- •1. Introduction. Es and their influence on a ability to live of the people
- •2. Classification and the notions of extreme situations and catastrophes.
- •1. Natural disasters:
- •3. The tasks and organization of a state service of medicine of catastrophes.
- •4. Basic features of a service mc in es.
- •5. Basic divisions of a service of mc.
- •Lecture №2
- •1. General principles of medical evacuation of the population in extreme situations.
- •3. The first aid.
- •2. Kinds and volume of medical aid.
- •The volume of the first medical aid:
- •4. Premedical aid.
- •5. The first doctor’s aid.
- •6. Qualified and specialized medical aid.
- •7. Medical sorting.
- •1. Introduction Characteristic of the main injury factors in catastrophes.
- •2. Characteristic of the amount and structure of population losses in catastrophes.
- •3. Medico-tactical characteristic of natural disasters.
- •1. Flood
- •2. Hurricanes and storms.
- •3. Earthquakes.
- •4. Snow avalanches, snow drifts and icings.
- •5. Lightning
- •6. Fires
- •Medico-tactical characteristic of transport catastrophes.
- •1. Aviation accidents.
- •2. Road - transport accidents.
- •3. Accidents on river and sea transport.
- •4. Railway accidents.
- •Medico-tactical characteristics of accidents.
- •Introduction.
- •Introduction.
- •Medico-tactical characteristic of accidents on chemically - dangerous enterprises.
- •The principal measures and means of protection from hata.
- •Medico-tactical characteristic of failures on radiation dangerous objects.
- •Protective measures of the staff and population.
- •Lecture №6
- •Extreme situations and disaster area
- •Medical help to children in catastrophes.
- •The plan of lecture
- •1. Behavior of the people in es and disaster area.
- •Organization of the psychiatric help at the stages of medical evacuation.
- •2. Peculiarities of organization of the medical help to children.
2. Hurricanes and storms.
Hurricane (Fr. ouragan), is a wind with 12 force marks according to the Beauport scale, i.e. more than 35 mps.
The Beauport wind scale – was offered by F. Beauport in 1806 – is conventional force 12-mark scale for an estimation of force of a wind on its action on ground subjects and on excitement of the sea: 0 - calm (without wind), 4 - moderate wind, 6 - strong wind, 10 – high wind (storm), 12 marks - hurricane.
Blowing over the land surface, the hurricane breaks and pulls out trees with their roots, breaks roofs and destroys houses, power lines and communication links, buildings and structures, puts out of action various equipment. The people can appear under fragments of the destroyed buildings and structures. Fragments and other objects, flying with high speed can put heavy traumas to the people.
One of most powerful and destructive for last years was hurricane «Hugo», which in October, 1989 has fallen upon a number of the states of Caribbean basin and on southeast coast of USA. The speed of a wind thus reached 220 km/h (60 m/sec), and height of waves was up to 4-6 m. As a result of action of hurricane 60 thousand people lost their homes and 150 thousand people without the electric power with general damage of about 12 billion dollars. The territory of Ukraine is exposed to tornados and cyclones. In Odessa area practically annually there are hurricanes of this or that force which cause great damage.
The hurricanes derive a large part of their energy from evaporations, which are increased, when temperature of a water surface rises. The lower pressure is in a core of hurricane, the higher is its activity. Dynamics of hurricanes is complex and is not investigated up to the end. On the average for one year in the world there are up to 35 hurricanes, thus perished people make about 5000, wounded - 6000, suffered - about 5 mln., homelesses - about 1.5 mln.
The possible character of the damages of the people. At hurricane (tornado) up to 50 % of traumas are inflicted by flying and falling subjects. In structure of damages the cranio-cerebral trauma (CCT) can make 50-70 %, (thus 18-20 % makes heavy CCT), fractures of the limbs, pelvis, spine - about 15%. The combined trauma can make 60-65%. The wounds are usually lacerated, polluted by sand, ground, splinters of glasses at a large depth.
3. Earthquakes.
Earthquakes are the fluctuations of the earth’s crust, arising as a result of explosions in depth of ground, breaks of layers of the earth crust, active volcanic activity. The area of underground impact causes elastic fluctuations (seismic waves), extending by the ground in all directions. The area of ground, from which the waves of earthquake are coming out, is named the center, and the place located on a surface is called the epicenter of the earthquake.
On number of victims, sizes of damage and area of suffered territories, on difficulty of the forecast and preliminary protection against them these natural accidents haven’t got any analogues. The geography of earthquakes - source of danger for the people and their property- varies greatly.
For a period of 10 years (from 1976 till 1986) the underground storms rather frequently «chose» for the application of their force the well settled, densely populated areas of Romania, Albania, India, Italy, Turkey, Canada, Chile, USA. Mexico underwent the most terrible ordeals in 1985. The capital of the country - Mexico City, the city - giant with the 17-million population has suffered most of all. The impacts proceeded painfully long. Under impacts of blind forces of the element the whole inhabited blocks turned to a heaps of ruins, in central areas of city the skyscrapers fell down as the cards’ houses. The television tower (100 meters in height) had fallen down, and demolished some buildings on the way. In January - February, 1986 earthquakes by intensity from 3,5 up to 8 and more marks occurred in Mexico, in area of Aleutian islands, in the south of Azerbaijan, twice in Tadjikistan. In April there were pushes on the islands of a Kuril ridge, in July in western part of Venezuela and in northwest of Tibet. At night on the 30 of August 31, 1985 the terrible underground storm, arisen in mountains of Carpathians, has fallen upon Moldavia (Moldova). From eight mark earthquakes the cities of Kishinev, Kagul, Leovo have suffered greatly. The damage inflicted by the earthquake, was about 500 mln. roubles. The hardest ordeal for the people was the strongest earthquake in Armenia in December, 1988 which has resulted in destruction of about 30 thousand of people. The material damage has made as a minimum of 5 billion roubles. So, the number of victims at the largest earthquakes for last twenty years was more than 600 thousands lost and about 2 millions injured. On the far incomplete data, the avalanches, sills, and also landslides and floods in Georgia, Azerbaijan, Kazakhstan and Kirghizia less than for 1,5 years (since February, 1987 till April 1988г.) have resulted in destruction of 150 people, ruining of about 3 thousand houses, 700 hospitals, schools, kindergartens etc.
Usually the fluctuations of the Earths’ crust are observed as a kind of impacts, their number and the intervals of time between them can be various and a less foreseen. The underground impacts can last for a share of second up to several tens seconds. However it appears of this time to be enough to destroy the whole cities. The total number of earthquakes reaches 300 thousands per one year, from them only about 10 thousands are felt by the people. On the average earthquakes carry away annually about 15 thousands of human lives.
Tsunami (Japanese) are the sea waves arising mainly as a result of shift upwards or downwards of the lengthy areas of the sea bed at underwater and coastal earthquakes. Speed of a tsunami is from 50 up to 100 km/h; height of waves in the field of occurrence from 0,1 up to 5 м, at coasts from 10 up to 50 м and more. A tsunami make devastating destructions on land.
The intensity of earthquake is measured by the force in numbers (presently - on a Richter’s scale). The intensity of earthquake decreases to the periphery of an accident zone. The earthquakes are accompanied, as a rule, by set of sounds of various intensity (such as explosions, peal of a thunder, sounds from destroying buildings, structures and so on).
1 number. Imperceptible earthquake. The intensity of fluctuations lays below the limit of sensitivity of the people, the concussions of ground are found out and are registered only by the seismographs.
2 numbers. Hardly perceptible earthquake, the fluctuations are felt only by separate people which are inside a building, especially on the top floors, and in the state of rest.
3 numbers. Weak Earthquake. The earthquake is felt by many people being inside the buildings; in the open air - only in favorable conditions. The fluctuations are similar to concussion created by the passing lorry. The attentive people notice easy rocking of the hanging things, stronger on the top floors.
4 numbers. Appreciable earthquake.
а) The earthquake is felt inside buildings by many people, but in the open air – by the few ones. The sleeping persons are awakening somewhere, but nobody is frightened. The fluctuations are similar to shaking created by passing hardly loaded lorry. Jingling of plates, dishes, windows, doors is heard as well as the quake of floors and walls. The trembling of the furniture begins. The hanging things are shaking easily. The liquid in open vessels vibrates. The push is observed in unmoving cars.
5 numbers. Awakening.
а) The earthquake is felt by all people indoors, in the open air -by many. A lot of sleeping persons are awakening. Some people run out from the buildings. The animals become anxious. There are shakings of the buildings on the whole. The hanging things are strongly shacked. The pictures are moved aside. In rare cases the pendulum clocks are stopped. Some unstable objects overturn and move. The unlocked doors and windows swing open and slam again. A liquid is splashed out from the filled open vessels in small quantity. The felt fluctuations are similar to ones created by fall of heavy subjects inside a building;
b) The damages of the first degree (thin cracks in plaster, breaking off of small pieces in buildings from a quarry stone, village constructions, the clay adobe houses) are possible.
c) In some cases the flow rate of the springs changes.
6 numbers. A fright.
а) The earthquake is felt by the majority of the people both inside the buildings, and in the open air. Many people which are in buildings, are frightened and run out to the street. Some of them loose their presence of mind. The domestic animals run out from their shelters. In rare cases the utensils and other glass products can be broken; the books fall down. The movement of heavy furniture is possible; chime of small bells over church towers is heard.
b) Damage of the first degree to separate brick houses and to many buildings made of the quarry stone, village structures, clay adobe houses.
In the last ones there are small cracks in walls, fall of a tile from roofs, cracks in the chimney stacks.
c) In rare cases the landslips on the slimy grounds occur, chaps up to 1 cm in size are possible. The changes of the flow rate of the springs and the water level in the wells are possible.
7 numbers. Breakage of buildings.
а) The majority of the people are frightened and run out from the buildings. Many people hardly keep away there feet. The fluctuations are marked by the persons driving cars. The large bells are sounding.
b) In many buildings (panel type, frame ferro-concrete buildings, wooden houses of good construction) damage of the first degree and in some buildings of the second degree is observed. In many buildings of A-type the damage of the third degree is observed (large deep and through cracks in walls, the falling down of the chimney stacks) and in some buildings there are damages of the fourth degree (destruction of internal walls and the ones of the frame’s filling, gaps in the walls, falling down of the buildings’ parts). In some cases there are landslides of the roadways on the steep slopes and chaps in the roads, the impairments of the socket-and-spigot joints, cracks in stone fences.
c) On a water surface the waves are formed, water becomes turbid due to a raising of silt, the water level in the wells and the flow rate of springs are changing. In rare cases the existing sources of water arise or vanish. There may be some cases of the sand flows or soil slips along the river banks.
8 numbers. The extensive building damages.
а) Fright and panic. Even the persons who are driving cars experience anxiety. Tree branches are broken off somewhere. Sometimes the heavy furniture moves and overturns. The hanging lamps are damaged;
b) There are damages of the 2nd degree in many houses of C-type and in the separate ones – of the 3rd degree. Damages of the 3rd degree are in many houses of B-type and in the separate ones – of the 4th degree. The damages of the fourth degree are in many buildings of the A-type, in separate – of the fifth degree (collapses of the walls, complete destruction of the buildings). The monuments and columns overturn. There are significant damages of artificial reservoirs; breaks of underground pipelines. In some cases – the deformation of the railway rails and damage of roads.
c) The floods are possible, frequently the sand and mud drifts are seen. The cracks in the grounds reach the width of 10 cm, and on slopes and coast of the rivers - more than 10 cm; besides a plenty of small cracks is seen, the rocks fall down; landslips, crumbling of a ground is often observed. There are high waves on a water surface.
10 numbers. The complete destruction of the buildings.
a) There are damages of the 4th degree in many houses of B-type, and of the 5th degree in some houses. Breakages of the 5th degree are in the buildings of A- and B-types. There can be dangerous damages of dams and embankments, serious impairments of the bridges, deformations of the subterranean pipelines. Pavements and the road asphalt form undulating surface.
b) There are cracks in the grounds in width of some decimeters and in some cases - up to 1 m. Wide ruptures appear in parallels to the water flows. There is crumbling of the loose soils from the steep slopes. The large landslips are possible. In coastal areas the sandy and slimy masses are moving. Splash-out of the water in canals, lakes, rivers is observed. New lakes appear.
11 numbers. Accident.
a) A serious damages even of buildings of good construction, bridges, dams, and railway ways are observed; the highways become unfit for use, destruction of underground pipelines is seen.
b) The significant deformations of ground such as wide cracks, breaks and movings in vertical and horizontal directions, numerous mountain landslides are observed. The definition of intensity of concussion requires special research.
12 numbers. The relief changes.
a) The strong damage and destruction practically of all over- and underground structures.
b) Radical changes of an earthly surface. The significant cracks in the soils with extensive vertical and horizontal moving is observed.
There are mountain droppings and crumbling on the river banks on the large areas. Lakes and waterfalls appear, the river beds are changing.
The basic centers of earthquakes are concentrated mainly in three zones.
The first zone – the Pacific Oceanic ones. It covers the coast of
Kamchatka, Alaska, the Western coast of the North and South America, then extends to Australia, passes through Indochina, the coast of China and grasps Japan. About 75 % of all earthquakes occur in the Pacific Oceanic seismic zone.
The second zone – the Mediterranean sea-Asiatic zone. It goes by a wide line from Portugal and Spain through Italy, Balkan peninsula, Turkey, Caucasus, Iran, the states of south-west-Asia through Central Asian republics, comes out to the territory near the Baikal lake and then joins the 1st zone at the coast of the Pacific ocean.
The 3rd zone stretches by mid-ocean ridges among the Atlantic ocean and Pacific ocean. In these places there are huge seismically active underwater mountain chains. From three seismic zones the most active is the coast of the Pacific ocean and its islands. 2/3 of the largest earthquakes of the world occur here.
The total number of earthquakes taking place in the Mediterranean sea-Asiatic zone (it is also often called the Alpine zone)is a little less in comparison with the Pacific Oceanic one. Separate descriptions of strong earthquakes taking place in the Mediterranean zone during five centuries BC and first five centuries of our era, are contained in the works of literature by ancient Greek scientists, philosophers, historians and dramatists reached up to us.
The significant territory of Ukraine (27 000 km2) is seismogenic. In the Crimea the earthquakes up to 9 numbers, in Southwest region - 7 numbers, in Kiev 4-6 numbers are possible.
At the moment of occurrence of natural calamity it is impossible to organize and to carry out the medical help, (except self-help and mutual aid). The most complicated conditions may appear as a result of the destruction of buildings, structures of the communications, systems of gas and water supply and sewerage systems. The city activity is broken, there are fires, there is a significant number of victims with traumas, burns, and the long-term crush-syndrome appear.
The possible features of the people injuries.
The analysis of the reasons of traumas made on the basis of study of past earthquakes, shows that in 10 % of cases traumas were caused directly by collapses, the destruction of walls and roofs of buildings, in 35 % - from falling constructions and fragments of structures and in 55 % - the reasons of traumas was the wrong behavior of injured, their not realized actions caused by psychological stress (jumping out of the windows, bruises at haste etc.).
Many people in a zone of earthquake suffer the infringements of mentality. The emotional reactions arising in connection with fears for the life and lives of one’s relatives are the stress situation effect. They are displayed in population by the feeling of fear, strong general excitation or inhibition, inner tension, by insomnia, various hysterical reactions.
At organization of medical maintenance for the injured population at earthquake it is necessary to provide:
Duly rendering of all kinds of the medical help at traumas, long-term crush-syndrome, burns, poisonings, overcooling (overheating), combined injuries, and also psychological and infectious diseases;
Rendering of the medical help to personnel of the formations carrying on rescue works;
Realization of treatment and prophylactic measures directed on the reduction of number of the people with psychological frustration, aggravation of somatic diseases, and also rendering assistance at premature labors and parturition without pathology;
The prevention of occurrence of mass infectious diseases and liquidation of epidemic outbreaks.
In conclusion of this unit we shall note:
а) According to international statistics, if the salvage and rescue personnel will enter a zone of earthquake within the 3 first hours, they can rescue from destruction 90 % of the survivors, in 6 hours the number of rescued can be 50%. In the further chances of rescue decrease, so there is no sense to carry out saving works in 10 days.
b) The psychologists state that it is impossible for the salvage and rescue personnel, including medical staff to work in a zone of accident for a long time. They can not endure prolonged mental tension.
c) During earthquake (flood, fire) the panic among a part of the population is inevitable. Only the prepared medical staff with the coordinated actions with personal structure of saving groups may render the medical help and stop the panic.
