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Hostel for students :: Talks, lectures
Providing first aid
1. When bleeding
Distinguish between arterial, venous and capillary bleeding. Blood poured from the gaping wound light red rhythmically pulsating jet with arterial bleeding and dark solid continuous stream - venous. Capillary bleeding - blood from damaged small vessels follows, as a sponge.
When first aid uses a temporary stop bleeding.
Ways to temporarily stop bleeding
Stop arterial bleeding should always begin with a finger pressed against the artery. For this palpable arterial pulsation, which finger is pressed against the bone for a short time required for applying a pressure bandage, tourniquet or twist. Bleeding from the wound, it is localized in the shoulder girdle, shoulder and forearm stops pressing on the subclavian artery to the edge I supraclavicular, and brachial artery - to the humerus on the inner edge of the biceps muscle. When arterial bleeding from the wounds of the lower extremity should press the femoral artery in the inguinal bend to the pubic bone.
Exalted position of the limb, and tamponade wound tight compressive bandage can help stop proffuznoe as well as the majority of arterial bleeding.
Forced flexion of the limb with push excessively flexed peredavlivaet arterial vessel. This effect is enhanced if podloktevoy knee joint or put tight cotton-gauze roll or any other object, and then securely fix the limb bent over position with his trouser belt.
To stop bleeding from the subclavian region and the upper half of the shoulder roll invest in axillary regions.
Arms bent at the elbows, give birth behind and tightly fixed to each other.
Overlay spin (tow) applies only when using simple and safe methods of unstoppable bleeding, and mostly used for bleeding from the amputated stump.
When applying spin (tow) must observe the following rules:
1) to give the exalted position of the limb;
2) apply a tourniquet above the wound and as close as possible to it;
3) a tourniquet is applied to clothing or any gasket (handkerchief, scarf, towel);
4) with the help of one or two rounds to stop the bleeding;
5) cash harness securely fastened;
6) finding unacceptable harness on a limb more than 2 hours in summer and 1 hour in winter;
7) in a prominent place (forehead victim) note the date and time of a tourniquet;
8) in the winter extremity tourniquet should wrap clothing or thick wool.
Patients with temporarily stopped bleeding should be rushed to a surgical hospital in a horizontal position on a board or stretcher.
2. When closed injuries
It closed damage include:
1) injuries;
2) damage to the ligaments and tendons;
3) dislocations.
Bruises - closed soft tissue injury without compromising the integrity of the skin that occur when struck with a blunt object, if dropped on a hard surface.
First aid for traumatic injuries. In order to prevent hemorrhage should be held cold at the site of injury, the affected body to ensure absolute peace and apply a pressure bandage. Contusions of the head, chest, abdomen, accompanied by severe pain and deterioration of general condition, the victim must be urgently taken to a doctor.
Stretching or damage to the ligamentous apparatus of the joint occur when sudden impulsive movement of the joints, far exceeding the limits of the usual mobility in it, or may be the result of a direct blow to the strained tendon.
Most frequent ankle ligament damage, interphalangeal, wrist and knee, with a smoothness defined contours of the joint, limitation of function and pain in the projection damaged ligaments.
First Aid:
1) the application of cold to the joint area;
2) produce immobilization of the joint fixing 8-shaped bandage;
3) to drink painkillers drugs;
4) in an emergency station.
Most often damaged extensor tendons of the fingers, the quadriceps and the heel (Achilles) tendon. First aid is to immobilize the limb with improvised means in position to provide convergence ends of the tendon.
Dislocation - articulated this shift ends of the bones with the damage of the joint capsule and ligaments of the joint. In dislocation appears sharp pain, deformity of the joint, limitation of active and passive movements and forced position of the limb.
Dislocations in large joints may be accompanied by significant soft tissue injury, blood vessels and nerve trunks, which determines the direction of the victim in an emergency hospital. First aid for dislocation include: attachment cold, giving exalted position of the injured extremity, immobilization of the affected joint means at hand, the need to bring the victim to emergency station.
3. When fractures
Fracture (violation of integrity of the bone) can be closed and open (broken skin).
At the turn marked a sharp localized pain, aggravated by movement of the limbs and load on her axis, swelling and limb segment circumference increase at fracture. Absolute signs of fracture: the deformation of the damaged segment and abnormal mobility of the bone.
First aid is to immobilize the limb transport, often using tires from scrap materials (boards, strips of plywood, etc.).
Properly executed transport immobilization prevents displacement increase bone fragments and reduces pain during the transport of the victim, and hence the possibility of traumatic shock, especially in hip fracture. In the absence of funds for upper extremity splinting can be hung on a headscarf or fix it to the body, lower - bandage to the healthy limb.
First-aid patients with open fractures must lubricate the skin around the wound with an alcoholic solution of iodine.
With an open fracture is totally unacceptable reduction in the depth of the wound on the surface of the protruding bone fragments or to cover their soft tissues, since with them in deep tissue may invade infectious agents. Protruding from the wound on the bone fragments should impose some sterile wipes.
With an open fracture limb with profuse bleeding must impose higher fracture tourniquet (spin) which is applied to the immobilization. To stop bleeding apply a pressure bandage on the wound. Secure and deliver the affected limb in a specialized hospital.
Providing first aid, should not seek to fix the existing limb deformation.
General principles of immobilization for fractures.
For fractures of the long bones must be fixed at least two joints adjacent to the damaged segment of the limb. Often it is necessary to fix the three joints. Immobilization is reliable in the case of fixation of the joints achieved operating part under the influence of muscle segment extremities. Thus, at the turn of the humerus fixed shoulder, elbow and wrist joints; at the turn of the shin bone is necessary to fix the knee, ankle and foot joints and all fingers.
Finiteness should be recorded on the average physiological state in which the flexor and extensor muscles equally relaxed.
During the application of tires should careful treatment of the injured limb to avoid possible further injury. It is desirable to immobilize the assistant who holds the limb in position.
4. At wounds
Wounds can be quite varied, depending on their origin, the degree of tissue damage, microbial contamination, location, depth. Wounds may vary in nature wounding weapon or instrument: sliced, chopped wounds, stab - the deepest and most dangerous; contused wounds, bite wounds - dangerous possibility of rabies.
When deep wounds not only damaged skin with subcutaneous fat, but muscle, bone, nerves, tendons, ligaments, sometimes large blood vessels. Penetrating injuries may be accompanied by damage to internal organs. In wounds necessarily arises bleeding, pain and almost always - hiatus, ie dehiscence.
It should be remembered that all the wounds are infected. In the first hours after injury microbes are mostly still on the surface of a fresh wound in the static state, ie, not yet propagated and do not show their painful properties. This should be considered when administering first aid.
First aid for injury - defense wounds from secondary pollution. Surrounding skin around the wound must double grease alcoholic solution of iodine and apply a sterile bandage, avoiding contact with the wound itself. Foreign bodies emplaced in the tissue extract should not be, as it may increase bleeding. Any washing wounds prohibited!
1. When scalping flap wounds often comes off to the side, subcutaneous tissue outside. In this case, an urgent need to lift the flap and also lubricate the skin surface with an alcoholic solution of iodine. If the wound is bleeding profusely, helping start with a temporary stop bleeding - imposing a pressure bandage on the wound, and when heavy bleeding - a tourniquet. In severe wounds limb immobilization necessary transport.
The victim should necessarily seek medical medical advice. Patients with any injury it is imperative to introduce anti-tetanus serum and toxoid.
2. When bitten wounds inflicted by any animal injured after first aid immediately sent to the emergency room, where it is decided the question of the presence or absence of indications for prophylactic vaccination against rabies.
3. When poisoned wounds (snake bites) that squeeze out from the wound first drop of blood; suck the venom by mouth for 15-20 minutes (secure if a healthy mouth and frequent spitting saliva); lubricate the bite iodine solution or brilliant; bandage; produce immobilization of the limb; give the victim fluids to drink; deliver to nearest medical facility. Prohibited: impose a tourniquet on the affected limb; cauterize the bite; make incisions in the skin to remove the poison.
5. Drowning
Drowning - filling airway fluid (usually water) or liquid masses (silt, mud), causing acute respiratory failure and cardiac activity.
By drowning can cause fatigue during long-distance swims, trauma - injury of stones or hard objects while diving, and drunkenness. Fainting can occur when a sudden sharp change in temperature when immersed in water; after overheating in the sun; redistribution of blood due to the overflow of the stomach with food; Overvoltage musculature; fear during an accidental fall into the water.
Character help the affected depends on the severity of his condition. If the victim is conscious, it is necessary to calm, to take off his wet clothes, wipe dry the skin, change clothes; if there is no consciousness, but kept the pulse and breathing, the victim should be given to inhale ammonia, free chest from hindering clothing; to activate the breath can be used for rhythmic twitching language.
In the absence of cardiac activity and respiration use the simplest methods of recovery of the body. First of all it is necessary to remove fluid from the airway. To this end, assisting with victim lays on his stomach on his bent knee, the head of the victim in this case hanging down and the water can flow out of the upper respiratory tract and stomach. After removal of water immediately begin artificial respiration, quickly clearing the pre-oral cavity affected by sand, silt, vomitus.
The most effective methods of artificial respiration mouth to mouth and mouth to nose. In carrying out artificial respiration victim is lying on his back with his head thrown back sharply. This situation contributes to the head most complete, open the entrance to the larynx. Mouth-to-mouth and mouth-to-nose to produce better through cheesecloth or other thin fabric. During blowing air into his mouth clamped nose, while blowing nose victim's mouth should be closed and the lower jaw thrust forward. Simultaneously with artificial respiration performed external cardiac massage, producing after each inhalation (insufflation) 3-4 clicking on the chest. Attempts to revive the drowned swing on the sheet, blanket, etc. (pump) is meaningless and should not occur.
Under any condition of the victim is taking steps to warming of the body by rubbing, massaging the upper and lower extremities.
All this takes place immediately after removal from the water drowned (on the beach, in a boat on a raft) until medical help arrives or delivery of injured to hospital, where he will be provided with adequate health care.
6. When solar heat stroke
Heat stroke - a painful condition that occurs as a result of total body overheating during prolonged exposure to high ambient temperature.
Heatstroke occurs because when overheating and excessive sweating, the body loses large amounts of fluid, blood thickens, breaks down the balance of salts in the body. In severe conditions, this leads to tissue hypoxia, in particular the brain.
Sunstroke occurs under the action of direct sunlight on the bare head. Usually this occurs when the body overheating and predominantly affects the central nervous system.
The first signs of heat stroke:
1) lethargy;
2) weakness;
3) nausea;
4) headache;
5) dizziness;
6) Blackouts;
7) face reddens;
8) sometimes there was a slight rise in body temperature.
With further overheating the body temperature rises to 38-40 ° C, appears vomiting, fainting may occur, and sometimes convulsions. In severe cases, there is agitation, hallucinations, delirium, seizures, type of seizures, loss of consciousness, coma. Frequent pulse, respiration, blood pressure is lowered.
Until medical help arrives victim should be put in the shade or in a well ventilated area. To head, as well as the region of large vessels (side of the neck, armpits, groin area) apply ice packs or cold water. Victim wrapped a wet sheet, blown cold air, as the evaporation of water from it will lower the temperature. To the nose tray cotton with ammonia. Quench your thirst with cold water, tea, coffee. If breathing has stopped performed artificial respiration.
With moderate and severe sunstroke victim should be taken to the medical facility for medical care.
To avoid heat or sunstroke, you must follow the rules for finding the sun, drinking the correct mode.
7. Burns, frostbite
First aid for thermal burns. Carefully remove the victim's smoldering remnants of clothing. Can not be separated from the burn surface adhering to it the remnants of clothing, they should be cut with scissors along the border of the burn and put a bandage on them directly.
Degree burns I treated with 70% alcohol. When II degree burns on the burned surface after treatment with alcohol impose a dry sterile bandage with grade III - IV - apply a sterile bandage. In extensive burns victim any power need to wrap clean sheets, blankets and carefully wrap up as quickly as possible to deliver in hospital. First-aid Do not open blisters, apply any lotion, wash, ointment dressing.
Used for the prevention of shock rest, warm and painkillers, drinking plenty of fluids in the form of soda-salt solution (1 tsp. Salt and 1/2 tsp. Baking soda to 1 quart of water). When transporting baked possibly placed on the intact part of the body and carefully wrap up and give as much as possible of the warm drink.
With burns of the respiratory tract from inhaled superheated air (in a fire) or smoke comes shortness of breath, hoarseness, and cough. An urgent need to send the victim to the hospital regardless of the severity of skin burns.
Chemical burns occur most often in contact with skin or mucous membranes of various chemicals: strong acids, alkalis, volatile oils, phosphorus, as well as prolonged exposure to vapors of gasoline or kerosene.
Первая помощь: немедленное и обильное обмывание в течение 5–10 мин пораженного участка водой, желательно под давлением. При ожогах известью или фосфором необходимо сначала сухим путем удалить остатки вещества и лишь после этого приступить к обмыванию. Пораженный участок обмывают нейтрализующими растворами: при ожогах кислотами или фосфором – 2% раствором двууглекислой соды или мыльной водой, при ожогах щелочами – 1–2% раствором лимонной, уксусной или борной кислоты. Затем накладывают сухую повязку, а при ожогах фосфором делают примочки из 2–5% раствора медного купороса или 5% раствора марганцовокислого калия. При ожогах фосфором нельзя применять масляных повязок.
Пострадавшего с любым видом отморожения помещают в теплое помещение. Больному дают горячий чай, кофе, вино.
Побелевшую часть тела растирают чисто вымытыми, увлажненными или смазанными стерильным вазелином руками, а лучше всего спиртом или водкой до тех пор, пока отмороженное место не покраснеет и не сделается теплым.
Нельзя выполнять растирание снегом, так как он охлаждает кожу. Грязные и острые льдинки могут повредить и загрязнить отмороженную кожу. По окончании растирания отмороженный участок высушить, обтереть спиртом и наложить на него чистую повязку с толстым слоем ваты.
Не следует смазывать отмороженный участок тела йодной настойкой или каким-либо жиром, так как это затрудняет последующее лечение. Если уже наступил отек или появились пузыри, то растирание делать нельзя.
8. При отравлении
Отравление препаратами бытовой химии. После попадания в организм крепкой кислоты или щелочи необходимо срочно вызвать скорую помощь. Немедленно удалить слюну и слизь изо рта. При признаках удушья провести искусственное дыхание рот в нос. При рвоте промывать желудок категорически запрещается, так как кислота или щелочь могут попасть в дыхательные пути. Эту процедуру может выполнять только медработник. Пострадавшему дают выпить 2–3 стакана воды. Ни в коем случае нельзя пытаться нейтрализовать ядовитые жидкости. Это приводит к образованию углекислоты, растягиванию желудка, усилению боли и кровотечения. При развитии удушья пострадавшего срочно отправить любым транспортом в лечебное учреждение. При отравлении препаратами бытовой химии (не содержащими кислоту или щелочь) до прибытия врача нужно вызвать у больного рвоту (если он в сознании).Больных в бессознательном состоянии нужно уложить так, чтобы голова была опущена и повернута набок, чтобы содержимое желудка не попало в дыхательные пути. При западении языка, судорогах, когда челюсти крепко сомкнуты, осторожно запрокинуть голову и выдвинуть нижнюю челюсть вперед и вверх, чтобы обеспечить дыхание через нос.
При отравлении снотворными или успокаивающими препаратами (седативными) пострадавшего нужно уложить, приподняв ему голову. Промыть желудок 1–2 л воды, вызвать рвоту, надавливая на корень языка. После чего дать выпить крепкий чай, съесть 100 г черных сухарей. Нельзя давать молоко. Оно ускоряет поступление вызвавшего отравление препарата в кишечник и препятствует выведению его из организма.
Больному в бессознательном положении категорически запрещается промывать желудок. Вода может попасть в дыхательные пути и привести к смерти от удушья. Если пострадавший не дышит или его дыхание угнетено, необходимо выполнять искусственное дыхание.
При отравлении алкоголем пострадавшему необходимо вдыхать пары нашатырного спирта, дать выпить 3–4 стакана воды (с добавлением 1 ч. л. питьевой соды на стакан), вызвать рвоту, выпить крепкого чая или кофе.
При отравлении метиловым спиртом или этиленгликолем необходимо дать выпить 100–150 мл этилового спирта (водки), если пострадавший в сознании, так как он является противоядием, замедляет распад метилового спирта.
При отравлении грибами немедленно доставить больного в больницу. До прибытия врача промыть желудок содовым раствором или раствором марганцовокислого калия, а кишечник – используя слабительные (касторовое масло, горькую соль), сделать клизму. Больному дают пить подсоленную воду.
При отравлении ингаляционным хлорофосом или карбофосом больного вынести на воздух, снять зараженную одежду, обмыть водой открытые участки тела.
При проглатывании ядохимиката делают промывание желудка 4–5 раз: дать выпить по 3–4 стакана подсоленной воды и вызвать рвоту.Затем принять слабительное – 1 ст. liter.горькой соли.Очень хорошо принять внутрь 5–6 таблеток бесалола или бекарбона.
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