What are the main goals of first aid. Providing first aid in emergency situations - basic rules and algorithm of actions

14.07.2019 -

Feet care

The concept of emergency conditions.

Lecture #1 Emergency conditions and their evaluation

Plan:

1. The concept of emergency conditions.

2. Goals and objectives of the first medical care.

3. Assessment of the victim's condition.

4. First aid

In case of accidents, acute developing diseases before arrival medical worker it is necessary to provide the simplest first aid measures. Often they can be used by the patient or the victim himself. Efficient delivery first aid is possible only with the appropriate knowledge and skills. Moreover, it is important to know not only what needs to be done in case of a given sudden illness or injury, but also what cannot be done in these cases.

First aid for a sudden illness or injury is diverse.

First of all, you need to check the work of the heart, the presence of a pulse. When cardiac arrest, you need to do an external heart massage.

At arterial bleeding by imposing a hemostatic tourniquet it is necessary to stop blood loss.

Only after taking these urgent measures that save a person’s life, you should familiarize yourself with the injuries (for example, examining the fracture site), you need to find out the complaints of the victim and, having familiarized yourself with his general condition and the main signs of the disease or injury, begin to provide first aid (PMP) .

So, in the presence of a burn or wound surface, its circumference is processed, observing maximum cleanliness and asepsis, a sterile bandage is applied.

In case of fractures of the bones of the limbs, immobility must be given, for example, a transport splint can be applied.

For sudden illnesses and injuries special meaning has general and local peace. Therefore, when providing first aid, it is necessary to comfortably lay the patient (injured) in bed or on a stretcher. In the presence of acute pain in the abdomen, it is forbidden to eat or drink, use a heating pad and laxative enemas.

You need to know that before the doctor arrives, you should not use antibiotics, which change the picture of the disease and make it difficult to recognize and treat the disease in a timely manner. Also not recommended for acute pain in the abdomen, use painkillers and laxatives, because. their acceptance makes it difficult to assess acute inflammation peritoneum.

First medical or first aid - a set of urgent simple measures to save a person's life and prevent complications in the event of an accident or sudden illness, carried out at the scene of the incident by the victim himself (self-help) or by another person nearby (mutual assistance).

tasks:

1. Rendering emergency care for the purpose of saving lives;

2. Prevention of complications;

3. Determining the severity of the state of the injured;

First aid- this is a complex of the simplest medical measures, carried out by people who do not necessarily have a special medical education. The first aid level does not involve the use of any special medical instruments, medicines or equipment.

The main purpose of first aid is the ability to provide assistance to a person who has been injured or suffering from sudden attack illness until qualified medical assistance, such as an ambulance, arrives.

Principles of rendering:

· Optimal time first aid - up to 30 min. after injury, in case of poisoning - up to 10 minutes. When breathing stops, this time is reduced to 5-7 minutes. The importance of the time factor is emphasized at least by the fact that among those who received first aid within 30 minutes. after an injury, complications occur twice as rarely as in persons who received assistance later than this period.

· The time from the moment of injury, poisoning and other accidents to the moment of receiving help should be reduced as much as possible.

First of all, it is necessary to stop the action of damaging factors: remove from the rubble or water, put out burning clothes, take it out of a burning room or zone of contamination with toxic substances, remove it from a car, etc.

It is important to be able to quickly and correctly assess the condition of the victim. On examination, first determine whether he is alive or dead, then determine the severity of the lesion, the condition, whether the bleeding continues.

Signs of life:

1. The presence of a pulse on the carotid artery;

2. The presence of independent breathing. Installed on the move chest, by respiratory noise;

3. Pupil reaction to light. If the open eye of the victim is closed with his hand, and then quickly taken to the side, then the pupil will narrow.

Signs of death:

1. Lack of pulse in the central arteries;

2. Lack of pupil reaction to light;

3. Clouding and drying of the cornea of the eyes;

4. When squeezing the eye from the sides with fingers, the pupil narrows and resembles cat eye;

5. The appearance of cadaveric spots and rigor mortis.

Remember not to:

1. Touch and drag the victim to another place, if he is not threatened by fire, collapse of the building, if he does not need to do artificial respiration and provide emergency medical care. When applying a bandage, splint, do not do anything that will cause additional pain, worsen your well-being;

2. Reset prolapsed organs in case of damage to the chest and especially the abdominal cavities;

3. Give water or oral medicine to an unconscious victim;

4. Touch the wound with your hands or any objects;

5. Remove visible foreign bodies from a wound in the abdominal, thoracic or cranial cavities. If you try to remove them, significant bleeding or other complications are possible. Before the arrival of the ambulance, cover with a dressing and carefully bandage;

6. Leave the victim unconscious on the back, especially with a note and vomiting. Depending on the condition, it must be turned on its side or, in extreme cases, its head should be turned sideways;

7. Remove clothes and shoes from the victim in serious condition, should only be torn or cut;

8. Let the victim look at his wound. Provide assistance calmly and confidently, calming and encouraging him;

9. Trying to pull the victim out of the fire, water, buildings that threaten to collapse, without taking proper measures for their own protection. Before providing first aid, look around to notice a possible source of danger in time - the threat of collapse, fire, explosion, destruction of buildings, etc.

Keep him warm, use every opportunity to keep him warm, in the absence of blankets and heating pads, use bottles of hot water, bricks and stones heated on a fire. If the victim is not damaged abdominal organs and he is conscious, give him as much to drink as possible, preferably water with the addition of salt (one teaspoon) and baking soda (half a teaspoon) per 1 liter of water. In case of damage abdominal cavity instead of drinking, you should apply napkins moistened with water, handkerchiefs, sponges to your lips.

TERMINAL STATES. SIGNS AND CHARACTERISTICS OF CLINICAL AND BIOLOGICAL DEATH

TERMINAL STATES borderline states between life and death critical level life disorders with a catastrophic drop in blood pressure, a profound disruption of gas exchange and metabolism. Classification of the terminal state: pre-agony, agony, clinical death. In addition, the state of the revived organism after resuscitation is also referred to the terminal states.

Clinical and biological death

A kind of transitional state between life and death, begins from the moment the activity of the central nervous system, blood circulation and respiration and continues for a short period of time until irreversible changes in the brain develop. From the moment they occur, death is regarded as biological (in the context of this article, I equate the concepts of social and biological death due to the irreversibility of the processes that have occurred in the body). Thus, the main dynamic characteristic clinical death is the possible reversibility of this state.

During clinical death, respiration, circulation and reflexes are absent, but cellular metabolism continues anaerobically. Gradually, the reserves of energy drinks in the brain are depleted, and nervous tissue dies.

It is generally accepted that under normal conditions the term of clinical death in a person is 3 ... 6 minutes. Clinical death is ascertained at the moment of complete cessation of blood circulation, respiration and switching off the functional activity of the central nervous system. Immediately after stopping and cessation of lung function metabolic processes decrease sharply, but do not stop completely due to the presence of the mechanism of anaerobic glycolysis. In this regard, clinical death is a reversible state, and its duration is determined by the time of the experience of the cortex. hemispheres brain in conditions of complete cessation of blood circulation and respiration.

The duration of the period of clinical death is influenced by the type of dying, its duration, the age of the patient, the temperature of his body when dying. So with the help of deep artificial hypothermia (reducing the temperature of the human body to 8-12 ° C), it is possible to extend the state of clinical death up to 1-1.5 hours.

After clinical death, irreversible changes occur in the tissues (primarily in the cells of the cerebral cortex), already determining the state of biological death, in which full recovery functions various bodies cannot be achieved.

The onset of biological death is established both by the cessation of breathing and cardiac activity, and on the basis of the appearance of so-called reliable signs biological death: a decrease in body temperature below 20 ° C, the formation of cadaveric spots 2-4 hours after cardiac arrest (occur due to accumulation of blood in the lower parts of the body), the development of rigor mortis (solidification of muscle tissue).

REANIMATION

resuscitation- restoration of vital functions of the body (primarily respiration and blood circulation). Resuscitation is carried out when there is no breathing and cardiac activity has stopped, or both of these functions are oppressed so much that both breathing and blood circulation do not practically meet the needs of the body. The main methods of R. are artificial respiration and heart massage.

The patient's chances of survival are higher the earlier they are started. resuscitation(they must be started no later than one minute from the onset of a cardiac catastrophe). Rules for conducting basic resuscitation measures:

If the patient does not respond to external stimuli, immediately go to paragraph 1 of these Rules.

1. Ask someone, for example, neighbors, to call an ambulance.

2. Correctly lay down the resuscitated person, ensuring patency respiratory tract. For this:

The patient should be laid on a flat hard surface and his head thrown back as much as possible.

To improve airway patency oral cavity Removable dentures or other foreign bodies must be removed. In case of vomiting, turn the patient's head to one side, and remove the contents from the oral cavity and pharynx with a swab (or improvised means).

3. Check for spontaneous breathing.

4. If there is no spontaneous breathing, start artificial respiration. The patient should lie in the position described earlier on his back with his head thrown back sharply. The pose can be provided by placing a roller under the shoulders. You can hold your head with your hands. Lower jaw should be pushed forward. The caregiver takes a deep breath, opens his mouth, quickly brings it closer to the patient's mouth and, pressing his lips tightly to his mouth, takes a deep breath, i.e. as if blows air into his lungs and inflates them. To prevent air from escaping through the resuscitator's nose, pinch his nose with your fingers. The caregiver then leans back and takes a deep breath again. During this time, the patient's chest collapses - there is a passive exhalation. The caregiver then blows air into the patient's mouth again. For hygienic reasons, the patient's face can be covered with a handkerchief before blowing air.

5. If there is no pulse on the carotid artery, artificial ventilation of the lungs must be combined with an indirect heart massage. For indirect massage, place your hands one on top of the other so that the base of the palm lying on the sternum is strictly on the midline and 2 fingers above xiphoid process. Without bending your arms and using your own body weight, smoothly shift the sternum towards the spine by 4-5 cm. With this displacement, compression (compression) of the chest occurs. Perform the massage so that the duration of the compressions is equal to the interval between them. The frequency of compressions should be about 80 per minute. In pauses, leave your hands on the sternum of the patient. If you are resuscitating alone, after doing 15 chest compressions, take two breaths in a row. Then repeat indirect massage in conjunction with artificial ventilation lungs.

6. Remember to constantly monitor the effectiveness of your resuscitation. Resuscitation is effective if the patient's skin and mucous membranes turn pink, the pupils narrowed and a reaction to light appeared, spontaneous breathing resumed or improved, and a pulse appeared on the carotid artery.

· Continue CPR until the ambulance arrives.

Health care- any actions aimed at preserving health and life.

Types of medical care determine its volume and depend on knowledge (presence and level medical education), which provides it, and the conditions and equipment available for the implementation of this knowledge, there are:

first aid (emergency care);
pre-medical medical care;
first medical aid;
qualified and specialized medical care.

First aid carried out at the scene by people who do not have a medical education, as well as in the order of self- and mutual assistance. First aid should be given as much as possible early dates after the accident in order to avoid complications and death of the victim, until the arrival of qualified specialists. Its main task is to save the life of the affected person and prevent possible complications. First aid includes three main groups of events:

1. Immediate cessation of exposure to the victim of external damaging factors and removal of him from adverse conditions in which he got (extraction from the water, removal from the gassed room, etc.).
2. Immediate start of medical care, depending on the nature and type of injury, accident or sudden illness.
3. Calling medical specialists or organizing the fastest transportation of the victim to the nearest medical institution.

Measures (volume) of first aid include: inspection of the scene, evacuation from the danger zone, temporary stop of bleeding, shock prevention and control, restoration of the heart and lungs (resuscitation), application of a sterile dressing on the wound, transport immobilization, etc. In many accidents, the rescuer himself may be victims, therefore, when providing first aid, you should take care of your own safety (for example, electric shock, blockages, etc.).

The order of first aid may be different depending on the specific situation. First, they perform those techniques on which the preservation of the life of the victim depends, or those without which it is impossible to perform subsequent first aid techniques. Sometimes, to save a life, it is enough to put him in a certain position, in other cases, it is necessary to immediately begin resuscitation or stop bleeding. All first aid techniques should be gentle, as gross interventions can worsen the patient's condition.

First aid carried out by medical specialists with a secondary medical education

First aid doctors give the injured general profile. The tasks of first medical aid are to maintain the vital activity of the affected organism, prevent complications and prepare it for evacuation.

Qualified and specialized medical care is injured in medical institutions corresponding level of qualification and specialization.

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An accident, a sudden illness often occurs in conditions where there are no necessary medicines, dressings, assistants, means of transport immobilization, there is no good lighting. AT similar cases it is necessary to carry out a set of available and appropriate measures aimed at saving the life of the victim.

When providing first aid, the following principles must be observed

1. All actions must be expedient, deliberate, decisive, quick and calm.
2. First of all, it is necessary to take measures to stop the impact of damaging moments (remove from water, remove from a burning room, extinguish burning clothes, etc.).
3. Quickly and correctly assess the condition of the victim. This is especially important if the victim (sick) is unconscious. When examining the victim, they determine whether he is alive or dead, determine the type and severity of the injury, the presence of bleeding.
4. After examining the victim, the method and sequence of first aid is determined.
5. Find out what funds are needed for first aid, based on specific conditions and opportunities.
6. After providing first aid, prepare the victim for transportation.
7. Organize the transportation of the victim to a medical facility.
8. Monitor the victim before being sent to a medical facility.
9. First aid should be provided not only at the scene, but also on the way to a medical institution.

Revealing signs of life and signs of death

In case of severe injury, electric shock, drowning, suffocation, poisoning, and a number of diseases, there may be a loss of consciousness, i.e. a state when the victim lies motionless, does not answer questions, does not respond to the environment. It occurs as a result of disruption of the central nervous system (CNS), mainly the brain.

Violation of the activity of the brain is possible with:

1) direct brain injury (bruise, concussion, crushing of the brain, cerebral hemorrhage, electrical injury), poisoning, including alcohol and medicines;
2) impaired blood supply to the brain (blood loss, fainting, cardiac arrest or severe impairment of its activity);
3) cessation of oxygen supply to the body (suffocation, drowning, compression of the chest by weight);
4) the inability of the blood to be saturated with oxygen (poisoning, metabolic disorders, for example, in diabetes, fever);
5) hypothermia or overheating (freezing, heat stroke, hyperthermia in a number of diseases).

The caregiver must clearly and quickly distinguish loss of consciousness from death.

If minimal signs of life are found, it is necessary to immediately begin resuscitation (revival).

The signs of life are:

1) the presence of a heartbeat. The heartbeat is determined by hand or ear on the chest in the region of the left nipple;
2) the presence of a pulse in the arteries. The pulse is determined on the neck (common carotid artery), in the area of the wrist joint ( radial artery), in the groin ( femoral artery) - rice. one;
3) the presence of breathing. Breathing is determined by the movement of the chest and abdomen, the moistening of a mirror applied to the nose and mouth of the victim, the movement of a piece of cotton wool or a bandage brought to the nasal openings (Fig. 2);
4) the presence of a reaction of pupils to light. When the eye is illuminated with a beam of light (for example, a flashlight), pupil constriction is observed - positive reaction pupil. In daylight, this reaction is checked by closing the eye with a hand for a while, then quickly moving the hand to the side, while constriction of the pupil will be noticeable (Fig. 3).

The most informative in the diagnosis of circulatory cessation is the absence of pulsation of large vessels (carotid, femoral) and the presence of wide pupils that do not respond to light.

The presence of signs of life signals the need for immediate resuscitation.

It should be remembered that the absence of a heartbeat, pulse, breathing and pupillary response to light does not indicate that the victim is dead.

A similar set of symptoms can also be observed in clinical death (see below).

Providing assistance is meaningless with obvious signs of death:

1) clouding and drying of the cornea of the eye;
2) the presence of the "cat's eye" symptom: when the eye is squeezed, the pupil is deformed and resembles a cat's eye (Fig. 4);
3) cooling of the body and the appearance of cadaveric spots. These blue-purple spots appear on the skin. When the corpse is on the back, they appear in the area of the shoulder blades, lower back, buttocks, and when positioned on the stomach - on the face, neck, chest, abdomen;
4) rigor mortis. This indisputable sign of death occurs 2-4 hours after death.

Rice. 1. Points for determining the pulse on the arteries and the place for listening to heart sounds (marked with a cross)

Rice. 2. Revealing signs of life with a mirror and a ball of cotton. Explanation in the text

Rice. 3. Determination of the reaction of the pupil to light:
a - the pupil before exposure to a beam of light; b - after exposure

Rice. 4. Clear signs of death:
a - the eye of a living person, b - clouding of the cornea in a dead person; c - symptom of "cat's eye".

After assessing the condition of the victim (sick), they begin to provide first aid, the nature of which depends on the type of injury, the degree of damage and the condition of the victim. The sequence of actions for various injuries and diseases is described in the relevant chapters.

When providing first aid, it is important not to cause additional injury to the victim.

To stop bleeding, apply a bandage on the brine, with thermal and chemical burns clothing must be removed from the victim.

Rules for removing clothes from the victim

When damaged upper limbs clothes are removed first from a healthy hand. Then, holding the injured hand, gently pulling on the sleeve, take off her clothes. If the victim lies on his back and it is impossible to put him down, then the clothes from the upper half of the torso and arms are removed in the following sequence.

Carefully pull the back of the shirt (dress, coat) up to the neck and transfer it over the head to the chest, then remove it from the sleeve good hand. Last of all, the injured hand is released by pulling off the clothes from it by the sleeve. From the lower part of the body, clothes are removed in a similar sequence. In some cases, when heavy bleeding and severe burns clothes are cut.

It must be remembered that in case of wounds, fractures, burns, sudden movements, movement, turning over the injured limbs sharply increase pain, worsen general state victim, up to cardiac arrest, breathing. Therefore, lifting the injured limb or the victim should be done carefully, supporting the damaged parts of the body from below.

Buyanov V.M., Nesterenko Yu.A.

First aid is care that is provided directly at the site of injury or illness. The importance of knowledge and possession of first aid techniques for any person has two aspects. The wounded often die not from injuries, but because the first aid was late, for example: if the artery was damaged, they could not quickly stop the bleeding (with a hand, tourniquet). Or the victim, lying on his back, suffocated (vomit, blood, sunken tongue). Part of the deaths is on the conscience of those who, being nearby, hesitated or did not know what to do. The main thing is to learn how to act correctly in the first seconds after finding the victim in order to save his life until the doctors arrive. The following recommendations will help you properly provide first aid to yourself, your friend, and others who will need it. First aid includes the following three groups of measures: immediate cessation of exposure to external damaging factors electricity, high or low temperature, squeezing with weights), removal of the victim from adverse conditions; providing first aid to the victim, depending on the nature and type of injury, accident or sudden illness (stopping bleeding, applying a bandage to a wound, artificial respiration, heart massage, etc.); organization of the speedy delivery of the victim to a medical institution. The sequence for first aid is shown in Figure 23.