2. Features of first aid for different types of lesions.

Consider the features of first aid for different types of lesions in the following sequence:

1. features cardiopulmonary resuscitation;

2. loss of consciousness;

3. bleeding;

4. frostbite;

5. overheating;

6. burns (thermal, chemical, elektroopiky);

7. drowning;

8. poisoning;

9. fractures.

1. Features of cardiopulmonary resuscitation (cpr, indirect heart massage).

Each employee and service operational staff should know rules of hospital care, methods of artificial respiration and indirect cardiac massage.

Provide first aid to the victim on the spot accident state death may only be a doctor.

The purpose of cardiopulmonary resuscitation (ShD and NMS) - Recovery of respiration and circulation. Progress in cardiac arrest and breathing.

Specifics of artificial respiration and cardiac massage:

1) types of artificial respiration: "mouth-mouth", "mouth-nose";

2) Put the victim on his back, under the neck - shaft, head thrown back;

3) clean the mouth, remove dentures;

4) with "mouth-mouth" - plug your nose, if the court has reduced the jaw, the "mouth-nose";

5) savior breathe in the air and blown into the mouth of the victim; presses on chest 4-5 times (deflection cells by 4-5 cm) with a frequency of 1 every second;

6) Repeat the savior of 10 - 15 times per minute until it recovers breath and will not be wiretapped by heart;

7) criteria for evaluation: the emergence of the pulse, respiration, pupil constriction

8) if for 0.5 hours not resumed breathing and the heart, not there are signs 7), theascertained death.

Methods of artificial respiration are manual and hardware. Manual methods - "with mouth to mouth "(Fig. 1) and" mouth-to-nose "(Fig. 2).

In the mouth or nose of the victim inhales savior of his lungs in lung victim in the amount of air volume 1000-1500 ml of 50% saturated with oxygen (50% used savior, breathing clean air his lungs).

Fig.1. Artificial respiration by "mouth to mouth": a - injection of air, b - exhale victim.

To assist the victim, who is in a state of clinical death, it is desirable to operate two men:

One-performs indirect heart massage;

Second - artificial respiration.

For this hold the victim's head thrown back, lying on his back horizontally open collar and took a deep breath, exhale air into the mouth of the victim (pre clean mouth), lips tightly attaching to enter the mouth of the victim. Nose of the patient clamped with your fingers to create a seal and prevent release of air blowing, outside. You can use a handkerchief, gauze, a special tube. Head maximum throw back to the chin was in line with your neck (resting pre-roller litter of any material). Mouth cavity examined fingers, which pull sterile cotton or gauze: extract blood clots from the mouth, mucus, artificial teeth and dentures. This operation is carried out by turning the head and shoulders aside. Then turn head to its previous position, the most neglected back.

Рис. 2. Штучне дихання методом "з рота в ніс": а - видих потерпілого; б - вдмухування повітря.

Rescuer breathes air into the mouth of the victim, after deep breathing air and throwing the nose of victim, then he release the victim's mouth and nose for passive exhalation. Meanwhile savior again gaining air.

When to open the victim's mouth is not possible due to convulsive clamping of jaw, then doing CPR "mouth-to-nose" while jaw not relax. Artificial respiration "mouth-to-mouth" performing is more efficient. And so rhythmically 1-2 hours. It is preferably to change rescuers every 15 minutes. Breath efficiency is tested by lifting the chest of the victim as a result of filling his lungs with air, which is blowed in. Sigh, as it was said, is passive during termination of airways. Rescuer rears his head and makes himself the next breath, then he leans back on the victim and blowing air into his lungs.

Injection rhythm - 15-20 times per minute, i.e. Every 5-6 seconds. Artificial ventilation continues to restore self-adequate breathing. For each blows in of air it is necessary to make 4-5 pushes to the chest of a victim.

The best airway of victim is provided in the following cases: by the maximum inclination of a head to the back; by opening his mouth; by pushing forward mandible.

The rhythm of artificial breathing is used, when small breath of victim is appeared. Features of the efficient reanimation: appearance of pulse on the large vessels forehead, hips, pink skin color, papillary constriction.

Indirect cardiac massage

When in the victim dilated pupils, lost consciousness not palpable pulse even on the neck, then paralyzed not only breathing but also heart stopped.

Then artificial respiration alternating with cardiac massage (Fig. 3).

Fig. 3. Indirect cardiac massage: a - in the adult; b - in teenager, c - in the child.

Cardiac massage - external (closed) indirect heart massage - a rhythmic click on the anterior wall of the chest of the victim, resulting in heart compressed between the sternum and the spine and pushes the blood from their cavities.

After termination of pressing chest and heart and straighten heart fills with blood that comes from the arteries. After compressing the heart blood enters the hepatic artery and the aorta, with relaxation - with pulmonary and hollow veins to the atrium.

Purpose heart massage - an artificial circulatory support in the body of the victim

and restore normal natural contractions of the heart. Preparing for massage heart is actually preparing to artificial respiration, cardiac massage as necessary held together with artificial respiration.

Technique of Indirect Massage of Heart

The victim is laid down on the back, a table or a table, he is undresses waist-deep with easily neglected head back & tied legs, and such position easies up the blood flow to the heart. A rescuer takes place on the left of the victim. By pushing on a one-third of victim’s chest (but not under the chest), with fast palm pushes, in a position of one over another from both hands of a rescuer, there are 5 pushes made – with frequency of 1 push per second in such a way, so that the breasts were displaced in direction of a spine on 4-5 sm. The heart is compressed and drives the blood through the circulatory system. Artificial respiration is alternated (air inflated) with the massage of heart (pushes).

There are 50-60 pushes upon chest per one minute and 10-15 inflations into the lungs. At pauses the hands aren’t taken away from the chest.

When the skin starts getting pinky, the pupils are narrowing as a reaction to the light, the pulse may appear – that is the heart’s functioning restarted. Than the artificial respiration may occur without the heart’s massage.

When the chest is still unmovable after the conditions mentioned above, then after two deep inflations the 15 pushes are made.

The efficiency of external heart’s massage is determined by:

The appearance of clear pulse;

Narrowing of pupils;

Appearance of self-breathing;

The decrease in bluishness of the skin and visible mucus shells.

For increase of efficiency of heart’s massage it’s recommended to lift the victim’s legs 0,5 m up, to achieve a better blood flow to the heart from the veins of lower body parts.

When however the pulse is absent, then the fibrillation of heart is occurring. Then it’s necessary to perform heart’s defibrillation, which is done only by doctors. The main task of reanimation of victim at his clinical death state – it’s the fight with hypoxia and stimulation of important organism’s functions.

After the degree of importance and urgency reanimation measures

divided into such groups:

Support artificial respiration and artificial circulation of blood;

Realization of intensive therapy is for proceeding in breathing and independent

to circulation of blood;

Normalizations of functions of the central nervous system, liver, kidneys, system

to metabolism.

Artificial respiration (ventilation of lungs) - one of methods of treatment all tates, when the independent breathing of victim cannot provide a sufficient satiation to blood by oxygen.

Sharp respiratory insufficiency and her extreme degree is a stop of breathing,- Regardless of reasons result in reduction to content of oxygen in an organism(hypoxias) and to surplus of carbon dioxide (hypercapnias). As a result of hypoxia and hypercapnias in the organism of man develop heavy violations of all organs, that it is possible to avoid only during the reanimation - artificial ventilation begun in good time

lungs - at artificial respiration "from a mouth in a mouth".

A device for the massage of heart is defibrillator of heart that creates short

electric charge of high tension through a heart, causes common reduction his muscles and removes fibrillations.

Defibrillator with mounted cardioscop, that sets a presence fibrillates of heart, gives an opportunity to look after, or defibrillates was succeeded, or it is not needed

to repeat a digit. Digit of electro-current in 3000-7000 in can very quickly take off fibrillates of heart.

To the children to one year the indirect massage of heart is conducted by one-arm,

or even by two fingers, and frequency of pushes must be 100-120 times after minute.

2.2 Loss of consciousness.

The loss of consciousness takes place as a result of sudden anemia brain

(fear, stress, pain, bleeding). Symptoms - a pale person and mucous membranes sharply

shells, breathing infrequent, superficial.

First aid:

- A victim is inlaid something heaving up feet and dropping a head;

- free a neck, breasts from clothing;

- to splash on cheeks, pour water, to give to smell an ammonium chloride;

- if breathing stopped are reanimation measures (ШД, НМС);

- to watch after a tongue, not give to drink!

The loss of consciousness lasts not long.