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Basic first aid measures. The full volume of first medical aid includes the implementation of urgent and measures that can be delayed

1. Measures to assess the situation and ensure a safe environment for first aid:

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

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

3) elimination of threatening factors for life and health;

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

5) assessment of the number of victims;

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

7) movement of the victim.

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

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

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

2) extension of the lower jaw;

3) determining the presence of breathing with the help of hearing, sight and touch;

4) determination of the presence of blood circulation, checking the pulse on the main arteries.

5. Measures to conduct cardiopulmonary resuscitation before the appearance of signs of life:

1) pressure with hands on the chest of the victim;

2) artificial respiration "Mouth to mouth";

3) artificial respiration "Mouth to nose";

4) artificial respiration using a device for artificial respiration

6. Measures to maintain airway patency:

1) giving a stable lateral position;

3) extension of the lower jaw.

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

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

2) digital pressure of the artery;

3) application of a tourniquet;

4) maximum flexion of the limb in the joint;

5) direct pressure on the wound;

6) applying a pressure bandage.

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

1) examination of the head;

2) examination of the neck;

3) conducting a breast examination;

4) examination of the back;

5) examination of the abdomen and pelvis;

6) examination of the limbs;

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

8) immobilization (using improvised means, auto-immobilization, using medical devices;

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

10) termination of exposure to hazardous chemicals on the victim (gastric lavage by taking water and inducing vomiting, removal from the damaged surface and washing the damaged surface with running water);

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

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

9. Giving the victim the optimal position of the body.

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

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

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

First aid actions should be determined by the actual situation;

It is necessary to ensure the safety of those who provide first aid;

It is necessary to use improvised means to provide the greatest possible first aid;

The provision of first aid should be combined with simultaneous preparation for evacuation;

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

List of first aid measures in a specific setting depends on damaging factors acting on a person and received damage.

In catastrophes with a predominance of mechanical (dynamic) damaging factors first aid measures include:

ª extraction of victims from under rubble, destroyed shelters, shelters;

ª Finding out if the victim is alive;

ª giving a physiologically advantageous position to the victim;

ª restoration of airway patency and mechanical ventilation;

ª closed (indirect) heart massage;

ª temporary stop of external bleeding by all available methods;

ª the introduction of painkillers using a syringe tube;

ª application of an aseptic dressing on a wound or a burn surface and an occlusive dressing for penetrating chest wounds using a sterile rubberized envelope of an individual dressing package (PPI);

ª immobilization of limbs in case of bone fractures and crushing of soft tissues;

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

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

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

ª extinguishing burning clothes;

ª application of an aseptic dressing;

ª covering the victim with a clean sheet;

ª warming the victim and giving painkillers.

In case of accidents with the release of AOHC into the environment in the order of first aid is carried out:

ª protection of the respiratory organs, eyesight and skin from direct exposure to AOHB by using personal protective equipment, cotton-gauze bandages, covering the face with wet gauze, a scarf, a towel, etc.;

ª administration of an antidote;

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

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

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

ª removal of respiratory protective equipment;

ª giving an optimal body position;

ª access to fresh air;

ª if AOXB enters the stomach - drink plenty of water in order to wash the stomach in a tubeless way, sorbents;

ª Follow up on casualties until medical assistance arrives.

During radiation accidents first aid includes:

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

ª termination of external irradiation of those affected by their fastest evacuation outside the territory contaminated with radioactive substances or into collective protective equipment;

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

ª partial sanitization of exposed skin areas;

ª removal of radioactive substances from clothing and footwear.

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

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

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

ª use of emergency non-specific prophylaxis;

ª carrying out partial or complete special processing.

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

Primary pre-medical medical and sanitary (ambulance pre-medical) care - type of medical care, the activities of which complement first aid. It turns out to be paramedical workers (paramedic or nurse) in the focus of the lesion or in the immediate vicinity of the site of the lesion using standard medical equipment.

Her appointment:

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

ª protection of wounds from secondary infection ;

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

ª prevention of the development of subsequent complications;

ª preparation of the affected for further evacuation.

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

Primary (ambulance) pre-medical health care includes the following Events (according to indications):

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

ª conducting cardiopulmonary resuscitation;

ª infusion of infusion means;

ª administration of painkillers and cardiovascular drugs;

ª introduction and ingestion of antibiotics, anti-inflammatory, sedative, anticonvulsant and antiemetic drugs;

ª introduction of sorbents, antidotes, etc.;

ª control of the correct application of tourniquets, bandages and splints and, if necessary, their correction and addition using standard equipment;

ª application of aseptic and occlusive dressings.

The medical staff providing first aid, in addition, monitors the correctness of first aid.

Primary (ambulance) medical care - type of medical care, including a complex of therapeutic and preventive measures performed by doctors of ambulance teams, medical and nursing teams and general practitioners, usually, at the prehospital stage of medical evacuation(a point of medical care deployed by medical and nursing teams, in an outpatient facility, a health center of the facility or another nearby health facility).

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

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

Given this situation, activities primary (ambulance) medical care are divided into 2 groups:

ª urgent measures;

ª activities that may be involuntarily delayed or provided at the next stage.

For urgent action relate:

Ø elimination of asphyxia :

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

Air duct introduction;

Language fixation;

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

Tracheostomy according to indications;

Artificial lung ventilation (ALV);

The imposition of an occlusive dressing with an open pneumothorax;

Puncture of the pleural cavity or thoracocentesis with tension pneumothorax;

Ø stop external bleeding :

Sewing a vessel in a wound or clamping a bleeding vessel;

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

Control of the correctness and expediency of applying a tourniquet;

Applying a tourniquet if indicated;

Ø carrying out anti-shock measures :

Transfusion of blood substitutes with significant bleeding;

Carrying out novocaine blockades;

The introduction of painkillers and cardiovascular drugs;

Ø amputation of a limb hanging on a soft tissue flap ;

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

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

Ø the introduction of antidotes, the use of anticonvulsants, bronchodilators and antiemetics;

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

Ø gastric lavage with a probe in case of chemical or radioactive substances entering the stomach;

Ø the use of antitoxic serum in case of poisoning with bacterial toxins and non-specific prevention of infectious diseases .

For events that may be delayed, relate:

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

Ø dressing change when the wound is contaminated with radioactive substances;

Ø carrying out novocaine blockades for moderate injuries;

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

Ø the appointment of various symptomatic agents for conditions that do not pose a threat to the life of the affected .

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

In general, the first 3 types of medical care ( first, primary (ambulance) pre-medical, medical medical and sanitary ) decide similar tasks , namely:

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

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

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

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

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

In this way, volume of medical care both in the lesion focus and at the stages of medical evacuation is not constant and may vary depending on the situation.

If in specific conditions all activities of this type of medical care are carried out, then it is considered that volume of medical care full.

If, however, in relation to some group of those affected in the lesion and at the stage of medical evacuation, it is not possible to perform certain therapeutic and preventive measures, it provides for the refusal to perform measures that can be delayed, and usually includes the implementation of urgent measures, then volume of medical care called abbreviated.

Depending on the type and scale of the emergency, the number of those injured and the nature of their injuries, the availability of medical forces and means, the state of territorial and departmental health care, the distance from the emergency area of hospital-type medical institutions capable of performing the full range of specialized medical care and their capabilities, different medical care options injured in emergencies:

Rendering to the injured before their evacuation to hospital-type medical institutions only the first or primary (ambulance) pre-hospital medical care;

Rendering to the injured before their evacuation to hospital-type medical institutions and primary (ambulance) medical care;

Rendering to the injured before their evacuation to hospital-type medical institutions and urgent measures of specialized medical care.

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

First aid is a set of simple measures to save the life and health of the victim at the scene.

According to Art. 31 of the Federal Law of November 21, 2011 No. 323-FZ "On the basics of protecting the health of citizens in the Russian Federation":

1. First aid prior to the provision of medical care is provided to citizens in case of accidents, injuries, poisoning and other conditions and diseases that threaten their life and health, by persons who are obliged to provide first aid in accordance with federal law or with a special rule and who have appropriate training, in including employees of the internal affairs bodies of the Russian Federation, employees, military personnel and employees of the State Fire Service, rescuers of emergency rescue units and emergency rescue services.

2. The list of conditions under which first aid is provided and the list of first aid measures are approved by the authorized federal executive body.

The obligation to provide first aid to police officers is assigned by the Federal Law of 07.02.2011 No. 3-FZ "On the Police".

In accordance with Art. 12 of this law, the police are entrusted with the following duties:

Provide first aid to persons who have suffered from crimes, administrative offenses and accidents, as well as to persons who are in a helpless state or in a state dangerous to their life and health, if specialized assistance cannot be received by them in a timely manner or is absent (clause 3 of part .one);

To take urgent measures in emergency situations to save citizens, protect property left unattended, to promote the uninterrupted work of rescue services in these conditions; ensure public order during quarantine measures during epidemics and epizootics (clause 7, part 1).

In accordance with Art. 27 of the Federal Law "On the Police" - a police officer, regardless of his position, location and time of day, is obliged to give first aid citizens who have suffered from crimes, administrative offenses and accidents, as well as citizens who are in a helpless state or in a state dangerous to their life and health.

The list of conditions under which first aid is provided, as well as the list of first aid measures, were approved by Order of the Ministry of Health and Social Development of the Russian Federation No. 477n dated May 4, 2012. (as amended by the order of the Ministry of Health of Russia dated 07.11.2012 No. 586n).

List of conditions under which first aid is provided:

1. Absence of consciousness.

2. Stopping breathing and circulation.

3. External bleeding.

4. Foreign bodies of the upper respiratory tract.

5. Injuries to various areas of the body.

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

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

8. Poisoning.

The list of first aid measures includes:

1. Measures to assess the situation and ensure a safe environment for first aid:

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

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

Elimination of threatening factors for life and health;

Termination of the effect of damaging factors on the victim;

Estimation of the number of victims;

Extraction of the victim from the vehicle or other hard-to-reach places;

Movement of the victim.

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

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

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

Promotion of the lower jaw;

Determination of the presence of breathing with the help of hearing, sight and touch;

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

5. Measures to conduct cardiopulmonary resuscitation before the appearance of signs of life:

Hand pressure on the chest of the victim;

Artificial lung ventilation

6. Measures to maintain airway patency:

Giving a stable lateral position;

Head tilt with chin lift;

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

General examination of the victim for the presence of bleeding;

Applying a pressure bandage.

Finger pressing of the artery;

Maximum flexion of the limb in the joint;

Tourniquet application

Carrying out a head examination;

Examination of the neck;

Carrying out a breast examination;

Performing a back examination

Examination of the abdomen and pelvis;

Examination of limbs;

Applying dressings for injuries of various areas of the body, including occlusive (sealing) for chest wounds;

Carrying out immobilization (using improvised means, autoimmobilization);

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

Termination of exposure to hazardous chemicals on the victim (gastric lavage by taking water and inducing vomiting, removal from the damaged surface and washing the damaged surface with running water);

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

Thermal insulation against frostbite and other effects of exposure to low temperatures.

9. Giving the victim an optimal body position.

10. Monitoring the state of the victim (consciousness, breathing, blood circulation) and providing psychological support.

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

The main principles that should guide the provision of first aid are:

Accuracy;

expediency;

Rapidity;

calm;

Determination;

Continuity.

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

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

With changes and additions from:

In accordance with Article 31 of the Federal Law of November 21, 2011 N 323-FZ "On the Basics of Protecting the Health of Citizens in the Russian Federation" (Sobraniye Zakonodatelstva Rossiyskoy Federatsii, 2011, N 48, Art. 6724) I order:

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

The conditions under which first aid is provided, as well as the activities carried out in this case, are determined.

So, help is provided for various injuries, poisoning, frostbite, burns, external bleeding, unconsciousness, etc.

It is established how the helper should behave.

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

A number of special events are planned. Among them - cardiopulmonary resuscitation, stopping external bleeding, measures to restore airway patency.

The type of medical care is an officially established list of therapeutic and preventive measures performed in the order of self- and mutual assistance by medical personnel of a certain qualification in the system of medical and evacuation support using standard medical equipment (with the exception of self- and mutual assistance).

Types of medical care: definition, optimal terms of rendering. The volume of medical care: definition and its dependence on the current situation.

A unified process of providing medical care to the injured (sick) and their treatment, carried out in peacetime (“calm”) in one place (hospital), in an emergency is divided into several types of medical care performed sequentially and at different times as they are removed during the evacuation affected (sick) from the focus of emergency,

The type of medical care is determined by:

the place of delivery;

training of persons providing it;

availability of necessary equipment.

Using the provisions of military medicine that justified themselves, the disaster medicine service recognized the expediency of dividing the unified medical process into five types of medical care:

1. First aid.

2. First aid (paramedic) assistance

3. First medical aid.

4. Qualified medical care.

5. Specialized medical care.

In general terms, the first four types of medical care (first, pre-medical, first medical and qualified) pursue similar goals, namely;

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

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

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

First aid- this is a type of medical care that includes a certain list of the simplest therapeutic and preventive measures performed directly at the site of the lesion or near it in the order of self-help and mutual assistance, as well as participants in emergency rescue operations (or medical workers) using standard and improvised means. First aid is provided in order to save the lives of the affected (patients), prevent the development of severe complications in them (eliminate the causes that can aggravate the condition of the affected and lead to death) and prepare them for further evacuation.

The optimal time for first aid is the first 30 minutes from the moment of injury (disease), and when breathing stops, this time is reduced to 5-10 minutes. The absence of assistance within 1 hour after the defeat increases the number of deaths among the seriously injured by 30%, up to 3 hours - by 60%, up to 6 hours - by 90%. Of those killed on the battlefield in Afghanistan, about 10% died from uncontrolled external bleeding from the distal extremities. According to the WHO, every 20 out of 100 people who die in peacetime accidents could have been saved if medical care had been provided to them at the scene.

The effectiveness of first aid is assessed, first of all, by preventing death among the victims during the first day after the disaster. So, for example, in the explosion at the railway station in Arzamas (1988), the potential mortality should have been 6%, while the actual one turned out to be 7% (the effectiveness of first aid was 0.85). In Bashkiria (a gas explosion on a product pipeline in 1989, a railway accident), the potential mortality should have been 12%, the actual mortality was 21% (0.57), in Armenia the corresponding figures are 15% and 62% (0.25).

The second indicator of the timeliness and quality of first aid is the frequency of complications of open injuries (wounds). If the frequency of complications in the rapid (immediate) provision of medical care is taken as the initial value of 100%, then in the provision of medical care after 30 minutes the frequency of complications will be 108%, up to 3 hours - 115%, and over 3 hours - 172%.

Thus, medical assistance is considered timely only when it saves the life of the affected (patient) and prevents the development of dangerous complications in him.

The list of first aid measures includes:

- termination of exposure to factors that can aggravate the condition of the affected (sick) or lead to death (extraction of victims from rubble, from fires, shelters, extinguishing burning clothes, putting on a gas mask in the infection zone, carrying out partial sanitization);

- Restoration of the patency of the upper respiratory tract (clearing them of mucus, blood, possible foreign bodies, fixing the tongue when it retracts, giving a certain position to the body);

- artificial ventilation of the lungs by the method of "mouth-to-mouth" and manual methods;

- carrying out an indirect heart massage;

- temporary stop of external bleeding (finger pressure of the vessel, application of a pressure bandage, twist, tourniquet);

- imposition of primary dressings for wounds and burns, occlusive dressing for open pneumothorax;

· - Immobilization with improvised means and simple splints for fractures, extensive burns and crushing of soft tissues of the extremities;

- the introduction of painkillers and antidotes;

· - "tubeless" gastric lavage (artificial induction of vomiting) in case of ingestion of chemical and radioactive substances into the stomach;

· - iodine prophylaxis, taking radioprotectors and antiemetics when exposed to ionizing radiation;

- the use of means of non-specific prevention of infectious diseases.

First aid- this is a type of medical care that is an addition to first aid, including a certain list of therapeutic and preventive measures performed by paramedical personnel (paramedic or nurse) in the affected area (center) using standard medical equipment. First aid aims to eliminate and prevent disorders (bleeding, asphyxia, convulsions, etc.) that threaten the life of the affected (patients) and prepare them for further evacuation.

The optimal time for first aid is no later than one hour after being defeated.

In addition to first aid measures, pre-hospital medical care includes:

· - elimination of asphyxia (toilet of the oral cavity and nasopharynx, if necessary, the introduction of an air duct, oxygen inhalation, artificial ventilation of the lungs with a manual breathing apparatus of the "AMBU" type);

- control over the correct application of a tourniquet, bandages, splints and, if necessary, their correction and addition using standard medical equipment;

- the use of painkillers, cardiovascular, anticonvulsants, respiratory analeptics, antidotes;

- drug prevention of wound infection;

- infusion of infusion means;

· - additional degassing (in case of infection with agents and hazardous substances), decontamination of exposed skin areas and adjacent areas of clothing;

- warming the victim, giving a plentiful warm drink (in the absence of vomiting and data for an injury to the abdominal organs) with the addition of 0.5 teaspoon of soda and salt per 1 liter of liquid, alcohol.

First aid is a type of medical care that includes a set of therapeutic and preventive measures performed by doctors (usually at the stage of medical evacuation) using standard medical equipment and aimed at eliminating the consequences of lesions (diseases) that directly threaten the lives of the affected (patients), as well as prevention of complications and preparation of the affected (patients), if necessary, for further evacuation.

The optimal time for first aid is the first 4-6 hours from the moment the lesion is received.

It has been established that shock 1 hour after injury may be irreversible. Among the causes of death, injury incompatible with life ranks first, traumatic shock ranks second, and acute blood loss ranks third. When carrying out anti-shock measures in the first 6 hours after injury, mortality is reduced by 25-30%. Approximately 1/3 of the victims die slowly, so in the first 6 hours they can be saved with the proper organization of medical and evacuation measures in emergency situations.

The main measures of first medical aid are divided by urgency into urgent and measures, the implementation of which in the current situation can be involuntarily delayed and transferred to the next stage of medical evacuation.

Urgent actions include:

- temporary stop of external bleeding (introduction of a tampon into the wound with skin sutures, stitching of the vessel in the wound, clamping the bleeding vessel, monitoring the correctness and expediency of applying a tourniquet or applying a tourniquet if indicated);

- elimination of asphyxia (suction of mucus, vomit and blood from the upper respiratory tract, introduction of an air duct, stitching of the tongue, cutting off or hemming of hanging flaps of the soft palate and lateral parts of the pharynx), artificial ventilation of the lungs, oxygen inhalation,

- inhalation of ethyl alcohol vapors with pulmonary edema, the imposition of an occlusive dressing with open pneumothorax, puncture of the pleural cavity or thoracocentesis with tension pneumothorax, tracheostomy according to indications);

- Carrying out anti-shock measures (transfusion of blood and blood substitutes in case of significant bleeding, carrying out novocaine blockades, administration of painkillers and cardiovascular drugs);

- transport immobilization (or its improvement) in case of bone fractures and extensive soft tissue injuries that threaten the development of life-threatening complications, the imposition of a standard sling splint in case of jaw fractures;

- cutting off a limb hanging on a flap of soft tissues (transport amputation);

- catheterization or capillary puncture of the bladder with urine evacuation in case of urinary retention;

- carrying out measures aimed at eliminating the desorption of chemicals from clothing and allowing to remove the gas mask from people coming from the focus of chemical damage (partial sanitization of exposed skin, degassing of dressings and clothing, replacing, if possible, clothing contaminated with persistent poisonous substances, removing gas masks from the seriously wounded and seriously ill);

· - washing the eyes in case of damage to the dermal blistering agents, followed by the introduction of special eye ointments into the conjunctival sac;

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

· - administration according to indications of antidotes, antibiotics, anticonvulsants, bronchodilators, antiemetics, cardiovascular and desensitizing agents;

- the use of antitoxic serum in case of poisoning with bacterial toxins and non-specific prevention of infectious diseases;

· - gastric lavage with a probe when chemical and radioactive substances enter the stomach and giving an adsorbent.

In conditions that do not threaten the life of the wounded and sick, to first aid measures that may be delayed, relate:

· - elimination of shortcomings of the first medical and first aid (correction of dressings, improvement of transport immobilization);

- Carrying out novocaine blockades for moderate injuries;

- injection of antibiotics and seroprophylaxis of tetanus in open injuries and burns;

- change of dressing when the wound is contaminated with radioactive substances;

- the appointment of various symptomatic agents for conditions that do not pose a threat to the life of the affected (patient).

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

List of first aid measures:

1. Measures to assess the situation and ensure a safe environment for first aid:

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

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

3) elimination of threatening factors for life and health;

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

5) assessment of the number of victims;

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

7) movement of the victim.

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

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

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

2) extension of the lower jaw;

3) determining the presence of breathing with the help of hearing, sight and touch;

4) determination of the presence of blood circulation, checking the pulse on the main arteries.

5. First aid measures for cardiopulmonary resuscitation before the appearance of signs of life:

1) pressure with hands on the chest of the victim;

2) artificial respiration "Mouth to mouth";

3) artificial respiration "Mouth to nose";

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

6. First aid measures to maintain airway patency:

1) giving a stable lateral position;

3) extension of the lower jaw.

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

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

2) digital pressure of the artery;

3) application of a tourniquet;

4) maximum flexion of the limb in the joint;

5) direct pressure on the wound;

6) applying a pressure bandage.

1) examination of the head;

2) examination of the neck;

3) conducting a breast examination;

4) examination of the back;

5) examination of the abdomen and pelvis;

6) examination of the limbs;

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

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

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

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

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

9. Giving the victim an optimal body position.

10. Monitoring the state of the victim (consciousness, breathing, blood circulation) and providing psychological support.

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

(Appendix N 2 to the order of the Ministry of Health and Social Development of the Russian Federation of May 4, 2012 N 477n)