home Adviсe Providing first aid to the injured. First aid in emergency situations - basic rules and algorithm of actions Rules for the provision of first medical

Providing first aid to the injured. First aid in emergency situations - basic rules and algorithm of actions Rules for the provision of first medical

First aid is a set of urgent measures aimed at saving a person's life. An accident, a sharp attack of illness, poisoning - in these and other emergencies, competent first aid is needed.

According to the law, first aid is not medical - it is provided before the arrival of doctors or the delivery of the victim to the hospital. First aid can be provided by anyone who is at a critical moment next to the victim. For some categories of citizens, first aid is an official duty. We are talking about police officers, traffic police and the Ministry of Emergency Situations, military personnel, firefighters.

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

First aid algorithm

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

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

Artificial respiration

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

Typical situations requiring IVL:

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

There are various ways of IVL. Mouth-to-mouth and mouth-to-nose artificial respiration is considered the most effective in providing first aid to a non-specialist.

If natural respiration is not detected during examination of the victim, it is necessary to immediately carry out artificial ventilation of the lungs.

mouth-to-mouth artificial respiration technique

Ensure patency of the upper airway. Turn the head of the victim to one side and use your finger to remove mucus, blood, foreign objects from the oral cavity. Check the victim's nasal passages, clean them if necessary.
Tilt the victim's head back while holding the neck with one hand.
Do not change the position of the head of the victim with a spinal injury!
Place a tissue, handkerchief, piece of cloth, or gauze over the victim's mouth to protect yourself from infections. Pinch the victim's nose with your thumb and forefinger. Inhale deeply, press your lips tightly against the victim's mouth. Exhale into the victim's lungs.
The first 5–10 breaths should be fast (20–30 seconds), then 12–15 breaths per minute.
Watch the movement of the victim's chest. If the victim's chest rises when inhaling air, then you are doing everything right.

Indirect cardiac massage

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

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

Attention! It is impossible to carry out a closed heart massage in the presence of a pulse.

Chest Compression Technique

Lay the victim down on a flat, hard surface. Do not perform chest compressions on a bed or other soft surfaces.
Determine the location of the affected xiphoid process. The xiphoid process is the shortest and narrowest part of the sternum, its end.
Measure 2-4 cm upward from the xiphoid process - this is the point of compression.
Place the base of your palm on the compression point. In this case, the thumb should point either to the chin or to the stomach of the victim, depending on the location of the resuscitator. Place the other hand on top of one hand, fold your fingers into the lock. Pressing is carried out strictly with the base of the palm - your fingers should not come into contact with the victim's sternum.
Perform rhythmic chest thrusts strongly, smoothly, strictly vertically, with the weight of the upper half of your body. Frequency - 100-110 pressures per minute. In this case, the chest should bend by 3-4 cm.
For infants, indirect heart massage is performed with the index and middle fingers of one hand. Teenagers - the palm of one hand.

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

If, during resuscitation, the victim regains breathing or a pulse appears, stop first aid and lay the person on his side, putting his hand under his head. Keep an eye on his condition until paramedics arrive.

Heimlich maneuver

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

Signs of airway obstruction:

Lack of complete breathing. If the windpipe is not completely blocked, the person coughs; if completely - holds on to the throat.
Inability to speak.
Blueness of the skin of the face, swelling of the vessels of the neck.

Airway clearance is most often performed using the Heimlich method.

Stand behind the victim.
Grab it with your hands, clasping them into a lock, just above the navel, under the costal arch.
Strongly press on the victim's abdomen, sharply bending your elbows.
Do not apply pressure to the victim's chest, except for pregnant women who apply pressure to the lower chest.
Repeat this several times until the airways are clear.

If the victim has lost consciousness and fallen, lay him on his back, sit on his hips and with both hands press on the costal arches.

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

Bleeding

Bleeding control is a measure to stop blood loss. When providing first aid, we are talking about stopping external bleeding. Depending on the type of vessel, capillary, venous and arterial bleeding is distinguished.

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

With venous bleeding, a pressure bandage is applied. To do this, tamponade of the wound is performed: gauze is applied to the wound, several layers of cotton wool are placed on top of it (if there is no cotton wool - a clean towel), and bandaged tightly. The veins squeezed by such a bandage quickly thrombose, and the bleeding stops. If the pressure bandage gets wet, apply firm pressure with the palm of your hand.

To stop arterial bleeding, the artery must be clamped.

Artery Clamping Technique: Firmly press the artery with your fingers or fist against the underlying bone formations.

Arteries are easily accessible for palpation, so this method is very effective. However, it requires physical strength from the first aid provider.

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

Technique for applying a hemostatic tourniquet

Apply a tourniquet to clothing or a soft pad just above the wound.
Tighten the tourniquet and check the pulsation of the vessels: the bleeding should stop, and the skin below the tourniquet should turn pale.
Put a bandage on the wound.
Record the exact time the tourniquet was applied.

A tourniquet can be applied to the limbs for a maximum of 1 hour. After its expiration, the tourniquet must be loosened for 10-15 minutes. If necessary, you can tighten again, but no more than 20 minutes.

fractures

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

Fracture First Aid Technique

Assess the severity of the victim's condition, determine the location of the fracture.
If there is bleeding, stop it.
Determine whether it is possible to move the victim before the arrival of specialists.
Do not carry the victim and do not change his position in case of spinal injuries!
Ensure the immobility of the bone in the fracture area - perform immobilization. To do this, it is necessary to immobilize the joints located above and below the fracture.
Put on a tire. As a tire, you can use flat sticks, boards, rulers, rods, etc. The tire must be tightly, but not tightly fixed with bandages or plaster.

With a closed fracture, immobilization is performed over clothing. With an open fracture, you can not apply a splint to places where the bone protrudes outward.

burns

A burn is damage to body tissues caused by high temperatures or chemicals. Burns vary in degrees as well as types of damage. According to the last reason, burns are distinguished:

thermal (flame, hot liquid, steam, hot objects);
chemical (alkalis, acids);
electrical;
radiation (light and ionizing radiation);
combined.

In case of burns, the first step is to eliminate the effect of the damaging factor (fire, electric current, boiling water, and so on).

Then, in case of thermal burns, the affected area should be freed from clothing (gently, without tearing off, but cutting off the adhering tissue around the wound) and, for the purpose of disinfection and anesthesia, irrigate it with a water-alcohol solution (1/1) or vodka.

Do not use oily ointments and greasy creams - fats and oils do not reduce pain, do not disinfect the burn, and do not promote healing.

Then irrigate the wound with cold water, apply a sterile dressing and apply ice. Also, give the victim warm salted water.

To speed up the healing of minor burns, use sprays with dexpanthenol. If the burn covers an area of more than one palm, be sure to consult a doctor.

Fainting

Fainting is a sudden loss of consciousness due to a temporary disruption of cerebral blood flow. In other words, it is a signal to the brain that it lacks oxygen.

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

The fainting state is characterized by the fact that a person rolls his eyes, becomes covered with cold sweat, his pulse weakens, his limbs become cold.

Typical situations of fainting:

fright,
excitement,
stuffiness and others.

If the person faints, put him in a comfortable horizontal position and provide fresh air (unbutton clothes, loosen belt, open windows and doors). Sprinkle cold water on the face of the victim, pat him on the cheeks. If you have a first-aid kit on hand, give a cotton swab moistened with ammonia to sniff.

If consciousness does not return for 3-5 minutes, call an ambulance immediately.

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

Drowning and sunstroke

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

First aid for drowning

Remove the victim from the water.
A drowning man grabs everything that comes to hand. Be careful: swim up to him from behind, hold him by the hair or armpits, keeping your face above the surface of the water.
Lay the victim on his knee with his head down.
Clear the oral cavity of foreign bodies (mucus, vomit, algae).
Check for signs of life.
In the absence of a pulse and breathing, immediately start mechanical ventilation and chest compressions.
After the restoration of breathing and cardiac activity, lay the victim on his side, cover him and ensure comfort until the arrival of paramedics.

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

Symptoms:

headache,
weakness,
noise in ears,
nausea,
vomit.

If the victim is still exposed to the sun, his temperature rises, shortness of breath appears, sometimes he even loses consciousness.

Therefore, when providing first aid, first of all, it is necessary to transfer the victim to a cool, ventilated place. Then release him from clothes, loosen the belt, undress. Place a cold, wet towel on his head and neck. Let me smell the ammonia. Give artificial respiration if necessary.

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

Causes of frostbite - high humidity, frost, wind, immobility. Aggravates the condition of the victim, as a rule, alcohol intoxication.

Symptoms:

feeling cold;
tingling in the frost-bitten part of the body;
then - numbness and loss of sensation.

First aid for frostbite

Keep the victim warm.
Take off any cold or wet clothing.
Do not rub the victim with snow or a cloth - this will only injure the skin.
Wrap the frostbitten area of the body.
Give the victim hot sweet drink or hot food.

Poisoning

Poisoning is a disorder of the body's vital functions that has arisen due to the ingress of poison or toxin into it. Depending on the type of toxin, poisoning is distinguished:

carbon monoxide,
pesticides,
alcohol
drugs,
food and others.

First aid measures depend on the nature of the poisoning. The most common food poisoning is accompanied by nausea, vomiting, diarrhea and stomach pain. In this case, the victim is recommended to take 3-5 grams of activated charcoal every 15 minutes for an hour, drink plenty of water, refrain from eating and be sure to consult a doctor.

In addition, accidental or intentional drug poisoning and alcohol intoxication are common.

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

Rinse the victim's stomach. To do this, make him drink several glasses of salted water (for 1 liter - 10 g of salt and 5 g of soda). After 2-3 glasses, induce vomiting in the victim. Repeat these steps until the vomit is "clean".
Gastric lavage is possible only if the victim is conscious.
Dissolve 10-20 tablets of activated charcoal in a glass of water, let the victim drink it.
Wait for the specialists to arrive.

Fainting can occur in any person, even in absolutely healthy people. However, most often a short-term loss of consciousness occurs due to oxygen starvation of the brain, powerful emotional experiences, as a result of heart failure. Regardless of the cause, fainting is scary and dangerous. When in front of your eyes a person loses control over himself and just falls, it is difficult to maintain composure. In such a situation, you need to pull yourself together, stop panicking and start acting quickly and competently.

Causes of fainting

Loss of consciousness can be triggered by anything. A single fainting may be the result of an emotional shock or overstrain. But if a person loses consciousness regularly, he must certainly be examined. Among the reasons that can cause fainting, the following can be noted:

In addition, expectant mothers often faint, especially in the first trimester of pregnancy. This is due to low pressure in a woman, hormonal changes in her body. A pregnant woman already does not feel very well - she feels nausea, constant weakness, dizziness. And if the body is deficient in food or oxygen, it instantly reacts to this with a fainting state.

Is it possible to feel the approach of fainting

Of course you can. The precursors to loss of consciousness are tinnitus, black dots before the eyes, cold sweat, freezing of the extremities, a feeling of stuffiness and lack of air, nausea, and weakness. If you feel just such symptoms, you should immediately take a comfortable body position that will protect you from injury when falling. Lie on your back and elevate your legs to increase the blood supply to the brain. If you are on the street, you need to sit on a bus stop or a bench and lower your head between your knees. At the same time, unbutton the top button of the shirt, loosen the tie, belt. When you feel a little better, you need to drink sweet tea or water.

What to do if right in front of your eyes a person lost consciousness? Well, if there is a doctor nearby, he will be able to provide emergency assistance. But there is no need to sow panic if you are alone with the problem. Correct and consistent actions will bring the patient out of a swoon.

The first thing to do is check the person's heartbeat. If not, you need to do a heart massage and artificial respiration.
If the heartbeat is heard (and it can be very weak), the unconscious person should be placed with his back on a flat surface. Raise your legs by placing a pillow or any other object under them. This position ensures maximum blood flow to the brain. In no case do not lower the patient's head below the level of the body.
The patient's head must be turned to the side so that the tongue does not sunk - this can interfere with normal breathing.
Unbutton the victim's collar, take off his tie, ask onlookers to move away. This way you provide the patient with enough oxygen.
To bring the patient to his senses, you can give him a sniff of ammonia. Put some ammonia on a cotton swab and bring it up to your nose. If ammonia is not at hand, use other liquids with a pungent odor - vinegar, alcohol, gasoline.
If the strong smell does not help, you can sprinkle cold water on the person. In no case do not hit him on the cheeks - this is an absolutely useless way.
After the patient has come to his senses, he should not make sudden movements. You need to take a comfortable position of the body and drink a glass of hot sweet tea.

Do not lift the patient until he has regained consciousness, do not pull or shake him. If a person does not come to his senses within 8-10 minutes, you need to call a doctor. Before the ambulance arrives, the doctor on the other end of the line can give some advice on how to bring the person to their senses.

Syncope Prevention

If a person often loses consciousness, it is necessary to consult a doctor on this issue. Especially if the fainting occurs in a child. After finding out the true cause of fainting, you need to follow general preventive measures that will avoid provoking factors. Nutrition should be balanced, in no case limited. There should be enough carbohydrates in the diet so that the glucose level does not decrease. You should eat more red meat, pomegranate, liver and dried fruits to normalize your hemoglobin levels.

Loads should be moderate, but regular - take a walk in the fresh air with a calm step. This will allow you to normalize the level of blood pressure and saturate the body with oxygen. Give up bad habits, do not neglect weekends and holidays, do not overheat, try not to be in cramped and enclosed spaces and the risk of fainting will be minimal. Also, talk to your doctor about taking nootropics, drugs that improve brain nutrition.

When a person faints in front of your eyes, it becomes scary. However, everyone should have first aid skills, even if a person is far from medicine. Often the provision of first aid determines the further condition of the patient, and sometimes saves his life.

Video: first aid for fainting

INSTRUCTIONS

FIRST AID

1. General Provisions

1.1. First aid is a set of measures aimed at restoring or preserving the life and health of the victim. It should be provided by someone who is next to the victim (mutual assistance), or the victim himself (self-help) before the arrival of a medical worker.

1.2. Responsibility for organizing training in providing first aid in a health-improving organization rests with the head and / or responsible officials.

1.3. In order for the first pre-medical aid to be effective, the health-improving organization must have:

First aid kits with a set of necessary medicines and medical supplies for first aid;

Posters depicting methods of providing first aid to victims of accidents and performing artificial respiration and external heart massage.

1.4. The person providing assistance should know the main signs of a violation of the vital functions of the human body, as well as be able to free the victim from the action of dangerous and harmful factors, assess the condition of the victim, determine the sequence of first aid methods used, and, if necessary, use improvised means when providing assistance and transporting the victim.

1.5. The sequence of actions when providing first aid to the victim:

Elimination of the impact on the body of the victim of dangerous and harmful factors (release him from the action of electric current, extinguishing burning clothes, removing him from water, etc.);

Assessment of the condition of the victim;

Determining the nature of the injury that poses the greatest threat to the life of the victim, and the sequence of actions to save him;

Implementation of the necessary measures to save the victim in order of urgency (restoration of airway patency; performing artificial respiration, external heart massage; stopping bleeding; immobilization of the fracture site; applying a bandage, etc.);

Maintaining the basic vital functions of the victim until the arrival of medical personnel;

Calling an ambulance or doctor, or taking steps to transport the victim to the nearest medical facility.

1.6. If it is impossible to call medical personnel to the scene, it is necessary to ensure the transportation of the victim to the nearest medical organization. It is possible to transport the victim only with steady breathing and pulse.

1.7. In the case when the condition of the victim does not allow him to be transported, it is necessary to maintain his basic vital functions until the arrival of a medical worker.

2. Signs to determine the state of health of the victim

2.1. Signs by which you can quickly determine the state of health of the victim are as follows:

Consciousness: clear, absent, impaired (the victim is inhibited or agitated);

The color of the skin and visible mucous membranes (lips, eyes) : pink, bluish, pale.

Respiration: normal, absent, disturbed (irregular, shallow, wheezing);

Pulse on the carotid arteries: well defined (correct or irregular rhythm), poorly defined, absent;

Pupils: dilated, constricted.

3. A complex of resuscitation measures

If the victim has no consciousness, breathing, pulse, the skin is cyanotic, and the pupils are dilated, you should immediately begin to restore the vital functions of the body by performing artificial respiration and external heart massage. It is required to note the time of respiratory arrest and blood circulation in the victim, the time of the start of artificial respiration and external heart massage, as well as the duration of resuscitation and report this information to the arriving medical personnel.

3.1. Artificial respiration.

Artificial respiration is carried out in cases where the victim does not breathe or breathes very badly (rarely, convulsively, as if with a sob), and also if his breathing constantly worsens, regardless of what caused it: electric shock, poisoning, drowning, etc. d. The most effective method of artificial respiration is the "mouth-to-mouth" or "mouth-to-nose" method, since this ensures that a sufficient volume of air enters the victim's lungs.

The "mouth-to-mouth" or "mouth-to-nose" method is based on the use of air exhaled by the caregiver, which is forced into the victim's airways and is physiologically suitable for the victim to breathe. Air can be blown through gauze, a handkerchief, etc. This method of artificial respiration makes it easy to control the flow of air into the lungs of the victim by expanding the chest after blowing and then subsiding as a result of passive exhalation.

To carry out artificial respiration, the victim should be laid on his back, unfasten clothing that restricts breathing and ensure the patency of the upper respiratory tract, which, in the supine position in an unconscious state, is closed by a sunken tongue. In addition, there may be foreign contents in the oral cavity (vomit, sand, silt, grass, etc.), which must be removed with the index finger wrapped in a scarf (cloth) or bandage, turning the victim's head to one side.

After that, the assisting person is located on the side of the victim’s head, slips one hand under his neck, and with the palm of the other hand presses on his forehead, tilting his head as much as possible. In this case, the root of the tongue rises and frees the entrance to the larynx, and the victim's mouth opens. The person assisting leans towards the victim's face, takes a deep breath with his mouth open, then fully covers the victim's open mouth with his lips and exhales vigorously, blowing air into his mouth with some effort; at the same time, he covers the nose of the victim with his cheek or fingers of the hand located on the forehead. In this case, it is imperative to observe the chest of the victim, which should rise. As soon as the chest has risen, the air injection is stopped, the assisting person raises his head, and the victim passively exhales. In order for the exhalation to be deeper, you can gently press the hand on the chest to help the air out of the lungs of the victim.

If the victim has a well-determined pulse and only artificial respiration is necessary, then the interval between artificial breaths should be 5 s, which corresponds to a respiratory rate of 12 times per minute.

In addition to the expansion of the chest, a good indicator of the effectiveness of artificial respiration can be the pinking of the skin and mucous membranes, as well as the exit of the victim from an unconscious state and the appearance of independent breathing.

When performing artificial respiration, the assisting person must ensure that the blown air enters the lungs, and not into the victim's stomach. When air enters the stomach, as evidenced by bloating "under the spoon", gently press the palm of your hand on the stomach between the sternum and navel. This may cause vomiting, so it is necessary to turn the head and shoulders of the victim to the side (preferably to the left) to clear his mouth and throat.

If the jaws of the victim are tightly clenched and it is not possible to open the mouth, artificial respiration should be carried out according to the "mouth to nose" method.

Young children are blown into the mouth and nose at the same time. The smaller the child, the less air he needs to inhale and the more often it should be blown in comparison with an adult (up to 15-18 times per minute).

When the first weak breaths appear in the victim, an artificial breath should be timed to the moment he begins to breathe independently.

Cease artificial respiration after the victim recovers sufficiently deep and rhythmic spontaneous breathing.

It is impossible to refuse to help the victim and consider him dead in the absence of such signs of life as breathing or pulse. Only a medical professional has the right to make a conclusion about the death of the victim.

3.2. External cardiac massage.

An indication for an external heart massage is cardiac arrest, which is characterized by a combination of the following symptoms: pallor or cyanosis of the skin, loss of consciousness, no pulse in the carotid arteries, cessation of breathing or convulsive, incorrect breaths. In case of cardiac arrest, without wasting a second, the victim must be laid on a flat hard base: a bench, a floor, in extreme cases, put a board under his back.

If assistance is provided by one person, he is located on the side of the victim and, bending over, makes two quick energetic blows (according to the “mouth-to-mouth” or “mouth-to-nose” method), then unbends, remaining on the same side of the victim, palm puts one hand on the lower half of the sternum (stepping back two fingers higher from its lower edge), and raises the fingers. He puts the palm of the second hand on top of the first across or along and presses, helping by tilting his body. When pressing, the arms should be straightened at the elbow joints.

Pressing should be done in quick bursts so as to displace the sternum by 4-5 cm, the duration of pressing is not more than 0.5 s, the interval between individual pressures is not more than 0.5 s.

In pauses, the hands are not removed from the sternum (if two people provide assistance), the fingers remain raised, the arms are fully extended at the elbow joints.

If the revival is performed by one person, then for every two deep blows (breaths), he makes 15 pressures on the sternum, then again makes two blows and again repeats 15 pressures, etc. At least 60 pressures and 12 blows must be done per minute, t i.e. perform 72 manipulations, so the pace of resuscitation should be high.

Experience shows that most of the time is spent on artificial respiration. You can not delay the blowing: as soon as the chest of the victim has expanded, it must be stopped.

With the correct performance of external heart massage, each pressure on the sternum causes a pulse to appear in the arteries.

The caregivers should periodically monitor the correctness and effectiveness of external cardiac massage by the appearance of a pulse on the carotid or femoral arteries. When carrying out resuscitation by one person, he should interrupt the heart massage for 2-3 seconds every 2 minutes. to determine the pulse on the carotid artery.

If two people are involved in resuscitation, then the pulse on the carotid artery is controlled by the one who conducts artificial respiration. The appearance of a pulse during a massage break indicates the restoration of the activity of the heart (the presence of blood circulation). At the same time, heart massage should be immediately stopped, but artificial respiration should be continued until stable independent breathing appears. In the absence of a pulse, it is necessary to continue to massage the heart.

Artificial respiration and external cardiac massage should be carried out until the patient is restored to stable independent breathing and heart activity or until he is transferred to medical personnel.

A prolonged absence of a pulse with the appearance of other signs of revival of the body (spontaneous breathing, constriction of the pupils, attempts by the victim to move his arms and legs, etc.) is a sign of cardiac fibrillation. In these cases, it is necessary to continue to give artificial respiration and heart massage to the victim before transferring him to medical personnel.

4. First aid for various types of damage to the child's body

4.1. Wound .

When providing first aid in case of injury, the following rules must be strictly observed.

It is forbidden:

Wash the wound with water or some medicinal substance, cover it with powder and lubricate with ointments, as this prevents the wound from healing, causes suppuration and contributes to the entry of dirt into it from the surface of the skin;

It is impossible to remove sand, earth, etc. from the wound, since it is impossible to remove everything that pollutes the wound;

Remove blood clots, clothing, etc. from the wound, as this can cause severe bleeding;

Cover wounds with duct tape or cobwebs to prevent tetanus infection.

Need to:

Helper wash hands or smear fingers with iodine;

Carefully remove dirt from the skin around the wound, the cleaned area of the skin should be smeared with iodine;

Open the dressing bag in the first aid kit in accordance with the instructions printed on its wrapper.

When applying a dressing, do not touch with your hands that part of it that should be applied directly to the wound.

If for some reason there was no dressing bag, a clean handkerchief, cloth, etc. can be used for dressing). Do not apply cotton wool directly to the wound. On the place of the tissue that is applied directly to the wound, drip iodine to get a spot larger than the wound, and then put the tissue on the wound;

Contact a medical organization as soon as possible, especially if the wound is contaminated with earth.

4.2. Bleeding .

4.2.1. internal bleeding.

Internal bleeding is recognized by the appearance of the victim (he turns pale; sticky sweat appears on the skin; breathing is frequent, intermittent, the pulse is frequent, of weak filling).

Need to:

Lay down the victim or give him a semi-sitting position;

Provide complete peace;

Apply "cold" to the intended site of bleeding;

Call a doctor or healthcare professional immediately.

It is forbidden:

Give the victim to drink if there is a suspicion of damage to the abdominal organs.

4.2.2. External bleeding.

Need to:

a) with mild bleeding:

Lubricate the skin around the wound with iodine;

Apply a dressing, cotton wool to the wound and bandage it tightly;

Without removing the applied dressing, apply additional layers of gauze, cotton wool on top of it and bandage it tightly if bleeding continues;

b) with heavy bleeding:

Depending on the site of injury, for a quick stop, press the arteries to the underlying bone above the wound in the blood flow in the most effective places (temporal artery; occipital artery; carotid artery; subclavian artery; axillary artery; brachial artery; radial artery; ulnar artery; femoral artery; femoral artery in the middle of the thigh; popliteal artery; dorsal artery of the foot; posterior tibial artery);

In case of severe bleeding from a wounded limb, bend it in the joint above the wound site, if there is no fracture of this limb. Put a lump of cotton wool, gauze, etc. into the hole formed during bending, bend the joint to failure and fix the bend of the joint with a belt, scarf and other materials;

In case of severe bleeding from a wounded limb, apply a tourniquet above the wound (closer to the body), wrapping the limb at the site of the tourniquet with a soft pad (gauze, scarf, etc.). Previously, the bleeding vessel should be pressed with fingers to the underlying bone. The tourniquet is applied correctly, if the pulsation of the vessel below the place of its application is not determined, the limb turns pale. The tourniquet can be applied by stretching (elastic special tourniquet) and twisting (tie, twisted scarf, towel);

Take the injured person with a tourniquet to a medical facility as soon as possible.

It is forbidden:

Tighten the tourniquet too tightly, as you can damage the muscles, pinch the nerve fibers and cause paralysis of the limb;

Apply a tourniquet in warm weather for more than 2 hours, and in cold weather for more than 1 hour, since there is a danger of tissue necrosis. If there is a need to leave the tourniquet longer, then you need to remove it for 10-15 minutes, after pressing the vessel with your finger above the bleeding site, and then apply it again to new areas of the skin.

4.3. Electric shock.

Need to:

As soon as possible, release the victim from the action of electric current;

Take measures to separate the victim from current-carrying parts, if there is no possibility of a quick shutdown of the electrical installation. To do this, you can: use any dry, non-conductive object (stick, board, rope, etc.); pull the victim away from current-carrying parts by his personal clothing, if it is dry and lags behind the body; cut the wire with an ax with a dry wooden handle; use an object that conducts electric current, wrapping it in the place of contact with the hands of the rescuer with dry cloth, felt, etc.;

Remove the victim from the danger zone at a distance of at least 8 m from the current-carrying part (wire);

In accordance with the condition of the victim, provide first aid, including resuscitation (artificial respiration and chest compressions). Regardless of the subjective well-being of the victim, deliver him to a medical facility.

It is forbidden:

Forget about personal safety measures when assisting a victim of electric current. With extreme caution, you need to move in the area where the current-carrying part (wire, etc.) lies on the ground. It is necessary to move in the zone of spreading of the earth fault current using protective equipment for isolation from the ground (dielectric protective equipment, dry boards, etc.) or without the use of protective equipment, moving the feet on the ground and not tearing them one from the other.

4.4. Fractures, dislocations, bruises, sprains .

4.4.1. For fractures,:

Provide the victim with immobilization (creation of rest) of the broken bone;

With open fractures, stop bleeding, apply a sterile bandage;

Apply a tire (standard or made from improvised material - plywood, boards, sticks, etc.). If there are no objects with which to immobilize the fracture site, it is bandaged to a healthy part of the body (an injured arm to the chest, an injured leg to a healthy one, etc.);

With a closed fracture, leave a thin layer of clothing at the splint site. Remove the remaining layers of clothing or shoes without aggravating the position of the victim (for example, cut);

Apply cold to the fracture site to reduce pain;

Deliver the victim to a medical institution, creating a calm position of the injured part of the body during transportation and transfer to medical personnel.

It is forbidden:

Remove clothes and shoes from the victim in a natural way, if this leads to additional physical impact (squeezing, pressing) on the fracture site.

4.4.2. When dislocated, you need:

Ensure complete immobility of the damaged part with a tire (standard or made from improvised material);

Deliver the victim to a medical facility with immobilization.

It is forbidden:

Try to correct the dislocation yourself. This should only be done by a medical professional.

4.4.3. For injuries, you need:

Create peace for a bruised place;

Apply "cold" to the site of injury;

Apply a tight bandage.

It is forbidden:

Lubricate the bruised area with iodine, rub and apply a warm compress.

4.4.4. When stretching ligaments, you need:

Bandage the injured limb tightly and provide it with peace;

Apply "cold" to the injury site;

Create conditions for blood circulation (raise the injured leg, hang the injured arm on a scarf to the neck).

It is forbidden:

Carry out procedures that can lead to heating of the injured area.

4.4.5. With a skull fracture(signs: bleeding from the ears and mouth, unconsciousness) and concussion (signs: headache, nausea, vomiting, loss of consciousness) need to:

Eliminate the harmful effects of the situation (frost, heat, being on the carriageway, etc.);

Move the victim in compliance with the rules of safe transportation to a comfortable place;

Lay the victim on his back, in case of vomiting, turn his head to one side;

Fix the head on both sides with rollers from clothes;

When suffocation occurs due to tongue retraction, push the lower jaw forward and maintain it in this position;

If there is a wound, apply a tight sterile bandage;

Put "cold";

Ensure complete rest until the doctor arrives;

Provide qualified medical assistance as soon as possible (call medical workers, provide appropriate transportation).

It is forbidden:

Give the victim any medication on their own;

Talk to the victim;

Allow the victim to get up and move around.

4.4.6. In case of spinal injury(signs: sharp pain in the spine, inability to bend the back and turn) need to:

Carefully, without lifting the victim, slip a wide board and other object similar in function under his back or turn the victim face down and strictly ensure that his torso does not bend in any position (to avoid damage to the spinal cord);

Eliminate any load on the muscles of the spine;

Provide complete peace.

It is forbidden:

Turn the victim on his side, plant, put on his feet;

Lay on a soft, elastic bedding.

4.5. For burns you need:

For burns of the 1st degree (redness and soreness of the skin), cut the clothes and shoes at the burnt place and carefully remove them, moisten the burnt place with alcohol, a weak solution of potassium permanganate, and other cooling and disinfecting lotions, and then go to a medical institution;

For burns of the II, III and IV degrees (blisters, necrosis of the skin and deep-lying tissues), apply a dry sterile bandage, wrap the affected area of the skin in a clean cloth, sheet, etc., seek medical help. If the burnt pieces of clothing are stuck to the burned skin, apply a sterile bandage over them;

If the victim shows signs of shock, immediately give him 20 drops of valerian tincture or another similar remedy to drink;

In case of eye burns, make cold lotions from a solution of boric acid (half a teaspoon of acid in a glass of water);

In case of a chemical burn, wash the affected area with water, treat it with neutralizing solutions: in case of an acid burn, a solution of baking soda (1 teaspoon per glass of water); for alkali burns - a solution of boric acid (1 teaspoon per glass of water) or a solution of acetic acid (table vinegar, half diluted with water).

It is forbidden:

Touch the burned areas of the skin with your hands or lubricate them with ointments, fats, and other means;

Open bubbles;

Remove substances, materials, dirt, mastic, clothing, etc. adhering to the burned area.

4.6. For heat and sunstroke:

Quickly move the victim to a cool place;

Lay on your back, placing a bundle under your head (you can use clothes);

Unfasten or remove clothing that restricts breathing;

Moisten the head and chest with cold water;

Apply cold lotions to the surface of the skin, where many vessels are concentrated (forehead, parietal region, etc.);

If the person is conscious, give cold tea, cold salted water to drink;

If breathing is disturbed and there is no pulse, perform artificial respiration and external heart massage;

Provide peace;

Call an ambulance or take the victim to a medical facility (depending on the state of health).

It is forbidden:

4.7. For food poisoning:

Give the victim to drink at least 3-4 glasses of water and a pink solution of potassium permanganate, followed by vomiting;

Repeat gastric lavage several times;

Give the victim activated charcoal;

Drink warm tea, put to bed, cover warmer (until the arrival of medical personnel);

In case of violation of breathing and blood circulation, start artificial respiration and external heart massage.

It is forbidden:

Leave the victim unattended until the ambulance arrives and takes him to a medical organization.

4.8. For frostbite, you need:

In case of slight freezing, immediately rub and heat the chilled area to eliminate vasospasm (excluding the possibility of damage to the skin, its injury);

In case of loss of sensitivity, whitening of the skin, do not allow rapid warming of supercooled areas of the body when the victim is in the room, use heat-insulating dressings (cotton-gauze, woolen, etc.) on the affected integuments;

Ensure the immobility of supercooled arms, legs, body body (for this you can resort to splinting);

Leave the heat-insulating bandage until a feeling of heat appears and the sensitivity of the supercooled skin is restored, then give hot sweet tea to drink;

In case of general hypothermia, the victim should be urgently delivered to the nearest medical institution without removing heat-insulating dressings and means (in particular, you should not remove icy shoes, you can only wrap your feet with a padded jacket, etc.).

It is forbidden:

Tear or pierce the formed blisters, as this threatens to fester.

4.9. When hit by foreign bodies in organs and tissues need to contact a healthcare professional or healthcare organization.

You can remove a foreign body yourself only if there is sufficient confidence that this can be done easily, completely and without serious consequences.

4.10. When drowning a person, you need:

Act thoughtfully, calmly and carefully;

The person providing assistance must not only swim and dive well himself, but also know the methods of transporting the victim, be able to free himself from his seizures;

Urgently call an ambulance or a doctor;

If possible, quickly clean the mouth and throat (open the mouth, remove the trapped sand, carefully pull out the tongue and fix it to the chin with a bandage or scarf, the ends of which are tied at the back of the head);

Remove water from the respiratory tract (put the victim on his knee with his stomach, head and legs hang down; beat on the back);

If, after removing the water, the victim is unconscious, there is no pulse on the carotid arteries, does not breathe, start artificial respiration and external heart massage. Carry out until complete recovery of breathing or stop when there are obvious signs of death, which the doctor must ascertain;

When restoring breathing and consciousness, wrap, warm, drink hot strong coffee, tea (give an adult 1-2 tablespoons of vodka);

Ensure complete rest until the doctor arrives.

It is forbidden:

Until the doctor arrives, leave the victim alone (without attention) even with a clear visible improvement in well-being.

4.11. When bitten.

4.11.1. For snake bites and poisonous insects,:

Suck the poison out of the wound as soon as possible (this procedure is not dangerous for the caregiver);

Restrict the victim's mobility to slow the spread of the poison;

Provide plenty of fluids;

Deliver the victim to a medical organization. Transport only in the supine position.

It is forbidden:

Apply a tourniquet to the bitten limb;

Cauterize the bite site;

Make incisions for better discharge of poison;

Give the victim alcohol.

4.11.2. For animal bites:

Lubricate the skin around the bite (scratch) with iodine;

Apply a sterile bandage;

Send the victim to a medical organization for vaccination against rabies.

4.11.3. When bitten or stung by insects (bees, wasps, etc.), you need to:

Remove sting;

Put "cold" in place of the edema;

Give the victim a large amount of drink;

In case of allergic reactions to insect venom, give the victim 1-2 tablets of diphenhydramine and 20-25 drops of cordiamine, cover the victim with warm heating pads and urgently deliver to a medical organization;

In case of respiratory failure and cardiac arrest, perform artificial respiration and external heart massage.

It is forbidden:

The victim should take alcohol, as it promotes vascular permeability, the poison lingers in the cells, swelling increases.

Ministry of Health of the Russian Federation

State budgetary educational institution of higher professional education

FIRST MOSCOW STATE MEDICAL UNIVERSITY named after I.M. SECHENOV

Medical Faculty

Department of Life Safety and Disaster Medicine

Topic #__"Fundamentals of organizing first aid for victims in emergency situations"

L E C T I A

for students of the Faculty of Medicine

Discussed at the educational and methodological

conferences

"___" __________ 201_

Protocol No. __________

Moscow, 2015.

LITERATURE 3

EDUCATIONAL SUPPORT: 3

1. Introduction 4

2.First aid: general information, legal support. 5

2.1. Regulatory framework for first aid. 6

2.2.List of conditions in which first aid is provided: 7

2.3.List of first aid measures: 7

3. General rules for first aid 10

3.1. First aid algorithm. eleven

3.2. Clinical and biological death. 13

4. First aid for bleeding 14

5. First aid for bruises, sprains and fractures. 17

5.1. Injury. 17

5.2. Stretching and tearing of ligaments, tendons, muscles. 17

5.3. Dislocation 18

5.4. Fractures 18

5.5. Compression of the limbs. 19

6. First aid for shock 19

7. First aid for emergency conditions: burns, hypothermia, frostbite, heat and sunstroke, electric shock, fainting, coma. 20

7.1. Burns. 20

7.2. Hypothermia. 21

7.3 Frostbite 22

7.4. Thermal and sunstroke. 22

7.5 Electric shock. 23

7.6 Drowning. 24

7.7. Fainting, coma. 25

8. Transportation of victims. 26

9. Mass destruction. Sorting Basics 27

10. Conclusion 28

LITERATURE

Goncharov S.F., Pokrovsky V.I. and others. "Guidelines for teaching the population to protect and provide first aid in emergency situations", - Moscow, 2009, 448 p.

Instructions for first aid in case of accidents at work: M .: Publishing house GALO Bubnov, 2007. -112 p.

Federal Law 323 FZ of November 21, 2011 "On the basics of protecting the health of citizens in the Russian Federation" Guidelines for conducting cardiopulmonary and cerebral resuscitation of the Russian National Council for Resuscitation "(2011)

Decree of the Government of the Russian Federation of September 4, 2003 No. 547 "On the preparation of the population in the field of protection against natural and man-made emergencies";

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

EDUCATIONAL AND MATERIAL SUPPORT:

Notebook (PC).

Multimedia projector.

Introduction

First aid is a natural part of people's lives, characteristic of different historical eras. Its origin dates back to ancient times. First aid is mentioned in Egyptian papyri, in Greek and Roman legends. People often met with the need to provide first aid for injuries, bleeding, poisoning, etc. and rendered it to the best of their knowledge, skills and abilities, which were passed down from generation to generation.

Over time, healers appeared - people more skilled in medicine. Perhaps, then there was a division of medical care between "non-professionals" and "professionals". This division further intensified. After some time, priests began to heal (do therapy), and hairdressers and corn masters did operations (surgical care). First aid in war conditions had its own characteristics. People who were wounded on the battlefield, in the absence of medical care, usually died. In 1080, knight monks with medical skills established a hospital in Jerusalem to treat pilgrims in the Holy Land. Later, after the conquest of Jerusalem by the crusaders in 1099, these knights founded a separate order of St. John the Baptist, which was entrusted with the function of protecting and providing medical assistance to pilgrims. Another name for these knights is the hospitaliers (hence the international word "hospital"). In the middle of the 19th century, the first international Geneva Convention was adopted, and the Red Cross was created to "help sick and wounded soldiers on the battlefields." The soldiers learned to treat their comrades before the arrival of the doctors. The concept of "first aid" first appeared in 1878 and was formed from the merger of "initial treatment" and "national aid", when in the UK the medical teams of citizens under the auspices of the Order of St. John were specially trained to provide assistance at railway junctions and in mining centers.

The further development of first aid is associated with the era of scientific and technological progress, when there were productions, technologies that use or produce nuclear, chemical or biological components that do not exist in natural conditions. As a result, harmful and dangerous factors of technogenic and anthropogenic origin have been added to natural hazards. In our country, in industries with harmful and dangerous factors, a system of providing first aid within the framework of labor protection began to form. The danger of using weapons of mass destruction in wartime led to the creation of the organizational foundations of first aid in civil defense (sanitary posts and sanitary squads). In recent decades, much attention has been paid to first aid in the Ministry of Emergency Situations due to the increase in the scale of emergencies and the nature of injuries to the population, including in transport.

With most pathological conditions caused by these factors, a person needs emergency medical care. Timely assistance can save the life of the victim. However, not always, an ambulance, a doctor, a nurse are at the scene and can provide the necessary medical care. More often, the life of a person in a critical situation depends on the skills and abilities of the people around him and himself to provide first aid.

The main causes of death of a victim in the focus of a catastrophe or natural disaster are severe mechanical trauma, shock, bleeding and impaired respiratory function. Moreover, a significant part of the victims (about 30%) die within the first hour; 60% - after 3 hours; and if help is delayed for 6 hours, then 90% of those seriously affected die. The importance of the time factor is due to the fact that among people who received first aid within 30 minutes after injury, complications occur 2 times less often than in people who received this type of assistance later. According to the World Health Organization, 20 out of 100 people killed in peacetime accidents could have been saved if help had been provided in a timely manner. Practice has shown that the optimal terms for first aid are: after injury - up to 30 minutes, in case of poisoning - up to 10 minutes, when breathing stops - 5-7 minutes.

First aid: general information, legal support.

The main goal of first aid is to carry out activities aimed at saving the life of the victim, eliminating the ongoing impact of adverse factors and quickly evacuating him to a medical institution.

The time from the moment of defeat to the receipt of first aid should be as short as possible (the Golden Hour rule).

Regulatory framework for first aid.

In the Russian Federation, a lot of attention is paid to the issues of first aid at the level of legislation and regulatory documents.

The main legislative and regulatory acts include:

Federal Law No. 323-FZ of November 21, 2011 “On the Fundamentals of Health Protection in the Russian Federation”;

Federal Law of December 21, 1994 No. 68-FZ “On the protection of the population and territories from natural and man-made emergencies”;

Federal Law of July 14, 1995 No. 151-FZ "On emergency rescue services and the status of rescuers";

Federal target program "Improving road safety in 2006-2012";

Order of the Ministry of Health of the Russian Federation dated March 26, 1999 No. 100 "On improving the organization of emergency medical care for the population of the Russian Federation."

Order of the Ministry of Health of Russia dated January 22, 2016 N 33n "On Amending the Procedure for the Provision of Emergency, Including Specialized Emergency Medical Care, approved by Order of the Ministry of Health of the Russian Federation dated June 20, 2013 N 388n"

The federal law "On the Fundamentals of Protecting the Health of Citizens in the Russian Federation" defines two types of assistance: first aid and medical assistance.

Medical care includes:

primary health care;

Specialized, including high-tech, medical care;

Ambulance, including emergency specialized, medical care;

Palliative care.

First aid is defined as assistance provided to victims prior to medical attention. It is provided to citizens in case of accidents, injuries, poisoning and other conditions and diseases that threaten their life and health.

First aid is defined as a type of medical care that includes a set of simple measures performed directly at the site of injury or near it in the order of self-help and mutual assistance, as well as by participants in emergency rescue operations, including medical workers, using standard and improvised means.

First aid must be provided by persons with appropriate training, including employees of the internal affairs bodies of the Russian Federation, the State Fire Service, rescuers of emergency rescue units and emergency rescue services. Drivers of vehicles and other persons have the right to provide first aid if they have the appropriate training and (or) skills.

The list of conditions and activities in which first aid is provided is determined by the Order of the Ministry of Health and Social Development of Russia dated May 04, 2012 No. 477n (as amended on November 7, 2012) “On approval of the list of conditions under which first aid is provided, and the list of first aid measures”.

List of conditions under which first aid is provided:

Lack of consciousness.

Respiratory and circulatory arrest.

External bleeding.

Foreign bodies in the upper respiratory tract.

Injuries to various areas of the body.

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

Frostbite and other effects of exposure to low temperatures.

Poisoning.

List of first aid measures:

Assessing the situation and providing a safe environment for first aid;

Calling an ambulance, other special services;

Determination of the presence of consciousness in the victim;

Restoration of airway patency and determination of signs of life in the victim;

Carrying out cardiopulmonary resuscitation until signs of life appear;

Maintaining airway patency;

General examination of the victim and temporary stop of external bleeding;

Detailed examination of the victim in order to identify injuries, poisoning and other conditions that threaten his life and health, and to provide first aid in case of detection of these conditions;

Giving the victim an optimal body position;

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

Transfer of the injured to the ambulance team, other special services, whose employees are obliged to provide first aid.

The conditions and the list of first aid measures will be discussed in more detail below, as well as in practical exercises.

Practical implementation measures to provide first aid is largely related to the production sector and the conditions of human life.

Labor Code of the Russian Federation obliges the employer in case of accidents to immediately organize first aid to the victim and, if necessary, deliver him to a medical organization (Article 228). In connection with these requirements, in industries, especially in industries with harmful and dangerous working conditions, the administration provides training for first aid personnel. As a rule, external training is carried out by groups of employees determined by the administration of the enterprise. They receive instructor certificates, the right to provide first aid themselves and to train staff in first aid on the ground. Such a procedure, for example, has been established in the energy sector, in transport, and so on. The administration of the enterprise also provides workplaces with the necessary equipment and medicines for first aid (individual and collective means of technical and medical protection, stretchers, immobilization tires, communications equipment). At many enterprises, first aid is included in the program of competitions in professional skills, which contributes to the strengthening and expansion of knowledge in this area among all staff.

A special place in the organization and provision of first aid to the population is given to in the civil defense system. This is largely due to the preparation of the population, objects to provide first aid in case of mass lesions, especially in the centers of nuclear, chemical, bacteriological contamination. For these purposes, sanitary posts and sanitary teams are created at facilities (enterprises, institutions, educational institutions, etc.), in municipal and other administrative entities.

Reference: Sanitary posts consist of 4 people: the chief and 3 sanitary guards. Designed to provide first aid at your enterprise. They are equipped with: first-aid kits, sanitary stretchers, stretcher straps, personal protective equipment, armbands and Red Cross emblems. Sanitary posts at enterprises in peacetime are equipped with “Health Corners”.

Sanitary squads consist of 24 people: commander, deputy commander, messenger, driver and 5 units of sanitary squads, 4 people in each link. Designed to search for and provide first aid in the centers of mass destruction, participate in the organization of the removal and export of the affected to the place of loading, for work in other formations and medical institutions. The personnel equipment of sanitary squads includes: sanitary bags (for each squad), personal protective equipment, sanitary stretchers, stretcher straps, individual water flasks, Red Cross sleeve insignia, etc.

First aid in emergency situations is provided before the arrival of medical personnel by rescuers of the Ministry of Emergency Situations, police officers, customs officers, drivers of vehicles, other officials, as well as in self- and mutual assistance. To this end, all of the above categories of citizens must undergo appropriate training in advance and master first aid techniques. Thus, in the Federal Law of December 10, 1995 No. 196-FZ “On Road Safety”, Article 20 states that the heads of enterprises are obliged to take measures to improve the skills of drivers in providing first aid to victims of road accidents. Federal Law No. 151-FZ “On emergency rescue services and the status of rescuers” (Article 27) defines the duties of rescuers: rescuers must be ready to provide first aid to victims. The duties of police officers to provide first aid to victims of crimes, administrative offenses and accidents are set out in the Federal Law of February 7, 2011 No. 3-FZ "On the Police". Particular emphasis should be placed on the obligations of citizens of the Russian Federation to provide first aid in emergency situations. According to the Federal Law of December 21, 1994 No. 68-FZ "On the protection of the population and territories from natural and man-made emergencies", citizens of the Russian Federation are obliged to:

To study the main ways to protect the population and territories from emergency situations;

Know how to provide first aid to victims;

Know the rules for using collective and individual protective equipment;

Constantly improve their knowledge and practical skills in this area.

First aid at home, on vacation, in nature, is almost entirely focused on self-help and mutual help techniques. Hence, knowledge of the basics of first aid is necessary for every person.

If we talk about medical workers (doctors, paramedical workers), then their knowledge of first aid is a prerequisite for their profession. The doctor is obliged not only to provide first aid to the victims in a timely manner in any conditions, but also to teach citizens these skills.

In conclusion of this section of the lecture, it should be noted that the Criminal Code of the Russian Federation provides for the responsibility of citizens for not providing assistance or leaving them in danger (Articles 124 and 125). Thus, failure to provide assistance to a patient without good reason by a person obliged to provide it is punishable by a fine, or by compulsory labor for a term of up to three hundred and sixty hours, or by corrective labor for a term of up to one year, or by arrest for a term of up to four months. The same act, if it caused by negligence the death of a patient or the infliction of grievous harm to his health, shall be punishable by compulsory labor for a term of up to four years, with deprivation of the right to hold certain positions or engage in certain activities for a term of up to three years.

General first aid rules

First aid is provided at the scene of the incident by the victim himself (self-help), his comrade (mutual assistance), at sanitary posts, sanitary teams or other officials (rescuers, police officers, etc.).

The legislation of the Russian Federation defines the categories of specialists who are required to provide first aid at the scene. These are medical workers, rescuers, firefighters or police officers. The rest of the citizens are required to call an ambulance, but they are not required to provide first aid on their own. For them, first aid is a right, not a duty.

Before providing first aid, it is necessary to obtain the consent of the victim to conduct it (if the victim is conscious). If he refuses, first aid is not provided. If the victim is a child under 14 years of age, and there are no relatives nearby, then first aid is provided without obtaining consent, and if there are relatives nearby, then their consent must be obtained. If the victim poses a threat to others, then it is better not to provide assistance to him.

You must not exceed your qualifications: prescribe medications, perform medical manipulations (set dislocations, etc.).

First aid algorithm.

When approaching the victim, you need to decide for yourself the question - will you provide first aid yourself, or will you limit yourself to calling an ambulance.

Call an ambulance.

Ensure your own safety at the scene.

To do this, you need to assess the situation. It must be remembered that only professional rescuers, firefighters and special forces personnel have the right to work in the centers of collapse, fire or explosion. Persons of other professions are prohibited from entering the danger zone, and are there on their own initiative. If you assess the threat to the life of yourself and others, you must call the rescue service. It must be remembered that if there is an unjustified risk, the person providing assistance may suffer himself and, as a result, will not be able to provide assistance to the victim.

First aid to victims carries risks for the rescuer. This includes contact with human biological fluids, particles of various substances in the air, and hazardous materials. To reduce the risk of infection, universal precautions must be used: eye protection, gloves, masks. In cases where contact with secretions from the victim's oral cavity poses a threat of infection, poisoning with toxic gases, artificial ventilation of the lungs can only be carried out through a special protective mask.

In the absence of a risk to one's own life, it is advisable to use personal protective equipment (masks, gloves, etc.) even before providing first aid.

Carefully, carefully examining the surrounding space, approach the victim and introduce yourself. For example, I am a student of a medical university, I know how to provide first aid. Can I help you? In case of refusal of the victim, no help is provided, it is necessary to observe the victim, for the presence of consciousness in him. If the victim is silent, or agrees, you need to start providing first aid.

Conduct an initial examination of the victim in order to assess his condition "alive - dead", as well as to search for a cause that poses a threat to life. The main attention is paid to assessing the state of vital functions: breathing, blood circulation, consciousness. The time for the initial examination is 15 - 20 seconds. You need to start with an assessment of consciousness (consciousness clear, confused, absence). At the same time, we determine the presence of a pulse on the carotid artery (put 4 fingers on the Adam's apple and slide sideways until a pulsation appears), then determine the presence - lack of breathing and then evaluate the size of the pupils and their reaction to light (narrow pupils or a lively reaction to light indicates that a person alive).

If there is a lack of heartbeat, breathing, then it is urgent to proceed to cardio-pulmonary resuscitation (hereinafter referred to as CPR). It must be remembered that in the absence of breathing and heartbeat, a person can die within 4 minutes.

In case of clinical death (the victim has no breathing, heartbeat), it is advisable to start resuscitation with electrical or mechanical defibrillation. Fibrillation is a chaotic contraction of the heart. With fibrillation, the release of blood into the vessels stops, after which the victim loses consciousness after a few seconds, then clinical death occurs. Fibrillation can be stopped with a powerful electric shock (electrical defibrillation) or a sharp blow to the sternum (mechanical defibrillation). As a result of these actions, a synchronous contraction of muscle fibers may occur and a pulse will appear. If a blow to the sternum (precordial blow) is delivered within the first minute after cardiac arrest, then the probability of revival exceeds 50%. If, after several blows to the sternum, a pulse does not appear on the carotid artery, then it is necessary to immediately begin an indirect heart massage and artificial ventilation of the lungs using the mouth-to-mouth method.

CPR is the artificial maintenance of breathing and blood flow in the victim. Chest compressions allow you to maintain a small but effective blood flow in the vessels of the heart and brain. During CPR, cerebral blood flow should be at least 50% of the norm (to restore consciousness), and at least 20% of the norm (to maintain cell activity). Early initiation of chest compressions increases the survival rate of victims by 2-3 times. It has been established that chest compressions and defibrillation performed within 3-5 minutes from circulatory arrest provide a survival rate of 49-75%.

CPR is best done with three people. One can carry out these activities only in the absence of assistants. If the victim cannot be revived in the first minute, then resuscitation measures must be carried out for a long time - until the ambulance arrives. One person (a man with average physical data) can carry out a CPR complex for no more than 3-4 minutes. Together with an assistant - no more than 10 minutes. The three of us - more than an hour.

The technique of conducting cardio-pulmonary resuscitation will be shown in practical classes.

Conducting a secondary inspection. A secondary examination is carried out if the victim does not need cardiopulmonary resuscitation, or cardiopulmonary resuscitation brought the victim back to life. The time for a secondary examination is 2-3 minutes, its purpose is to identify the presence of injuries, damage. Inspection is carried out by gently feeling the entire body of the victim. If the victim is conscious, then we find out from him the localization of pain. When wounds, injuries, bleeding, other injuries are detected, we begin to provide assistance to the victim (temporary stop of external bleeding, immobilization of limbs, bandaging, etc.).

Giving the victim a safe position. After CPR or in other cases when the victim is unconscious, care should be taken to ensure that he does not suffocate from falling tongue, vomit. To do this, first of all, you should make sure that there is no damage to the cervical spine and then turn the victim on his side. You should simultaneously turn the head, shoulders and torso of the victim towards yourself. It is also necessary to bend the leg at the knee, located on top, to give stability to the position. If a spinal fracture is suspected, the victim is not turned on his side, only his head is turned.

Creation of psychological and physiological comfort before the arrival of an ambulance. All victims need psychological help. A separate lecture is devoted to this topic.

Constant monitoring of the condition of the victim. The victim at any time may disappear breathing and heartbeat, open bleeding. In this case, CPR is repeated.

We decided to prepare you even better and made an overview of emergency assistance in emergencies. We hope that these tips will never be useful to you, but just in case, keep the article bookmarked.

General rules

In most emergencies, qualified medical assistance is needed: the first thing to do is call a doctor right away. These tips do not replace medical advice! Remember the main rule: do no harm.

In an emergency, first of all, make sure of your own safety: first aid will be meaningless if the result is one more victim.

Before traveling to another country, find out and save the telephone numbers of local medical services.

Always check the contraindications of any medication and be aware of possible allergies.

Fainting

Signs: Nausea, dizziness and loss of consciousness.

What to do: Put in a comfortable position, unbutton the squeezing clothes, provide an influx of fresh air, give a sniff of ammonia. If consciousness does not return within 3-5 minutes, call an ambulance.

If fainting is accompanied by convulsions, call an ambulance immediately. Put soft clothes under the person’s head so that there are no injuries, after an attack, check that there are no vomit in the mouth that make it difficult to breathe, and turn the person on his side.

Sunstroke

Signs: Nausea, dizziness, headache, weakness after (or during) exposure to the sun.

What to do: Go to a cool, ventilated place without direct sunlight, unbutton constricting clothes, put a cold towel on your head, drink water, smell ammonia.

Dislocation

Signs: During outdoor activities, it costs nothing to twist your leg. A dislocation is a pretty painful thing, so it's not a problem to recognize.

What to do: Don't try to fix the dislocation on your own. It is necessary to ensure maximum immobility of the joint (fix the limb above and below the site of dislocation) and move to the hospital. If there is damage to the skin, apply a simple clean bandage. You can apply an ice pack wrapped in a towel to the dislocation site for 15-20 minutes and drink painkillers (ibuprofen, nimesulide).

fracture

Signs: Pain and dysfunction of the limb.

What to do: As with a dislocation, the only thing you can do before the doctors arrive is to rest the injured arm or leg. If the victim or victim needs to get to the hospital on their own, you can fix the joints above and below the injury site with a splint - any flat solid object (ruler, stick, tightly folded newspaper or magazine). The splint is applied over clothing and fixed with bandages (examples). If the fracture is open, the splint should not touch the wound. If you know that medical assistance will be provided in the near future, it is easier to do without a splint - there will be more harm from improper imposition. As with a dislocation, you can apply an ice pack and take pain medication.

Important: If there is the slightest suspicion of a fracture of the spine, in no case do not move the victim!

Bleeding

In case of minor bleeding, apply a clean, tight bandage of bandage, gauze, or plain cloth. In the case of arterial bleeding, when the blood flows profusely and quickly, you need to press the artery against the bone above the bleeding site (see the pressure point in the figure) or apply a tourniquet above the bleeding site.

A tourniquet is applied to clothing or tissue (not skin) above the site of bleeding, but as close as possible to it (example). A tourniquet can be any dense strip of fabric (not a rope). Be sure to write down the exact time when the tourniquet is applied: it cannot be kept for longer than 1 hour. If during this time the victim or victim did not get (s) to the hospital, loosen the tourniquet for 10-15 minutes and tighten it again for another 20 minutes.

Drowning

Signs: Unlike spectacular films, a drowning person may not scream or wave his arms: his body is vertical in the water, his legs do not support movement, his head is low in the water, often hiding under it.

What to do: Retrieve the drowning or drowning person from the water by supporting the armpits and keeping his or her face above the surface of the water. On the shore, put the victim (s) with his stomach on his knee, squeeze his back and chest: this is how water should come out (example). Be sure to make sure that there is nothing in the mouth and nose that makes it difficult to breathe. If breathing is not restored, cardiopulmonary resuscitation should be performed (see below).

Stroke

Signs: Sudden inability to speak or understand speech, slurred speech, dizziness or sudden headache for no particular reason, loss of balance, numbness or immobility of one half of the face (facial features may change) or body. A stroke can happen at a young age - and this is especially dangerous, because. no one expects such a serious illness, and therefore seeks medical help later. If you suspect the person is having a stroke, ask him or her to smile (the smile will not be symmetrical), raise both arms at the same time (one side of the body will work less), ask a simple question (the speech may be slurred).

What to do: Call a doctor immediately or go to the hospital. During this time, provide access to fresh air. If a person has high blood pressure, you can drink the medicine that he usually takes for pressure. When vomiting, you need to turn your head to the side so that the vomit does not make breathing difficult.

heart attack

Signs: Pressure and pain in the chest, especially radiating to the shoulder blade and left arm, palpitations or arrhythmia, nausea, a feeling of fear. A heart attack has already ceased to be a disease of the elderly and can happen at 30 or 20 years old, and this is a deadly disease, so it is better to pay extra attention.

What to do: Urgently call a doctor, and while he is driving, give the victim to chew a few tablets of aspirin and nitroglycerin.

Heimlich maneuver

This technique is used if a person is choking and cannot breathe, is unable to speak or even cough. Stand behind the victim or victim, wrap your arms around him or her just above the navel, under the ribs, clench your hands into a fist and make a few sharp pushing upward movements (as if drawing the letter J with your fist) - you can watch a video on how to do this, for example.

Cardiopulmonary resuscitation

It is used in cases where the victim (s) has no breathing and heartbeat (check the pulse on the wrist and on the carotid artery in the neck). This artificial respiration and indirect heart massage.

Artificial respiration (there is a pulse, the person is not breathing):

1. Ensure the patency of the respiratory tract: you need to remove water, vomit, foreign objects from the mouth and nose. This can be done with a napkin or handkerchief by turning the person's head to the side.

2. Tilt the victim(s) head back, pinch his or her nose, inhale and exhale briefly into the victim(s) mouth through a napkin or piece of cloth. Example.

3. Take 1 breath every 5-6 seconds (10-12 breaths per minute). When performed correctly, the chest will rise slightly. Continue artificial respiration until the person breathes on their own or until an ambulance arrives.

Indirect cardiac massage (no pulse at the wrists and carotid artery):

1. The victim(s) must lie on a hard surface.

2. Find a point 3-4 cm above the xiphoid process (i.e. from the lower edge of the sternum). Place the base of the palm on this point (the fingers do not touch the chest of the victim or victim), the second palm on top. Press on the chest strictly vertically, applying not the strength of the hands (so you get tired very quickly), but the entire weight of your body. Example.

3. The pressure frequency is 100-120 per minute until the pulse is restored. Depth of pressing - 5 cm.
If the victim (s) has neither breathing nor a pulse, combine artificial respiration and chest compressions in the following proportion: two breaths for 30 pressures. If you doubt your abilities - do only an indirect heart massage. Resuscitation measures are carried out before the arrival of doctors.

You can take first aid courses in Minsk in