Providing first aid is necessary for a person with an injury or attack chronic disease before the arrival of a qualified medical team.

Today there are three types of medical care in different situations:

first aid,
first aid,
first medical aid.

First aid is provided by the population nearby at the time of the incident. It turns out with the help of improvised means. First aid is provided by a paramedic. The first medical is the initial set of measures to eliminate the consequences of the lesion, provided by doctors.

Thus, we can say that the first necessary aid to the victim before arrival qualified specialist each of us can provide. And sometimes, the initial knowledge necessary for this allows you to save life.

There is a first aid procedure:

determining the need for emergency care,
instant decision making on the possibility of its provision,
ambulance call,
providing first aid to the injured person, based on their own skills and strengths.

There are a number of situations where it is necessary urgent care doctors and when PMP no longer helps:

unconscious state of the patient
labored breathing,
chest pain unclear etiology,
bleeding from rapid loss blood,
sharp incessant pain in the abdomen.

In any other cases, whether to call an ambulance or not is decided individually, relying on your feelings. But do not forget that it is better to call an ambulance and make sure that such assistance was not necessary than not to receive timely medical treatment.

How to do high-quality artificial respiration and massage of the heart muscle

In the absence or rarity of one's own breathing, mouth-to-mouth artificial respiration is an effective means of restoring it. It should be done before the onset of positive dynamics or total absence signs of life with rigor mortis. There are cases when the return to life was possible several hours after the cessation of breathing.

It is necessary to carry out the following actions:

1. Lay the victim on his back on a horizontal surface.

2. Release from tight clothes, tie, belt, buttoned trousers.

3. Remove the false teeth from the mouth and remove the mucus.

4. Care is needed to ensure that the tongue does not sink, which is achieved by pushing mandible forward. This can be done in the following ways:

- Leaning with your thumbs on the edge of the lower jaw, place the remaining four fingers behind the corners of the lower jaw and push it forward a little.
- If there is no effect from the first method, you can try to insert a flat object (spoon handle, plank or metal plate) between the molars located behind. And with the help of this item, try to open your cheekbones.

To open the larynx will help the position in which the head is thrown back. In this case, one hand is placed under the back of the head, and with the help of the second, pressure is applied to the forehead area. As a result, the chin should be on the same level with the neck. This will provide best walkthrough air.

5. You can start the process of artificial respiration with a special tube or directly into the nose or mouth of the victim. It consists in inhaling air from the lungs of the person providing assistance.

6. It is necessary to firmly press the lips of the person helping to the lips of the victim and pinch the nose of the latter. It is immediately necessary to make several exhalations and then continue them at intervals of 5-6 seconds. After each exhalation, it is necessary to allow air to exit the lungs, freeing the mouth and nose.

7. For a more complete exhalation, you can slightly press on the chest. It is necessary to ensure that the patient's chest moves. Air must enter the lungs. If it was not possible to avoid getting into the stomach and instead of moving the chest, its swelling is observed, it is urgent to put pressure on upper bound diaphragms to release air. These actions should be carried out before bringing the victim to feelings or the arrival of a doctor.

During the process of artificial respiration, it is necessary to monitor the reaction of the patient. In the event that he moves his eyelids, lips or tries to swallow, you should stop the procedure and allow him to start breathing on his own. In the event that artificial respiration is continued after the start of one's own, it can be harmful. If, after a moment, the victim does not begin to breathe, you must immediately resume artificial respiration.

To bring to life together with artificial respiration, an indirect (external) heart massage is necessary. It is carried out by rhythmic pressing movements on the chest, as a result of which the heart muscle is pressed against the spine, and blood is squeezed out of it.

1. In order for the massage to be carried out more effectively, you need to provide horizontal position the victim.

2. Remove clothing from the upper body and remove all objects that squeeze the body and interfere normal breathing.

3. Having settled down on one side of the victim, you need to bend over. In the area of the lower chest, put the upper part of one hand, and on it the other hand. Pressing movements should be made with the help of inclinations own body. The push of the hands should be quick and provide pressure down the chest by 3-6 cm. It should be borne in mind that it should fall on lower part. The upper from such movements may break. Also, pressure on the area below the chest should be avoided, this can cause damage internal organs.

4. Blowing should be done between pressures. One blow should fall between 4-6 pressures. It is better if these actions are performed by two people.

If everything is absolutely correct, then after some time, the victim will notice changes:

The complexion will improve, it will acquire a pinkish tint instead of a gray-blue,
There will be independent attempts to breathe,
The pupils will decrease in size. This sign is one of the most informative.
The appearance of the victim's own pulse.

How to act in case of electric shock

All actions taken will directly depend on the condition of the victim. In order to properly evaluate it, you must:

Keep in mind that a temporary improvement in the condition of the victim may entail sharp deterioration. Only a visiting doctor can ascertain death.

What kind of help is given to the wounded?

First of all, if there is a wound, it should be taken into account that there is a possibility of bacteria getting inside, which are present on the object that caused the lesion, on the skin of the victim, on the ground or dressing material. One of the most common diseases of this nature is tetanus. It can be prevented by the administration of serum. All dressings and hands of the assisting person must be sterile processed.

When providing this type of assistance, the following basic rules should be considered:

Do not use water, ointments and powders to treat the wound inside. This will slow down the healing process and can lead to infection.
Only a doctor can clean the wound from earth, dirt and sand. If you try to do it yourself, you can bring dirt and germs even deeper.
Do not remove blood clots from the wound. They prevent infection and bleeding.
Do not use electrical tape to treat a wound.

It is necessary to provide first aid in the presence of a first aid kit with sterile dressings. A sterile napkin is applied to the wound, and a bandage is wrapped on top. At the same time, you should not touch these objects with your hands. In their absence, you can replace it with a clean cloth or a handkerchief treated with alcohol or iodine.

Types of bleeding and help with them

Bleeding may be:

Venous - follows dark blood continuously at a fairly strong pressure.
Arterial - the blood has a scarlet color, flows out in pulsating shocks.

Providing first aid for blood flowing from an artery is reduced to:

Giving a high position to the limb,
Bandaging the affected area,
With absence positive effect, it is necessary to squeeze blood vessels involved in supplying the wounded area with blood. To do this, you can bend the limb in the joint, bandage it with a tourniquet, or pinch the vessel above the wound with your fingers. They can be elastic fabric, ribbon, suspenders, belt, tie, belt. The place of application of the tourniquet must be wrapped in cloth in advance or applied over clothing.
Before applying the tourniquet must be stretched. The process of applying a tourniquet consists in preliminary stretching and further wrapping of the limb so that there are no gaps left. Do not pull too tight, as this can damage the nerve endings. The limb should be wrapped in such a way that there are no gaps left. Do not pull too tight, otherwise it will damage the nerve endings. This tourniquet is used for no more than 2 hours.
After the first hour, it is worth removing the tourniquet for a while so that blood flow to the limb is formed.

At venous bleeding:

The vein is clamped below the lesion.
A tourniquet is applied to the limb. It is necessary to fix the time so that the use of the tourniquet does not exceed 1 hour.
A sterile dressing is applied to the wound.

Assistance with special occasions bleeding

If there is a wound on the lower part of the face, pressing the artery against the edge of the jaw will help stop the bleeding.
If the temple and forehead are affected, the vessel is squeezed in front of the ear.
Bleeding with damage to the neck and head stops when squeezing the carotid artery.
The defeat of the shoulder and armpit with arterial bleeding can be eliminated by compression of the subclavian artery.
Bleeding from the fingers is stopped by compressing the arteries of the forearm, from the legs - by pressing the femoral artery.
Methods of providing first aid for the flow of blood from the nose are to apply a cold lotion to the area of the bridge of the nose and lightly compress the wings of the nose. You can insert cotton flagella with hydrogen peroxide into the nostrils. A slight tilt of the head back is desirable.

What to do if fractures occur

The main task in a fracture is to provide rest for the affected part of the body. This is necessary not only to minimize pain syndrome, but also additional damage to the soft tissues of the bone.

A fracture of the skull requires the application of cold to the head. To determine the presence of such a pathology will allow ear and mouth bleeding, lack of consciousness.
Spinal fracture is one of the most difficult cases. If there is a possibility of its occurrence, it is necessary to place a board under the victim and turn him over on his stomach, making sure that the body does not bend. This is necessary to ensure the integrity spinal cord.
A clavicle fracture is suspected if there is pain and swelling in the area. It is necessary to apply cold to the affected area, tie a hand to the neck with a rag, bend it and bandage it at a right angle to the body, after placing a ball of cotton in armpit.
With a fracture of the hand, pain, swelling, non-standard shape, movement in the place where the joint is absent is observed. First aid can be provided in the form of splinting, if for some reason this is not possible, it is necessary to wrap a hand to the body and hang it on a scarf to the neck.
fracture lower extremities determined by following symptoms: pain, swelling, irregular shape at the site of the fracture. With a fracture or dislocation femur it is necessary to lay a tire, which can be a board, stick, cardboard, plywood. It should be of such a size that it starts at the armpit and ends near the heel. If necessary, it is possible to apply another splint for the entire length of the leg. The splint is attached to the limb with a bandage or tissue flap in several places, avoiding the site of injury.
A rib fracture is characterized by pain during inhalation and exhalation, coughing and physical activity. The first aid technique in this case is to tightly wrap the chest during exhalation.

If there is reason to believe that the victim did not receive a fracture or dislocation, it will be enough to apply cold to the bruised area. In case of bruising of the abdomen with severe pain, as well as fainting, it is necessary to call an ambulance to exclude damage to internal organs with bleeding.

What to do with burns

Burns can be of four degrees. Their definition depends on the amount of affected tissue and depth:

The first degree is characterized only by reddening of the skin,
The second is the appearance of blisters,
The third is the partial death of tissues on the damaged segment of the skin,
Fourth - necrosis of the skin to the full depth to the bone.

The way to help, characteristic of any type of burn - water, steam, fire, hot objects is:

Gently removing clothing without touching the wound. It is better to use scissors for this.
Bandaging the wound with sterile materials.
Sending the victim to the hospital in case of severe burns.

You cannot do the following:

lubricate the wound with any ointments and oils, this will only increase the healing time.
pierce or burst blisters,
tear off the remnants of burnt objects - clothes, resinous substances - from the skin.

When the skin is damaged by acids - hydrochloric, sulfuric and nitric - it is necessary:

Urgent flush under a strong stream of water for a quarter of an hour. If such rinsing is not possible, a container with large quantity water, where you can lower the affected part of the body and actively move it inside.
Use a solution of potassium permanganate or a 10% solution of baking soda for washing.
Cover the affected skin with gauze impregnated with oil and lime water, taken in equal amounts.
In case of damage to the eyes, they should be washed with a 5% solution of soda.
If the respiratory tract is affected, you can use a spray gun with soda solution for spraying and inhalation.

How to deal with frostbite

Such cases naturally arise in winter time and with them you need to do the following:

Rub the frozen areas with warm knitted gloves. Snow cannot be used for this. This will cause even more ice crystal damage.

Having brought the victim into the room, it is necessary to lower the affected part of the body into a basin filled with water at room temperature. As sensation resumes, the water should be gradually diluted with warmer water, eventually bringing it up to body temperature.
Then you can use greasy creams and oils to lubricate the affected area.
Bandage the affected area with a warm cloth.
As a prevention of complications, experts advise to raise the affected limb.

How to remove a foreign body

Remove what is under the skin foreign body can only be completely. In case of any difficulties, it is better to immediately consult a doctor. After removing the foreign body, the wound is treated around with iodine, then a bandage is applied.

In case of contact with the eye, it is necessary to rinse with a solution boric acid or tap water. The process is carried out using a jet of water from a pipette, kettle, cotton wool or bandage. You need to put the person on the side where the eye was not injured, and pour the washing solution from the corner of the eye with outside to the inside.

If there is a foreign body in the airways or esophagus, do the following few tricks:

Turn the victim with his back to you and apply 5 blows between the shoulder blades with the base of the palm.
If the foreign body has not yet been removed, perform the Heimlich maneuver: stand behind the victim and clasp him with both hands around the waist, then clench one hand into a fist and firmly grip the fist with the other. Next, press your fist to your stomach and make a sharp movement inward and upward. Repeat this 5 times.

What to do with heat stroke and fainting

If there are signs of sunstroke: weakness, headache, changes in pulse, respiration, the appearance of convulsions - a person needs:

Place in the shade or room with low temperature,
lay down,
undress,
Cool down the body using fanning,
sprinkle cold water,
Moisten the chest and head.

With thermal and sunstroke often there is presyncope or fainting accompanied by dizziness, vomiting, darkening of the eyes, loss of consciousness. First aid for quitrents is:

Laying the victim on a horizontal surface with raised legs and lowered head.
Bringing a fleece with ammonia to the nose.
Drinking for the injured cold water.
In the absence of own breathing, it is necessary to use artificial methods.

Help with poisoning

In case of poisoning with toxic substances, the victim should receive assistance in the form of:

Gastric lavage. It can be done by taking 3-4 glasses of water or weak solution potassium permanganate followed by induction of vomiting. It is advisable to repeat several times.
Subsequent consumption of large amounts of milk and egg white.
Providing the victim with an influx of oxygen.
Ensuring rest in bed with a warm blanket.

How to help the drowning

First of all, a person must be removed from the water,
A person who has been pulled out of the water after drowning has airways containing a large number of water. To remove it, the victim must be put upside down, resting his chest on the hip of the rescuer.
Open the victim's mouth and remove, if possible, water from the upper respiratory tract.
Then start artificial respiration. If the drowned person is white skin, you can start artificial respiration immediately after extraction from the water.

Knowing the main ways to provide assistance before the arrival of doctors, you can save a person’s life and avoid serious complications.

The provision of first aid is to provide the victim right at the scene of a complex of the simplest and most elementary medical actions. It is carried out by people who were close to the victim. As a rule, the provision of first aid occurs in the first thirty minutes after the injury.

What is trauma?

Trauma is a deterioration in a person's well-being and health as a result of negative influence any factor individually or together: physical, chemical, biological. If the incident occurred at work, then a person may suffer for socio-psychological, organizational, technical and other reasons.

Providing first aid to victims can help prevent severe and irreversible consequences injury.

Universal first aid instructions

A person can get injured at home, at the workplace and even on a walk. No matter where he is injured, there is a standard set of first aid rules.

The environment needs to be assessed. That is, whether the victim is close to the threat of fire, a possible explosion, collapse, and so on.
The next step is to take steps to avoid possible danger both for the victim himself and for the person who provides first aid (for example, taking the victim out of the fire, electric shock zones, etc.).
Then the total number of victims and the severity of their injuries are determined. First of all, first aid is provided to people with the most severe injuries.
Now the first aid is being rendered to the injured:

if the victim is unconscious and he has no pulse on the carotid artery, then resuscitation should be carried out (revival);
if the victim is unconscious, but his pulse is felt, then it is necessary to bring him to consciousness;
if the victim has an injury, then with arterial bleeding a tourniquet is applied, and with signs of fractures, transport tires are applied;
if there are wounds on the body, then a bandage should be applied.

Injuries at the enterprises

At any enterprise, especially if it is a production workshop, it is provided not only for safety briefings, the availability of plans and instructions for providing first aid, but also the presence of filled first-aid kits and special posters in the places of duty. They should schematically depict the procedure for carrying out measures to provide assistance to victims.

The first-aid kits located at the duty stations of the production workshop must contain the following medicines and things, without which first aid in case of accidents is impossible:

For overlay various dressings and tourniquets - individual dressing bags, bandages and cotton wool.
For bandaging fractures and their fixation - cotton-gauze bandages and splints.
To stop heavy bleeding- harnesses.
For cooling bruises and fractures - an ice pack or a special cooling bag.
A small drinking bowl - for washing the eyes and taking medicines.
When fainting - a bottle or ampoules of ammonia.
For disinfection of wounds - iodine, brilliant green, hydrogen peroxide.
For washing and lubricating burns - 2% or 4% solution of boric acid, 3% solution of baking soda, petroleum jelly.
Validol and other cardio drugs - with severe heart pain.
Tweezers, scissors, pipette.
Soap and towel.

First aid in the production workshop

First aid at work is as follows:

Carrying out all the procedures described in the first aid instructions. That is, assessing the situation, ensuring safety and providing first aid.
Calling an ambulance. That is, dial a centralized number both in Russia and in Ukraine - “OZ”. In the service, it is necessary to describe in detail and at the same time quickly the type of damage and under what circumstances it was received.
Fixing the time, causes and type of accident, as well as the condition of the victim and a description of the measures that were taken before the doctors arrived. All this information is transferred to the arriving doctor.
Monitoring the health of the victim and staying in constant contact with him until the arrival of an ambulance.

electrical injury

Electrical injury is the result of a person's contact with any source of electricity.

Electrical injury symptoms:

feeling general weakness body (for example, rapid or labored breathing, rapid heartbeat and so on);
there may be a reaction to noise and light.

Providing first aid with electric shock to affected people:

First of all, the victim must be relieved of the effects of electric current on him. This can be done with the help of improvised means (for example, a rope, a dry board, and so on) or by turning off the network.
Assistance to the victim is provided by a person who must wrap his hands with rubberized cloth or wear special gloves. If there is nothing similar nearby, then suitable dry the cloth.
The victim is touched in those places where the clothes do not fit snugly to the body.
If the person is not breathing, then resuscitation is necessary.
To prevent pain shock The patient is given pain medication.
An aseptic bandage is applied to the affected area.

Thermal burns

Thermal burns are the result of exposure high temperature from fire, boiling water, steam and anything else on the tissue of the body. Such damage is divided into four degrees, each, in turn, is characterized by its own symptoms:

the first degree - there is hyperemia and swelling of the skin;
second degree - blisters appear on the skin that are filled with liquid, there is also a burning pain;
third degree: phase A - necrosis spreads, phase B - necrosis is distributed to all layers of the skin;
fourth degree - there is necrosis of damaged skin, adjacent areas, as well as tissues.

First aid in case of damage by thermal factors:

It is necessary to immediately stop the effect of the thermal reagent on the victim (for example, knock the fire off clothes with water, cloth, sand, and so on).
Next, shock prevention is carried out - painkillers are given to the victim.
If the clothing is not stuck to the body, but is damaged, then it must be disposed of (cut off).
Aseptic dressings are applied to clean damaged areas.
All other actions must be done by a doctor.

Stop bleeding

According to their types of bleeding are divided into capillary, arterial, mixed.

The main task of the person who provides first aid is to stop bleeding and prevent infection from entering the wound.

Rules for first aid for bleeding:

If the bleeding is capillary and light (shallow), then the wound is treated antiseptic and a sterile dressing is applied.
If the bleeding is strong and arterial or mixed, then it is necessary to apply a tourniquet, under the bottom of which a cotton-gauze pad and a note with the time of its application are placed.

If foreign objects are present in the wound, they must be carefully removed with tweezers. The skin around the injury is treated with antiseptic agents.

Dislocations and fractures

From the first time, it is very difficult to determine a dislocation or fracture (especially if it is closed). To do this, you need to take an x-ray.

Therefore, the rules for providing first aid before the arrival of an ambulance for dislocations and fractures are the same and consist in performing a set of the following actions:

The victim is placed in a comfortable position for him.
A bandage is applied to the affected area. If the fracture is obvious, then a splint is applied.
At severe pain the victim is given pain medication to prevent shock.
If the fracture is open, then the skin adjacent to the damaged area is disinfected, and a cotton-gauze pad is applied to the wound. Then everything is re-bandaged.

Resuscitation - artificial respiration

In production, cases are not ruled out when a person may stop breathing. This can be both the result of an injury, and due to the personal characteristics of the body.

If this happens, then the victim must be urgently resuscitated. For this, artificial respiration or indirect heart massage is performed.

First aid instructions for respiratory arrest:

The victim is turned over on his back and placed on a hard surface.
The person conducting resuscitation should close the victim's nose with one hand, and open his mouth with the other.
The person assisting draws air into the lungs, tightly presses his lips to the lips of the victim and energetically releases the air. In this case, it is necessary to observe the chest of the victim.
Sixteen to twenty breaths are taken in one minute.

Artificial respiration should be continued until:

the victim will not fully recover breathing;
a medical worker (doctor or nurse) will not arrive;
there were signs of death.

If artificial respiration fails, but death is not established, then it is necessary to proceed with an indirect heart massage.

Indirect cardiac massage

Thanks to this procedure, the victim resumes blood circulation.

The person providing first aid must know the location of the heart - between the sternum (movable flat bone) and the spine. When you press down on your sternum, you feel your heart contract. As a result, blood begins to flow from it into the vessels.
First, a person takes two breaths using the mouth-to-mouth artificial respiration technique.
Then one palm moves to the lower half of the sternum (this is two fingers higher from its lower edge).
The second palm is placed on the first perpendicular or parallel.
Further, the assisting person presses on the victim's sternum, helping himself by tilting the body. During this procedure, the elbows do not bend.
The pressure is carried out quickly, during execution the sternum goes down four centimeters for half a second.
Between pushes it is necessary to do half-second intervals.
Indentations alternate with breaths. For every 15 compressions, 2 breaths are taken.

It is more effective to carry out an indirect heart massage together - one person makes pressure, the other - inhales.

What can not be done when providing first aid?

During first aid, in no case should you do the following:

apply excessive force (for example, press on the chest during resuscitation, pull tourniquets and bandages, and so on);
when performing a mouth-to-mouth breathing procedure, pads (for example, gauze) should not be used;
it is necessary to determine the signs of breathing very quickly, it is impossible to waste precious time;
with severe arterial bleeding, one should not waste time on releasing the victim from clothing;
if the victim has various origins burns (for example, from fire or as a result of chemical exposure), they must not be washed with fats and oils, used alkaline solutions, rip off their clothes, pierce burn blisters and peel off the skin.

First aid points. What to do if fractures occur

The manual of the Ministry of Emergency Situations of Russia will help you not to get lost in difficult situation participants in the accident, eyewitnesses heart attack in a sick person. The book also lists first aid algorithms for traumatic injuries and emergency conditions. Such as external bleeding from injuries, abdominal wounds, penetrating chest wounds, bone fractures and thermal burns, as well as hypothermia and frostbite. Readers will learn how to behave properly in order to actually help someone who is struck by an electric shock or swallowed water in the river, or maybe became a victim of serious poisoning. The manual also contains recommendations for assistance in case of injuries and chemical burns to the eyes, bites from poisonous snakes, insects, as well as heat and sunstroke.

1. Priority actions in the provision of first aid to the sick and injured

First of all, help is given to those who are suffocating, who have profuse external bleeding, penetrating wounds of the chest or abdomen, who are in an unconscious or serious condition.

	Make sure you and the victim are safe. Use medical gloves to protect against biological fluids the victim. Remove (bring) the victim to a safe area.
	Determine the presence of a pulse, spontaneous breathing, pupillary reaction to light.
	Ensure patency of the upper respiratory tract.
	Restore breathing and heart activity by applying artificial respiration and chest compressions.
	Stop external bleeding.
	Apply a sealing bandage to the chest for a penetrating wound.

Only after stopping external bleeding, restoring spontaneous breathing and heartbeat, do the following:

2. The order of cardiopulmonary resuscitation

2.1. Rules for determining the presence of a pulse, spontaneous breathing and pupillary response to light (signs of "life and death")

Start resuscitation only if there are no signs of life (points 1-2-3).

2.2. Sequence artificial ventilation lungs

	Ensure patency of the upper airway. Using gauze (handkerchief), remove mucus, blood, other foreign objects.
	Tilt the victim's head back. (Lift the chin while holding the cervical spine.) Do not perform if a fracture is suspected cervical spine!
	Pinch the victim's nose with a large one and index fingers. Using a device for artificial ventilation of the lungs of the "mouth-device-mouth" type, seal the oral cavity, make two maximum, smooth exhalations into his mouth. Allow two to three seconds for each passive exhalation of the victim. Check whether the victim's chest rises when inhaling and falls when exhaling.

2.3. Rules for conducting a closed (indirect) heart massage

The depth of pushing through the chest should be at least 3-4 cm, 100-110 pressures in 1 minute.

	- children infancy massage is performed with the palmar surfaces of the second and third fingers; - for teenagers - with the palm of one hand; - in adults, the emphasis is on the base of the palms, thumb directed at the head (legs) of the victim. The fingers are raised and do not touch the chest.
	Alternate two "breaths" of artificial lung ventilation (ALV) with 15 pressures, regardless of the number of people conducting resuscitation.
	Control your heart rate carotid artery, reaction of pupils to light (determination of the effectiveness of resuscitation).

It is necessary to carry out a closed heart massage only on a hard surface!

2.4. Removal of a foreign body from the respiratory tract using the Heimlich maneuver

Signs: The victim is suffocating (convulsive respiratory movements), unable to speak, suddenly becomes bluish, may lose consciousness.

Children often inhale parts of toys, nuts, candies.

	Place the baby on the forearm of the left hand, palm right hand slap 2-3 times between the shoulder blades. Turn the baby upside down and lift him by the legs.
	Grab the victim from behind with your hands and clasp them into a “lock” just above his navel, under the costal arch. With force, sharply press - with brushes folded into a "castle" - into the epigastric region. Repeat the series of pressures 3 times. Pregnant women squeeze lower divisions chest.
	If the victim is unconscious, sit on top of the thighs, with both palms, sharply press on the costal arches. Repeat the series of pressures 3 times.
	Extract foreign object fingers wrapped in a napkin, bandage. Before removing a foreign body from the mouth of the victim, lying on his back, turn his head to one side.

IF DURING THE REANIMATION DURING THE REANIMATION THE INDEPENDENT BREATHING, THE HEART RATE DO NOT RECOVER, AND THE PUPILS REMAIN DIFFERENT FOR 30-40 MINUTES AND THERE IS NO HELP, THERE SHOULD BE CONSIDERED THAT THE VICIOUS BIOLOGICAL DEATH HAS COME.

3. Algorithms for providing first aid to victims of traumatic injuries and emergency conditions

3.1. First aid for external bleeding

	Make sure that nothing threatens either you or the victim, put on protective (rubber) gloves, take out (bring) the victim out of the affected area.
	Determine the presence of a pulse on the carotid arteries, the presence of independent breathing, the presence of a reaction of the pupils to light.
	With significant blood loss, lay the victim with raised legs.
	Stop the bleeding!
	Apply (clean) aseptic bandage.
	Ensure the immobility of the injured part of the body. Put a cold (ice pack) on the bandage over the wound (on the sore spot).
	Place the victim in a stable lateral position.
	Protect the victim from hypothermia, give plenty of warm sweet drinks.

Pressure points for arteries

3.2. Ways to temporarily stop external bleeding

Clamp the bleeding vessel (wound)

Finger pressure on the artery is painful for the victim and requires great endurance and strength from the caregiver. Before applying a tourniquet, do not release the pressed artery so that bleeding does not resume. If you start to get tired, ask someone from those present to press your fingers from above.

Impose pressure bandage or perform wound tamponade

Apply a hemostatic tourniquet

A tourniquet is an extreme measure to temporarily stop arterial bleeding.

	Apply a tourniquet to a soft lining (items of the victim's clothing) above the wound as close to it as possible. Bring the tourniquet under the limb and stretch.
	Tighten the first turn of the tourniquet and check the pulsation of the vessels below the tourniquet or make sure that the bleeding from the wound has stopped and the skin below the tourniquet has turned pale.
	Apply subsequent turns of the tourniquet with less force, applying them in an ascending spiral and grabbing the previous turn.
	Put a note with the date and exact time under the tourniquet. Do not cover the tourniquet with a bandage or splint. In a conspicuous place - on the forehead - make the inscription "Tourniquet" (with a marker).

The duration of the tourniquet on the limb is 1 hour, after which the tourniquet should be loosened for 10-15 minutes, after clamping the vessel, and tightened again, but not more than 20-30 minutes.

Stopping external bleeding with a twist tourniquet (a more traumatic way to temporarily stop bleeding!)

	Apply a tourniquet-twist (turnstile) from narrowly folded improvised material (fabric, scarves, ropes) around the limb above the wound over clothing or by placing the fabric on the skin and tie the ends with a knot so that a loop forms. Insert a stick (or other similar object) into the loop so that it is under the knot.
	Rotating the stick, tighten the twist tourniquet (tourniquet) until the bleeding stops.
	Secure the stick with a bandage to prevent it from unwinding. Loosen the tourniquet every 15 minutes to prevent tissue death in the limb. If the bleeding does not come back, leave the tourniquet open, but keep it on in case of rebleeding.

3.3. First aid for abdominal wounds

	It is impossible to set the prolapsed organs into abdominal cavity. It is forbidden to drink and eat! Wet your lips to quench your thirst.
	Place a roll of gauze bandages around the fallen organs (protect the fallen internal organs).
	Apply an aseptic dressing over the rollers. Without pressing the fallen organs, bandage the bandage to the stomach.
	Apply cold to the bandage.
	Protect the victim from hypothermia. Wrap yourself in warm blankets and clothes.

3.4. First aid for penetrating chest injury

Signs: bleeding from a wound on the chest with the formation of bubbles, suction of air through the wound.

	If there is no foreign object in the wound, press your palm to the wound and close the air in it. If the wound is through, close the inlet and outlet wound openings.
	Cover the wound with an airtight material (seal the wound), fix this material with a bandage or plaster.
	Give the victim a semi-sitting position. Apply cold to the wound with a cloth pad.
	If there is a foreign object in the wound, fix it with bandage rollers, plaster or bandage. It is forbidden to remove foreign objects from the wound at the scene of the incident!

Call (on your own or with the help of others)" ambulance",

3.5. First aid for nosebleeds

Causes: trauma to the nose (blow, scratch); disease (high arterial pressure, decreased blood clotting); physical stress; overheating.

	Sit the victim down, slightly tilt his head forward and let the blood drain. Squeeze the nose just above the nostrils for 5-10 minutes. In this case, the victim must breathe through his mouth!
	Invite the victim to spit out blood. (If blood enters the stomach, vomiting may occur.)
	Apply cold to the bridge of your nose (wet handkerchief, snow, ice).
	If the bleeding from the nose does not stop within 15 minutes, insert rolled-up gauze swabs into the nasal passages.

If the bleeding does not stop within 15-20 minutes, send the victim to a medical facility.

3.6. First aid for broken bones

Call (on your own or with the help of others) an ambulance.

3.7. Rules of immobilization (immobilization)

Immobilization is obligatory event. Only in case of a threat to the injured rescuer is it permissible to first move the injured to a safe place.

	Immobilization is performed with immobilization of two adjacent joints located above and below the fracture site.
	Flat narrow objects can be used as an immobilizing agent (tire): sticks, boards, rulers, rods, plywood, cardboard, etc. Sharp edges and corners of improvised tires should be smoothed. The tire after application must be fixed with bandages or plaster. A splint for closed fractures (without skin damage) is applied over clothing.
	At open fractures do not apply the splint to places where bone fragments protrude.
	Attach the tire along its entire length (excluding the level of the fracture) to the limb with a bandage, tightly, but not very tight, so that blood circulation is not disturbed. In case of a fracture of the lower limb, the splint should be applied on both sides.
	In the absence of splints or improvised means, the injured leg can be immobilized by bandaging it to healthy leg and the arm to the body.

3.8. First aid for thermal burns

Call (on your own or with the help of others) an ambulance. Ensure the transfer of the victim to the burn department of the hospital.

3.9. First aid for general hypothermia

Call (on your own or with the help of others) an ambulance.

With signs of your own hypothermia, fight sleep, move; use paper, plastic bags and other means to insulate your shoes and clothes; seek or build shelter from the cold.

3.10. First aid for frostbite

In case of frostbite, use oil or petroleum jelly; it is forbidden to rub frostbitten parts of the body with snow.

Call (on your own or with the help of others) an ambulance, ensure the delivery of the victim to a medical facility.

3.11. First aid for electric shock

Call (on your own or with the help of others) an ambulance.

	Determine the presence of a pulse on the carotid artery, the reaction of the pupils to light, spontaneous breathing.
	If there are no signs of life, perform cardiopulmonary resuscitation.
	When restoring spontaneous breathing and heartbeat, give the victim a stable lateral position.
	If the victim has regained consciousness, cover and warm him. Monitor his condition before arrival medical personnel, cardiac arrest may occur.

3.12. First aid for drowning

Call (on your own or with the help of others) an ambulance.

3.13. First aid for traumatic brain injury

Call (on your own or with the help of others) an ambulance.

3.14. First aid for poisoning

3.14.1. First aid for oral poisoning (when a toxic substance enters through the mouth)

Call an ambulance urgently medical care. Find out the circumstances of the event drug poisoning present the medicine wrappers to the arriving health worker).

If the victim is conscious

If the victim is unconscious

Call (on your own or with the help of others) an ambulance, ensure the delivery of the victim to a medical facility.

3.14.2. First aid for inhalation poisoning(when a toxic substance enters through the respiratory tract)

Signs of carbon monoxide poisoning: pain in the eyes, ringing in the ears, headache, nausea, vomiting, loss of consciousness, redness of the skin.

Signs of household gas poisoning: heaviness in the head, dizziness, tinnitus, vomiting; sharp muscle weakness, increased heart rate; drowsiness, loss of consciousness, involuntary urination, blanching (blue) of the skin, shallow breathing, convulsions.

Call an ambulance.

4. First aid algorithms for acute diseases and emergency conditions

4.1. First aid for a heart attack

Signs: sharp pain in the chest, radiating to the left upper limb, accompanied by "fear of death", palpitations, shortness of breath.

Call, instruct others to call an ambulance. Ensure receipt fresh air, unfasten tight clothing, give a semi-sitting position.

4.2. First aid for eye injuries

4.2.1. When hit by foreign bodies

Ensure the transfer of the victim to a medical facility.

4.2.2. At chemical burns eye

The victim should only move by the hand with the accompanying person!

When exposed to acid you can wash your eyes with a 2% solution baking soda(per glass boiled water add baking soda to the tip of a table knife).

When exposed to alkali you can wash your eyes with a 0.1% solution of citric acid (add 2-3 drops of lemon juice to a glass of boiled water).

4.2.3. In case of eye and eyelid injuries

The victim must be in the "lying" position.

Ensure the transfer of the victim to a medical facility.

4.3. First aid for poisonous snake bites

Limit the movement of the affected limb.

If consciousness is not restored for more than 3-5 minutes, call (on your own or with the help of others) an ambulance.

4.6. First aid for heat (sun) stroke

Signs: weakness, drowsiness, thirst, nausea, headache; increased breathing and fever, loss of consciousness are possible.

Call (on your own or with the help of others) an ambulance.

O HIV may be the primary damaging agent for the lung parenchyma and lead to the development of a syndrome similar to emphysema.

SaO2 may decrease in cirrhosis of the liver - apparently due to pulmonary arteriovenous anastomoses and anastomoses between the portal and pulmonary veins.

What is First Aid?

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

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

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

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

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

Who can and who is obliged to provide First Aid?

Legal basis providing First Aid:

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

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

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

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

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

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

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

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

The ER doctor stood on the porch, smoking, inhaling deeply, swearing silently. Then he turned to me and burst out:
- No, well, wow ... well, what kind of freaks ... they brought a person from an accident. His spine was broken, and they pulled him out of the car by the arms, then they put him in the back seat of the Oka and to us. Collected - everything would be fine. And now a cripple for life - will not walk. And where do the well-wishers come from...
He also cursed these eyewitnesses of the accident, then threw the bull into the urn, spat angrily and left. And I was left to stand and think - what is happening on our roads with what is correctly called "providing first aid."

car accident. Accident. Affected people. Injuries, blood, screams, pain. And you are a casual witness or, God forbid, a participant in what is happening. Every driver has a potential chance to be in such a situation. And then the question arises - what to do? How can you help people injured in an accident? Should I rush to help or just call an ambulance and stand on the sidelines and wait for the specialists to arrive?
Everyone's first impulse normal person, especially who grew up in Russia and absorbed the principle “die yourself, but help a comrade” with mother’s milk - to help. But, alas, how often people, trying to help the victims, harm them and, what is even worse, harm themselves.

A simple and common example: a man was walking down the street. Walked, and suddenly fell. Dressed decently, not drunk, not sick - at least outwardly. Obviously, something happened to him and he needs help. Around the lying, as a rule, a crowd gathers. And these are not onlookers, but people who want to help. However, no one dares to approach first. Why? Yes, because no one knows what to do and how to do it. As soon as someone appears who has begun to act, those around him are ready to do whatever he says. But for now, stand and watch. Some are shocked, some are confused. Someone is simply afraid to do anything, remembering the stories in which the person who tried to help did even worse and ended up being punished. Our trouble is that the drivers do not know how to help properly. In Europe and the United States, standards for first aid have long been in place - a clear algorithm that allows you to do everything possible before the arrival of specialists - efficiently, quickly and safely. In Russia, until now, drivers, preparing to obtain a license, memorize the answers to several questions about medical care, which are completely out of touch with reality. Sometimes the basics of first aid are also taught in driving schools, but, as a rule, fragmentary and unsystematic. What can we talk about if 90 percent of drivers who have first-aid kits in the car do not know how to use most of the tools and preparations located there? And those who know will not always use these drugs, since the law prohibits giving him any medicines without the consent of the patient, and even more so - to do this to people who do not have a minimum medical education. By the way, about laws. If you carefully study all juristic documents concerning the provision of first aid, it will become clear that this subject itself is completely taken out of the legal field of medicine. There are articles stipulating the responsibility of medical workers. But there is nothing regulating the provision of first aid without the use of medicines. On the other hand, in our Criminal Code there are two articles relating to such situations: leaving in danger and failure to provide assistance. Example - the article "Failure to provide assistance to the sick" applies only to people who are obliged to provide this assistance in accordance with the law or with a special rule. There is no law that obliges any person, as they say, from the street, to provide assistance. The article “Leaving in danger” is a little closer to the conditions of an accident. It punishes deliberate abandonment without assistance only in cases where the perpetrator had the opportunity to provide assistance, was obliged to take care of the victim, or himself put him in a state dangerous to life or health. In fact, any person who has not done anything falls under the scope of this article. But what can the average driver or pedestrian do? He has no first aid skills, no medical education either. The only thing for which such a person can be punished is that he did not call for specialists called upon to provide this very assistance. That is, a call to an ambulance or the Ministry of Emergency Situations completely frees the eyewitness of the tragedy from the obligation to somehow act further. What happens? Yes, the fact that first aid is not an obligation, but a right. We may or may not help. The main thing is to call a doctor. And the problem is that many - for the reasons listed above - choose not to help. In addition to the lack of knowledge, there is another powerful deterrent here - the fear of responsibility if the victim is harmed or dies during the provision of assistance. What does the law say about this? But nothing. According to our legislation, even if assistance was provided incompetently, there will be no legal consequences. And if all the conditions are met - having knowledge of first aid, following the rules for its provision - a person is beyond jurisdiction, no matter what the result is.

So what is the end result? Should I help or not? Everyone must answer this for himself. Although I think that everything decent people Without hesitation, they will say: “Yes.” And then the question is - how to provide first aid correctly? That is what we want to tell you in this article. Let's take as a basis the European standard of the Red Cross - that minimum amount of knowledge, without which it is simply impossible to get a driver's license in European countries. Of course, the format of the article will not allow to fully teach all the necessary skills, but the basic information, fundamental principles we will give you. We hope this will serve as at least food for thought.

Today's topic is the doctor's call. The topic is important, necessary and undeservedly forgotten by many first aid methodologists. This is the part general algorithm assistance. Imagine an isosceles triangle. One of its peaks is you and the victim. The second is the on-duty dispatch service (DDS), an ambulance call center. The third is an ambulance. These three points are connected in series - we call and report the situation, the signal goes to the substation nearest to us and the car leaves from there. At what stage can we help? At the stage of information transfer from the Center to the substation? Hardly. But on the other two - yes, and very significantly. How are applications usually received from the public? We call by dialing 03 or - with cell phone- short number 911 or 112. The operator answers us. What should she know? Details of what happened, the circumstances? No, these details do not interest her. Relatively speaking, in front of the girl-dispatcher there is a computer in which the program for filling out the call card is open. There are several points in it, and until the first one is completed, it is impossible to move on to the second. And the very first thing that a DDS employee needs to know is the gender of the victim. Then there is age. And then - what happened, what are the symptoms. The last thing we need is an address. The more clearly and in detail we present the information, the faster the signal will reach the substation. So an example phone conversation should look like this:

Operator:
- Ambulance, I'm listening to you.
You:
- Girl, accept the application. car accident. One victim, male. Middle-aged (no need to go into details and find out exact age). Multiple wounds and bruises. Unconscious. Breathe. The address is Shchelkovskoe highway, opposite the house number 15.

Listening to you, the operator has already filled out the application and sent it to the destination. The more accurately you gave the address, the faster the ambulance will find you. In order to fully control the process, you can ask the operator for the order number of the departing brigade. It will always be possible to find out from it which car and where it left for you. In the conditions of an accident, such information does not play a significant role, but it may be useful in the future if there are any complaints about the work of doctors.

What to do if there are many victims? Upon receipt of such information, its own response mechanism is “turned on”, and several cars go to the scene of the tragedy. The rule here is simple - one victim - one car. When calling, it is important to report the exact number of people who need help. If you are not sure - name the approximate number, but in the direction of excess (we see three - we say "five").

That, in fact, is all. Simple, isn't it? The minimum set of knowledge, but how important it is sometimes to put them into practice. So remember:

Providing first aid is your right, not your obligation.
If you don't know how to help, call the experts. This in itself will be a help.
If it is wrong to call an ambulance, it will come anyway. But - much later. And maybe these very minutes will not be enough for doctors to save a person's life.

We wish you peace and confidence on the roads!

Article 124. Failure to provide assistance to a patient

Failure to provide assistance to the patient good reasons by a person obliged to provide it in accordance with the law or with a special rule, if this negligently entailed the infliction of medium-gravity harm to the health of the patient, is punishable by a fine in the amount of up to 40 thousand rubles or in the amount of wages or other income of the convicted person for a period of up to three months, or by corrective labor for a term of up to one year, or by arrest for a term of two to four months.
The same act, if by negligence it entailed the death of a patient or the infliction of grave harm to his health, is punishable by deprivation of liberty for a term of up to three years, with or without deprivation of the right to hold certain positions or engage in certain activities for a term of up to three years.
Criminal Code of the Russian Federation
Article 125. Leaving in danger
Knowingly leaving without help a person who is in a state of danger to life or health and deprived of the opportunity to take measures for self-preservation due to infancy, old age, illness or due to his helplessness, in cases where the perpetrator had the opportunity to help this person and was obliged to take care of him or he himself placed him in a state of danger to life or health, is punishable by a fine in the amount of up to 80 thousand roubles, or in the amount of the wage or salary, or any other income of the convicted person for a period of up to six months, or by compulsory works for a term of 120 to 180 hours, or correctional labor for a term of up to one year, or arrest for a term of up to three months, or imprisonment for a term of up to one year.

Algorithm for calling an ambulance.

What to tell the operator:
- sex of the victim;
- the age of the victim;
- what happened and the condition of the victim;
- the most accurate address.

"First aid - the right or a duty"
article author: Ilya Boyko, lifeguard,
magazine "Your road", issue for March-April 2008