Life is very unpredictable, so often we become witnesses different situations. When we are talking about health, quick response and basic knowledge can save human life. Based on this, everyone needs to have experience in such a noble cause as providing first aid in case of emergency conditions.

What is an emergency?

In medicine, this is a series of symptoms in which it is necessary to provide the first. In other words, pathological condition, which is characterized by rapid changes in health for the worse. Emergency conditions are characterized by the presence of a probability of death.

Health emergencies can be classified according to the process of occurrence:

1. External - arise under the action of an environmental factor that directly affects human health.
2. Internal - pathological processes in the human body.

Such a division helps to understand the root cause of the human condition and thus provide quick help. Some pathological processes in the body arise on the basis of external factors that provoke them. Due to stress, a spasm of the heart vessels is likely to occur, as a result of which myocardial infarction often develops.

If the problem is in chronic disease, for example, disorientation in space, then quite realistically such a condition can provoke an emergency situation. Due to contact with external factor there is a possibility of serious injury.

Emergency medical care - what is it?

Providing emergency care in emergencies - This is a set of actions that must be performed in case of sudden diseases that pose a threat to human life. Such assistance is provided immediately, because every minute counts.

Emergencies and emergency medical care - these two concepts are very closely related. After all, often health, and maybe even life, depends on quality first aid. Decisive action can greatly help the victim before the ambulance arrives.

How can you help someone in a difficult situation?

In order to provide correct and qualified assistance, it is necessary to have basic knowledge. Children are often taught how to behave in school. It's a pity that not everyone listens carefully. If such a person is close to someone who is in a life-threatening situation, he will not be able to provide the necessary assistance.

There are times when minutes count. If nothing is done, the person will die, so it is very important to have basic knowledge.

Classification and diagnosis of emergency conditions

There is a huge number difficult situations. The most common of them are:

• stroke;
• heart attack;
• poisoning;
• epilepsy;
• bleeding.

Providing first aid in emergencies

Each emergency situation is in itself threatening to a person's life. The ambulance provides medical care, respectively, the actions of a nurse in emergencies should be thoughtful.

There are situations when the reaction should be immediate. Sometimes there's no way to call ambulance"at home, and a person's life is in danger. In such cases, you need to know how to behave, that is, the provision of emergency medical care should not be based on spontaneous chaotic actions, but should be carried out in a certain sequence.

Stroke as an acute circulatory disorder of the brain

A disease that is characterized by a problem with the vessels of the brain and poor clotting blood. One of the main causes of stroke is hypertension, that is, high blood pressure.

Stroke is serious illness, which long time strikes people precisely because of its suddenness. Doctors say that the highest quality medical care is possible only in the first hours after a hypertensive crisis.

One of the symptoms is severe headache and nausea. Dizziness and loss of consciousness strong heartbeat and fever. Often the pain is so strong that it seems: the head will not stand it. The reason is the blockage of blood vessels and obstruction of blood to all parts of the brain.

Emergency medical assistance: Keep the patient calm, unfasten clothing, provide air access. The head should be slightly higher than the body. If there are prerequisites for vomiting, it is necessary to lay the patient on his side. Give an aspirin tablet to chew and call an ambulance immediately.

Heart attack - ischemic heart disease

A heart attack is a manifestation of the heart, as a result of which irreversible processes occur. The heart muscle refuses to work smoothly, as the blood flow through the coronary veins is disturbed.

Myocardial infarction can cause prolonged ischemic disease such as angina pectoris. The main symptom of the disease is strong pain in which does not pass after taking nitroglycerin. The pain is so paralyzing that the person is unable to move. Feelings are all over left side, pain can occur both in the shoulder, arm, and in the jaw. There is a fear of imminent death.

Rapid breathing and an irregular heartbeat, combined with pain, confirm a heart attack. Facial pallor, weakness and - also symptoms of a heart attack.

Emergency medical assistance: The most correct solution in this situation is to immediately call the ambulance team. Here time goes by for minutes, since the life of the patient depends on how correctly and timely medical care is provided. It is important to learn to recognize Age does not matter here, because even quite young people are increasingly facing this problem.

The problem is that many simply ignore dangerous state and do not even suspect how fatal the consequences can be. Emergencies and emergency medical care are very related. One such condition is myocardial infarction. If the first symptoms of the disease appear, you should immediately put an aspirin or nitroglycerin tablet under the tongue (lowers blood pressure). It is worth remembering that the mortality from the disease is very high, so do not joke with your health.

Poisoning as a reaction of the body to an allergen

Poisoning is a disruption internal organs after exposure to a toxic substance. Poisonings are different: food, ethyl alcohol or nicotine, medications.

Symptoms: Abdominal pain, dizziness, vomiting, diarrhea, fever body. All of these symptoms are indicative of something wrong with the body. General weakness occurs as a result of dehydration.

Emergency Medical Treatment: It is important to immediately flush the stomach with plenty of water. Recommended use activated carbon to neutralize the allergen that caused the poisoning. Need to take care of plentiful drink because the body is completely exhausted. It is better to stop eating food during the day. If the symptoms persist, you should consult a doctor.

Epilepsy as a brain disorder

Epilepsy is chronic illness which is characterized by constant seizures. Attacks are manifested in the form of severe convulsions, up to a complete loss of consciousness. In this state, the patient does not feel anything, the memory is completely turned off. The ability to speak is lost. This condition is associated with the inability of the brain to cope with its functions.

Seizures are the main symptom of epilepsy. The attack begins with a piercing cry, then the patient does not feel anything. Some types of epilepsy may resolve without obvious symptoms. Most often this happens in children. Helping children in emergencies is no different from helping adults, the main thing is to know the sequence of actions.

Emergency Medical Aid: A person with epilepsy can be more harmed by the impact of a fall than by the seizure itself. When convulsions appear, it is necessary to lay the patient on a flat, preferably hard surface. Make sure that the head is turned to one side so that the person does not choke on his saliva, this position of the body prevents the tongue from sinking.

You should not try to delay convulsions, just hold the patient so that he does not hit sharp objects. The attack lasts up to five minutes, and does not pose a danger. If the convulsions do not go away or the attack happened to a pregnant woman, it is necessary to call an ambulance team.

To be on the safe side, it is not out of place to ask for it. Epilepsy patients do this from time to time, so those who are nearby need to know how to provide first aid.

Bleeding: what to do with large blood loss?

Bleeding is an outflow a large number blood from vessels due to injury. Bleeding can be internal or external. The condition is classified according to the vessels from which blood flows. The most dangerous is arterial.

If this is external bleeding, then it can be determined if blood flows from open wound. At big loss vital fluid observed: dizziness, rapid pulse, sweating, weakness. With internal pain in the abdomen, bloating and traces of blood in the feces, urine and vomit.

Emergency Medical Care: If there is a slight loss of blood, it is enough to treat the wound with an antiseptic and cover the affected area with adhesive tape or If the wound is deep, it belongs to the category of "emergency conditions" and emergency medical care is simply necessary. What can be done at home? Close the affected area with a clean cloth and, as far as possible, raise the place of blood loss above the level of the patient's heart. In this case, immediate hospitalization is simply necessary.

After arriving at medical institution The actions of the nurse in emergency conditions are as follows:

• clean the wound;
• apply a bandage or sutures.

In case of severe bleeding, the help of a qualified doctor is necessary. Remember: the victim must not be allowed to lose too much blood, immediately take him to the hospital.

Why be able to provide medical care?

Emergencies and emergency medical care are closely related to each other. Thanks to the right and quick action it is possible to maintain a person's health until the ambulance arrives. Often a person's life depends on our actions. Everyone needs to be able to provide medical care, because life is unpredictable.

Definition. Emergency conditions are pathological changes in the body that lead to sharp deterioration health, threaten the life of the patient and require emergency therapeutic measures. There are the following emergency conditions:

Directly life threatening

Not life-threatening, but without assistance, the threat will be real

Conditions in which failure to provide emergency assistance will lead to permanent changes in the body

Situations in which it is necessary to quickly alleviate the patient's condition

situations requiring medical intervention in the interests of others due to inappropriate behavior of the patient

restoration of respiratory function

relief of collapse, shock of any etiology

relief of convulsive syndrome

prevention and treatment of cerebral edema

CARDIOLUMMARY REANIMATION.

Definition. Cardiopulmonary resuscitation (CPR) is a set of measures aimed at restoring lost or severely impaired vital body functions in patients in a state of clinical death.

The main 3 receptions of CPR according to P. Safar, "rule ABC":

A ire way open - ensure airway patency;

B reath for victim - start artificial respiration;

C irculation his blood - restore blood circulation.

A- carried out triple trick according to Safar - tilting the head, the maximum forward displacement of the lower jaw and opening the patient's mouth.

Give the patient an appropriate position: lay on a hard surface, putting a roller of clothes on his back under the shoulder blades. Tilt your head as far back as possible

Open your mouth and look oral cavity. With convulsive compression of the masticatory muscles, use a spatula to open it. Clear the oral cavity of mucus and vomit with a handkerchief wound around the index finger. If the tongue is sunk, turn it out with the same finger

Rice. Preparation for artificial respiration: put forward lower jaw forward (a), then move the fingers to the chin and, pulling it down, open the mouth; with the second hand placed on the forehead, tilt the head back (b).

Rice. Restoration of airway patency.

a- opening the mouth: 1-crossed fingers, 2-capturing the lower jaw, 3-using a spacer, 4-triple reception. b- cleaning of the oral cavity: 1 - with the help of a finger, 2 - with the help of suction. (fig. by Moroz F.K.)

B - artificial lung ventilation (ALV). IVL is the blowing of air or an oxygen-enriched mixture into the lungs of a patient without / using special devices. Each breath should take 1-2 seconds, and the respiratory rate should be 12-16 per minute. IVL at the stage first aid carried out "mouth to mouth" or "mouth to nose" exhaled air. At the same time, the effectiveness of inhalation is judged by the rise chest and passive exhalation of air. Either an airway, face mask and Ambu bag, or tracheal intubation and Ambu bag are usually used by the ambulance team.

Rice. IVL "mouth to mouth".		Get up from right side, holding the head of the victim in a tilted position with his left hand, at the same time cover the nasal passages with his fingers. Right hand the lower jaw should be pushed forward and upward. In this case, the following manipulation is very important: a) hold the jaw by the zygomatic arches with the thumb and middle fingers; b) index finger open the mouth; c) with the tips of the ring finger and little finger (fingers 4 and 5) control the pulse on the carotid artery.
	Take a deep breath, clasping the mouth of the victim with your lips and blowing. For hygienic purposes, cover the mouth with any clean cloth. At the moment of inspiration, control the rise of the chest When signs of spontaneous breathing appear in the victim, mechanical ventilation is not immediately stopped, continuing until the number of spontaneous breaths corresponds to 12-15 per minute. At the same time, if possible, the rhythm of breaths is synchronized with the recovering breathing of the victim. Mouth-to-nose ventilation is indicated when assisting a drowning person, if resuscitation is carried out directly in the water, in case of fractures cervical spine (tilting the head back is contraindicated). IVL using the Ambu bag is indicated if the provision of assistance is mouth-to-mouth or mouth-to-nose Rice. IVL with the help of simple devices. a - through S - shaped air duct; b- using a mask and an Ambu bag; c- through an endotracheal tube; d- percutaneous transglottal IVL. (fig. by Moroz F.K.)		Rice. IVL "from mouth to nose"

C - indirect heart massage.

The patient lies on his back on a hard surface. The caregiver stands on the side of the victim and puts the hand of one hand on the lower middle third of the sternum, and the second hand on top, across the first to increase pressure.

the doctor should stand high enough (on a chair, stool, stand, if the patient is lying on a high bed or on the operating table), as if hanging with his body over the victim and putting pressure on the sternum not only with the effort of his hands, but also with the weight of his body.

The rescuer's shoulders should be directly above the palms, the arms should not be bent at the elbows. With rhythmic pushes of the proximal part of the hand, they press on the sternum in order to shift it towards the spine by approximately 4-5 cm. The pressure force should be such that on the carotid or femoral artery one of the team members could clearly identify the artificial pulse wave.

The number of chest compressions should be 100 in 1 minute

The ratio of chest compressions to artificial respiration in adults is 30: 2 whether one or two people are doing CPR.

In children, 15:2 if CPR is performed by 2 people, 30:2 if it is performed by 1 person.

simultaneously with the onset of mechanical ventilation and massage intravenous bolus: every 3-5 minutes 1 mg of adrenaline or 2-3 ml endotracheally; atropine - 3 mg intravenously bolus once.

Rice. Position of the patient and caregiver indirect massage hearts.

ECG- asystole ( isoline on the ECG)

intravenously 1 ml of 0.1% solution of epinephrine (adrenaline), repeated intravenously after 3-4 minutes;

intravenous atropine 0.1% solution - 1 ml (1 mg) + 10 ml of 0.9% solution of sodium chloride after 3-5 minutes (until the effect or a total dose of 0.04 mg / kg is obtained);

Sodium bicarbonate 4% - 100 ml is administered only after 20-25 minutes of CPR.

if asystole persists, immediate percutaneous, transesophageal, or endocardial temporary pacing.

ECG- ventricular fibrillation (ECG - teeth of different amplitudes randomly located)

electrical defibrillation (EIT). Shocks of 200, 200 and 360 J (4500 and 7000 V) are recommended. All subsequent discharges - 360 J.

In ventricular fibrillation, after the 3rd shock, cordarone in the initial dose of 300 mg + 20 ml of 0.9% sodium chloride solution or 5% glucose solution, again - 150 mg each (up to a maximum of 2 g). In the absence of cordarone, enter lidocaine- 1-1.5 mg/kg every 3-5 minutes for a total dose of 3 mg/kg.

Magnesia sulfate - 1-2 g IV for 1-2 minutes, repeat after 5-10 minutes.

EMERGENCY AID FOR ANAPHILACTIC SHOCK.

Definition. Anaphylactic shock is an immediate systemic allergic reaction to reintroduction allergen as a result of rapid massive immunoglobulin-E-mediated release of mediators from tissue basophils (mast cells) and basophilic granulocytes of peripheral blood (R.I. Shvets, E.A. Fogel, 2010).

Provoking factors:

reception medicines: penicillin, sulfonamides, streptomycin, tetracycline, nitrofuran derivatives, amidopyrine, aminophylline, aminophylline, diaphylline, barbiturates, anthelmintic drugs, thiamine hydrochloride, glucocorticosteroids, novocaine, sodium thiopental, diazepam, radiopaque and iodine-containing substances.

Administration of blood products.

Food products: chicken eggs, coffee, cocoa, chocolate, strawberries, strawberries, crayfish, fish, milk, alcoholic beverages.

Administration of vaccines and sera.

Insect stings (wasps, bees, mosquitoes)

Pollen allergens.

Chemicals (cosmetics, detergents).

Local manifestations: edema, hyperemia, hypersalivation, necrosis

Systemic manifestations: shock, bronchospasm, DIC, intestinal disorders

Urgent care:

Stop contact with allergens: stop parenteral administration of the drug; remove the insect sting from the wound with an injection needle (removal with tweezers or fingers is undesirable, since it is possible to squeeze out the remaining poison from the reservoir of the poisonous gland of the insect remaining on the sting) Apply ice or a heating pad to the injection site cold water for 15 min.

Lay the patient down (head above the legs), turn the head to the side, protrude the lower jaw, if available removable dentures- take them off.

If necessary, perform CPR, tracheal intubation; with laryngeal edema - tracheostomy.

Indications for IVL anaphylactic shock:

Swelling of the larynx and trachea with impaired patency  - respiratory tract;

Intractable arterial hypotension;

Violation of consciousness;

Persistent bronchospasm;

Pulmonary edema;

Development - coagulopathy bleeding.

Immediate tracheal intubation and mechanical ventilation is performed with loss of consciousness, a decrease in systolic blood pressure below 70 mm Hg. Art., in the event of stridor.

The appearance of stridor indicates obstruction of the lumen of the upper respiratory tract by more than 70–80%, and therefore the patient's trachea should be intubated with a tube of the largest possible diameter.

Medical therapy:

Provide intravenous access into two veins and start transfusion of 0.9% - 1.000 ml of sodium chloride solution, stabisol - 500 ml, polyglucin - 400 ml

Epinephrine (adrenaline) 0.1% - 0.1 -0.5 ml intramuscularly, if necessary, repeat after 5-20 minutes.

With anaphylactic shock medium degree severity, a fractional (bolus) injection of 1-2 ml of a mixture (1 ml of -0.1% adrenaline + 10 ml of 0.9% sodium chloride solution) is shown every 5-10 minutes until hemodynamic stabilization.

Intratracheal epinephrine is administered in the presence of an endotracheal tube in the trachea - as an alternative to intravenous or intracardiac routes of administration (2-3 ml at a time in a dilution of 6-10 ml in isotonic sodium chloride solution).

prednisolone intravenously 75-100 mg - 600 mg (1 ml = 30 mg prednisolone), dexamethasone - 4-20 mg (1 ml = 4 mg), hydrocortisone - 150-300 mg, (if it is impossible intravenous administration- intramuscular).

with generalized urticaria or with a combination of urticaria with Quincke's edema - diprospan (betamethasone) - 1-2 ml intramuscularly.

with Quincke's edema, a combination of prednisolone and antihistamines new generation: semprex, telfast, clarifer, allertec.

membrane stabilizers intravenously: vitamin C 500 mg/day (8–10 10 ml of 5% solution or 4–5 ml of 10% solution), troxevasin 0.5 g/day (5 ml of 10% solution), sodium etamsylate 750 mg/day (1 ml = 125 mg), the initial dose is 500 mg, then every 8 hours, 250 mg.

intravenously eufillin 2.4% 10–20  ml, no-shpa 2 ml, alupent (brikanil) 0.05% 1–2 ml (drip); isadrin 0.5% 2 ml subcutaneously.

with persistent hypotension: dopmin 400 mg + 500 ml 5% r-ra glucose intravenously drip (dose titrated until the level is reached systolic pressure 90 mm Hg) and is prescribed only after replenishment of the volume of circulating blood.

with persistent bronchospasm 2 ml (2.5 mg) salbutamol or berodual (fenoterol 50 mg, iproaropium bromide 20 mg) preferably through a nebulizer

with bradycardia, atropine 0.5 ml -0.1% of the solution subcutaneously or 0.5 -1 ml intravenously.

It is advisable to administer antihistamines to the patient only after stabilization blood pressure, as their action may aggravate hypotension: diphenhydramine 1% 5 ml or   suprastin 2% 2-4 ml, or tavegil 6 ml intramuscularly, cimetidine 200-400 mg (10% 2-4 ml) intravenously, famotidine 20 mg every 12 hours (0.02 g of dry powder diluted in 5 ml of solvent) intravenously, pipolfen 2.5% 2-4 ml subcutaneously.

Hospitalization in the department intensive care/ Allergology with generalized urticaria, Quincke's edema.

EMERGENCY CARE FOR ACUTE CARDIOVASCULAR FAILURE: CARDIOGENIC SHOCK, FANE COLLAPSE

Definition. Acute cardiovascular failure is a pathological condition caused by the inadequacy of cardiac output to the metabolic needs of the body. It can be due to 3 reasons or a combination of them:

Sudden decrease in myocardial contractility

Sudden decrease in blood volume

Sudden drop in vascular tone.

Causes of occurrence: arterial hypertension, acquired and congenital heart defects, pulmonary embolism, myocardial infarction, myocarditis, cardiosclerosis, myocardiopathies. Conventionally, cardiovascular insufficiency is divided into cardiac and vascular.

Acute vascular insufficiency is characteristic of conditions such as fainting, collapse, shock.

Cardiogenic shock: emergency care.

Definition. Cardiogenic shock is an emergency condition arising from acute circulatory failure, which develops due to a deterioration in myocardial contractility, pumping function of the heart, or a violation of the rhythm of its activity. Causes: myocardial infarction, acute myocarditis, heart injury, heart disease.

The clinical picture of shock is determined by its form and severity. There are 3 main forms: reflex (pain), arrhythmogenic, true.

reflex cardiogenic shock complication of myocardial infarction that occurs at the height of the pain attack. It often occurs with lower-posterior localization of a heart attack in middle-aged men. Hemodynamics normalizes after the relief of the pain attack.

Arrhythmogenic cardiogenic shock a consequence of cardiac arrhythmia, often against the background of ventricular tachycardia> 150 in 1 minute, atrial fibrillation, ventricular fibrillation.

True cardiogenic shock a consequence of a violation of myocardial contractility. The most severe form of shock against the background of extensive necrosis of the left ventricle.

Weakness, lethargy or short-term psychomotor agitation

The face is pale with a grayish-ash tinge, skin covering marble color

Cold clammy sweat

Acrocyanosis, cold extremities, collapsed veins

The main symptom is a sharp drop in SBP< 70 мм. рт. ст.

Tachycardia, shortness of breath, signs of pulmonary edema

oliguria

0.25 mg acetylsalicylic acid chew in the mouth

Lay down the patient with raised lower limbs;

oxygen therapy with 100% oxygen.

With an anginal attack: 1 ml of a 1% solution of morphine or 1-2 ml of a 0.005% solution of fentanyl.

Heparin 10,000 -15,000 IU + 20 ml of 0.9% sodium chloride intravenously drip.

400 ml of 0.9% sodium chloride solution or 5% glucose solution intravenously over 10 minutes;

intravenous jet solutions of polyglucin, refortran, stabisol, reopoliglyukin until blood pressure stabilizes (SBP 110 mm Hg)

With heart rate> 150 per minute. – absolute indication for EIT, heart rate<50 в мин абсолютное показание к ЭКС.

No stabilization of blood pressure: dopmin 200 mg intravenously + 400 ml of 5% glucose solution, the rate of administration is from 10 drops per minute until the SBP is at least 100 mm Hg. Art.

If there is no effect: norepinephrine hydrotartrate 4 mg in 200 ml of 5% glucose solution intravenously, gradually increasing the infusion rate from 0.5 μg / min to SBP 90 mm Hg. Art.

if the SBP is more than 90 mm Hg: 250 mg of dobutamine solution + in 200 ml of 0.9% sodium chloride intravenously by drip.

Hospitalization in the intensive care unit / intensive care unit

First aid for fainting.

Definition. Fainting is an acute vascular insufficiency with a sudden short-term loss of consciousness due to an acute insufficiency of blood flow to the brain. Causes: negative emotions (stress), pain, a sudden change in body position (orthostatic) with a disorder of the nervous regulation of vascular tone.

Tinnitus, general weakness, dizziness, pallor of the face

Loss of consciousness, the patient falls

Pale skin, cold sweat

Pulse is thready, blood pressure drops, extremities are cold

The duration of fainting from a few minutes to 10-30 minutes

Lay the patient down with head down and legs up, free from tight clothing

Give a sniff of 10% aqueous ammonia (ammonia)

Midodrine (gutron) orally 5 mg (tablets or 14 drops of 1% solution), maximum dose - 30 mg / day or intramuscularly, or intravenously 5 mg

Mezaton (phenylephrine) intravenously slowly 0.1-0.5 ml 1% solution + 40 ml 0.9% sodium chloride solution

With bradycardia and cardiac arrest atropine sulfate 0.5 - 1 mg intravenously by bolus

When breathing and circulation stops - CPR

Collapse emergency.

Definition. Collapse is an acute vascular insufficiency that occurs as a result of inhibition of the sympathetic nervous system and an increase in the tone of the vagus nerve, which is accompanied by the expansion of arterioles and a violation of the ratio between the capacity of the vascular bed and the bcc. As a result, venous return, cardiac output and cerebral blood flow are reduced.

Reasons: pain or its expectation, a sharp change in body position (orthostatic), an overdose of antiarrhythmic drugs, ganglioblockers, local anesthetics (novocaine). Antiarrhythmic drugs.

General weakness, dizziness, tinnitus, yawning, nausea, vomiting

Paleness of the skin, cold clammy sweat

Decreased blood pressure (systolic blood pressure less than 70 mm Hg), bradycardia

Possible loss of consciousness

Horizontal position with legs elevated

1 ml 25% cordiamine solution, 1-2 ml 10% caffeine solution

0.2 ml 1% mezaton solution or 0.5 - 1 ml 0.1% epinephrine solution

For prolonged collapse: 3–5 mg/kg hydrocortisone or 0.5–1 mg/kg prednisone

With severe bradycardia: 1 ml -0.15 solution of atropine sulfate

200 -400 ml of polyglucin / rheopolyglucin

Providing first aid requires a special approach from the medical staff. Algorithms for helping patients with common symptoms are available for download.

Quality first aid for emergencies (ES) is vital. Each condition and disease requires a special approach from the medical staff.

Algorithms for helping patients with different symptoms are available for download.

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The main thing in the material

First aid for emergencies includes the provision of primary medical measures to patients whose condition threatens their health. These are exacerbations of various diseases, seizures, injuries and poisoning.

When providing first aid, conditions are distinguished that differ in the speed of their development in the patient's body.

For example, some conditions may develop over several days (ketoacidotic coma in diabetes mellitus), while others develop rapidly (anaphylactic shock).

In all such emergency situations, the task of physicians is to prevent the deterioration of the patient's condition. This will improve the patient's condition.

The Ministry of Health has prepared amendments to the procedure for primary care for adults. Learn how to implement requirements without delay in the magazine "Deputy Chief Physician"

When providing first aid, it is important to pay attention to the appearance of the patient. He can say more than a man's complaints spoken aloud. Many signs can be recognized by a person without a medical education.

For example, this is loss of consciousness, unusual skin color, voice change, high temperature, atypical pulse, etc.

By these and other signs, one can understand that a person needs to be provided emergency assistance in emergency situations.

What is important to consider:

Help with NA has several important tasks:

• eliminate a real threat to life, for which priority medical measures are taken;
• ensure the smooth operation of the main systems of the human body;
• minimize the risk of complications.

And finally, the physician must act effectively and accurately, so as not to harm the health of the patient.

Help with various conditions and diseases

First aid includes a number of typical activities indicated in first aid algorithms for various conditions and diseases.

Let's look at a few examples.

1. With dehydration (dehydration), the first actions of physicians include:
   • intravenous administration of a special solution in an amount equal to 10% of the patient's weight (trisol, quartasol, sodium chlorine solution, etc.);
   • the rate of injection of the solution is observed. The first 2 liters - at a rate of up to 120 ml per minute, then - at a rate of 30-60 ml per minute;
   • preferably the introduction of a solution of quartasol.
2. In case of infectious-toxic shock, the first medical aid for emergency conditions includes:
   • carrying out oxygen inhalation;
   • staging prednisolone 60 mg with a solution of sodium chloride;
   • trental is administered intravenously or drip;
   • if these drugs are not available, 400 ml of gemodez, saline and glucose, etc. are injected intravenously.
   • further with it doctors of a hospital are engaged.
3. In acute neurological syndrome, emergency care includes:
   • placing it in the most functionally advantageous position;
   • psychomotor agitation is removed, for which the patient is given diazepam, sodium oxybutyrate, prednisolone, oxygen inhalation, etc.;
   • in the presence of hyperthermia - amidopyrine, reopyrin, etc.;
   • further care includes general and local physical hypothermia.

Approved new rules for the organization of palliative care. In the article of the magazine "Deputy Chief Physician" read how the duties of the medical staff were divided, what information and medical devices now need to be provided to relatives and how to refer patients to social services. In the application - ready-made documents to organize the work.

How to provide first aid for anaphylactic shock

In emergencies that develop rapidly, first aid is vital. For example, with anaphylactic shock, doctors have a few minutes at their disposal.

9 steps emergency medical care:

1. The entry of the alleged allergen into the human body must be stopped immediately. If this is a drug, its administration should be stopped immediately, and ice should be applied to the injection site.
2. The physician evaluates the general condition, the type of skin, breathing and blood circulation of the patient, the patency of the respiratory tract.

An ambulance is immediately called, and if the patient is in the hospital, the resuscitation team.

1. Epinephrine (adrenaline) is injected intramuscularly into the middle of the anterolateral surface of the thigh in a dosage corresponding to the age and weight of the person. Most patients respond to the first dose of adrenaline, if this does not happen, after 5-15 minutes the procedure is repeated.
2. Having laid the patient on his back, he should raise his legs and turn his head to the side so as to prevent the tongue from falling and asphyxia. If the patient has dentures, they must be removed.

At this stage, it is important to ensure that the patient breathes freely. The rest of the actions are performed by ambulance doctors or resuscitation team.

1. If there is difficulty in breathing, a triple intake according to P. Safar is performed, an endotracheal tube is inserted.

If there is swelling of the larynx or pharynx, it is necessary to intubate the trachea. In severe cases, a conicotomy is performed.

1. After normalization of breathing, an influx of fresh air into the room is organized. If this is not possible, pure oxygen is used.
2. Intravenous access should be established. According to the doctor's prescription, a solution of sodium chloride is introduced. Doctors must be prepared to conduct emergency resuscitation.

Help with NS also includes chest compressions according to indications.

1. Readings such as respiratory rate, pressure, pulse and oxygenation are continuously monitored. So, if there is no special monitor, the pulse and pressure must be manually monitored every 3-5 minutes.
2. The patient is transported to the intensive care unit.

In the folder of the head

When does a clinic have the right to deviate from the standards? Four cases from practice and counterarguments for inspectors to avoid sanctions from Roszdravnadzor - in the magazine "Deputy Chief Physician".

Help with OOI

A particularly dangerous infection requires a special approach to first aid.

If disinfectants enter the body

• if chloractive preparations, for example, disinfectants, have entered the patient's stomach, immediate gastric lavage with a 2% hyposulfite solution is necessary;
• in case of formaldehyde poisoning, a 3% solution of acetate or sodium carbonate is added to the washing water;
• if the disinfectant gets into the eyes, it is necessary to rinse them with a 2% solution of baking soda or running water for 3-7 minutes;
• in the presence of irritation, a solution of sodium sulfacyl 30% is instilled into the eyes;
• if disinfectants come into contact with the skin, the affected area of ​​\u200b\u200bthe skin is washed with water. Then it is lubricated with a softening ointment;
• if disinfectants have passed through the respiratory tract, the victim is taken to fresh air or to a well-conditioned room. The nasopharynx and mouth are washed with water;
• if these actions did not have a positive effect and the victim became worse, he is placed in a hospital for further diagnosis.

As we can see, first aid and medical actions differ depending on what kind of condition is suspected in the patient.

Below are algorithms for providing assistance for various diseases and conditions in the form of a memo for download.

The first aid provided must be correct and timely. Our memos reflect the key points that are worth paying attention to.

For example, what mistakes should not be made when drowning, how to help with various injuries and to carry out the fastest localization.

1. Wounds: emergency care depending on the type and location

First aid tasks

Closed pneumothorax, arterial hypertension, cholelithiasis, etc. - all these are conditions in which competent first aid is important.

In the memos, briefly - the tasks of health workers, their primary actions, the necessary medicines and techniques.

Life sometimes brings surprises, and they are not always pleasant. We get into difficult situations or become their witnesses. And often we are talking about the life and health of loved ones or even random people. How to act in this situation? After all, quick action, the correct provision of emergency assistance can save a person's life. What are emergencies and emergency medical care, we will consider further. And also find out what should be the help in case of emergency, such as respiratory arrest, heart attack and others.

Types of medical care

The medical care provided can be divided into the following types:

• Emergency. It appears in the event that there is a threat to the life of the patient. This can be with an exacerbation of any chronic diseases or with sudden acute conditions.
• Urgent. It is necessary during the period of exacerbated chronic pathology or in case of an accident, but there is no threat to the life of the patient.

• Planned. This is the implementation of preventive and planned activities. At the same time, there is no threat to the patient's life even if the provision of this type of assistance is delayed.

Emergency and emergency care

Emergency and emergency medical care are very closely related to each other. Let's take a closer look at these two concepts.

In emergencies, medical attention is required. Depending on where the process takes place, in case of emergency, assistance is provided:

• External processes that arise under the influence of external factors and directly affect human life.
• internal processes. The result of pathological processes in the body.

Emergency care is one of the types of primary health care, provided during exacerbation of chronic diseases, in acute conditions that do not threaten the patient's life. It can be provided both on a day hospital and on an outpatient basis.

Emergency assistance should be provided in case of injuries, poisoning, acute conditions and diseases, as well as in case of accidents and in situations where assistance is vital.

Emergency care must be provided in any medical institution.

Pre-hospital care is very important in emergency situations.

Major emergencies

Emergency conditions can be divided into several groups:

1. Injuries. These include:

• Burns and frostbite.
• Fractures.
• Damage to vital organs.
• Damage to blood vessels with subsequent bleeding.
• Electric shock.

2. Poisoning. Damage occurs within the body, unlike injuries, it is the result of external influences. Violation of the work of internal organs with untimely emergency care can lead to death.

Poison can enter the body:

• Through the respiratory organs and mouth.
• Through the skin.
• Through the veins
• Through mucous membranes and through damaged skin.

Medical emergencies include:

1. Acute conditions of internal organs:

• Stroke.
• Myocardial infarction.
• Pulmonary edema.
• Acute liver and kidney failure.
• Peritonitis.

2. Anaphylactic shock.

3. Hypertensive crises.

4. Attacks of suffocation.

5. Hyperglycemia in diabetes mellitus.

Emergency conditions in pediatrics

Every pediatrician should be able to provide emergency care to the child. It may be required in case of a serious illness, in case of an accident. In childhood, a life-threatening situation can progress very quickly, since the child's body is still developing and all processes are imperfect.

Pediatric emergencies requiring medical attention:

• Convulsive syndrome.
• Fainting in a child.
• Coma in a child.
• collapse in a child.
• Pulmonary edema.
• The child is in shock.
• infectious fever.
• Asthmatic attacks.
• Croup syndrome.
• Incessant vomiting.
• Dehydration of the body.
• Emergency conditions in diabetes mellitus.

In these cases, the emergency medical service is called.

Features of emergency care for a child

The doctor's actions must be consistent. It must be remembered that in a child, the disruption of the work of individual organs or the whole organism occurs much faster than in an adult. Therefore, emergencies and emergency medical care in pediatrics require a quick response and coordinated action.

Adults should ensure the calm condition of the child and provide full cooperation in collecting information about the patient's condition.

The doctor should ask the following questions:

• Why did you seek emergency help?
• How was the injury received? If it's an injury.
• When did the child get sick?
• How did the disease develop? How did it go?
• What preparations and agents were used before the arrival of the doctor?

The child must be undressed for examination. The room should be at normal room temperature. In this case, the rules of asepsis must be observed when examining a child. If it is a newborn, a clean gown should be worn.

It should be borne in mind that in 50% of cases where the patient is a child, the diagnosis is made by the doctor based on the information collected, and only in 30% - as a result of the examination.

At the first stage, the doctor should:

• Assess the degree of disruption of the respiratory system and the work of the cardiovascular system. Determine the degree of need for emergency therapeutic measures according to vital signs.
• It is necessary to check the level of consciousness, breathing, the presence of convulsions and cerebral symptoms and the need for urgent measures.

You need to pay attention to the following points:

• How does the child behave?
• Sluggish or hyperactive.
• What an appetite.
• Condition of the skin.
• The nature of the pain, if any.

Medical emergencies and care

The health worker must be able to quickly assess emergencies, and emergency medical care must be provided in a timely manner. A correct and quick diagnosis is the key to a quick recovery.

Treatment emergencies include:

1. Fainting. Symptoms: pallor of the skin, skin moisture, muscle tone is reduced, tendon and skin reflexes are preserved. Blood pressure is low. There may be tachycardia or bradycardia. Fainting can be caused by the following reasons:

• Failure of the organs of the cardiovascular system.
• Asthma, various types of stenosis.
• Diseases of the brain.
• Epilepsy. Diabetes mellitus and other diseases.

Assistance is as follows:

• The victim is placed on a flat surface.
• Unbutton clothes, provide good access to air.
• You can spray water on the face and chest.
• Give a sniff of ammonia.
• Caffeine benzoate 10% 1 ml is administered subcutaneously.

2. Myocardial infarction. Symptoms: pain burning, squeezing, similar to an attack of angina pectoris. Pain attacks are undulating, decrease, but do not stop completely. The pain gets worse with every wave. At the same time, it can give to the shoulder, forearm, left shoulder blade or hand. There is also a feeling of fear, a breakdown.

Assistance is as follows:

• The first stage is pain relief. Nitroglycerin is used or Morphine or Droperidol is administered intravenously with Fentanyl.
• It is recommended to chew 250-325 mg of Acetylsalicylic acid.
• You need to measure your blood pressure.
• Then it is necessary to restore the coronary blood flow.
• Beta-adrenergic blockers are prescribed. During the first 4 hours.
• Thrombolytic therapy is carried out in the first 6 hours.

The doctor's task is to limit the size of necrosis and prevent the occurrence of early complications.

The patient must be urgently admitted to an emergency medicine center.

3. Hypertensive crisis. Symptoms: headache, nausea, vomiting, goosebumps, numbness of the tongue, lips, hands. Double vision, weakness, lethargy, high blood pressure.

Emergency assistance is as follows:

• It is necessary to provide the patient with rest and good access to air.
• With crisis type 1 "Nifedipine" or "Clonidine" under the tongue.
• At high pressure intravenously "Clonidine" or "Pentamine" up to 50 mg.
• If tachycardia persists, - "Propranolol" 20-40 mg.
• In a type 2 crisis, Furosemide is administered intravenously.
• With convulsions, Diazepam is administered intravenously or Magnesium sulfate.

The doctor's task is to reduce the pressure by 25% of the initial one during the first 2 hours. With a complicated crisis, urgent hospitalization is necessary.

4. Coma. It may be of different types.

Hyperglycemic. Develops slowly, begins with weakness, drowsiness, headache. Then there is nausea, vomiting, increased thirst, itchy skin. Then loss of consciousness.

Urgent care:

• Eliminate dehydration, hypovolemia. Sodium chloride solution is injected intravenously.
• Intravenously administered "Insulin".
• With severe hypotension, a solution of 10% "Caffeine" subcutaneously.
• Carry out oxygen therapy.

Hypoglycemic. It starts off sharp. The moisture of the skin is increased, the pupils are dilated, blood pressure is reduced, the pulse is quickened or normal.

Emergency care means:

• Ensuring complete rest.
• Intravenous administration of glucose.
• Correction of arterial pressure.
• Urgent hospitalization.

5. Acute allergic diseases. Serious diseases include: bronchial asthma and angioedema. Anaphylactic shock. Symptoms: the appearance of skin itching, there is excitability, increased blood pressure, a feeling of heat. Then loss of consciousness and respiratory arrest, failure of the heart rhythm are possible.

Emergency care is as follows:

• Position the patient so that the head is below the level of the legs.
• Provide air access.
• Open the airways, turn the head to the side, protrude the lower jaw.
• Introduce "Adrenaline", re-introduction is allowed after 15 minutes.
• "Prednisolone" in / in.
• Antihistamines.
• With bronchospasm, a solution of "Euphyllin" is administered.
• Urgent hospitalization.

6. Pulmonary edema. Symptoms: well expressed shortness of breath. Cough with white or yellow sputum. The pulse is fast. Seizures are possible. Breath is wheezing. Wet rales are heard, and in a serious condition "dumb lungs"

We provide emergency assistance.

• The patient should be in a sitting or semi-sitting position, legs lowered.
• Carry out oxygen therapy with defoamers.
• Enter / in "Lasix" in saline.
• Steroid hormones such as Prednisolone or Dexamethasone in saline.
• "Nitroglycerin" 1% intravenously.

Let's pay attention to emergency conditions in gynecology:

1. Ectopic pregnancy disturbed.
2. Torsion of the pedicle of an ovarian tumor.
3. Apoplexy of the ovary.

Consider the provision of emergency care for ovarian apoplexy:

• The patient should be in a supine position, with a raised head.
• Glucose and "Sodium chloride" are administered intravenously.

It is necessary to control indicators:

• Blood pressure.
• Heart rate.
• body temperature.
• Respiratory frequency.
• Pulse.

Cold is applied to the lower abdomen and urgent hospitalization is indicated.

How are emergencies diagnosed?

It is worth noting that the diagnosis of emergency conditions should be carried out very quickly and take literally seconds or a couple of minutes. The doctor must at the same time use all his knowledge and make a diagnosis in this short period of time.

The Glasgow scale is used when it is necessary to determine the impairment of consciousness. It evaluates:

• Eye opening.
• Speech.
• Motor responses to pain stimuli.

When determining the depth of the coma, the movement of the eyeballs is very important.

In acute respiratory failure, it is important to pay attention to:

• Color of the skin.
• Color of mucous membranes.
• Breathing frequency.
• Movement during breathing of the muscles of the neck and upper shoulder girdle.
• Retraction of the intercostal spaces.

Shock can be cardiogenic, anaphylactic, or post-traumatic. One of the criteria may be a sharp decrease in blood pressure. In traumatic shock, first of all, determine:

• Damage to vital organs.
• The amount of blood loss.
• Cold extremities.
• Symptom of "white spot".
• Decreased urine output.
• Decreased blood pressure.
• Violation of the acid-base balance.

The organization of emergency medical care consists, first of all, in maintaining breathing and restoring blood circulation, as well as in delivering the patient to a medical institution without causing additional harm.

Emergency Algorithm

For each patient, the methods of treatment are individual, but the algorithm of actions for emergency conditions must be performed for each patient.

The principle of action is as follows:

• Restoration of normal breathing and circulation.
• Help with bleeding.
• It is necessary to stop convulsions of psychomotor agitation.
• Anesthesia.
• Elimination of disorders that contribute to the failure of the heart rhythm and its conduction.
• Conducting infusion therapy to eliminate dehydration of the body.
• Decrease in body temperature or its increase.
• Conducting antidote therapy in acute poisoning.
• Strengthening natural detoxification.
• If necessary, enterosorption is carried out.
• Fixation of the damaged part of the body.
• Correct transportation.
• Constant medical supervision.

What to do before the doctor arrives

First aid in emergency conditions consists of performing actions that are aimed at saving human life. They will also help prevent the development of possible complications. First aid for emergencies should be provided before the doctor arrives and the patient is taken to a medical facility.

Action algorithm:

1. Eliminate the factor that threatens the health and life of the patient. Conduct an assessment of his condition.
2. Take urgent measures to restore vital functions: restoring breathing, artificial respiration, heart massage, stopping bleeding, applying a bandage, and so on.
3. Maintain vital functions until the ambulance arrives.
4. Transportation to the nearest medical facility.

1. Acute respiratory failure. It is necessary to carry out artificial respiration "mouth to mouth" or "mouth to nose". We tilt our head back, the lower jaw needs to be shifted. Close your nose with your fingers and take a deep breath into the victim's mouth. It is necessary to take 10-12 breaths.

2. Heart massage. The victim is in a supine position on his back. We stand on the side and put palm on palm on top of the chest at a distance of 2-3 fingers above the lower edge of the chest. Then we perform pressure so that the chest is displaced by 4-5 cm. Within a minute, 60-80 pressures must be done.

Consider the necessary emergency care for poisoning and injuries. Our actions in gas poisoning:

• First of all, it is necessary to take the person out of the polluted area.
• Loosen tight clothing.
• Assess the patient's condition. Check pulse, breathing. If the victim is unconscious, wipe the temples and give a sniff of ammonia. If vomiting has begun, then it is necessary to turn the head of the victim to one side.
• After the victim was brought to his senses, it is necessary to carry out inhalation with pure oxygen so that there are no complications.
• Then you can give hot tea, milk or slightly alkaline water to drink.

Help with bleeding:

• Capillary bleeding is stopped by applying a tight bandage, while it should not compress the limb.
• We stop arterial bleeding by applying a tourniquet or clamping the artery with a finger.

It is necessary to treat the wound with an antiseptic and contact the nearest medical facility.

Providing first aid for fractures and dislocations.

• With an open fracture, it is necessary to stop the bleeding and apply a splint.
• It is strictly forbidden to correct the position of the bones or remove fragments from the wound.
• Having fixed the place of injury, the victim must be taken to the hospital.
• A dislocation is also not allowed to be corrected on its own; a warm compress cannot be applied.
• It is necessary to apply cold or a wet towel.
• Rest the injured part of the body.

First aid for fractures should occur after bleeding has stopped and breathing has normalized.

What should be in a first aid kit

In order for emergency assistance to be provided effectively, it is necessary to use a first aid kit. It should contain components that may be needed at any moment.

The first aid kit must meet the following requirements:

• All medicines, medical instruments, as well as dressings should be in one special case or box that is easy to carry and transport.
• First aid kit should have many departments.
• Store in an easily accessible place for adults and out of the reach of children. All family members should know about her whereabouts.
• Regularly check the expiration dates of the drugs and replenish the used medicines and products.

What should be in the first aid kit:

1. Preparations for the treatment of wounds, antiseptics:

• Brilliant green solution.
• Boric acid in liquid or powder form.
• Hydrogen peroxide.
• Ethanol.
• Alcoholic iodine solution.
• Bandage, tourniquet, adhesive plaster, dressing bag.

2. Sterile or plain gauze mask.

3. Sterile and non-sterile rubber gloves.

4. Analgesics and antipyretics: "Analgin", "Aspirin", "Paracetamol".

5. Antimicrobials: Levomycetin, Ampicillin.

6. Antispasmodics: Drotaverine, Spazmalgon.

7. Cardiac drugs: "Corvalol", "Validol", "Nitroglycerin".

8. Adsorbents: "Atoxil", "Enterosgel".

9. Antihistamines: Suprastin, Dimedrol.

10. Ammonia.

11. Medical instruments:

• Clamp.
• Scissors.
• Cooling package.
• Disposable sterile syringe.
• Tweezers.

12. Antishock drugs: Adrenaline, Eufillin.

13. Antidotes.

Emergencies and emergency medical care are always highly individual and depend on the person and specific conditions. Every adult should have an understanding of emergency care in order to be able to help their loved one in a critical situation.

Fainting is a sudden, short-term loss of consciousness due to impaired blood circulation in the brain.

Fainting can last from a few seconds to several minutes. Usually a person comes to his senses after a while. Fainting in itself is not a disease, but rather a symptom of a disease.

Fainting can be due to various reasons:

1. Sudden sharp pain, fear, nervous shocks.

They can cause an instant decrease in blood pressure, resulting in a decrease in blood flow, a violation of the blood supply to the brain, which leads to fainting.

2. General weakness of the body, sometimes aggravated by nervous exhaustion.

General weakness of the body, due to a variety of reasons, ranging from hunger, poor nutrition, and ending with constant excitement, can also lead to low blood pressure and fainting.

3. Staying in a room with insufficient oxygen.

Oxygen levels can be reduced due to the presence of a large number of people in the room, poor ventilation and air pollution from tobacco smoke. As a result, the brain receives less oxygen than it needs, and the victim faints.

4. Long stay in a standing position without movement.

This leads to stagnation of blood in the legs, a decrease in its flow to the brain and, as a result, to fainting.

Symptoms and signs of fainting:

The reaction is a short-term loss of consciousness, the victim falls. In a horizontal position, the blood supply to the brain improves and after a while the victim regains consciousness.

Breathing is rare, superficial. Blood circulation - the pulse is weak and rare.

Other signs are dizziness, tinnitus, severe weakness, veil before the eyes, cold sweat, nausea, numbness of the extremities.

First aid for fainting

1. If the airways are free, the victim is breathing and his pulse is felt (weak and rare), he must be laid on his back and his legs raised.

2. Loosen tight clothing, such as collars and waistbands.

3. Put a wet towel on the victim's forehead, or wet his face with cold water. This will lead to vasoconstriction and improve the blood supply to the brain.

4. When vomiting, the victim must be transferred to a safe position, or at least turn his head to the side so that he does not choke on vomit.

5 It must be remembered that fainting can be a manifestation of a severe, including an acute illness that requires emergency care. Therefore, the victim always needs to be examined by his doctor.

6. Do not rush to lift the victim after consciousness has returned to him. If conditions allow, the victim can be given hot tea to drink, and then help to rise and sit down. If the victim again feels faint, he must be laid on his back and raise his legs.

7. If the victim is unconscious for several minutes, most likely it is not fainting and qualified medical assistance is needed.

Shock is a condition that threatens the life of the victim and is characterized by insufficient blood supply to tissues and internal organs.

The blood supply to tissues and internal organs can be disrupted for two reasons:

Heart problems;

Decrease in the volume of fluid circulating in the body (heavy bleeding, vomiting, diarrhea, etc.).

Symptoms and signs of shock:

Reaction - the victim is usually conscious. However, the condition can worsen very quickly, up to loss of consciousness. This is due to a decrease in blood supply to the brain.

The airways are usually free. If there is internal bleeding, there may be a problem.

Breathing - frequent, superficial. Such breathing is explained by the fact that the body is trying to get as much oxygen as possible with a limited amount of blood.

Blood circulation - the pulse is weak and frequent. The heart tries to compensate for the decrease in circulating blood volume by speeding up the circulation. A decrease in blood volume leads to a drop in blood pressure.

Other signs are that the skin is pale, especially around the lips and earlobes, cool and clammy. This is because the blood vessels in the skin close to direct blood to vital organs such as the brain, kidneys, etc. The sweat glands also increase activity. The victim may feel thirsty, due to the fact that the brain feels a lack of fluid. Muscle weakness occurs due to the fact that blood from the muscles goes to the internal organs. There may be nausea, vomiting, chills. Chill means lack of oxygen.

First aid for shock

1. If the shock is caused by impaired blood circulation, then first of all you need to take care of the brain - to ensure the supply of oxygen to it. To do this, if damage allows, the victim must be laid on his back, his legs raised and the bleeding stopped as soon as possible.

If the victim has a head injury, then the legs cannot be raised.

The victim must be laid on his back, putting something under his head.

2. If the shock is caused by burns, then first of all it is necessary to ensure the termination of the effect of the damaging factor.

Then cool the affected area of ​​the body, if necessary, lay the victim with raised legs and cover with something to keep warm.

3. If the shock is caused by a violation of cardiac activity, the victim must be given a semi-sitting position, placing pillows or folded clothes under his head and shoulders, as well as under his knees.

Laying the victim on his back is impractical, since in this case it will be more difficult for him to breathe. Have the victim chew an aspirin tablet.

In all these cases, it is necessary to call an ambulance and, before its arrival, monitor the condition of the victim, being ready to start cardiopulmonary resuscitation.

When assisting a victim in shock, it is unacceptable:

Move the victim, except when necessary;

Give the victim food, drink, smoke;

Leave the victim alone, except in cases where it is necessary to leave to call an ambulance;

Warm the victim with a heating pad or some other source of heat.

ANAPHYLACTIC SHOCK

Anaphylactic shock is an extensive allergic reaction of an immediate type that occurs when an allergen enters the body (insect bites, drug or food allergens).

Anaphylactic shock usually develops within seconds and is an emergency that requires immediate attention.

If anaphylactic shock is accompanied by loss of consciousness, immediate hospitalization is necessary, since the victim in this case may die within 5-30 minutes with asphyxia or after 24-48 hours or more due to severe irreversible changes in vital organs.

Sometimes a fatal outcome can occur later due to changes in the kidneys, gastrointestinal tract, heart, brain and other organs.

Symptoms and signs of anaphylactic shock:

Reaction - the victim feels anxiety, a feeling of fear, as shock develops, loss of consciousness is possible.

Airways - Swelling of the airways occurs.

Respiration - similar to asthmatic. Shortness of breath, chest tightness, cough, intermittent, difficult, may stop altogether.

Blood circulation - the pulse is weak, rapid, may not be palpable on the radial artery.

Other signs - the chest is tense, swelling of the face and neck, swelling around the eyes, redness of the skin, rash, red spots on the face.

First aid for anaphylactic shock

1. If the victim is conscious, give him a semi-sitting position to facilitate breathing. It is better to put him on the floor, unbutton the collar and loosen other pressing parts of the clothing.

2. Call an ambulance.

3. If the victim is unconscious, move him to a safe position, control breathing and blood circulation and be ready to proceed with cardiopulmonary resuscitation.

ATTACK OF BRONCHIAL ASTHMA

Bronchial asthma is an allergic disease, the main manifestation of which is an asthma attack caused by impaired bronchial patency.

An attack of bronchial asthma is caused by various allergens (pollen and other substances of plant and animal origin, industrial products, etc.)

Bronchial asthma is expressed in attacks of suffocation, experienced as a painful lack of air, although in reality it is based on difficulty exhaling. The reason for this is the inflammatory narrowing of the airways caused by allergens.

Symptoms and signs of bronchial asthma:

Reaction - the victim may be alarmed, in severe attacks he cannot utter a few words in a row, he may lose consciousness.

Airways - may be narrowed.

Breathing - characterized by obstructed elongated exhalation with many wheezing wheezes, often heard at a distance. Shortness of breath, cough, initially dry, and in the end - with the separation of viscous sputum.

Blood circulation - at first the pulse is normal, then it becomes rapid. At the end of a prolonged attack, the pulse may become thready until the heart stops.

Other signs are anxiety, extreme fatigue, sweating, tension in the chest, talking in a whisper, blue skin, nasolabial triangle.

First aid for an attack of bronchial asthma

1. Remove the victim to fresh air, unfasten the collar and loosen the belt. Sit with an inclination forward and with an emphasis on the chest. In this position, the airways open.

2. If the victim has any medications, help them use them.

3. Call an ambulance immediately if:

This is the first attack;

The attack did not stop after taking the medicine;

The victim has too difficult breathing and it is difficult for him to speak;

The victim is showing signs of extreme exhaustion.

HYPERVENTILATION

Hyperventilation is an excess of lung ventilation in relation to the level of metabolism, due to deep and (or) frequent breathing and leading to a decrease in carbon dioxide and an increase in oxygen in the blood.

The cause of hyperventilation is most often panic or serious excitement caused by fear or any other reasons.

Feeling a strong excitement or panic, a person begins to breathe more often, which leads to a sharp decrease in the carbon dioxide content in the blood. Hyperventilation sets in. The victim begins in connection with this to feel even more anxiety, which leads to increased hyperventilation.

Symptoms and signs of hyperventilation:

Reaction - the victim is usually alarmed, feels confused. Airways - open, free.

Breathing is naturally deep and frequent. As hyperventilation develops, the victim breathes more and more often, but subjectively feels suffocation.

Blood circulation - does not help to recognize the cause.

Other signs - the victim feels dizzy, sore throat, tingling in the arms, legs or mouth, the heartbeat may increase. Looking for attention, help, can become hysterical, faint.

First aid for hyperventilation.

1. Bring a paper bag to the nose and mouth of the victim and ask him to breathe the air that he exhales into this bag. In this case, the victim exhales air saturated with carbon dioxide into the bag, and inhales it again.

Usually after 3-5 minutes, the level of saturation of the blood with carbon dioxide returns to normal. The respiratory center in the brain receives relevant information about this and gives a signal: to breathe more slowly and deeply. Soon the muscles of the respiratory organs relax, and the entire respiratory process returns to normal.

2. If the cause of hyperventilation was emotional arousal, it is necessary to calm the victim, restore his sense of confidence, persuade the victim to sit down and relax calmly.

ANGINA

Angina pectoris (angina pectoris) - an attack of acute pain behind the sternum, due to transient insufficiency of the coronary circulation, acute myocardial ischemia.

The cause of an attack of angina pectoris is insufficient blood supply to the heart muscle, caused by coronary insufficiency due to narrowing of the lumen of the coronary (coronary) artery of the heart with atherosclerosis, vascular spasm, or a combination of these factors.

Angina pectoris can occur due to psycho-emotional stress, which can lead to spasm of pathologically unchanged coronary arteries of the heart.

However, most often, angina pectoris still occurs when the coronary arteries narrow, which can be 50-70% of the lumen of the vessel.

Symptoms and signs of angina pectoris:

Reaction - the victim is conscious.

The airways are free.

Breathing - superficial, the victim does not have enough air.

Blood circulation - the pulse is weak and frequent.

Other signs - the main symptom of pain syndrome - its paroxysmal. Pain has a fairly clear beginning and end. By nature, the pain is compressive, pressing, sometimes in the form of a burning sensation. As a rule, it is localized behind the sternum. Characterized by irradiation of pain in the left half of the chest, in the left hand to the fingers, left shoulder blade and shoulder, neck, lower jaw.

The duration of pain in angina pectoris, as a rule, does not exceed 10-15 minutes. Usually they occur at the time of physical exertion, most often when walking, and also during stress.

First aid for angina pectoris.

1. If the attack has developed during physical exertion, it is necessary to stop the load, for example, stop.

2. Give the victim a semi-sitting position, placing pillows or folded clothing under his head and shoulders, as well as under his knees.

3. If the victim has previously had angina attacks, for the relief of which he used nitroglycerin, he can take it. For faster absorption, a nitroglycerin tablet must be placed under the tongue.

The victim should be warned that after taking nitroglycerin, there may be a feeling of fullness in the head and headache, sometimes dizziness, and, if you stand, fainting. Therefore, the victim should remain in a semi-sitting position for some time even after the pain has passed.

In the case of the effectiveness of nitroglycerin, an angina attack disappears after 2-3 minutes.

If after a few minutes after taking the drug the pain has not disappeared, you can take it again.

If, after taking the third tablet, the victim's pain does not go away and drags on for more than 10-20 minutes, it is urgent to call an ambulance, since there is a possibility of developing a heart attack.

HEART ATTACK (MYOCARDIAL INFARCTION)

Heart attack (myocardial infarction) - necrosis (necrosis) of a section of the heart muscle due to a violation of its blood supply, manifested in a violation of cardiac activity.

A heart attack occurs due to blockage of a coronary artery by a thrombus - a blood clot that forms at the site of a narrowing of the vessel during atherosclerosis. As a result, a more or less extensive area of ​​the heart is “turned off”, depending on which part of the myocardium was supplied with blood by the clogged vessel. A thrombus cuts off the supply of oxygen to the heart muscle, resulting in necrosis.

Causes of a heart attack can be:

Atherosclerosis;

Hypertonic disease;

Physical activity in combination with emotional stress - vasospasm during stress;

Diabetes mellitus and other metabolic diseases;

genetic predisposition;

Environmental influence, etc.

Symptoms and signs of a heart attack (heart attack):

Reaction - in the initial period of a painful attack, restless behavior, often accompanied by a fear of death, in the future, loss of consciousness is possible.

The airways are usually free.

Breathing - frequent, shallow, may stop. In some cases, asthma attacks are observed.

Blood circulation - the pulse is weak, fast, may be intermittent. Possible cardiac arrest.

Other signs are severe pain in the region of the heart, usually occurring suddenly, more often behind the sternum or to the left of it. The nature of the pain is compressive, pressing, burning. Usually it radiates to the left shoulder, arm, shoulder blade. Often with a heart attack, unlike angina pectoris, the pain spreads to the right of the sternum, sometimes captures the epigastric region and "gives" to both shoulder blades. The pain is growing. The duration of a painful attack during a heart attack is calculated in tens of minutes, hours, and sometimes days. There may be nausea and vomiting, the face and lips may turn blue, severe sweating. The victim may lose the ability to speak.

First aid for a heart attack.

1. If the victim is conscious, give him a semi-sitting position, placing pillows or folded clothes under his head and shoulders, as well as under his knees.

2. Give the victim an aspirin tablet and ask him to chew it.

3. Loosen the squeezing parts of the clothing, especially at the neck.

4. Immediately call an ambulance.

5. If the victim is unconscious but breathing, put him in a safe position.

6. Control breathing and blood circulation, in case of cardiac arrest, immediately begin cardiopulmonary resuscitation.

Stroke - caused by a pathological process acute disorder blood circulation in the brain or spinal cord with the development of persistent symptoms of damage to the central nervous system.

The cause of a stroke can be a hemorrhage in the brain, cessation or weakening of the blood supply to any part of the brain, blockage of the vessel by a thrombus or embolus (a thrombus is a dense blood clot in the lumen of a blood vessel or heart cavity, formed in vivo; an embolus is a substrate circulating in the blood, not normally occurring and capable of causing blockage of blood vessels).

Strokes are more common in the elderly, although they can occur at any age. More commonly seen in men than in women. About 50% of those affected by a stroke die. Of those who survive, about 50% become crippled and have another stroke weeks, months, or years later. However, many stroke survivors regain their health through rehabilitation measures.

Symptoms and signs of a stroke:

The reaction is confused consciousness, there may be a loss of consciousness.

The airways are free.

Breathing - slow, deep, noisy, wheezing.

Blood circulation - the pulse is rare, strong, with good filling.

Other signs are a severe headache, the face may turn red, become dry, hot, speech disturbances or slowdowns may be observed, the corner of the lips may sag even if the victim is conscious. The pupil on the affected side may be dilated.

With a slight lesion, weakness, with a significant one, complete paralysis.

First aid for stroke

1. Call for qualified medical assistance immediately.

2. If the victim is unconscious, check if the airways are open, restore airway patency if it is broken. If the victim is unconscious, but breathing, move him to a safe position on the side of the injury (to the side where the pupil is dilated). In this case, the weakened or paralyzed part of the body will remain at the top.

3. Be prepared for rapid deterioration and CPR.

4. If the victim is conscious, lay him on his back with something under his head.

5. The victim may have a micro-stroke, in which there is a slight speech disorder, slight clouding of consciousness, slight dizziness, muscle weakness.

In this case, when providing first aid, you should try to protect the victim from falling, calm and support him and immediately call an ambulance. Control DP - D - K and be ready to provide emergency assistance.

epileptic seizure

Epilepsy is a chronic disease caused by damage to the brain, manifested by repeated convulsive or other seizures and is accompanied by a variety of personality changes.

An epileptic seizure is caused by excessively intense excitation of the brain, which is due to an imbalance in the human bioelectrical system. Typically, a group of cells in one part of the brain loses electrical stability. This creates a strong electrical discharge that rapidly spreads to the surrounding cells, disrupting their normal functioning.

Electrical phenomena can affect the entire brain or only part of it. Accordingly, there are major and minor epileptic seizures.

A minor epileptic seizure is a short-term disturbance of brain activity, leading to a temporary loss of consciousness.

Symptoms and signs of a small epileptic seizure:

The reaction is a temporary loss of consciousness (from a few seconds to a minute). The airways are open.

Breathing is normal.

Blood circulation - pulse normal.

Other signs are an unseeing gaze, repetitive or twitching movements of individual muscles (head, lips, arms, etc.).

A person comes out of such a seizure as suddenly as he enters it, and he continues the interrupted actions, not realizing that a seizure has occurred to him.

First aid for a small epileptic seizure

1. Eliminate the danger, seat the victim and calm him down.

2. When the victim wakes up, tell him about the seizure, as this may be his first seizure and the victim does not know about the disease.

3. If this is your first seizure, see your doctor.

A grand mal seizure is a sudden loss of consciousness accompanied by severe convulsions (convulsions) of the body and limbs.

Symptoms and signs of a grand mal seizure:

Reaction - begins with sensations close to euphoric (unusual taste, smell, sound), then loss of consciousness.

The airways are free.

Breathing - may stop, but recovers quickly. Blood circulation - pulse normal.

Other signs - usually the victim falls to the floor without consciousness, he begins to have sharp convulsive movements of the head, arms and legs. There may be a loss of control over physiological functions. The tongue is bitten, the face turns pale, then becomes bluish. The pupils do not react to light. Foam may come out of the mouth. The total duration of the seizure ranges from 20 seconds to 2 minutes.

First aid for a major epileptic seizure

1. Noticing that someone is on the verge of a seizure, you must try to make sure that the victim does not harm himself when falling.

2. Make room around the victim and put something soft under his head.

3. Loosen clothing around the victim's neck and chest.

4. Do not try to restrain the victim. If his teeth are clenched, do not try to open his jaws. Do not try to put something in the victim's mouth, as this can lead to trauma to the teeth and block the airways with their fragments.

5. After the cessation of convulsions, transfer the victim to a safe position.

6. Treat all injuries sustained by the victim during the seizure.

7. After the seizure has stopped, the victim must be hospitalized if:

The attack happened for the first time;

There was a series of seizures;

There are damages;

The victim was unconscious for more than 10 minutes.

HYPOGLYCEMIA

Hypoglycemia - low blood glucose Hypoglycemia can occur in a diabetic patient.

Diabetes is a disease in which the body does not produce enough of the hormone insulin, which regulates the amount of sugar in the blood.

If the brain does not receive enough sugar, then, just as with a lack of oxygen, brain functions are impaired.

Hypoglycemia can occur in a diabetic patient for three reasons:

1) the victim injected insulin, but did not eat on time;

2) with excessive or prolonged physical activity;

3) with an overdose of insulin.

Symptoms and signs of hypoglycemia:

The reaction is confused consciousness, loss of consciousness is possible.

Respiratory tract - clean, free. Breathing - rapid, superficial. Blood circulation - a rare pulse.

Other signs are weakness, drowsiness, dizziness. Feeling of hunger, fear, pallor of the skin, profuse sweat. Visual and auditory hallucinations, muscle tension, trembling, convulsions.

First aid for hypoglycemia

1. If the victim is conscious, give him a relaxed position (lying or sitting).

2. Give the victim a sugar drink (two tablespoons of sugar in a glass of water), a sugar cube, chocolate or sweets, you can caramel or cookies. The sweetener doesn't help.

3. Provide rest until the condition is completely normal.

4. If the victim has lost consciousness, transfer him to a safe position, call an ambulance and monitor the condition, be ready to proceed with cardiopulmonary resuscitation.

POISONING

Poisoning - intoxication of the body caused by the action of substances entering it from the outside.

Poisonous substances can enter the body in various ways. There are different classifications of poisoning. So, for example, poisoning can be classified according to the conditions for the entry of toxic substances into the body:

During a meal;

Through the respiratory tract;

through the skin;

When bitten by an animal, insect, snake, etc.;

through mucous membranes.

Poisoning can be classified according to the type of poisoning:

food poisoning;

medicinal poisoning;

Alcohol poisoning;

Chemical poisoning;

gas poisoning;

Poisoning caused by bites of insects, snakes, animals.

The task of first aid is to prevent further exposure to the poison, to accelerate its removal from the body, to neutralize the remains of the poison and to support the activity of the affected organs and body systems.

To solve this problem, you need:

1. Take care of yourself so as not to get poisoned, otherwise you will need help yourself, and the victim will have no one to help.

2. Check the reaction, respiratory tract, breathing and blood circulation of the victim, if necessary, take appropriate measures.

5. Call an ambulance.

4. If possible, set the type of poison. If the victim is conscious, ask him about what happened. If unconscious - try to find witnesses of the incident, or packaging from toxic substances or some other signs.