pressure bandage to a wound site does not reliably stop bleeding or there are multiple sources of bleeding supplied by a single artery, local compression may be effective.

It is necessary to apply a tourniquet only in extreme cases, when all other measures have not given the expected result.

Principles of applying a tourniquet:

§ I apply a tourniquet above the bleeding site and as close to it as possible over clothing or over several rounds of bandage;

§ the tourniquet should be tightened only until the peripheral pulse disappears and bleeding stops;

§ each subsequent tour of the tourniquet must partially cover the previous tour;

§ the tourniquet is applied for no more than 1 hour during a warm period, and no more than 0.5 hour during a cold period;

§ A note is inserted under the applied tourniquet indicating the time of application of the tourniquet;

§ after bleeding has stopped open wound apply a sterile bandage, bandage it, fix the limb and send the wounded person to the next stage of medical care, i.e. evacuated.

A tourniquet can damage nerves and blood vessels and even lead to the loss of a limb. A loose tourniquet can stimulate more intense bleeding, since it is not the arterial that stops, but only the venous blood flow. Apply the tourniquet as last resort in life-threatening conditions.

Fractures

Fracture -This is a complete or partial violation of the integrity of the bone that occurs due to external mechanical influence.

Types of fractures:

§ closed (the integrity of the skin is not compromised);

§ open (the integrity of the skin above or near the site of fracture deformation is compromised).

Signs of fractures:

§ deformation (change in shape);

§ local (local) soreness;

§ swelling of soft tissues over the fracture, hemorrhage in them;

§ at open fractures - laceration with visible bone fragments;

§ limb dysfunction;

§ pathological mobility.

§ patency check respiratory tract, breathing and circulation;

§ overlay transport immobilization service means;

§ aseptic dressing;

§ anti-shock measures;

§ transportation to health care facilities.

Signs of a mandibular fracture:

§ fracture of the lower jaw is more common due to impact;

§ in addition to the general signs of fractures, they are characterized by displacement of teeth, disruption of normal bite, difficulty or impossibility of chewing movements;

§ with double fractures of the lower jaw, the tongue may retract, which causes suffocation.

Emergency first aid:

§ check airway patency, breathing, blood circulation;

§ stop arterial bleeding temporarily by pressing the bleeding vessel;

§ secure the lower jaw with a sling bandage;

§ If your tongue sinks, making breathing difficult, fix your tongue.

Rib fractures.Rib fractures occur due to various mechanical influences on the chest. There are single and multiple fractures ribs

Signs of a rib fracture:

§ rib fractures are accompanied by sharp local pain when palpating, breathing, coughing;

§ the victim spares the damaged part of the chest; breathing on this side is shallow;

§ in case of damage to the pleura and lung tissue air from the lungs enters the subcutaneous tissue, which looks like swelling on the damaged side of the chest; subcutaneous tissue crunches when touched (subcutaneous emphysema).

Emergency first aid:

§ As you exhale, apply a circular pressure bandage to the chest;

§ With injuries to the chest organs, call an ambulance to hospitalize the victim in a hospital specializing in chest injuries.

Wounds

Wounds are damage to soft tissues in which the integrity of the skin is compromised. At deep wounds subcutaneous tissue, muscles, nerve trunks and blood vessels are injured.

Types of woundsThere are cut, chopped, stab and gunshot wounds.

In appearance, wounds are:

§ scalped - areas of skin and subcutaneous tissue peel off;

§ torn - irregularly shaped defects with many angles are observed on the skin, subcutaneous tissue and muscle, the wound has different depths along its length. The wound may contain dust, dirt, soil, and pieces of clothing.

Emergency first aid:

§ check ABC (airway, breathing, circulation);

§ during primary care just rinse the wound with saline solution or clean water and apply a clean bandage, elevate the limb.

Emergency first aid for open wounds:

§ stop the main bleeding;

§ remove dirt, splinters and debris by irrigating the wound with clean water, saline solution;

§ apply an aseptic dressing;

§ at extensive wounds fix the limb

Lacerationsare divided into:

superficial (including only the skin);

deep (involve underlying tissues and structures).

Puncture woundsusually not accompanied by massive external bleeding, but be alert to the possibility internal bleeding or tissue damage.

Emergency first aid:

§ do not remove deeply stuck objects;

§ stop the bleeding;

§ stabilize foreign body using a bulky bandage and, as necessary, immobilization with splints.

§ apply an aseptic bandage.

Thermal lesions

Burns

Thermal burn -This is an injury that occurs when body tissue is exposed to high temperature.

The depth of the lesion is divided into 4 degrees:

1st degree -hyperemia and swelling of the skin, accompanied by burning pain;

2nd degree -hyperemia and swelling of the skin with detachment of the epidermis and the formation of blisters filled with clear liquid; severe pain observed in the first 2 days;

3A, 3B degrees -In addition to the dermis, subcutaneous tissue and muscle tissue are damaged, necrotic scabs are formed; pain and tactile sensitivity are absent;

4th degree -necrosis of the skin and underlying tissues up to bone tissue, the scab is dense, thick, sometimes black in color until charred.

In addition to the depth of the lesion, the area of the lesion is also important, which can be determined using the “rule of palm” or “rule of nine”.

According to the “rule of nine,” the area of the skin of the head and neck is equal to 9% of the body surface; breasts - 9%; abdomen - 9%; backs - 9%; lower back and buttocks - 9%; hands - 9% each; hips - 9% each; legs and feet - 9% each; perineum and external genitalia - 1%.

According to the "rule of the palm", the area of an adult's palm is approximately 1% of the body surface.

Emergency first aid:

§ termination of the thermal factor;

§ cooling the burned surface with water for 10 minutes;

§ applying an aseptic dressing to the burn surface;

§ warm drink;

§ evacuation to the nearest health facility in a lying position.

Frostbite

Cold has a local effect on the body, causing frostbite in individual parts of the body, and a general effect, which leads to general cooling (freezing).

Frostbite is divided into 4 degrees according to the depth of damage:

With general cooling, compensatory reactions initially develop (narrowing peripheral vessels, change in breathing, the appearance of trembling). As it deepens, a phase of decompensation begins, accompanied by gradual depression of the central nervous system, weakening of cardiac activity and respiration.

A mild degree is characterized by a decrease in temperature to 33-35 C, chills, pale skin, and the appearance of “goose bumps”. Speech is slow, weakness, drowsiness, and bradycardia are noted.

The average degree of cooling (stuporous stage) is characterized by a decrease in body temperature to 29-27 C. The skin is cold, pale or bluish. There is drowsiness, depression of consciousness, and difficulty moving. The pulse is slowed to 52-32 beats per minute, breathing is rare, blood pressure is reduced to 80-60 mm. rt. Art.

Severe cooling is characterized by lack of consciousness, muscle rigidity, and convulsive contractions. masticatory muscles. Pulse 34-32 beats. per minute Blood pressure is reduced or undetectable, breathing is rare and shallow, the pupils are constricted. When the rectal temperature drops to 24-20 C, death occurs.

Emergency first aid:

§ stop the cooling effect;

§ after removing damp clothing, cover the victim warmly and give him a hot drink;

§ provide thermal insulation of cooled limb segments;

§ evacuate the victim to the nearest health facility in a prone position.

Sun and heat stroke

Symptoms of solar and heatstroke close and appear suddenly.

Sunstrokeoccurs on a clear summer day with prolonged exposure to the sun without a hat. Tinnitus, dizziness, nausea, vomiting appear, body temperature rises to 38-39 C, sweating, redness of the facial skin are noted, pulse and breathing increase sharply. In severe cases, severe agitation, loss of consciousness, and even death can occur.

Heatstrokeoccurs after physical activity high temperature external environment. The skin becomes moist and sometimes turns pale. Body temperature rises. The victim may complain of weakness, fatigue, nausea, and headache. Tachycardia and orthostatic hypertension may occur.

Emergency first aid:

§ move the victim to a cooler place and give him something to drink moderate amount liquids;

§ put cold on the head, on the heart area;

§ lay the victim on his back;

§ If the victim's blood pressure has dropped, elevate the lower limbs.

Acute vascular insufficiency

Fainting- sudden short-term loss of consciousness with weakening of the cardiac and respiratory systems. Fainting is based on cerebral hypoxia, which is caused by transient disorder cerebral blood flow.

In patients with fainting, three periods are distinguished: prefainting, actual fainting, and postfainting.

Presyncopemanifested by a feeling of lightheadedness, darkening of the eyes, ringing in the ears, weakness, dizziness, nausea, sweating, numbness of the lips, fingertips, pallor of the skin. Duration from several seconds to 1 minute.

While faintingthere is a loss of consciousness, a sharp decline muscle tone, shallow breathing. The pulse is labile, weak, arrhythmic. In case of relatively long-term disturbance cerebral circulation There may be clinically tonic convulsions, involuntary urination. Fainting lasts up to 1 minute, sometimes more.

Post-syncopelasts from a few seconds to 1 minute and ends full restoration consciousness.

Emergency first aid:

§ lay the patient on his back with his head slightly lowered or raise the patient's legs to a height of 60-70 cm in relation to the horizontal surface;

§ loosen tight clothing;

§ provide access to fresh air;

§ bring a cotton swab moistened with ammonia to your nose;

§ splash his face with cold water or pat his cheeks, rub his chest;

§ Make sure that the patient sits for 5-10 minutes after fainting;

If you suspect organic cause fainting requires hospitalization.

Convulsions

Cramps -involuntary muscle contraction. Spasmodic movements can be widespread and involve many muscle groups of the body (generalized spasms) or localized to a specific muscle group of the body or limb (localized spasms).

Generalized seizurescan be stable, lasting a relatively long period of time - tens of seconds, minutes (tonic), or rapid, often alternating states of contraction and relaxation (clonic).

Localized seizurescan also be clonic and tonic.

Generalized tonic spasms involve the muscles of the arms, legs, torso, neck, face and sometimes the respiratory tract. The arms are often in a state of flexion, the legs are usually extended, the muscles are tense, the torso is elongated, the head is thrown back or turned to the side, the teeth are clenched tightly. Consciousness may be lost or retained.

Generalized tonic convulsions are more often a manifestation of epilepsy, but can also be observed with hysteria, rabies, tetanus, eclampsia, cerebrovascular accident, infections and intoxications in children.

Emergency first aid:

§ protect the patient from bruises;

§ free him from restrictive clothing;

emergency medical care

§ free the patient's mouth from foreign objects(food, removable dentures);

§ To prevent tongue bite, insert the corner of a rolled towel between your molars.

Strike by lightning

Lightning usually strikes people who are in the open during a thunderstorm. The damaging effect of atmospheric electricity is primarily due to very high voltage (up to 1,000,0000 W) and discharge power; in addition, the victim can receive traumatic lesions as a result of the action of an air blast wave. Severe burns (up to IV degree) are also possible, since the temperature in the area of the so-called lightning channel can exceed 25,000 C. Despite the short duration of exposure, the victim’s condition is usually serious, which is primarily due to damage to the central and peripheral nervous system.

Symptoms:loss of consciousness from several minutes to several days, conical convulsions; after restoration of consciousness, anxiety, agitation, disorientation, pain, delirium; hallucinations, paresis of limbs, hemi- and paraparesis, headache, pain and pain in the eyes, tinnitus, burns of the eyelids and eyeball, clouding of the cornea and lens, “lightning sign” on the skin.

Emergency first aid:

§ restoration and maintenance of airway patency and artificial ventilation of the lungs;

§ indirect massage hearts;

§ hospitalization, transporting the victim on a stretcher (preferably in a lateral position due to the risk of vomiting).

Electric shock

Most dangerous manifestation Electrical injury is clinical death, which is characterized by cessation of breathing and heartbeat.

First aid for electrical injury:

§ release the victim from contact with the electrode;

§ preparing the victim for resuscitation measures;

§ performing mechanical ventilation in parallel with closed cardiac massage.

Bee, wasp, bumblebee stings

The venom of these insects contains biological amines. Insect bites are very painful local reaction it manifests itself in the form of swelling and inflammation. Swelling is more pronounced when biting the face and lips. Single bites do not work general reaction body, but stings of more than 5 bees are toxic, with chills, nausea, dizziness, and dry mouth.

Emergency first aid:

· remove the sting from the wound with tweezers;

· treat the wound with alcohol;

Who doesn't want to be healthy?
Probably, there will not be a single person who proudly shouted back: “I am.” The opposite situation is observed, everyone wants to be healthy, every holiday they make toasts with appropriate wishes, they consider health - main value in our century.
But nevertheless they do not take care of it, miss it, lose it...

Years flash by, education, career, family, children.. Diseases.. Sadly, over the years we almost inevitably acquire diseases. Which progress very quickly, become chronic, leading to premature old age. Well, we can’t continue any further...

However, I’m not here to sigh on a virtual heap and read a dying epilogue to us all!

You can start fighting and change your life for the better at any stage. And at 30, and at 40, and at 60.. It’s just that the opportunities in this fight will be different.

hirudotherapy(leech treatment),
apitherapy(treatment with bees, honey and other bee products).
There are also methods treatment mumiyo, medicinal herbs, pet therapy.

Particular attention is paid healthy eating and personal experience author, who has tried most of the techniques described here.

Alternative medicine provides an alternative to medical officialdom and allows a person to find own methods treatment without drugs, cleanse your body from waste, toxins and excessive tension (we remember the hackneyed truth that all diseases are from nerves).

Psychological tests and techniques for dealing with stress ( healthy human psyche) will help you survive in the world of speed. Lack of time should not affect your health. The techniques proposed here take very little time, but require regular implementation.

It is possible to restore your health, it all depends on you, your desire, and perseverance. And the blog website will do everything to provide you with the necessary information.

Let everything take its course? Or systematically do something every day for your precious health. Just a little bit, half a step! But it will be a movement that actually happens.

If you do nothing for years, and then one Monday you start everything at once - do exercises, go on a diet, start leading... healthy image life, then I can upset you.. You won’t last long. 97% of all beginners quit this “disastrous” activity by the end of the week. Everything is too abrupt, too much, too scary.. Change everything..
But you and I will not be globalists doomed to failure, we are little by little, but every day Let's take care of our health.

Let's start working on health? Not tomorrow.. Not from Monday.. But here.. And now!

On the website you will find many effective and affordable ways and methods to improve your own health at home. We are considering treatment methods

by using massage(mostly targeted, which allows you to help yourself),
physical exercises,
therapeutic fasting,

Send your good work in the knowledge base is simple. Use the form below

Students, graduate students, young scientists who use the knowledge base in their studies and work will be very grateful to you.

Posted on http:// www. allbest. ru/

fainting
Collapse
Hypertensive crisis
Anaphylactic shock
Angina attack
Acute myocardial infarction
Clinical death

Algorithms for providing first aid in emergency conditions

Fainting

Fainting - attack short-term loss consciousness caused by transient cerebral ischemia associated with weakening of cardiac activity and acute disorder regulation of vascular tone. Depending on the severity of factors contributing to cerebrovascular accident.

There are: cerebral, cardiac, reflex and hysterical views fainting states.

Stages of development of fainting.

1. Precursors (pre-fainting state). Clinical manifestations: discomfort, dizziness, tinnitus, lack of air, cold sweat, numbness of the fingertips. Lasts from 5 seconds to 2 minutes.

2. Impaired consciousness (fainting itself). Clinic: loss of consciousness lasting from 5 seconds to 1 minute, accompanied by pallor, decreased muscle tone, dilated pupils, and weak reaction to light. Shallow breathing, bradypnea. The pulse is labile, most often bradycardia up to 40 - 50 per minute, systolic blood pressure decreases to 50 - 60 mm. rt. Art. With deep fainting, convulsions are possible.

3. Post-syncope (recovery) period. Clinic: correctly oriented in space and time, pallor, rapid breathing, labile pulse and low blood pressure may persist.

Algorithm of treatment measures

2. Unfasten the collar.

3. Provide access to fresh air.

4. Wipe your face with a damp cloth or sprinkle with cold water.

5. Inhalation of vapors ammonia (reflex stimulation respiratory and vasomotor centers).

If the above measures are ineffective:

6. Caffeine 2.0 IV or IM.

7. Cordiamine 2.0 i/m.

8. Atropine (for bradycardia) 0.1% - 0.5 s.c.

9. When you come out of a fainting state, continue dental procedures with taking measures to prevent relapse: carry out treatment when horizontal position patient with adequate premedication and sufficient anesthesia.

Collapse

Collapse is a severe form vascular insufficiency(decreased vascular tone), manifested by a decrease in blood pressure, dilation of venous vessels, a decrease in the volume of circulating blood and its accumulation in blood depots - capillaries of the liver, spleen.

Clinical picture: sharp deterioration general condition, severe pallor of the skin, dizziness, chills, cold sweat, a sharp decrease in blood pressure, rapid and weak pulse, frequent, shallow breathing. Peripheral veins become empty, their walls collapse, which makes venipuncture difficult. Patients remain conscious (if they faint, patients lose consciousness), but are indifferent to what is happening. Collapse can be a symptom of such severe pathological processes as myocardial infarction, anaphylactic shock, bleeding.

Algorithm of treatment measures 1. Place the patient in a horizontal position.

2. Provide a flow of fresh air.

3. Prednisolone 60-90 mg IV.

4. Norepinephrine 0.2% - 1 ml IV in 0.89% sodium chloride solution.

5. Mezaton 1% - 1 ml IV (to increase venous tone).

6. Korglyukol 0.06% - 1.0 IV slowly in 0.89% sodium chloride solution.

7. Polyglucin 400.0 IV drip, 5% glucose solution IV drip 500.0.

Hypertensive crisis

Hypertensive crisis - sudden rapid rise Blood pressure accompanied by clinical symptoms from target organs (usually the brain, retina, heart, kidneys, gastrointestinal tract, etc.).

Clinical picture. Severe headaches, dizziness, tinnitus, often accompanied by nausea and vomiting. Visual impairment (mesh or fog before the eyes). The patient is excited. In this case, there is trembling of the hands, sweating, and sharp redness of the skin of the face. The pulse is tense, blood pressure is increased by 60-80 mm. rt. Art. compared to usual. During a crisis, angina attacks and acute cerebrovascular accident may occur.

Algorithm of treatment measures 1. Intravenously in one syringe: dibazol 1% - 4.0 ml with papaverine 1% - 2.0 ml (slow).

2. For severe cases: clonidine 75 mcg sublingually.

3. Intravenous Lasix 1% - 4.0 ml in saline solution.

4. Anaprilin 20 mg (for severe tachycardia) under the tongue.

5. Sedatives- Elenium 1-2 tablets orally.

6. Hospitalization.

It is necessary to constantly monitor blood pressure!

first aid fainting

Anaphylactic shock

A typical form of drug-induced anaphylactic shock (DAS).

The patient experiences an acute state of discomfort with vague painful sensations. There is a fear of death or a condition inner restlessness. Nausea, sometimes vomiting, and cough are observed. Patients complain of severe weakness, tingling and itching of the skin of the face, hands, and head; a feeling of a rush of blood to the head, face, a feeling of heaviness behind the sternum or compression of the chest; the appearance of pain in the heart area, difficulty breathing or the inability to exhale, dizziness or headache. Disorder of consciousness occurs in the terminal phase of shock and is accompanied by disturbances in speech contact with the patient. Complaints arise immediately after taking the drug.

Clinical picture of LAS: hyperemia of the skin or pallor and cyanosis, swelling of the eyelids of the face, profuse sweating. Breathing is noisy, tachypnea. Most patients develop motor restlessness. Mydriasis is noted, the reaction of the pupils to light is weakened. The pulse is frequent, sharply weakened peripheral arteries. Blood pressure decreases quickly, in severe cases diastolic pressure not determined. Shortness of breath and difficulty breathing appear. Subsequently, the clinical picture of pulmonary edema develops.

Depending on the severity of the course and the time of development of symptoms (from the moment of antigen administration), fulminant (1-2 minutes), severe (after 5-7 minutes), moderate severity (up to 30 minutes) forms of shock are distinguished. The shorter the time from drug administration to the onset of clinical symptoms, the more severe the shock, and the less chance of a successful treatment outcome.

Algorithm of treatment measures Urgently provide access to the vein.

1. Stop administering the drug that caused anaphylactic shock. Call an ambulance for yourself.

2. Lay the patient down, raise the lower limbs. If the patient is unconscious, turn the head to the side and extend the lower jaw. Inhalation of humidified oxygen. Ventilation of the lungs.

3. Inject intravenously 0.5 ml of a 0.1% solution of adrenaline in 5 ml of isotonic sodium chloride solution. If venipuncture is difficult, adrenaline is injected into the root of the tongue, possibly intratracheally (a puncture of the trachea below the thyroid cartilage through the conical ligament).

4. Prednisolone 90-120 mg IV.

5. Diphenhydramine solution 2% - 2.0 or suprastin solution 2% - 2.0, or diprazine solution 2.5% - 2.0 IV.

6. Cardiac glycosides according to indications.

7. For obstruction of the respiratory tract - oxygen therapy, 2.4% aminophylline solution 10 ml intravenously per physio. solution.

8. If necessary, endotracheal intubation.

9. Hospitalization of the patient. Allergy identification.

Toxic reactions to anesthetics

Clinical picture. Anxiety, tachycardia, dizziness and weakness. Cyanosis, muscle tremors, chills, convulsions. Nausea, sometimes vomiting. Respiratory disorder, decreased blood pressure, collapse.

Algorithm of treatment measures

1. Place the patient in a horizontal position.

2. Fresh air. Allow the ammonia vapor to inhale.

3. Caffeine 2 ml s.c.

4. Cordiamine 2 ml s.c.

5. In case of respiratory depression - oxygen, artificial respiration (according to indications).

6. Adrenaline 0.1% - 1.0 ml per physical. i.v. solution

7. Prednisolone 60-90 mg IV.

8. Tavegil, suprastin, diphenhydramine.

9. Cardiac glycosides (according to indications).

Angina attack

Angina attack - paroxysm of pain or other discomfort(heaviness, compression, pressure, burning) in the heart area lasting from 2-5 to 30 minutes with characteristic irradiation (in left shoulder, neck, left shoulder blade, lower jaw), caused by an excess of myocardial oxygen consumption over its supply.

An increase in blood pressure provokes an attack of angina, psycho-emotional stress, which always occurs before and during treatment with a dentist.

Algorithm of treatment measures 1. Termination of dental intervention, rest, access to fresh air, free breathing.

2. Nitroglycerin in tablets or capsules (bite the capsule) 0.5 mg under the tongue every 5-10 minutes (total 3 mg under blood pressure control).

3. If the attack is stopped, recommendations for outpatient monitoring by a cardiologist. Resumption of dental benefits - upon stabilization of the condition.

4. If the attack is not stopped: baralgin 5-10 ml or analgin 50% - 2 ml IV or IM.

5. If there is no effect, call an ambulance and hospitalization.

Acute myocardial infarction

Acute myocardial infarction is ischemic necrosis of the heart muscle, resulting from an acute discrepancy between the need for oxygen in the myocardium and its delivery through the corresponding coronary artery.

Clinic. The most characteristic clinical symptom is pain, which is often localized in the region of the heart behind the sternum, less often affecting the entire anterior surface of the chest. Irradiates to the left arm, shoulder, scapula, interscapular space. The pain usually has a wave-like character: it increases and decreases, it lasts from several hours to several days. Objectively, pallor of the skin, cyanosis of the lips, excessive sweating, decreased blood pressure. In most patients, the heart rhythm is disturbed (tachycardia, extrasystole, atrial fibrillation).

Algorithm of treatment measures

1. Urgent cessation of intervention, rest, access to fresh air.

2. Call the cardiology ambulance team.

3. With systolic blood pressure? 100 mm. rt. Art. sublingually 0.5 mg of nitroglycerin tablets every 10 minutes (total dose 3 mg).

4. Mandatory pain relief: baralgin 5 ml or analgin 50% - 2 ml IV or IM.

5. Oxygen inhalation through a mask.

6. Papaverine 2% - 2.0 ml IM.

7. Eufillin 2.4% - 10 ml per saline. i.v. solution

8. Relanium or Seduxen 0.5% - 2 ml 9. Hospitalization.

Clinical death

Clinic. Loss of consciousness. Absence of pulse and heart sounds. Stopping breathing. Pale and cyanotic skin and mucous membranes, absence of bleeding from the surgical wound (tooth socket). Pupil dilation. Respiratory arrest usually precedes cardiac arrest (in the absence of breathing, the pulse remains at carotid arteries and the pupils are not dilated), which is taken into account during resuscitation.

Algorithm of therapeutic measures RESUSCITATION:

1. Lay on the floor or couch, throw back your head, push out your jaw.

2. Clear the airways.

3. Insert an air duct, perform artificial ventilation and external cardiac massage.

during resuscitation by one person in the ratio: 2 breaths per 15 sternal compressions; during resuscitation by two people in the ratio: 1 breath per 5 compressions of the sternum. Keep in mind that the frequency of artificial respiration is 12-18 per minute, and the frequency of artificial circulation is 80-100 per minute. Artificial ventilation lungs and external cardiac massage are carried out before the arrival of the “resuscitation”.

During resuscitation, all drugs are administered only intravenously, intracardiacly (adrenaline is preferable - intertracheal). After 5-10 minutes, the injections are repeated.

1. Adrenaline 0.1% - 0.5 ml in a dilution of 5 ml. physical solution or glucose intracardially (preferably intertracheally).

2. Lidocaine 2% - 5 ml (1 mg per kg of weight) IV, intracardiac.

3. Prednisolone 120-150 mg (2-4 mg per kg of weight) IV, intracardially.

4. Sodium bicarbonate 4% - 200 ml i.v.

5. Ascorbic acid 5% - 3-5 ml i.v.

6. Cold head.

7. Lasix according to indications: 40-80 mg (2-4 ampoules) IV.

Resuscitation is carried out taking into account the existing asystole or fibrillation, which requires electrocardiographic data. When diagnosing fibrillation, a defibrillator is used (if one is available), preferably before drug therapy.

In practice everything listed activities are carried out simultaneously.

Posted on Allbest.ru

...