First aid for burns, frostbite, drowning. Causes, types and degree of burns. Signs of electric shock. Exemption from the action of electric current. Causes, signs and degree of frostbite. First aid

Textbook “Training of firefighters and rescuers. Medical

Topic number 14: "First aid for burns and frostbite."

Lesson 1. Causes, types and degree of burns. Signs of electric shock. Exemption from the action of electric current. Causes, signs and degrees of frostbite. Providing first aid for burns and frostbite. Techniques for providing self-help and mutual assistance with frostbite.

Literature used in the preparation of the lesson:

Textbook “Training of firefighters and rescuers. Medical training. IN AND. Dutov.

Textbook "Emergency work in the lesions."

Preparatory part 5-10 minutes………………………………..……………..…3 p.

Main part - 70 minutes……………………………………………………….…..3 p.

1 study question…………………...………………………………..3 p.

2 study question……………………………...……………………..7 p.

Final part 5-10 minutes………………………………….……..…………...11 p.

Expanded lesson plan

1. Preparatory part. (5-10 min)

Guard building;

Topic announcement;

Survey on the material covered.

2. Main part (30 min.).

1 study question: What is a burn?

A burn is tissue damage due to exposure to heat, chemicals, or electricity.

There is an opinion that the only cause of burns is exposure high temperature, but in fact, burns also occur under the influence of certain chemicals and electric current. In the literature, damage to the skin and underlying tissues with high doses of ionizing radiation is sometimes also characterized by the term "radiation burns". Taking into account the peculiarities of the formation and development of these injuries, it is preferable to define them as local radiation injuries. There are also burns that occur under the action of ultraviolet radiation.

Typically, burns affect the skin, but sometimes subcutaneous tissues can also be burned, as well as internal organs even in the absence of skin lesions. So, if you ingest a very hot liquid or caustic substance (for example, acid), a burn of the esophagus and stomach can occur, and inhalation of smoke and hot air (for example, during a fire) can lead to a burn of the lungs.

With burns (with the exception of the lightest), the burnt tissue dies. When tissues are damaged by a burn, fluid begins to seep out of small blood vessels, causing edema to form. With extensive burns and damage a large number blood vessels may go into shock. Unlike other types of shock in burn shock, a sharp decrease blood pressure is not mandatory and is often observed only in its most severe forms. An early sign burn shock is a decrease in the amount of urine.

An electrical burn occurs when an electrical current is passed through the human body from a current source; this sometimes creates a very high temperature (3000-5000°C). This type of electrical burn, sometimes called an arc burn, causes complete destruction and charring of the skin at the point where the current enters the body. Dry skin has a high electrical resistance (the ability to stop or slow down the movement of current), therefore, at the point of contact with the current source, most of the electrical energy is converted into heat, resulting in a burn. As a rule, electrical burns also severely damage the subcutaneous tissues, and the area of ​​damage to the subcutaneous tissues can be much larger than the area of ​​skin damage. Severe electrical shock can cause respiratory arrest and heart rhythm disturbances.

Chemical burns are caused by exposure to various irritants and poisons, including strong acids and alkalis, phenols and cresols (organic solvents), mustard gas (mustard gas), and phosphorus. In chemical burns, the zone of tissue death slowly expands for several hours after the injury.

Symptoms

The severity of the burn depends on the area of ​​the affected tissue and the depth of the damage. Burns of any nature are divided into four degrees of severity.

I degree burns are the least severe - the most superficial layer of the skin (epidermis) is damaged. The skin at the site of the burn is red, painful, very sensitive to touch, swollen. The burned area turns pale with light pressure, but no blisters form.

Second degree burns are accompanied by deeper damage with detachment of the epidermis. Bubbles form on the skin - red or whitish at the base, filled with a clear thick liquid. When touched, the burn area is very painful and sometimes turns white.

III degree burns are characterized by even deeper tissue damage and are divided into 2 types: IIIa - damage to almost the entire thickness of the skin (dermis), but with the preservation of part of the germ layer; IIIb - necrosis of all layers of the skin and subcutaneous fat.

IV degree burns are the most severe. In this case, necrosis occurs not only of the skin and subcutaneous fat, but also of deeper tissues: muscles, tendons, bones.

With burns of III and IV degrees, the burnt surface can be either grayish-white and soft, or dark (black), charred, similar to dressed leather. Pale, pale pink, grayish coloration of the skin can be observed due to remote exposure to infrared radiation (without ignition of clothing), scalding, and the action of certain chemicals. This coloration is usually not persistent and after 2-3 days is replaced by a dark (dark brown) with the formation of a hard scab. In deep burns, a network of small thrombosed blood vessels shows through the skin under or around the burnt surface. Sometimes blisters form on the burned skin. Hair in the burn area is easily pulled out from the root. The burned area is insensitive; as a rule, deep burns are not accompanied by pain, since the nerve endings located in the skin are destroyed.

With burns of I-IIIa degrees (they are classified as superficial), recovery occurs due to tissue regeneration. At the same time, it is sometimes possible to distinguish between a severe burn of the II degree and a burn of the III degree only a few days after the injury. With burns of IIIb-IV degrees, independent tissue repair is impossible, surgical intervention is necessary. Electrical burns are rarely superficial, while UV burns are rarely deep.

About 85% of all burns are minor, and the necessary care can be provided at home, in a doctor's office, or in a hospital emergency room. The first step is to remove all clothing, especially if it is smoldering (such as a synthetic shirt), soaked in hot tar, or soaked in chemicals, to stop exposure to heat and prevent further damage to the skin. Chemicals, including acids, alkalis, organic compounds, must be washed off the skin with plenty of water as soon as possible.

Hospitalization is most often required in the following situations:

If there are widespread superficial and (or) deep burns, as well as electric shock burns;

If the face, hands, genitals or feet are burned;

If it is difficult for the victim to provide proper assistance at home;

If the age of the victim is less than 2 or more than 70 years;

If internal organs are burned.

Light burns

In the event of a slight burn, immediately immerse the affected part of the body in cool water. In case of a chemical burn, the burnt area should be washed with plenty of water for a long time. In case of burns of the fingers, it is very important to remove rings, rings, etc. as soon as possible (before the development of pronounced edema).

In the doctor's office or hospital emergency department, the primary toilet of the burn wound is performed, which includes washing the skin around the burn with antiseptic solutions (0.25% ammonia solution, 3% boric acid solution, warm water and soap) followed by treatment with 30% ethyl alcohol. Foreign bodies and exfoliated epidermis are carefully removed from the burned surface. Too contaminated places are cleaned with gauze balls with a 3% hydrogen peroxide solution or irrigated with antiseptic solutions. Blisters, if they are damaged or can be easily damaged, are usually removed. After treatment, the burned skin is dried with napkins, then an ointment with antiseptics is applied to the burn area. Further local treatment carried out by an open method (without bandages) or with the help of periodically replaced gauze bandages. It is extremely important to prevent contamination of the burn area, as damage to the top layer of the skin dramatically increases the likelihood of infection developing and spreading. Antibiotics help prevent infection, but can often be dispensed with. If the tetanus shot has been done for a long time, tetanus toxoid is administered.

It is recommended to keep the burned arm or leg in an elevated position (above the level of the heart) to reduce swelling. This can only be done in a hospital - by raising part of the bed or otherwise. If the joint is affected by second or third degree burns, a splint may be required to limit movement in the joint and thereby prevent further damage. Many burn victims require pain medication, including drugs, at least for the first few days.

severe burns

For more severe, life-threatening burns, immediate care is needed, preferably in a hospital with a burn unit. A person injured in a fire, already at the scene or in an ambulance, is usually given oxygen through a mask to neutralize the effects of carbon monoxide (carbon monoxide) that often forms in a fire. The doctor and nurse must first make sure that the victim can breathe freely and that he has not received life-threatening injuries. Treatment begins with the replacement of lost fluid and measures to prevent the development of infectious complications. For severe burns, hyperbaric oxygen therapy is sometimes used: the patient is placed in a special chamber where oxygen is supplied under high blood pressure. This method of treatment is especially important when a burn is combined with severe carbon monoxide poisoning. However, it makes sense to use this method within the first 24 hours after a burn, and besides, it is not widely available.

If the airways and lungs were damaged during the fire, then a tube is inserted into the trachea to normalize breathing. The need for this procedure (intubation) is determined primarily by the frequency of breathing: if breathing is too frequent or, conversely, too slow, not enough air enters the lungs, which means that not enough oxygen enters the blood. Intubation may be necessary in cases where the face is injured or when breathing is difficult due to increasing swelling of the tissues of the larynx. Sometimes the tube is inserted when there is no obvious damage to the airways, but when there is a high probability of it: for example, after a fire in a confined space or explosion, when there is soot in the nasal or oral cavity, when the hair in the nose is damaged by fire. If breathing is normal, then all that is needed is to give oxygen through the mask.

The primary treatment of the burn surface in patients in a state of shock is postponed until the removal from this state. After cleansing the burn area, an antibiotic cream or ointment is applied to it; then a sterile bandage is applied to the affected area, which is usually changed 2-3 times in a day. With an extensive burn, the likelihood of severe infectious complications is extremely increased, so antibiotics are usually prescribed intravenously. In the event that the previous tetanus vaccination was done a long time ago, tetanus toxoid is administered.

Extensive burns lead to life-threatening dehydration. To make up for the loss of fluid, it is administered intravenously. Deep burns can be accompanied by myoglobinuria, a condition in which the protein myoglobin is released from damaged muscles, which has a detrimental effect on the kidneys. If you do not enter enough fluid, then the patient may develop kidney failure.

Burned skin forms a hard crust called an eschar that restricts the blood supply to the affected area. This can be dangerous, especially if the eschar completely surrounds the arm or leg (called a circular burn). In such cases, the doctor makes an incision in the scab to reduce pressure on the healthy tissue underneath.

Even a deep burn heals completely if its area is small (no more than 1-2 cm in diameter) and if it is not infected. But if a large area of ​​the dermis is damaged, skin grafting is necessary to close the burnt area. A skin graft is a section of healthy skin taken either from an unburned part of the victim's body (autograft), or from another living person or corpse (allograft), or from an animal (xenograft) - usually a pig, since pig skin is most similar to human. Autografts remain at the transplant site permanently, while skin grafts from other people or animals perform a temporary function - they protect the affected area while the healing process is in progress, and are rejected by the body after 10-14 days.

Physical and occupational therapy usually helps to minimize scarring and, as far as possible, preserve the function of the burnt areas.

Before skin grafting, it is desirable to develop the affected joints in order to restore normal range of motion in them. After transplantation, the affected area is usually immobilized for 5-10 days until the graft heals, after which the exercises are resumed.

For normal healing of burns, the victim needs proper nutrition, therefore, if a person cannot eat on his own, nutritional mixtures are prescribed, which sometimes have to be administered through a tube inserted through the nose into the stomach (nasogastric tube). In case of bowel dysfunction - due to damage to the bowel or multiple operations - nutrients are administered intravenously.

Healing of severe burns takes long time, sometimes years, and the victim may develop severe depression. As a rule, psychological support is provided to patients in burn centers, for which social services, psychiatrists and other specialists are provided.

Lesson 2: What is frostbite?

Frostbite is damage to any part of the body (up to necrosis) under the influence of low temperatures. Most often, frostbite occurs in cold weather. winter time at a temperature environment below -10oC - -20o C. If you stay outdoors for a long time, especially with high humidity and strong wind, you can get frostbite in autumn and spring when the air temperature is above zero.

Frostbite in the cold is caused by tight and damp clothes and shoes, physical overwork, hunger, forced prolonged immobility and uncomfortable position, previous cold injury, weakening of the body as a result of previous diseases, sweating of the feet, chronic diseases vessels of the lower extremities and of cardio-vascular system, severe mechanical damage with blood loss, smoking, etc.

Statistics show that almost all severe frostbite, which led to amputation of limbs, occurred in a state of extreme intoxication.

Under the influence of cold, complex changes occur in the tissues, the nature of which depends on the level and duration of the decrease in temperature. Under the influence of temperatures below -30oC, the main value in frostbite is the damaging effect of cold directly on the tissues, and cell death occurs. Under the action of temperatures up to -10o - -20oC, at which most frostbite occurs, vascular changes in the form of a spasm of the smallest blood vessels are of paramount importance. As a result, blood flow slows down, the action of tissue enzymes stops.

Frostbite degrees

Frostbite I degree (the mildest) usually occurs with short exposure to cold. The affected area of ​​the skin is pale, reddened after warming, in some cases it has a purple-red tint; edema develops. Skin necrosis does not occur. By the end of the week after frostbite, slight peeling of the skin is sometimes observed. Full recovery occurs by 5-7 days after frostbite. The first signs of such frostbite are a burning sensation, tingling, followed by numbness of the affected area. Then there is skin itching and pain, which can be both minor and pronounced.

Frostbite II degree occurs with prolonged exposure to cold. AT initial period there is blanching, cooling, loss of sensitivity, but these phenomena are observed at all degrees of frostbite. Therefore, the most feature- formation in the first days after the injury of blisters filled with transparent contents. Complete restoration of the integrity of the skin occurs within 1 - 2 weeks, granulation and scarring are not formed. With frostbite of the II degree after warming, the pain is more intense and longer than with frostbite of the I degree, skin itching, burning are disturbing.

With frostbite III degree, the duration of the period of cold exposure and decrease in temperature in the tissues increases. The blisters formed in the initial period are filled with bloody contents, their bottom is blue-purple, insensitive to irritations. There is a death of all elements of the skin with the development of granulations and scars as a result of frostbite. Descended nails do not grow back or grow deformed. Rejection of dead tissue ends at 2 - 3rd week, after which scarring occurs, which lasts up to 1 month. The intensity and duration of pain is more pronounced than with frostbite II degree.

Frostbite IV degree occurs with prolonged exposure to cold, the decrease in temperature in the tissues with it is the greatest. It is often combined with frostbite III and even II degree. All layers of soft tissues become dead, bones and joints are often affected.

The damaged area of ​​the limb is sharply cyanotic, sometimes with a marble color. Edema develops immediately after warming and increases rapidly. The temperature of the skin is much lower than that of the tissues surrounding the area of ​​frostbite. Blisters develop in less frostbitten areas where there is frostbite III - II degree. The absence of blisters with significantly developed edema, loss of sensitivity indicate frostbite of the IV degree.

Under conditions of a long stay at low air temperature, not only local lesions are possible, but also a general cooling of the body. Under the general cooling of the body should be understood the state that occurs when the body temperature drops below 34oC.

The onset of general cooling is facilitated by the same factors as the frostbite bet: high humidity air, damp clothes, strong wind, physical overwork, mental trauma, past illnesses and injuries.

There are mild, moderate and severe degrees of general cooling.

Mild degree: body temperature 32-34oC. Skin pale or moderately cyanotic, goosebumps, chills, speech difficulties appear. The pulse slows down to 60-66 beats per minute. Blood pressure is normal or slightly elevated. Breathing is not disturbed. Frostbite of I-II degree is possible.

Medium degree: body temperature 29-32oC, sharp drowsiness, depression of consciousness, a meaningless look are characteristic. The skin is pale, cyanotic, sometimes marbled, cold to the touch. The pulse slows down to 50-60 beats per minute, weak filling. Arterial pressure is reduced slightly. Breathing is rare - up to 8-12 per minute, superficial. Frostbite of the face and limbs of I-IV degree is possible.

Severe degree: body temperature below 31oC. Consciousness is absent, convulsions, vomiting are observed. The skin is pale, cyanotic, cold to the touch. The pulse slows down to 36 beats per minute, weak filling, there is a pronounced decrease in blood pressure. Breathing is rare, superficial - up to 3-4 per minute. There are severe and widespread frostbite up to glaciation.

First aid for frostbite

Actions in the provision of first aid vary depending on the degree of frostbite, the presence of general cooling of the body, age and concomitant diseases.

First aid consists in stopping the cooling, warming the limb, restoring blood circulation in the tissues affected by cold and preventing the development of infection. The first thing to do with signs of frostbite is to deliver the victim to the nearest warm room, remove frozen shoes, socks, gloves. Simultaneously with the implementation of first aid measures, it is urgent to call a doctor, ambulance to provide medical assistance.

In case of frostbite of the 1st degree, the cooled areas should be warmed to redness with warm hands, light massage, rubbing with a woolen cloth, breathing, and then apply a cotton-gauze bandage.

With frostbite II-IV degree, rapid warming, massage or rubbing should not be done. Apply a heat-insulating bandage to the affected surface (a layer of gauze, a thick layer of cotton, again a layer of gauze, and on top of an oilcloth or rubberized cloth). The affected limbs are fixed with the help of improvised means (a board, a piece of plywood, thick cardboard), applying and bandaging them over the bandage. As a heat-insulating material, you can use padded jackets, sweatshirts, woolen fabric, etc.

The victims are given hot drinks, hot food, a small amount of alcohol, one tablet of aspirin, analgin, 2 tablets of "No-shpa" and papaverine.

It is not recommended to rub the sick with snow, as the blood vessels of the hands and feet are very fragile and therefore they can be damaged, and the resulting micro abrasions on the skin contribute to infection. You can not use the rapid warming of frostbitten limbs near the fire, uncontrolled use of heating pads and similar sources of heat, as this worsens the course of frostbite. An unacceptable and ineffective first aid option is rubbing oils, fat, rubbing alcohol on tissues with deep frostbite.

With a general cooling of a light degree, it is enough effective method is warming the victim in a warm bath at an initial water temperature of 24 ° C, which is increased to normal temperature body.

With a moderate and severe degree of general cooling with respiratory and circulatory disorders, the victim must be taken to the hospital as soon as possible.

"Iron" frostbite

In practice, there are also cold injuries that occur when warm skin comes into contact with a cold metal object. As soon as a curious kid grabs some piece of iron with his bare hand or, even worse, licks it with his tongue, he will firmly stick to it. You can get rid of the shackles only by tearing them off along with the skin. The picture is downright heartbreaking: the child squeals in pain, and his bloody hands or mouth shock the parents.

Fortunately, the "iron" wound is rarely deep, but still it must be urgently disinfected. Rinse it first with warm water and then with hydrogen peroxide. The released oxygen bubbles will remove the dirt that has got inside. Then try to stop the bleeding. A hemostatic sponge applied to the wound helps well, but you can get by with a sterile bandage folded several times, which must be properly pressed and held until the bleeding stops completely. But if the wound is very large, you should immediately consult a doctor.

It happens that a stuck child does not run the risk of breaking away from the insidious piece of iron, but loudly calls for help. Your correct actions will help to avoid deep wounds. Instead of tearing off the skin "with meat", just pour warm water over the sticky place (but not too hot!). Having warmed up, the metal will surely let go of its unlucky prisoner.

Since the conversation is about metal objects, recall that in the cold they take heat from the child. Therefore, in winter, children should not be given shovels with metal handles. And be sure to wrap the metal parts of the sled with cloth or cover with an old blanket. Do not allow children to ride on carousels and swings for a long time, climb on metal shells that are installed in every yard. And be sure to protect their hands with mittens.

Prevention of hypothermia and frostbite

There are a few simple rules, which will allow you to avoid hypothermia and frostbite in severe frost:

Do not drink alcohol - alcohol intoxication (as well as any other) actually causes a large loss of heat, while at the same time causing the illusion of warmth. An additional factor is the inability to focus on the signs of frostbite.

Do not smoke in the cold - smoking reduces peripheral blood circulation, and thus makes the limbs more vulnerable.

Wear loose clothing - this promotes normal blood circulation. Dress like a "cabbage" - while between the layers of clothing there are always layers of air that perfectly retain heat. Outerwear must be waterproof.

Tight shoes, lack of insoles, damp dirty socks often serve as the main prerequisite for the appearance of scuffs and frostbite. Particular attention should be paid to shoes for those who often sweat feet. You need to put warm insoles in boots, and wear woolen ones instead of cotton socks - they absorb moisture, leaving your feet dry.

Do not go out into the cold without mittens, a hat and a scarf. The best option– mittens made of water-repellent and windproof fabric with fur inside. Gloves made of natural materials, although comfortable, do not save from frost. Cheeks and chin can be protected with a scarf. In windy cold weather before going outside, lubricate open areas of the body with a special cream.

Do not wear metal (including gold, silver) jewelry - rings, earrings, etc. in the cold. Firstly, the metal cools much faster than the body to low temperatures, as a result of which "sticking" to the skin is possible with painful sensations and cold injuries. Secondly, the rings on the fingers impede the normal circulation of blood. In general, in the cold, try to avoid contact of bare skin with metal.

Get a friend's help - keep an eye on a friend's face, especially the ears, nose and cheeks, for any noticeable changes in color, and he or she will watch yours.

Do not let the frostbitten area freeze again - this will cause much more significant damage to the skin.

Do not remove shoes from frostbitten limbs in the cold - they will swell and you will not be able to put on shoes again. It is necessary to reach a warm room as soon as possible. If your hands are cold, try warming them under your arms.

When you return home after a long walk in the cold, be sure to check for frostbite on the limbs, back, ears, nose, etc. Freezing frostbite can lead to gangrene and subsequent loss of a limb.

As soon as on a walk you feel hypothermia or freezing of the limbs, you need to go to any warm place- a shop, a cafe, an entrance - for warming up and inspecting places potentially vulnerable to frostbite.

If your car stalled away from locality or in an unfamiliar area, it is best to stay in the car, call for help, or wait for another vehicle to pass on the road.

Stay away from the wind - the chance of frostbite in the wind is much higher.

Do not wet the skin - water conducts heat significantly better than air. Don't go out into the cold with wet hair after a shower. Wet clothes and shoes (for example, a person fell into the water) must be removed, the water wiped off, if possible, put on dry ones and bring the person to heat as soon as possible. In the forest, it is necessary to kindle a fire, undress and dry clothes, during this time vigorously doing physical exercises and basking by the fire.

It can be useful for a long walk in the cold to take with you a pair of interchangeable socks, mittens and a thermos with hot tea. Before going out into the cold, you need to eat - you may need energy.

It should be borne in mind that in children the thermoregulation of the body is not yet fully adjusted, and in the elderly and in some diseases this function is impaired. These categories are more prone to hypothermia and frostbite, and this should be taken into account when planning a walk. When letting a child go for a walk in the cold on the street, remember that it is advisable for him to return to warmth and warm up every 15-20 minutes.

Finally, remember that The best way to get out of an unpleasant situation is not to fall into it. If you don't like extreme sensations, hard frost try not to leave the house unless absolutely necessary.

3. Final part (5-10 min).

Survey on the topic covered;

Grading in the educational journal;

Assignments for self-study.

Organization of first aid for victims at work

First aid for victims of accidents and sudden illnesses is a set of urgent measures aimed at stopping the effect of the damaging factor, eliminating the threat to life, alleviating the suffering of the victim and preparing him for sending to a medical institution.

First aid is the simplest medical actions performed as soon as possible directly at the scene of the incident by the production personnel who happened to be close at that moment, who passed special training and mastering the basic methods of providing medical care.

It is considered optimal to provide first aid to the victim - within 30 minutes after the injury.

The obligation of the employer is to organize training with a test of practical skills in providing first aid to victims of the most dangerous and harmful production factors that are most typical for this type of production and the mandatory presence of trained personnel at each work site in each work shift.

1. Free the victim from exposure to dangerous production factor(electric current, chemicals, water, mechanical impact, etc.) using regular or improvised means and methods that are safe for yourself.

2. Assess the condition of the victim, free from clothing restricting breathing, if necessary, take the victim to fresh air.

3. Determine the nature and degree of damage, for which carefully expose the damaged areas, parts of the body and decide on emergency measures.

4. Perform the necessary measures to save the victim in order of urgency - restore breathing, stop bleeding, immobilize the fracture site, apply bandages, etc.

5. Maintain the basic vital functions of the victim until the arrival of medical personnel.

6. Call medical workers, prepare the victim for transportation.

Requirements for staff in the provision of first aid

The person providing assistance should know: the basics of working in extreme situations; the main signs of violation of the vital functions of the human body; rules, methods, methods of providing first aid in relation to a specific situation; the main methods of carrying and evacuating the victims.

The person providing assistance should be able to: quickly and correctly assess the situation: assess the condition of the victim, diagnose the type and recognize the features of the injury; determine the type of necessary first aid, the sequence of measures for its provision; correctly implement the entire complex of emergency resuscitation care, taking into account the condition of the victim; temporarily stop bleeding by applying a tourniquet, pressure bandage, finger pressure of the vessel; perform artificial respiration and closed heart massage; apply bandages, transport tires, provide assistance in case of burns, poisoning, frostbite, electric shock, etc.

First aid for burns, frostbite

First aid for thermal and electrical burns

Depending on the area and depth of the lesion, burns are divided into 4 degrees:

 the first - is characterized by redness, swelling, painful sensations;

 the second - the appearance of blisters filled with a yellowish liquid;

 the third - the onset of incomplete necrosis of the skin;

 fourth - the presence of a brown or black scab, necrosis of the skin.

In case of thermal and electrical burns - throw a coat, any dense fabric on the ignited clothes, knock down the flame with water. First aid for burns - protection of the affected areas from infection, germs and the fight against shock. Affected areas - do not touch with hands, lubricate with ointments, fats, oils, sprinkle with soda; it is impossible to pierce, open blisters, remove substances adhering to the burnt place in order to avoid exposing the wound; a sterile dressing is applied to small burns of 2-4 degrees, extensive lesions are wrapped in a sterile sheet. Clothes and shoes from burned places should not be torn off, they must be cut and carefully removed. Shelter warmer, drink tea, give painkillers, create peace until the doctor arrives.

First aid for chemical burns

With chemical burns, it must be taken into account that the depth of tissue damage depends on the concentration and duration of exposure to the chemical. Therefore, it is important to reduce the concentration and duration of action of this substance as soon as possible. To do this, the affected area must immediately be washed with a large amount of running water. cold water within 15-20 minutes.

If acid or alkali gets on the skin through clothes - rinse with water from clothes, carefully cut and remove wet clothes from the victim, start washing the affected areas of the skin with water. Upon contact with the human body, chemical active substances in solid form - it is necessary to remove them with dry cotton wool, rinse the affected area thoroughly with water.

After washing with water, the affected areas must be treated with appropriate neutralizing solutions in the form of lotions, dressings. Alkaline - are treated with a 1-2% solution of boric acid, acidic - with a soda solution. Further assistance - as with thermal burns.

First aid for frostbite

First aid for frostbite - immediate warming of the victim, especially the frostbitten part of the body, for which the victim must be transferred to a warm room as soon as possible. It is necessary to warm the frostbitten part of the body, restore blood circulation in it. The greatest effect is achieved through a warm bath at a temperature of 20 ° C with a gradual 20-30 min. temperature increase up to 40 °C.

After the bath, the areas must be dried, covered with a sterile bandage and warmly covered. You can not lubricate them with fat, ointments, because. this will make subsequent processing more difficult.

Frostbitten areas of the body should not be rubbed with snow (ice will injure the skin, which will contribute to infection). You can massage with clean hands, starting from the periphery to the torso.

With frostbite of the nose, ears, they can be warmed with the warmth of the hands. Before entering the victim into the room, a heat-insulating bandage should be applied. The victim must be kept calm, the bandage should be left until a feeling of heat and warmth appears. Give aspirin, analgin, strong tea, coffee.

First aid for poisoning, wounds, electric shock

First aid for poisoning

In case of poisoning, victims should be immediately evacuated to a medical facility.
In case of gas poisoning, incl. carbon monoxide, natural, acetylene, gasoline vapors, etc. appears headache, "knocking in the temples"; tinnitus; general weakness, dizziness, palpitations, nausea and vomiting. With severe poisoning, drowsiness, apathy, indifference occurs, and with severe poisoning, an excited state with erratic movements, loss or retention of breath, dilated pupils. In case of poisoning, the victim must be taken out or taken out of the poisoned zone, unbuttoned clothes that restrict breathing, provide fresh air, lay him down, raise his legs, cover him warmly, let him smell ammonia. In case of ammonia poisoning, it is necessary to give the victim to drink 10 glasses of warm water with vinegar, inducing vomiting, give warm milk. In case of gas poisoning, the victim should be taken out to fresh air, laid down, legs raised, and given tea and coffee.

First aid for fractures, dislocations, wounds

The victim experiences acute pain, which increases sharply when trying to change the position of the damaged part of the body.

In case of an open fracture, after stopping the bleeding and applying a sterile bandage, it is necessary to immobilize the injuries of the limb using a finished splint, stick, board, ruler, etc.

With a closed fracture, clothes should not be removed from the victim, the splint should be applied over the clothes. To reduce pain, cold lotions, a bubble with ice, snow, cold water etc.

In case of wounds, it is impossible to wash the wound with water, any medicinal substance, cover it with powder, lubricate it with ointments; it is impossible to remove sand, earth, etc. from the wound, it is necessary to remove the dirt around the wound, cleaning the skin from its edges to the outside, so as not to further contaminate the wound. Lubricate the cleaned area around the wound with iodine, apply a bandage using an individual bag or a clean handkerchief, a clean cloth. Do not apply cotton wool directly to the wound.

First aid for electric shock

If the victim is conscious with stable breathing and pulse, he should be laid on a bedding, for example, from clothes; unfasten clothing that restricts breathing; create an influx of fresh air; create a normal thermal regime, complete rest, continuously monitor the pulse and breathing. If the victim is unconscious - observe his breathing, in cases of respiratory failure - take measures to eliminate the retraction of the tongue by pushing the lower jaw forward and holding it in this state. When vomiting, it is necessary to turn the victim's head and shoulders to the left to remove vomit.

It is impossible to allow the victim to move, and even more so to continue working until the decision of the doctor. The victim should be moved only when he and the person providing assistance are in danger.

If, after release from the action of the current, the victim breathes rarely and convulsively, it is necessary to perform artificial respiration with simultaneous external heart massage. In case of a lightning strike, the same assistance is provided as in case of electric shock.