All types of first aid. Bandages for the upper limbs, shoulder and forearm

Screening examinations of a pregnant woman are a necessary method for diagnosing intrauterine diseases of the child. Ultrasound is the gold standard among research methods, as it is safe and has good imaging capabilities. From the 10th week, signs can be detected genetic defects fetus In order to standardize the study, certain ultrasound diagnostic protocols have been adopted in Russia. They reflect most of the nuances that need to be paid attention to during the study.

There are 2 main protocols for ultrasound diagnostics in a pregnant woman: at 10-14 weeks (first screening) and 20-24 (second screening). For correct decoding their results, it is necessary to know the normal characteristics of the fetus at various stages of gestation and correlate them with screening data. The third study is of a review nature and does not have a special form.

Decoding the first screening protocol

This document outlines the main indicators of the growth and vital activity of the embryo, the state of the structures that ensure the development of the fetus. These include:

• the uterus itself (its wall and appendages);
• yolk sac - important component the body of the embryo, which is the first source of germ cells, the “first liver” and the first hematopoietic organ. It functions only in the first trimester;
• chorion is a modified endometrium of the uterus, which subsequently participates in the formation of the placenta.

Let us consider the normal characteristics of these formations and possible pathologies, which can be detected by ultrasound at 10-14 weeks of pregnancy.

Uterus

Since all pathological changes in the uterus are clearly visualized in the first trimester, its structure must be carefully studied. This will help you choose adequate pregnancy management tactics and prevent complications during delivery. You should also pay attention to the dynamic condition of the cervix, which will help to timely identify isthmic-cervical insufficiency and prescribe the correct therapy.

Ultrasound examination of the appendages (ovaries and fallopian tubes) allows us to diagnose the following pathological changes:

• ectopic pregnancy;
• presence of neoplasms;
• the presence of fluid in the pelvis;
• cystic deformation of organs.

A normal ultrasound result indicates that the wall of the uterus and its appendages are unchanged.

Yolk sac

The yolk sac is a temporary organ that, by the second trimester of pregnancy, becomes sclerosed (degenerates into connective tissue) and loses its functions. At the first screening, in the period from the 10th to the 12th week, it can be visualized as an echogenic formation of an oval or spherical shape. Its diameter (in the protocol it is designated “medium internal”) is 7-10 mm.

After the 12th week of pregnancy, this formation may normally be absent. This change is physiological, therefore, when interpreting the ultrasound, you should not be alarmed by the absence of the yolk sac.

Chorion

TO pathological changes chorion, which are detected by ultrasound screening, fall into 3 groups:

• undesirable localization (previa) - a condition when the chorion and, as a result, the placenta will be located in the area of ​​the os of the uterus. When interpreting an ultrasound, attention should be paid to this nuance, as it will determine the tactics for subsequent pregnancy management;
• chorion detachment (partial or complete) is an extremely negative sign that threatens to be interrupted;
• neoplasms (chorionepithelioma).

Normally, the diagnostician will note the location of the chorion and the absence of changes in its structure.

Fetal assessment

At the first ultrasound screening, three main indicators are assessed, which allow us to objectively judge the development of the embryo.

The coccygeal-parietal size (CTR) is the length of the fetus, which is measured at the most protruding points of the coccyx (if it is possible to determine) and the parietal bones. It is important to evaluate the CTE in accordance with the gestational age, which will allow us to draw a conclusion about the course of development of the embryo. Normal indicators of the coccygeal-parietal size, according to the clinical recommendations of Professor O.V. Makarov, are:

A slight discrepancy between the CTE and the menstrual period may be an option normal development. A difference of more than 7 mm from the average is a sign of pathology in 76% of cases.

The nuchal space is the distance between the inner surface of the skin of the fetus and the outer surface of the soft tissues of the fetus, which is assessed in the neck area. The main pathological sign that you should pay attention to when deciphering is the expansion of the collar space by more than 5 mm. In this case, the risk of intrauterine pathologies increases significantly.

When deciphering the results of the first screening, you should pay attention to the decrease in the fetal pulse. Normal values ​​after the 10th week are 150 beats/min. An unfavorable prognostic sign during pregnancy is fetal bradycardia - when the heart rate is less than 100 beats/min.

Explanation of the second screening protocol

The study protocol for a pregnant woman at 20-24 weeks identifies 4 groups of results that require decoding and interpretation:

• fetometry - involves assessing the size of the body parts of the fetus and their correspondence to the gestational age;
• fetal anatomy is a group of data that allows us to draw a conclusion about the state of the internal organs of the fetus;
• condition of temporary organs (placenta, umbilical cord, amniotic fluid);
• condition of the uterus and its appendages (ovaries and fallopian tubes).

Changes in these structures suggest the presence of pathology in the child’s intrauterine development. It is important to note that during the second screening the fetus is already visualized very clearly, therefore, in addition to the signs genetic abnormalities, the doctor can see gross defects. They are entered as a separate line in the protocol.

During the second screening, the EMF (estimated fetal weight) is also calculated. To do this, use several formulas (Zhordania, Yakubova, and so on) and calculate the arithmetic mean. However, the PMP may deviate significantly from actual indicators. Therefore, you should not give it crucial.

Fetometry

The main task of these measurements is to determine the proportionality of the fetal body and the correspondence of the lengths of body parts to the child’s age. The asymmetry of these structures may indicate the presence of genetic diseases. For example, unilateral shortening femur- This is a manifestation of Down syndrome. Fetometry helps determine the need for further research, including invasive ones.

Here are the normal characteristics of the parts of the fetal body that are necessary when deciphering fetometric indicators:

Index	Gestation period (week)	Average values ​​(mm)	Standard options (mm)
BPR (biparietal size)	20	4.7	4,3-5,1
	21	5	4,5-5,3
	22	5.3	5,0-5,7
	23	5.6	5,3-6,0
	24	5.9	5,6-6,4
LZR (fronto-occipital size)	20	60	57-64
	21	64	61-67
	22	67	63-70
	23	70	66-73
	24	74	70-77
Abdominal circumference	20	4.7	4,3-5,1
	21	5.1	4,7-5,5
	22	5.4	5,0-5,9
	23	5.7	5,4-6,2
	24	6.1	5,7-6,5
Head circumference	20	177	174-180
	21	188	184-192
	22	196	193-200
	23	209	205-212
	24	221	218-224
Humerus length	20	33	30-37
	21	36	32-39
	22	39	35-42
	23	42	39-46
	24	45	42-49
Length of forearm bones	20	29	26-32
	21	32	29-35
	22	35	31-38
	23	38	34-42
	24	41	38-44
Femur length	20	3.3	2,9-3,6
	21	3.6	3,2-4,0
	22	3.9	3,5-4,2
	23	4.1	3,7-4,6
	24	4.4	4,0-4,7

The table shows current data from Professor Strizhakov’s monograph, however, it is important to note that they are constantly changing (within 2-3 mm). The final decision based on fetometry data should be made by the doctor.

The average PMP values ​​are 400-650 g.

Fetal anatomy

The main purpose of studying the internal organs of the fetus is to detect defects. Most of them are easy to diagnose. In this case, the ultrasound doctor will determine the presence of pathology, the type of developmental disorder and note these data in the protocol. This is true for:

• central nervous system organs (the most common defect is anencephaly);
• kidneys (polycystic disease, hydronephrosis);
• bladder (megacystic);
• lungs;

When deciphering fetal anatomy data, attention should be paid to a four-chamber section of the heart. Normal measurement results:

• left ventricle - 4
• right ventricle - 4
• left atrium - 4
• right atrium - 6

The condition of temporary organs, the uterus and its appendages, as a rule, is not described in detail. The localization of the placenta and its correspondence to the gestational age, the number of vessels in the umbilical cord (normally 3) and the abundance of amniotic fluid ( normal values: volume 500-1500 ml; amniotic fluid index 10-20).

Deciphering screening study protocols is a rather complex process that requires knowledge of normal fetal parameters and their adequate interpretation. Based on these data, we can draw a conclusion about the course of pregnancy. However, in order to avoid making a mistake in your conclusions, you should seek help from a doctor.

First aid- this is the view medical care, including a set of simple medical measures aimed at temporarily eliminating the causes, life-threatening stricken. First medical aid is performed at the scene of injury by the victim himself (self-help) or by other citizens (mutual aid) who happen to be nearby.

At bruises superficial tissues and internal organs may be damaged.

Dislocations

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

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

Bleeding- effusion of blood from damaged blood vessels.

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

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

First aid

BASIC RULES FOR PROVIDING FIRST MEDICAL AID IN EMERGENCY CONDITIONS

First aid- these are the simplest urgent measures necessary to save the life and health of victims in the event of damage, accidents and sudden illnesses. It must be present at the scene of the incident until a doctor arrives or the victim is taken to the hospital.

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

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

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

STRAINS, DISLOCATIONS, BRUISES,

FRACTURES, RULES OF CARE

FIRST AID

Sprains

Stretching- damage to soft tissues (ligaments, muscles, tendons, nerves) under the influence of a force that does not violate their integrity. Most often, sprains of the ligamentous apparatus of the joints occur due to incorrect, sudden and sharp movements. In more severe cases, tearing or complete break ligaments and joint capsule. Signs: the appearance of sudden severe pain, swelling, impaired movement in the joints, hemorrhage into the soft tissues. When you feel the stretched area, pain appears.

First medical aid is to provide rest to the victim, tightly bandage the damaged joint, ensuring its mobility and reducing hemorrhage. Then you need to consult a traumatologist.

Dislocations

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

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

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

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

When providing first aid in unclear cases, when it is not possible to distinguish a dislocation from a fracture, the victim is treated as if he had an obvious broken bone.

Bruises

At bruises superficial tissues and internal organs may be damaged. Signs: pain, swelling, bruising.

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

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

First aid is to provide complete rest to the affected person and apply ice to the head.

Fractures

Fracture- This is a violation of the integrity of the bone.

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

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

Signs: severe pain, impairment motor function limbs, a kind of bone crunch. With open fractures, bone fragments may be visible in the wound. Fractures of the bones of the extremities are accompanied by their shortening and curvature at the fracture site. Damage to the ribs can make breathing difficult; when palpated at the fracture site, a crunching sound (crepitus) of rib fragments can be heard. Fractures of the pelvic and spinal bones are often accompanied by urination disorders and impaired movement in the lower extremities. When skull bones are fractured, bleeding from the ears often occurs. In severe cases, fractures are accompanied by shock. Shock develops especially often in open fractures with arterial bleeding.

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

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

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

First aid is to ensure immobility (transport immobilization) of the injured limb with splints or sticks, planks and other objects at hand.

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

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

WOUNDS AND BLEEDING, RULES OF CARE

FIRST AID

Wounds

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

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

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

Puncture wounds are the result of penetration of piercing objects into the body. Puncture wounds are often penetrating. The shape of the entrance hole and wound channel depends on the type of wounding weapon and the depth of its penetration. Puncture wounds are characterized by a deep canal and often significant damage to internal organs. Internal bleeding in the body cavity and the development of infections are common.

Chopped wounds are characterized by deep tissue damage, wide gaping, bruising and concussion of surrounding tissues; bruised and lacerated wounds - big amount crushed, bruised, blood-soaked tissues.

Gunshot wounds arise as a result of a bullet or shrapnel wound and can be through, when there are entrance and exit wound holes, blind, when a bullet or shrapnel gets stuck in the tissue, and tangential, in which a bullet or shrapnel, flying tangentially, damages the skin and soft tissues without getting stuck in them.

First aid is to first expose the wound; in this case, depending on the nature of the wound, weather and local conditions, outer clothing is removed or cut. First, remove clothes from the healthy side, and then from the affected side. In the cold season, to avoid chilling, as well as in in case of emergency When providing first aid to a victim who is in serious condition, the clothing in the area of ​​the wound is cut. Do not remove stuck clothing from the wound; it must be carefully cut with scissors. A bandage is applied to any wound, aseptic if possible. In most cases, the means of applying an aseptic dressing is a medical dressing bag, and in its absence - a sterile bandage, cotton wool, etc. as a last resort- clean cloth. If the wound is accompanied by significant bleeding, it is stopped by any suitable method.

In case of extensive soft tissue injuries, bone fractures and injuries to large blood vessels and nerve trunks, immobilization of the limb with special or improvised means is necessary. The victim is administered a painkiller, given antibiotics, and quickly transported to a medical facility.

Bleeding

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

Signs: scarlet blood flows from the wound in a strong, pulsating stream.

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

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

The procedure for applying a hemostatic tourniquet

1. A tourniquet is applied when large arteries of the extremities are damaged above the wound so that it completely compresses the artery.

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

3. Be sure to attach a note to the tourniquet indicating the time of application of the tourniquet.

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

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

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

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

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

INJURIES OF THE FACIAL PART OF THE HEAD, RULES

Injuries oral cavity

In accidents, the oral cavity is often injured and teeth are damaged. First aid: if a person is unconscious and blood is flowing from the mouth, after wrapping a bandage, a clean handkerchief or a piece of clean cloth around the finger, raise the head and place a small cushion under it. If possible, make sure that the blood does not flow down the back of the throat.

If the victim is conscious and has no other serious injuries (concussion or contusion of the brain, damage to internal organs, internal bleeding, etc.), sit him down with his head tilted so that he can spit out blood.

If teeth are knocked out and the gums are bleeding heavily, make a tampon from a sterile bandage, place it on the site of the knocked out tooth and ask the victim to lightly (to avoid damaging the formed blood clot and resumption of bleeding) bite the tampon. Usually after 5-10 minutes the bleeding stops. You should avoid eating for the next two hours. If necessary, moisten the oral cavity with a small amount of liquid (warm water, cooled tea, etc.). During the day, food and water consumed should not be hot.

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

Eye injuries

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

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

If your eyes are injured by branches in the forest, consult a doctor, and before that, cover your eye with a clean scarf. Remember to never rub your eyes with dirty hands. Do not wash puncture and cut wounds of the eyes and eyelids with water.

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

Foreign body in the nose

If a foreign body gets into the nose, do not try to remove it with your fingers, especially in small children, otherwise you will push it deeper. Ask an older child to blow his nose, after holding the nasal passage free of foreign matter. If the attempt is unsuccessful, consult a doctor quickly; The sooner the foreign body is removed, the fewer complications there are during its removal.

Nose bleed

Causes: impact, nose picking, hesitation atmospheric pressure and air humidity, physical overexertion, overeating, stuffiness and overheating.

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

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

Foreign bodies entering the ear

If a foreign body gets into the ear, do not remove it sharp object, which will cause more harm than the foreign body itself; If a live insect gets into the ear, drop a little pure olive oil into the ear, which then (after tilting the ear) will flow out of it, and the insect will come out with it. Sometimes it is enough to turn your ear towards a source of strong light: the insect can come out on its own. Do not rinse your ear with water under any circumstances: if the foreign bodies are beans, peas or grains, they will swell and will be difficult to remove. Consult a doctor if you cannot remove the foreign body from your ear.

Entry of foreign bodies into the respiratory tract

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

The victim is an adult: tilt him forward so that his head drops below his shoulders, hit him hard on the back (between the shoulder blades) with your palm several times, thereby causing a reflex cough. If the foreign body comes out of the throat and breathing function is restored, the victim should be given water to drink in small sips.

If the above measures do not help and the victim is not breathing, try pressing on the stomach; in this case, you should act carefully so as not to damage vital organs. Grab the victim with your arms while standing from behind. Clench the fingers of one hand into a fist, press it to the stomach between the navel and the chest, clasp the fist with the other hand and pull both hands towards you and up, trying to squeeze out the air still remaining there from the lungs and thereby push out the foreign body stuck in the respiratory tract.

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

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

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

Consult a doctor if the foreign body cannot be removed.

RULES FOR WOUND TREATMENT AND APPLICATION OF STERILE DRESSINGS

Rules for treating wounds

After the bleeding has stopped, the skin around the wound is treated with a solution of iodine, potassium permanganate, brilliant green, alcohol, vodka or cologne. Cotton or gauze swab moistened with one of these liquids, the skin is lubricated from the edge of the wound from the outside. You should not pour them into the wound, as this will increase the pain, damage the tissue inside the wound and slow down the healing process. If there is a penetrating wound to the abdomen, you should not eat or drink. After treatment, the wound is covered with a sterile bandage.

If sterile material is not available, gauze or a clean cloth can be used. Apply iodine to the area of ​​the bandage that will be in contact with the wound.

Rules for applying sterile dressings

Bandage for head and neck injuries

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

If the neck, larynx or back of the head is injured, apply a cross-shaped bandage. Using circular turns, the bandage is first secured around the head, and then above and behind the left ear it is lowered in an oblique direction down onto the neck. Next, the bandage is passed along the right side surface of the neck, covers the front surface with it and is returned to the back of the head, passed above the right and left ears, and the moves made are repeated. The bandage is secured by wrapping the bandage around the head.

At extensive wounds head and their location in the face area, a bandage is applied in the form of a “bridle”. After 2-3 securing circular moves through the forehead, the bandage is passed along the back of the head to the neck and chin, several vertical moves are made through the chin and crown, then from under the chin the bandage is passed along the back of the head.

A sling-shaped bandage is applied to the nose, forehead and chin. Under the bandage on wound surface cover with a sterile napkin or bandage.

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

Chest bandages

A spiral or cross-shaped bandage is applied to the chest. For a spiral bandage, tear off the end of a bandage about 1.5 m long, place it on a healthy shoulder girdle and leave it hanging obliquely on the chest. Using a bandage, starting from the bottom of the back, bandage the chest in spiral turns. The loose ends of the bandage are tied. A cruciform bandage is applied from below in a circular manner, fixing with 2-3 turns of the bandage, then from the back on the right to the left shoulder girdle with a fixing circular motion, from below through the right shoulder girdle, again around the chest. The end of the bandage of the last circular move is secured with a pin.

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

Belly bandages

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

A spica bandage is applied to the lower abdomen on the abdomen and groin area. It starts with wrapping around the abdomen, then wrapping the bandage around the outer surface of the thigh and around it, then wrapping around the stomach again. Small non-penetrating abdominal wounds and boils are covered with a sticker using an adhesive plaster.

Bandages on upper limbs, shoulder and forearm

Spiral, spica and cruciform bandages are usually applied to the upper extremities.

The spiral bandage on the finger begins with a turn around the wrist, then the bandage is led along the back of the hand to nail phalanx and make a spiral application of the bandage from the end to the base and, with a reverse application along the back of the hand, secure the bandage to the wrist.

If the palmar or dorsal surface of the hand is damaged, a cross-shaped bandage is applied, starting with a fixation on the wrist, and then along the back of the hand to the palm.

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

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

Bandage for lower limbs

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

A figure-eight bandage is applied to the ankle joint. The first fixing turn of the bandage is made above the ankle, then down to the foot and around it, then the bandage is moved along the back of the foot above the ankle and returned to the foot, then to the ankle, and the end of the bandage is secured in circular turns above the ankle.

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

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

A T-shaped bandage is applied in the perineal area. bandage or bandage with a scarf.

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

16.6. SYNOPSIS, PROLONGED COMPRESSION SYNDROME, TRAUMATIC SHOCK, RULES

FIRST MEDICAL AID

Fainting

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

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

First aid is to lay the victim on his back so that his head is slightly lowered and his legs are raised. To make breathing easier, free your neck and chest from tight clothing; cover the victim with something warm, place a heating pad at his feet; rub the whiskey with ammonia and let it smell; Splash your face with cold water. In case of prolonged fainting, artificial respiration is indicated. After the victim regains consciousness, give him hot coffee.

Long-term compartment syndrome

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

Having discovered a person in the rubble, measures must be taken to free him. The rubble is removed carefully, as it may collapse. The victim is removed only after he is completely freed from compression. Then he is carefully examined. On the damaged part of the body there may be abrasions and dents that repeat the outlines of the protruding parts of the pressing objects; the skin may be pale, sometimes bluish, and cold to the touch. The damaged limb will begin to swell quickly 30-40 minutes after its release.

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

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

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

Shown hot tea, coffee, drinking plenty of fluids with addition baking soda, 2-4 g per dose (up to 20-40 g per day).

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

Victims with traumatic toxicosis are quickly and carefully transported on stretchers to a medical facility.

Traumatic shock

Traumatic shock- a life-threatening complication of severe injuries, characterized by disruption of the central nervous system, blood circulation, metabolism and other vital functions. Shock can be caused by single or repeated injuries. Shock occurs especially often during major bleeding, and in winter when the wounded person cools down.

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

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

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

First aid is to place the victim in a position with legs up and head down. Eliminate the reasons causing disturbance breathing (ensure the patency of the upper respiratory tract, fix the tongue when it is retracted, clear the mouth, free the neck and chest from constricting clothing, unfasten the trouser belt). Perform artificial respiration using mouth-to-mouth or mouth-to-nose methods. For penetrating chest wounds, immediately cover the wound with several sterile drapes, securing them in the chest. Stop external bleeding. For arterial bleeding, apply a tourniquet, and for venous and capillary bleeding, apply pressure bandages. In case of cessation of cardiac activity, perform an indirect massage

First aid is complex urgent measures aimed at saving human 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:

1. Make sure that when providing first aid you are not in danger and you are not putting yourself in danger.
2. Ensure the safety of the victim and others (for example, remove the victim from a burning car).
3. 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.
4. Call specialists: from the city - 03 (ambulance) or 01 (rescue).
5. Provide emergency first aid. Depending on the situation, this could be:
   • restoration of airway patency;
   • cardiopulmonary resuscitation;
   • stopping bleeding and other measures.
6. 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.

Exist various ways 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, it is necessary to immediately artificial ventilation lungs.

Mouth-to-mouth artificial respiration technique

1. Ensure patency of the upper respiratory tract. Turn the victim's head to the side and use your finger to remove mucus, blood, and foreign objects from the mouth. Check the victim's nasal passages and clear them if necessary.
2. 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!

3. 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.

4. 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

1. Place the victim on a flat, hard surface. Chest compressions should not be performed on beds or other soft surfaces.
2. Determine the location of the affected xiphoid process. The xiphoid process is the shortest and narrowest part of the sternum, its end.
3. Measure 2–4 cm up from the xiphoid process - this is the point of compression.
4. Place the heel of your palm on the compression point. Wherein thumb should point to either the chin or abdomen of the victim, depending on the location of the resuscitator. 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.
5. 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.

1. Stand behind the victim.
2. Grasp it with your hands, clasping them together, just above the navel, under the costal arch.
3. 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 in lower section chest.

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

If the victim has lost consciousness and fallen, place 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 the 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

1. Apply a tourniquet to clothing or soft padding just above the wound.
2. Tighten the tourniquet and check the pulsation of the blood vessels: the bleeding should stop and the skin below the tourniquet should turn pale.
3. Apply a bandage to the wound.
4. Write it down exact time when a 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

1. Assess the severity of the victim’s condition and determine the location of the fracture.
2. If there is bleeding, stop it.
3. 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!

4. 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.
5. 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 sudden loss consciousness caused by a temporary disturbance 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

1. 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.

2. Place the victim with his stomach on his knee so that his head is down.
3. Clean the oral cavity of foreign bodies (mucus, vomit, algae).
4. Check for signs of life.
5. If there is no pulse or breathing, immediately begin mechanical ventilation and chest compressions.
6. Once 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,
• noise in ears,
• 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.

At 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

1. Keep the victim warm.
2. Remove frozen or wet clothing.
3. Do not rub the victim with snow or cloth - this will only injure the skin.
4. Wrap up the frostbitten area of ​​your body.
5. 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:

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

   Gastric lavage is only possible if the victim is conscious.

2. Dissolve 10–20 tablets of activated carbon in a glass of water and give it to the victim to drink.
3. Wait for the specialists to arrive.

In life we ​​quite often encounter various kinds situations in which human life is at risk. Fires in shopping centers, extreme weather conditions, work-related injuries, gunshot attacks or assault with a bladed weapon are options for receiving physical harm in modern life weight. They await a person at almost every step, having an accidental or deliberate background, but the very fact that a person needs the ability to defend himself against them is a fairly weighty argument today. And knowledge of the rules of first aid plays an important role here. Indeed, it is often the first few minutes after damage to a person’s physical health by one or another threatening factor that influence the course of his pathological condition and influence the results after receiving possible injury generally.

What is first aid?

Every conscious representative of the current society should know the concept, rules and sequence of actions to provide first aid. Due to daily natural or technical disasters, the lives of tens, hundreds, thousands of people are exposed to danger every day. And it’s quite strange that not everyone today is familiar with the concept of what first aid is and how to act in the event of an unusual situation in which one or more people have been injured. Whether it is the fault of higher-ups who regulate the enlightenment of citizens, or whether it is an omission of society itself - in fact, is no longer so important. However, the problem of the educational moment in this vein is worth thinking about.

So what is first aid? This is a set of measures for emergency resuscitation of the physical condition of a victim whose health is accidentally or intentionally destabilized by weather, technical, situational conditions or intentional damage to his physiological well-being before the arrival of qualified doctors. In other words, this is a set of actions aimed at maintaining the viability of one person by another in the event of an unforeseen incident, health threatening victims of circumstances. The sequence of first aid is determined by the specifics of a particular case, since in different tragic situations different injuries occur and various types of damage are caused to the victim’s health. Physiological damage is relieved depending on the nature of the damage, so each specific emergency incident requires a specific set of actions to prevent the spread of danger.

Implications for society

The importance of first aid to victims carries enormous meaning. We all know very well that the healthcare system in the state is imperfect; there are a lot of nuances that do not allow it to work at one hundred percent. Somewhere there is underfunding, somewhere there is a lack of resources, somewhere there is simply someone’s negligence - and, as a result, ambulance crews do not arrive at the scene as quickly as we would like. And it is at this moment that skills in providing first aid to victims are needed; it is at these moments that emergency intervention and assistance in localizing the injuries received by victims is required. Many lives were saved precisely thanks to the timely measures taken by people who found themselves close to the emergency situation.

The need for knowledge about first aid

Today they talk about what first aid is in school lessons, at workshops in universities, at meetings in various levels institutions and enterprises. But little is said about this. Or not enough to prevent the number of people affected by emergency circumstances. In addition to educational insufficiency, imperfect and the legislative framework, which regulates the legal actions of participants in catastrophic and emergency situations. Although there is criminal liability for failure to act in the provision of pre-medical care.

What first medical aid is and what actions it is accompanied by, unfortunately, is not known enough by a high percentage of the population. And in vain. The need to educate youth at different stages educational process due to its importance in view of frequent emergency incidents, where such knowledge will be simply vital.

Today, in the conditions of the cruel world of civil strife, military operations, terrorism and even random emergency situations, every schoolchild, every student or employee of a production and technical enterprise, and what can I say, absolutely every person of conscious age should be familiar with the concept of first aid. Life safety as a subject about the basics of safe life should become not just an extracurricular activity, as is now customary to practice in secondary schools once every two weeks, but a full-fledged lesson. Why is it worse than art classes? And is it really less significant than a workshop on ethics and aesthetics? Life safety and first medical aid are complementary concepts, since thanks to this knowledge people learn to help each other in difficult emergency situations, and the ability to provide first aid makes it possible to put into practice the vital lessons learned in today’s unsafe world. As well as in the post-educational period: all enterprises and institutions should be equipped with reminders and instructions on assisting victims before a doctor arrives at the scene of an incident. different forms ownership and areas of operation.

First aid training can at least give life to the victim, next to whom an enlightened person will be present in time, and, at a maximum, reduce mortality due to emergency incidents, natural disasters, terrorist attacks, where the wounded will receive timely assistance from experienced and knowledgeable people who happened to be nearby at that moment.

One of the fairly common injuries is a burn. Domestic situations with boiling water, steam, fire or chemical exposure upon contact with the source of the spread inevitably lead to burns on the body. In this case, different types of damage are stopped different types first aid. A set of standard measures aimed at helping victims of thermal effects is determined the following actions:

The specified sequence of first aid should not be disrupted by additional incorrect actions. For example, it is absolutely forbidden to:

• carry or transport the victim without examination - there may be fractures or deep damage to internal organs;
• treat the affected areas of the skin with improvised folk remedies - such actions can only aggravate the situation;
• clean the burn without sterile paraphernalia in the form of bandages and anesthesia;
• apply bandages or tourniquets without specific medical experience - an incorrectly applied bandage can increase swelling and provoke painful shock;
• puncture the resulting blisters;
• remove stuck clothing.

By following the correct technique for providing first aid, you can save the victim from painful stress and shock, preventing the lesion from spreading further.

Help for carbon monoxide or smoke poisoning

There are also frequent situations in which a person is not only exposed to thermal injury, but also becomes hostage to a lack of air due to severe poisoning from smoke screens formed as a result of a raging fire. Here, intervention and knowledge of the rules of first aid are also necessary, since if the victim is not helped in time, his health may worsen and deteriorate to the point of coma.

As in cases with burns, the degree of human smoke poisoning is divided into several stages according to the level of impact on the body. Easy level smoke damage provokes severe dizziness, accompanied by surges in blood pressure, nausea, possible vomiting, sore throat, which ultimately leads to nausea paroxysmal cough And severe redness facial skin. The average degree of poisoning occurs with a longer stay of the victim in the area of ​​exposure to smoke and is characterized by a short loss of consciousness, sudden mental overexcitation, followed by apathy, the appearance of hallucinations, noise attacks in the ears, as well as tachycardia and high pressure. But the most dangerous is the severe level of smoke intoxication; it is characterized by the most harmful manifestations. These may be convulsive attacks in the limbs, which gradually spread throughout the body, respiratory failure, heart damage similar to a heart attack due to lack of oxygen and, as a culmination, coma.

What is the set of first aid rules for such situations?

• Moving the victim to a place where he will not be overtaken by another smoke screen attack.
• Relief from the inconvenience of tight clothing, which makes it difficult for a smoke poisoned person to breathe - removing a tie, unbuttoning the collar of a shirt, loosening a tight belt.
• Providing the victim with drinks in the form of strong hot tea or milk.
• Providing sorbents such as Polysorb, Enterosgel, and activated carbon.
• Removing the patient from fainting by applying cotton wool with ammonia to the olfactory apparatus.
• Ensuring patency of the airways by freeing them from vomit.
• Avoiding hypothermia with blankets or heating pads.
• In case of absence of breathing, measures for indirect cardiac massage and artificial respiration are carried out.

Providing first aid to a carbon monoxide victim can not only prevent him from falling into a coma, but also save his life.

Help with open wounds and bleeding

Bleeding is a fairly serious pathology of the condition. human body, which with heavy blood loss inevitably leads to death. That is why you need to be able to stop it in time. In short, first aid for open wounds entirely aimed at stopping bleeding. But what specific measures need to be taken in this case as a pre-medical intervention?

• In cases where the wound is shallow and accompanied by slight bleeding, you must initially clean the wound with plenty of water and apply a disinfected, clean bandage to its surface.
• If the blood loss is significant, it is necessary to apply a compressive gauze or fabric tape that will prevent it. The bandage soaked in blood is not removed; the bandage is reapplied on top of it.
• If the bleeding is jet and pulsating, you need to apply a tourniquet to the artery closest to it - the forearm area, shoulder, thigh.
• If the wound is blocked by a protruding object, it cannot be removed without qualified medical professionals. It is necessary to apply a bandage around it, trying to fix it.
• If you are bleeding from the nose, do not tilt your head back. On the contrary, you need to blow your nose thoroughly, lower your head down and apply cold air to the bridge of your nose.
• Internal bleeding should be controlled by applying cold to the abdomen, taking a sitting position, and temporarily refusing food, drink, and medications.
• In case of penetrating wounds and internal organs erupting outward, you need to cover them with a damp cloth, do not let them dry out.
• If you are wounded in the head, apply a clean bandage to the wound and call an ambulance immediately.
• If the chest is affected, you should try to close the injured area as tightly as possible and apply cold to it until the doctor arrives. If the wound is caused by a gunshot, it is necessary to find the entry hole and close it too.
• If the injury occurs with a traumatic amputation, the severed limbs must be placed in a sterile bag and left in the cold. For the next six hours they can still be sewn on with high probability engraftment.
• If the wound is caused by compression or falling under rubble, it requires a tourniquet, cold treatment, and the victim must drink plenty of fluids.

Knowledge of these first aid instructions for open wounds allows you to save a person’s life by reducing blood loss.

Help with a fracture

Situations often occur in which people injure their limbs with possible open or closed fractures. And while waiting for paramedics, it is also necessary to maintain the correct body position before they arrive at the scene. Timely first aid if a victim’s body is damaged by fractures can not only reduce the risk of complications and shorten the time of disability, but also save him from disability. This type of injury is one of the most common, so every conscientious citizen needs to know the list of measures to help the victim.

The sequence of first aid provided to a fracture victim consists of the following aspects:

• immobilizing the victim is the primary task of the assistant providing pre-medical assistance; the injured limb must remain motionless until doctors arrive to avoid painful shock, loss of consciousness and damage to surrounding tissues;
• when the victim complains about severe pain there is no need to find out what exactly causes this discomfort - a fracture, dislocation or severe bruise; need to provide him comfortable position with a minimum of movements and call an ambulance;
• if the victim needs to be transported, he should mandatory it is necessary to apply a splint to prevent the movement of broken bones, after first anesthetizing the affected segment;
• open fractures are subjected to disinfection of the skin with brilliant green, iodine or alcohol and application of a pressure bandage to prevent blood loss;
• In no case should you try to independently place broken bones in their original physiological place of growth;
• Taking painkillers in the form of “Analgin”, “Tempalgin”, “Amidopyrine” and similar medications will help alleviate the patient’s condition;
• Drinking plenty of water, hot tea, and warming the victim with a blanket will prevent the problem from getting worse.

Help with drowning and water-filled lungs

In cases of drowning and filling of the lungs with fluid, complex measures are taken for chest compressions and artificial respiration. The basics of first aid in the context of this type of trauma to the human body are a priority in life safety lessons. Cardiopulmonary resuscitation is considered a basic skill in helping victims of drowning, lung filling, and many other incidents. What first aid is given to a drowned person?

• Checking the pulse and breathing of a drowning victim.
• The belief that there are no foreign bodies in the victim’s mouth.
• Convenient positioning of the victim's body before starting cardiopulmonary resuscitation: he should lie on a hard surface on his back with his head thrown back, mouth open and lower jaw to avoid
• Indirect cardiac massage is characterized by pressing the palms of the hands on the chest of a drowned person with a frequency of at least 100 compressions per minute and with pressure forces such that the adult’s sternum bends by 5-6 cm.
• Artificial respiration from mouth to mouth - the nose is pinched and a stream of air is blown into the victim’s lungs. If the expansion of his lungs is not observed (the chest does not rise from artificial respiration), this means that the lungs are clogged.

It is much easier for two assistants to perform CPR than for one. But if the situation is this way, then pressing on the chest and blowing air into the victim’s lungs should alternate, performed by one person in the amount of 10-12 pressures per breath. Indirect cardiac massage and artificial respiration continue for thirty minutes until the victim is revived or the first signs of biological death appear.

Help for a heart attack or stroke

Heart attack and stroke are common pathologies of the cardiovascular and nervous system of the human body. These are phenomena that affect not only people of older age categories. Absolutely anyone can be exposed to it, regardless of age. As a result heart attack or a stroke, a person may die if first aid is not provided to him in a timely manner. This is basically what happens if no one is near the patient at the time of the attack. But how can you help someone who has suffered a heart attack or stroke?

Psychological first aid

The topic of first aid is raised not only in the event of physiological damage to victims at the time of an emergency. Quite often, in moments of catastrophes or accidents, people are attacked by a kind of numbness and they are plunged into a severe state of stress, culminating in shock. In such cases, people also need help: you need to try to talk to the person as calmly as possible, hold hands, and convince them that everything is over, that the danger has passed. In extreme cases, gentle clapping on the cheeks will help bring you out of the state of stupor. A glass will also help a person come to his senses. clean water and a comfortable body position - you can sit him on a soft surface with a back and cover him with a blanket.

LESSON PLAN #1

date according to the calendar-thematic plan for the 2014/2015 academic year

Groups: MSR-21

Number of hours: 2

Topic of the training session:Introduction. Types of medical care and principles of its provision

Type of training session: lesson in learning new things educational material

Type of training session: lecture, conversation, story

Goals of training, development and education: introduce with types of medical care, basic principles of its provision, methods of transporting victims.

Formation: knowledge on a given topic. Questions: see the text of the lecture

Goals and objectives of the SNMP.

Medical evacuation and methods of transporting victims.

Personal safety. Inspection of the scene of the incident and the victim

Development: independent thinking, imagination, memory, attention,student speech (enrichment of vocabulary words and professional terms)

Upbringing: feelings and personality qualities (worldview, moral, aesthetic, labor).

As a result of mastering the educational material, students should: have an idea of ​​the types of LUTS provision; know the goals and objectives of emergency medical services, methods of transporting victims.

Logistics support for the training session: withsituational tasks, tests, classroom equipment

Interdisciplinary and intradisciplinary connections: health care organization

Update the following concepts and definitions: ambulance and emergency medical care

PROGRESS OF THE CLASS

1. Organizational and educational moment: checking attendance for classes, appearance, protective equipment, clothing, familiarization with the lesson plan - 5 minutes .

2. Student survey - 10 minutes .

3. Familiarization with the topic, questions, setting educational goals and objectives - 5 minutes:

4. Presentation of new material (conversation) - 50 minutes

5. Fixing the material - 5 minutes :

6. Reflection - 10 minutes.

7. Homework - 5 minutes . Total: 90 minutes.

Homework: pp. 4-9; additionally - Website: www.website

Literature:

BASIC

1. P.V. Glybochko, V.N. Nikolaenko, etc. “First medical aid, textbook” Moscow, publishing center “Academy”, 2013

2. V.M. Buyanov. "First Medical Aid", Moscow: "Medicine", 1986

ADDITIONAL
3. I.V.Yaromich “Ambulance and emergency medical care”, Minsk: “Higher School”, 2010

4. A.L. Yurikhin. "Desmurgy" Moscow: "Medicine", 1984

5. L.I. Kolb, S.I. Lenovich “Nursing in surgery”, Minsk: “Higher School”, 2007

TEXT OF LECTURE

Topic 1. Types of medical care and principles of its provision

The meaning of first aid and the rules for its provision

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

First medical aid can be provided at the scene of injury by the victim himself (self-help), by his comrade (mutual aid), or by sanitary squads. First aid measures are:

Temporary stop of bleeding

Applying a sterile dressing to the wound and burn surface

Artificial respiration and chest compressions

Administration of antidotes, administration of antibiotics, administration of painkillers (for shock)

Putting out burning clothes

Transport immobilization

Warmth, shelter from heat and cold

Putting on a gas mask, removing the affected person from the contaminated area

Partial sanitization.

Providing first aid as early as possible is crucial for the further course and outcome of the injury, and sometimes even saving life. In case of severe bleeding, electric shock, drowning, cessation of cardiac activity and breathing, and a number of other cases, first aid should be provided immediately.

When providing first aid, standard and improvised means are used. Standard means of providing first aid are dressings - bandages, medical dressing bags, large and small sterile dressings and napkins, cotton wool, etc. To stop bleeding, hemostatic tourniquets are used - tape and tubular, and for immobilization special splints - plywood, ladder, mesh, etc. When providing first aid, some medications are used - 5% alcohol solution of iodine in ampoules or in a bottle, 1-2% alcohol solution of brilliant green in a bottle, validol in tablets, tincture of valerian, ammonia in ampoules , sodium bicarbonate (baking soda) in tablets or powder, petroleum jelly, etc. For personal prevention of injuries from radioactive, toxic substances and bacterial agents to the affected areas, an individual first aid kit (AI-2) is used.

Types of medical care, basic principles of its provision.

In accordance with the current classification, there are the following types medical assistance:

1. First aid (unqualified). It turns out not to be medical personnel, in the order of self- and mutual assistance, at the scene of the incident. We are not talking about making a diagnosis at this stage. Immediate elimination of life-threatening conditions is required. See the list of PMP activities above. Any type of first aid, always and in all cases consists of three points that the rescuer has to decide:

Termination of the damaging factor;

Actual assistance activities;

Transport the victim to the nearest health care facility.

2. Pre-hospital medical care (first qualified medical aid). It turns out that medical personnel with average medical education(nurse, paramedic, midwife, rehabilitation nurse! and so on.). As a rule, health workers should have some equipment with appropriate medical equipment, which is included in first aid kits. Such assistance is provided in a medical institution, but cases of assistance being provided at home, in a field, forest, on a lake, etc. are not excluded.

The purpose of providing such assistance:

Correction of deficiencies in the provision of assistance at the previous stage (PMP);

Maintaining the life of the victim and preventing possible complications;

Preparing the patient for transportation.

The diagnosis is still not made.

Thus, the first 2 types of help are quite close.

3. First aid; It turns out that he is a doctor of any profile. He does not have to be qualified as a surgeon, traumatologist, etc. This stage of medical care solves the following tasks:

Elimination of causes that threaten the life of the victim;

Support the function of vital organs;

Prevention of complications;

Preparations for further evacuation.

4.Qualified medical care; It turns out that he is already a general practitioner (surgeon, resuscitator, traumatologist). In accordance with the structure of healthcare, this is the stage of the central district hospital.

5. Specialized medical care; It turns out that the doctor narrow specialist(neurosurgeon, urologist, combustiologist, ophthalmologist, ENT doctor.In accordance with the structure of healthcare, this is the stage of a regional (city) hospital. True, specialized care is also possible at the level of the central district hospital, with the team of surgeons strengthened by a “narrow” specialist who arrived on their call from the regional hospital.

Principles of providing PHC:

Timeliness;

Efficiency;

Continuity;

The sequence of treatment and preventive measures at all stages of medical evacuation.

Goals and objectives of the SNMP.

Emergency (emergency) medical care is a form of medical care in the event of a sudden occurrence in a patient.

diseases, injuries, poisoning, other emergency conditions, sudden deterioration in the health of a patient with chronic diseases,threatening his life, in which urgent (emergency) medical intervention is required (Law of the Republic of Belarus “Onhealthcare”, Article 16).

Operates in Belarus government system organization of emergency medical services, including:

prehospital stage:

In cities, emergency stations with substations and branches, trauma centers;

In rural administrative areas, emergency departments of the Central District Hospital and emergency medical services posts,

In the regions - emergency departments in regional hospitals;

hospital stage:

Emergency hospitals,

Branches emergency hospitalization general hospital network

Structure of the EMS service

IN populated areas with a population of over 100 thousand people, SNMP stations are being created.

SNMP substations are created in city districts and in administrative-territorial units with a population of 50-100 thousand people.

The LUTS department is a structural unit of the state health care organization that provides LUTS.

The SNMP post is organized as part of the station (substation, department) of the SNMP as its structural unit by decision

head of a state health care organization.

Principles of organization of NUMS

1. availability,

2. efficiency in work,

3. timeliness,

4. completeness,

5. high quality of assistance provided,

6. ensuring unhindered hospitalization,

7. maximum continuity in work.

Tasks of the emergency medical services service:

1. timely provision LUTS in patients

2. ensuring the continuity of the diagnostic and treatment process atstage of LUTS provision in interaction with outpatient

polyclinic and hospital government organizationshealthcare,

3. ensuring the constant readiness of the emergency medical service service for work duringin the event of emergencies,

4. organizational and methodological work to improve the service LUTS.

The NUMS service operates:

1. in 24-hour operation mode,

2. in high alert mode,

3. in emergency mode

Medical evacuation and methods of transporting victims.

At the scene of the incident, first of all, it is necessary to stop the victim’s bleeding, apply bandages to the wounds, and fix bone fractures with splints. Only after this can it be carried, loaded and transported to a medical facility, as quickly and carefully as possible.

Inept extraction and transfer of victims can lead to serious complications- increased bleeding, displacement of bone fragments and painful shock. To prevent this from happening, two or three people should remove the victim from the car, lift and place him on a stretcher.

In the absence of standard stretchers, they can be easily made from boards, poles, plywood, blankets, and coats.

For example, you can connect two poles with wooden spacers with straps, and put a blanket, coat or other material on top.

This device can be used after removing the victim from the car, if you are alone at the scene of the accident, and an emergency situation - fire, threat of explosion, bleeding, cessation of breathing and cardiac arrest in the victim - does not allow you to wait for help. The use of a stretcher ensures free passage of the airways, relative immobility of the spine and even slight traction, which is especially important if the cervical region spine.

To transfer the victim onto a stretcher, it is necessary: ​​two people stand on the side where there is no wound, burn or fracture, one puts his hands under the victim’s head and back, the second under the legs and pelvis, and on command they lift at the same time so that the spine remains straight. If there are three people lifting, then one supports the head and chest, the second supports the back and pelvis, and the third supports the legs. In this position, carefully lift, carry and lower the victim onto a stretcher, trying not to cause him pain.

1. General rules for carrying and lifting victims
Rules for carrying victims on stretchers:
- They should be carried on a flat surface feet first, and if the victim is unconscious, then head first, this way it is more convenient to observe him and ensures blood flow to the brain.
- You should move carefully, in short steps. To prevent the stretcher from swaying, the carriers should not keep pace.
- On steep ascents and descents, ensure that the stretcher is in horizontal position, for which purpose the rear end is raised on the ascent and the front end on the descent. In this case, the handles of the stretcher can be placed on the shoulders of the carriers.
- Carrying victims on stretchers over long distances is much easier if you use straps / belts, ropes /, which reduce the load on the hands. A loop is made from the strap in the shape of a figure eight and adjusted to the height of the porter.
The length of the loop should be equal to the span of your arms outstretched to the sides. The loop is put on the shoulders so that it crosses on the back, and the loops hanging on the sides are at the level of the lowered hands; these loops are threaded into the handles of the stretcher.
Methods for removing victims from the source of a disaster:
- Extraction on a coat, raincoat, tarpaulin. The victim is carefully laid on a spread out coat, a belt or rope is passed through the sleeves and secured around the body. The victim is dragged along.

-Carrying by hand. The person providing assistance stands next to the victim, kneels down, grabs him under the buttocks with one hand, and under the shoulder blades with the other. The victim hugs the rescuer's neck. The porter then straightens up and carries the victim.

-Carrying on your back. The porter seats the victim on an elevated place, stands between the legs with his back to him and kneels. Grasping the victim’s hips with both hands, he rises with him. The victim is held by hugging the rescuer by the neck (this method is used for carrying over longer distances).

- Carrying on the shoulder. If the victim is unconscious, the porter lifts him onto his right shoulder with his stomach down. The victim's head is on the porter's back.

- Carrying for two. One of the porters takes the victim under the armpits, the second stands between his legs and his back to him, picking up his legs just below the knees. For wounds with broken limbs, this method is not applicable.

- Carrying with a lock. The most convenient way to carry the victim. To form a “lock”, each of the two assisting people grabs their right hand left hand at the hand, and with your left hand - the right hand of your partner, also at the hand. A chair is formed in which the victim is carried, holding the rescuers by the shoulders or neck with two or one hand.

- Carrying using a pole. The pole can be made from a pipe, a wooden pole at least 2.5 - 3 meters long, the ends of the sheet are tied in a knot and pushed under the pole, a second sheet or blanket is wrapped around the victim’s buttocks, and its ends are tied behind the pole.

2. Carrying the injured without a stretcher

Carrying the affected persons without a stretcher can be carried out by one or two porters with or without stretcher straps.

The stretcher strap is a canvas belt 360 cm long and 6.5 cm wide, with a metal buckle at the end. At a distance of 100 cm from the buckle, an overlay is sewn from the same fabric, allowing you to pass the end of the belt through it and fold the strap in the shape of a figure eight (Fig. 1).

Stretcher strap and how to use it

Rice. 1 a - stretcher strap; b - strap fit; c - the strap is correctly put on.

To carry the victim, the strap is folded either into a figure of eight or into a ring using a buckle. The folded strap must be correctly adjusted to the height and build of the porter: a strap folded in a figure eight should be put on the thumbs of outstretched hands without sagging (Fig. 1, a), and a strap folded in a ring should be put on the thumbs of one outstretched hand and the other, bent in the elbow joint at a right angle (Fig. 1, b).
To work with a stretcher, the strap is folded into a figure eight and put on so that its loops are located on the sides of the stretcher, and the crossing of the belt occurs on the back at the level of the shoulder blades (Fig. 1, c).

If there is no stretcher strap, it is easy to make: a ring - from two, an eight - from five waist belts.

Carrying the affected person by one porter using a stretcher strap can be done in two ways.

First way. The affected person is placed on his healthy side. A stretcher strap, folded into a ring, is placed under the victim so that one half of the strap is under the buttocks, and the other, threaded under the armpits, is on the back. The free end of the strap should lie on the ground. Thus, loops are formed on the sides of the victim (Fig. 2, a).

Fig.2. Carrying the affected person on a strap (first method).
a- the strap is put on the affected person; b - carrying the affected person on a strap folded in a figure eight.

The porter lies down in front of the victim, with his back to him, puts his hands into the loops of the strap the victim is wearing, pulls them onto his shoulders, ties the loops with the free end of the strap and places the victim on his back. Then he gradually rises, becoming on all fours, on one knee and, finally, to his full height. The victim sits on a strap, pressed by it to the porter (Fig. 2, 6). This method is convenient because both hands of the porter remain free, and the victim does not have to hold on to the porter, since the strap holds him quite securely.
The disadvantages of this method include the pressure that the strap puts on the victim's back. Therefore, for wounds and damage to the chest, not the first, but the second method of carrying on a strap is used.

Second way. The porter puts a strap folded in a figure eight on the victim’s legs, lays him on his healthy side and, pressing his back against him, puts the strap on himself so that the cross of it falls on his chest. Then the porter rises, as in the first method (Fig. 3). With such a carrying, the chest of the victim remains free, but the porter must support his arms; the victim must hold on to the shoulders or waist belt of the porter.

Rice. 3. Carrying the affected person on a strap (second method).

Both methods are not applicable for fractures of the hip, pelvis, or spine. The second method, in addition, cannot be used in case of serious damage to both upper extremities.

If the victim is carried on a strap by two porters, then they, having folded the stretcher strap into a figure eight, put it on themselves so that the cross of the strap of the strap is between them at the level of the hip joints, and the loop goes through the right for one, and through the other left shoulder. The bearers lower themselves behind the victim, facing each other, one on the right and the other on the left knee, lift the victim and place him on their closed knees, then place the strap under the victim’s buttocks and stand on their feet (Fig. 4).

Fig.4. Carrying on a strap by two porters.

There are a number of ways to carry the affected person in the arms by one or two porters. Carrying the affected persons in the arms by one porter.

First way. The porter places the victim on an elevated place, between his legs and goes down on one knee. The victim grabs the bearer by the shoulders or holds on to his belt; the bearer takes the affected person under the hips with both hands and stands up (Fig. 5).

Rice. 5. Carrying without straps (first method).

Second way. Having dropped to one knee at the side of the victim, the porter takes him with one hand under his back, the other under his buttocks, and the victim clasps the porter by the shoulders. After this, the porter stands up.

Third way. For relatively long distances, it is most convenient to carry the affected person on the shoulder (Fig. 6).

Rice. 6. Carrying without straps (third method).

It is more difficult for one person to carry the injured in his arms than on a strap. Therefore, these methods are used only when carrying short distances. Carrying the affected person in the arms of two porters can be done in several ways.

First way. The bearers join their hands to form a “seat” (“lock”). A “castle” can be made by connecting two hands (one hand of one porter and one hand of the other), three hands (two hands of one porter and one hand of the other) and four hands (Fig. 7, a, b and c).

a b c

Rice. 7. Hand castle (a, b, c)

In the first case, the porters, having one free hand each, can support the victim with them. In the second case, the victim can be supported by one of the porters. In the third case, the victim himself wraps his arms around the shoulders of the porters. The victim is placed on a “seat”, as when carried on a strap (Fig. 8, a and b). You can also use a folded waist belt as a “seat”.

Rice. 8. Carrying with a lock from the hands (a, b).

Second way. One of the bearers approaches the victim from behind and picks him up under the armpits with his arms bent at the elbows; another bearer stands between the legs of the victim with his back to him and clasps his legs with his hands. The first bearer should not join his hands on the chest of the affected person, so as not to make it difficult for him to breathe (Fig. 9).

Rice. 9. Carrying for two without straps

Third way. The bearers, approaching the victim, stand on one (healthy) side of him and kneel on one knee. The porter, located at the head of the affected person, puts one hand under his back, the other under his lower back. Another porter, located at the feet of the affected person, places one hand under his buttocks and the other under his legs. Both porters, getting to their feet, lift the injured person. This method is suitable for carrying over short distances, as well as for placing the injured on a stretcher.

An indispensable method is to carry the injured on a stretcher.

Sanitary stretchers are designed to carry injured people in a lying position. They consist of two wooden or metal beams, two articulated steel struts with legs and a removable panel with a headboard. The struts of the stretcher along with the legs are also removable; they are attached to the beams with bolts and nuts; The hinges of the spacers are equipped with spring locks and latches, so that the stretcher cannot spontaneously fold when carrying or transporting the injured person on it.

The headboard is made in the form of a pillow, which is stuffed with hay (straw, grass, etc.). On both sides of the stretcher cloth there are “sleeves” sewn on, which are used for putting the cloth on the bars. At the foot and head ends of the panel, on the right and left, with the help of bolts holding the legs, two canvas belts with buckles are secured, intended for tying the rolled up stretcher. To reduce sagging, a transverse canvas strip is sewn underneath in the middle part of the panel.

Stretcher length 221.5 cm, width 55 cm, weight 9.5-10 kg. All stretchers are made the same size and are suitable for any type of transport.

The stretcher is being deployed in the following way: both porters unfasten their belts; then, pulling the handles, they open the stretcher and, resting their knees on the spacers, straighten them to the fullest extent. Each porter checks whether the locks of the spacers are well closed (Fig. 11, a and b).

a b

Rice. 11. Deployment of the stretcher.

The stretcher is rolled up like this: the porters simultaneously open the latches of the locks and, pulling the spreaders towards themselves, half fold the stretcher, and then turn them over with their legs up. When the panel sags on the side opposite to the legs, move the bars completely, place the stretcher on the legs and, having folded the panels into three folds, tie them with belts.

To make it easier to carry the injured person on a stretcher, use a strap. Each porter puts on a strap in a figure eight so that its loops lie closer to the cloth. The handles of the stretcher are threaded through the loops. The front porter places his hands in front of the strap, the back one behind it.

If stretchers are not available, they can be made from scrap materials. The affected persons can be carried over a short distance on a blanket, etc. (Fig. 12). A stretcher made from improvised means is convenient for work: two poles connected by wooden struts and intertwined with straps, wire or rope. A stretcher can be quickly made from 1-2 bags and 2 poles. To carry victims with spinal injuries, it is necessary to place a wide board on top of the stretcher panel, and on top of it - some kind of soft bedding (coat, raincoat, hay, etc.).

Rice. 12. Carrying on a blanket.

The main purpose of carrying and evacuation (transportation) of the affected is their rapid delivery to places of medical care and treatment.
Methods of transporting victims

1. If the victim is in a comatose state, has burns on the buttocks or back, or is observed frequent vomiting, then it should only be transported in a prone position (d). The same position can be used to transport victims with a spinal fracture, when there are only flexible canvas stretchers and there is no way to wait for specialized help.

2. In a supine position with bent in knee joints(b) or with elevated legs transport victims with penetrating wounds of the abdominal cavity (c), fractures lower limbs, with internal bleeding or suspicion of it (c).

3. If there is a fracture of the pelvic bones, the upper third of the femur, and these fractures are suspected, the victim should be transported in a supine position in the “frog” position. To do this, his legs are slightly bent at the knee and hip joints and spread apart. Place a cushion of clothing or blanket under your knees.

4. For spinal injuries, suspected damage spinal cord, fracture of the pelvic bones, transportation of victims should be carried out only on a solid stretcher or a vacuum mattress. If they are not available, then an improvised stretcher made from a door leaf, a wide board or a wooden board can be used.

5. In a half-sitting or sitting position (f, g), they transport victims with neck wounds, penetrating chest wounds, fractures of the upper limbs and difficulty breathing due to drowning.

6. Victims with TBI and possible vomiting are transported in the “sideways” position (e).

Transportation of victims with fractures

It is possible to transport victims with fractures only after applying transport tire(standard or made from improvised means), limiting the mobility of the injured limb. This will reduce the manifestation of pain and reduce the likelihood of developing traumatic shock.

In case of an open fracture, before proceeding directly to applying a splint, you should stop the bleeding (hemostatic tourniquet, pressure bandage), treat the edges of the wound with alcohol, brilliant green or tincture of iodine and apply aseptic dressing. To apply a bandage, use a sterile bandage or dressing bag, which can be purchased at any pharmacy. If it is impossible to purchase them, you can use a piece of clean (preferably ironed with a hot iron on both sides) white cotton or linen fabric.

Before applying a splint, the limb should be wrapped in a piece of cloth, clothing, gauze or a layer of cotton wool. After its application, transportation of victims with fractures is carried out in accordance with general rules. The method of delivery to a medical facility is selected by the first aid provider, depending on the available capabilities.

A gentle way to transport the affected is to transport them by inland waterways, as well as by rail, especially in passenger carriages. The only drawback with such methods of transportation, especially over short distances (up to 100 km), is the repeated overload of the injured (the need to transport the injured to the loading sites, and then overload at automobile transport at unloading points).

Personal safety. Inspection of the scene of the incident and the victim

The ability to provide first aid quickly and effectively is highly valued under normal circumstances. However, in emergency situations, when you cannot expect the help of specialists, the importance of this ability increases immeasurably. Despite the lack or complete absence of medicines and medical instruments, you can provide first aid to yourself or other survivors. No matter how limited your capabilities, combining even minimal knowledge and skills with improvised equipment can save lives.

As always in emergency, the need for first aid should be assessed, priority tasks, and then create an action plan and implement it. Regardless of the circumstances, the following rules should be followed.

Keep calm. No matter how serious the injury or dangerous situation, panic will only weaken your ability to think and reduce the effectiveness of your actions. In addition, you will lose time, and in a crisis situation, time can be the difference between life and death.

Avoid unnecessary risks. This is not cowardice. You can't help anyone if you get hurt yourself. Before you act, think carefully and calmly, but if possible, quickly.

Try to calm and comfort the victims.

Find out if there are other survivors who are still active who could help you cope with the situation. In particular, look to see if there are any medics or people more experienced than you among the survivors.

Use your senses as much as possible when assessing the consequences of an accident. Ask. Look. Listen. Sniff it. Then think and act. Ask the person to describe their symptoms, tell you what they think happened, and what they feel is wrong.