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Home » 2010 » May » 12 » Organization and ways of pre-medical help. First aid kit.
Organization and ways of pre-medical help. First aid kit.
Organization and ways of pre-medical help. First aid kit.

As a result of existence and development of any extreme situation there can be victims or human loses. Character of an extreme situation does not allow to prepare in advance resources necessary for aiding the first medical aid ( medical personnel, medicines, medical institutions, specialised transport).Thus there is a question of giving the first, pre-medical help to the victim.
For giving the first medical aid everything available and first-aid kits are used. Places of storage and the structure of the first-aid kit, unfortunately, till the present moment is defined by orders and instructions of the branch ministries and departments. Ministry of Health of Ukraine develops only the general recommendations which are not the supervising document for all enterprises and organisations, and have only the general, recommendatory character. For example, the centre of medicine of accidents together with employees of emergency and practical doctors has developed the list of packing for automobile first-aid kit of new sample. The list of medical products which should be part of automobile first-aid sets № 1 and № 2, is confirmed by the order of Health Ministry of Ukraine from 07.07.1998 № 187. The first-aid set № 1 is intended for equipment of passenger cars with the quantity of passengers less than 9, and also cargo vehicles; the first-aid set № 2 for passenger vehicles with number of passengers more than 9.
The composition and place of storage of the first-aid set cars are installed by the order the head of department of the State automobile inspection from 24.04.2000 № 20. According to this order with a view of improvement of giving the first medical aid to the victims in road accident all cars, participants of traffic, should be completed by the first-aid set № 1 since July, 1st, 2000, and the first-aid set № 2 since September, 1st, 2000 (according to a vehicle kind).
In what is the advantage of first-aid sets of the new sample? The matter is that by means of this first-aid kit it is possible at modern level to give the first medical aid in extreme situations, namely;
1) anaesthetize;
2) to stop bleeding;
3) to restore breath to the victim;
4) to produce immobilization limbs and cervical spine (the first-aid set № 2).
By data statisticians, at road and transport incidents prevail polytraumas and in most cases victims die in the result of development of a painful shock because of impossibility to anesthesia at first 15 minutes after injury.
The important component of new first-aid sets is the effective anaesthetic буторфанола тартрат (1 ml of 0,2 % of a solution). This synthetic opioid analgesic which is in several times stronger than morphine, effectively warns development of a painful shock after injury. The preparation is in a plastic disposable syringe-tube, is sterile, and in extreme conditions for anaesthesia it can be entered even through clothes of victim. The use of this analgesic will suspend development of a traumatic shock in bad injury and will allow taking the victim to a medical institution for giving specialised help.
There are some more innovations. For example, to stop a bleeding except a traditional plait in the new first-aid set there are two styptic napkins «Koleteks». For clearing of breathing passages from emetic weights or blood in the first-aid set special polyethylene gloves are provided, and for artificial pulmonary ventilation- a special film-valve is provided. It corresponds to hygienic requirements - at its application contact of the person assisting, to emetic weights or blood of the victim is completely excluded.
In the first-aid set № 2 there is a set of modern, easy, freely modeled elastic splint for limbs immobilization at traumas, and also a special set of collars for cervical spine immobilization at fractures are added. The specified collars and splints are simple enough in usage. Their application essentially reduces essentially risk of displacement of fracture while transportation the victim. Consequently, it promotes the fastest recover and reduces risk to became disabled. Thus, the search and use of improvised means for immobilization are to be minimal, that gives the chance to reduce time and to raise quality of the rendered acute care.
Today first-aid sets № 2 are completed with elastic splints SAM SPLINT of the American manufacture. In each first-aid set of the new sample there is the short instruction developed by experts of the centre, on application of medical products available there. Thus, any person who has found in an incident, can give the first medical aid. It is necessary only to open the first-aid set and to follow the instruction. All medicines in the first-aid set are in 16 cells of a polyethylene cover that does using medicines convenient, and gives the chance to find without superfluous time losses necessary agents.
there are some interesting recommendations about giving the first aid in an instruction of a bodyguard of Kiev "Oriental cherry» company. Work of a bodyguard is constantly connected with the raised risk for own life, besides, his duty is to prevent and foresee the dangers threatening to its ward. If the bodyguard did not manage to prevent drawing of physical injuries to its client he (bodyguard) is the one who should give the first aid to a victim.
«... In ES you should always estimate the need of the first aid, establish priorities, and then to make a plan of action and to carry it out. Certainly, your decisions can strongly depend on a concrete situation, but, irrespective of circumstances, adhere to following rules.
• Keep calm. Whatever serious was the injury or dangerous situation, the panic only will weaken your ability to think and will lower efficiency of your actions. Besides, you will waste time, and in a crisis situation time can solve in favour of a life or death.
• Avoid unnecessary risk. It not cowardice. You won't be able to help anyone if you suffer yourself.
• Before doing smth, think carefully and easy, but, whenever possible, quickly.
• Try to calm and console victims.
• Find out, whether there are other escaped people who have kept activity who could help to cope you with a situation. In particular, look, whether there are any survived medics or people, more skilled, than you.
• At an estimation of consequences of accident use your sense organs as much as possible. Ask. Look. Listen. Smell. Then think and operate. Ask suffered to describe the symptoms, to tell you, what, in his opinion, has happened, and then, ask what he thinks is wrong with him... »
as it was shown above the main rules of your behaviour were described using simple and accessible language .
The first medical aid gives directly on a place of defeat or near to it with use of improvised means. Timely and correctly rendered first medical aid rescues a life to a victim and warns development of failures. In case of absence nearby people a victim should take care about first aid himself. At the organisation of the first aid the special attention should be paid on timeliness if the injures are accompanied by a bleeding, a shock, asphyxia, consciousness loss, carbon poisoning.
Firstly you should do such actions as: stop external hemorrhage with the help of wound tampon and small pillows of the dressing package, a pressing bandage, tourniquet imposing (garrot using improvised means), anesthetics introduction , elimination asphyxia, carrying out of artificial ventilation, indirect massage of heart for the purpose of restoration of warm activity, closing wounded surfaces with a bandage.

Rules of bleeding stop. 
the following bleedings are distinguished:
• the capillary;
• the arterial;
• the venous.
The capillary bleeding occurs when small vessels are damaged. Blood exudes on all surface of a wound, as from a sponge. As a rule, such bleeding isn't plentiful. The capillary bleeding is imposed with a help of a pressing bandage directly on a wound .
The arterial bleeding is defined on scarlet, bright red colour of blood which is thrown out from a wound by a pulsing stream, sometimes in the form of a fountain. It is dangerous to life as the wounded man for a short time interval can lose a considerable amount of blood. Therefore it is necessary to stop bleeding quickly.
The most simple way to stop it is to press an artery with a finger above a wound place.
Digital pressed arteries is only the first measure which is applied at an arterial bleeding. It can be applied only during very short term necessary for preparation for imposing of a tourniquet or garrot on finiteness or a sterile pressing bandage on other parts of a body.
When shin arterial bleeding the popliteal artery should be pressed. Pressing is made by both hands. The big fingers are put on a forward surface of a knee joint, and other fingers grope an artery in a popliteal pole and press it to a bone.
When hip arterial bleeding press a femoral artery which is on an internal surface of the top part of a hip directly under inguinal fold
When there is thoracic [superior] limb arterial bleeding press a brachial artery to a humeral bone at an internal surface of a two-headed muscle of a shoulder four fingers of a hand. Efficiency of a press is checked on a pulsation of a radial artery on an internal surface of an elbow bend.
When a neck wound bleeding, press carotid on the side of wound below a wound.
To stop limb bleeding tourniquet or garrotes are put. The place of putting bleeding stop tourniquets coincides with the places of pressing the arteries.
The most reliable way of a stop limb arterial bleeding is putting rubber or cloth made garrot , made of improvised means: a belt, a towel, etc.
When tourniquet putting (garrot) it is necessary to follow the next rules:
• the tourniquet (garrot) should be put as close to a bleeding wound as possible ;
• the tourniquet (garrot) should be imposed over clothes (or over several rounds of bandage); the imposed tourniquet (garrot) should be well visible, it cannot be closed by clothes or bandage;
• one should tighten a tourniquet (garrot) before the bleeding stop; the excessive tightening of a tourniquet (garrot) increases painful feelings and quite often injures nervous trunks; poorly tightened tourniquet (garrot) strengthens bleeding;
• in a cold season a limb below a tourniquet should be wrapped up warmly, but it is impossible to apply artificial warming;
• the tourniquet (garrot) cannot be held more than 1,5-2 hours, otherwise death of a lomb can be. If after tourniquetor garrot imposing 1,5-2 hours have passed it is necessary to weaken a tourniquet slightly and smoothly, the damaged artery should be pressed with fingers above a wound at this time, and then put down a tourniquet again , but above that place where it has been put earlier. Under a tourniquet or garrot a note should be enclosed, where time (hours, minutes) of putting is written.
Injured people with a strong arterial bleeding after tourniquet (garrrot) putting should be taken to the hospital immediately. During winter the tourniquet should be weakened for a short time each half an hour.
The next way to stop an arterial bleeding is maximum limb bending.

to stop a bleeding from wounds in hand and forearm it is necessary to put curtailed of a gauze, cotton wool or a hard soft material a roll in an elbow bend, to bend a hand in an elbow, and to attach forearm tightly to a shoulder.
To stop bleeding from a brachial artery a roll should be put in an auxiliary crease and the hand bent in an elbow strong bandage to a chest.
If there is bleeding in an auxiliary crease the hands are bent in an elbow as much as possible and elbows are tied, thus subclavian artery clasps a clavicle to the first rib. This way cannot be used when limbs are fractured.
When small arteries are damaged, and also at breast, head, stomach, neck wounds and other parts of a body arterial bleedings are stopped by putting a sterile pressing bandage. In this case on a wound some layers of a sterile gauze or bandage are put and densely bandaged.
The venous bleeding is defined on dark red, cherry colour of blood which runs from a wound in a continuous stream, but slowly, without pushes.
Such bleeding can the plentiful. For its stop it is enough to put a sterile hard pressing bandage and to give raised position of the suffered part of a body. At damage of large veins on limbs a tourniquet is put. In this case a tourniquet is put below a wound and tighten less hardly, than at an arterial bleeding.
The correct stop of a nasal bleeding has a great value. In this case the victim should lay or sit with an unbuttoned collar of a shirt, without a headdress, the head should be thrown slightly back, it is necessary to put a hot-water bottle to his feet, on bridge of nose cold lotions should be put.
Internal hemorrhage arises in the result of strong injury. Its signs: sharp pallor of person, weakness, frequent pulse, a short wind, dizziness, strong thirst and an unconscious state. In such cases it is necessary to deliver a victim immediately to a medical institution, and before that to provide the victim full rest. On a stomach or to a trauma place it is necessary to put a bubble with ice; the cold narrows vessels, promotes a bleeding stop, you shouldn't give drink to a victim without doctor's permission. Evacuation of such victims is made firstly with much care.
Managements of wounds and bandaging.
Wounds are mechanical infringements of an integrity of integuments or mucous membranes. Such wounds are distinguished: cut, chipped, chopped, contused, smashed, fragmentary, fire and others wounds.
Wounds can be superficial when the top layers of a skin (graze) are damaged only, and deeper when not only all layers of a skin, but also laying fabrics (hypodermic tissue, muscles, internals) are damaged. 
If the wound gets into any cavity: chest, belly, skulls - it is called a penetrating wound.
Bruised, smashed and cut wounds are received in the result of blows of falling designs and fragments of walls of the destroyed buildings and constructions . they are accompanied by a huge hemorrhage in hypodermic tissues and in deeper fabrics.
The majority of wounds bleeds because of damaged vessels.
The main object is to stop bleeding , to protect a wound from pollution, to create rest of the damaged limb.
Protection of a wound from pollution and infection with microbes is reached by bandaging. For bandaging the gauze and the cotton wool are used with high hygroscopicity. A strong bleeding is stopped putting a pressing bandage or blooding stop tourniquet(on limbs).
At bandaging it is necessary to observe following rules:
• you shouldn't wash out independently a wound because microbes can be brought;
• you should take out pieces of wood, cloths, ground etc. only if they are on the surface of a wound;
• it is impossible to touch wound surface (a burn surface) with hands because there are too many microbes;
• it is necessary to do bandaging only by purely washed up hands if possible wiped by cologne or alcohol.
• a dressing which close wounds Should be sterile.
• in case of absence of a sterile dressing one can use purely washed scarf or a piece of cloth, preferably white colour, it is desirable to iron it;
• before bandaging the skin round a wound needs to be wiped with vodka (alcohol, cologne), and you should wipe in a direction from a wound, and then to grease a skin with iodic tincture.
Before bandaging, on a wound gauze napkins (one or the several, depending on wound size) are put, then a wound is bandaged. Bandaging is usually made from left to right, circular courses of bandage. Bandage is taken in the right hand, the free end it grasped by thumb and point finger of the left hand
Specific cases are chest and belly cavity, a skull penetrating wounds .
At penetrating chest wound there is a threat of respiratory standstill and a lethal outcome for a victim because of asphyxia (asthma).
In the result of chest penetrating wound cavity external atmospheric and intrabelly pressure is leveled. When the injured tries to breath in, the air gets to a chest cavity and lungs do not finish. It is necessary to breath out, to press the wound with your hand and to stick with any improvised material (an adhesive tape, packing for a sterile package, a polyethylene package). If the victim is unconscious, it is necessary to press sharply a thorax for imitation of breath out and also to stick a wound. If it's necessary artificial ventilation should be used.
When abdominal cavity penetrating wound it is necessary to close a wound sterile roller bandage. If internals have dropped out outside one shouldn't try to put them inside, it is necessary to bandage them accurately to a trunk. Victims with penetrating chest and abdominal cavity wounds aren't allowed to drink.
When there is a skull penetrating wound it is necessary to remove splinters of sticking out bones or extraneous subjects, and to bandage a wound.
As a dressing it is better to use standard dressing packages.
For opening of a package you should take it in the left hand, grasp the made an incision edge of a cover with the right hand and jerky break it. From a paper fold get a pin and fix it on your clothes, having developed a paper cover, take the bandage end to which the vatno-gauze small pillow is sewn, in the left hand, and in right - the rolled bandage and is planted with hands. The bandage stretches, the second small pillow which can move on bandage will be thus visible. This small pillow is used when the wound is perforating, one small pillow thus closes an entrance aperture, and the second target for what small pillows move apart on the necessary distance.
It is possible to touch small pillows with hands only from the party marked with a colour thread. A small pillow underside impose on a wound. Using circular courses of bandage it's fixed, and the end of a bandage is pined up. If there is only one wound, small pillows are put together, and at wounds of the small sizes they are put against each other.
There are following rules of bandaging of various types of bandages.
The most simple bandage is circular. It is imposed on a wrist, the bottom part of a shin, a forehead etc. At its imposing bandage is imposed so that each subsequent turn it completely closed the previous.
Spiral bandage is applied at limbs bandaging .Bandaging begins like a circular one, doing on one place two-three turns of bandage to fix it. Bandaging begins with the thinnest part of a limb. To bandage properly a bandage should be turned over after a coupe of turns. At the end of bandaging a bandage is fixed with a help of a pin or it's cut into two parts and ties up.
At foot or hand articulation bandaging figure-of-eight [cross] bandage is used, it's named so because at it imposing a bandage forms figure "8"all time .
At bandaging of the wound located on a breast or on a back, a so-called cross [figure-of-eight] bandage is used.
At shoulder joint wound spica [spiral reverse] bandage is used.
Cravat [many-tailed, scarf] bandage is used at head, elbow joint and buttock wound.
On chin, nose, nape and forehead sling [four-tailed] bandage is imposed. For its preparation take a piece of wide bandage in length about 1m and from each end it is cut on length, the middle part leaving whole, at small wounds instead of a bandage it is possible to apply a label.
At imposing a bandage a victim should be set or laid, because even at small damages, under the influence of nervous excitation or a pain there can be short-term loss of consciousness - a faint.
First-aid help at fractures, burns, shock, faint and electric trauma.
Is the result of accidents people, except wounds, can have fractures of bones, burns, electric traumas. They can have a shock or unconscious state.
Fractures can occur in a result of strong blow, falling etc.
Closed fractures when the bone is broken, but the skin integrity is not broken, and open fractures, when in the area of fracture there is a wound, are distinguished.
Giving the first aid at fractures, it is necessary to provide an immovability of a place of a fracture, than the pain decreases and the further displacement of bone fragments is prevented. This is reached by putting on the damaged part of a body immobilizing, that is a bandage creating an immovability, bandage.
For immobilizing standard ready splints are used. However in some cases there won't be any of them at the place of accident, therefore for overlaying splints an improvised means are used (sticks, canes, skis, umbrellas, suitable size of a board, pieces of plywood, ruler, bunches of rods of a cane, etc.).
At splint imposing it is necessary to provide immovability, at least two joints - one is above fracture, another - below fracture, and at fracture of large bones even three.
When imposing splints, it is necessary to stick to the following rules:
• the damaged limb cannot be extended;
• if there is an open wound at the fracture site and there is a strong bleeding, then first of all a tourniquet above a wound and fracture is put, and then a bandage on a wound, and after that - splints from two sides of a limb are put;
• both splints should grasp the joints located above and below of fracture;
• a splint before imposing should be wrapped up with cotton wool or a soft fabric.
In case of the closed fracture it is necessary to give first aid cautiously not to cause additional damages in the result of displacement of fragments of bones.
The splint should adjoin to the broken limbs. When there is a forearm fracture the arm is bent in an elbow joint under a right angle so that the palm has been turned to a thorax, then impose the splint so that the fingers cover its one end, and the second came for an elbow joint. In such position the splint is fixed with a bandage or other material, and a hand is suspended on a kerchief.
At humorous fracture the forearm needs to be bent under a right angle in an elbow joint, and on the broken bone two splints should be imposed if it's possible: one - from shoulder lateral aspect so that its one end was above the humeral joint, the second hardly below an elbow joint, and another - from an auxiliary hollow to an elbow joint. Then both splints are bandaged to a shoulder. The bent forearm is suspended on a belt or a kerchief.
At hips ' fracture one needs to have at least two big splints. One splint should be put on an external surface of the damaged limb. Thus the splint should be of such length that its one end was close to an armpit, and another supported foot a little. The second splint is imposed on an internal surface of a foot so that its one end reached perineum, and another - went beyond the foot a little. In such position of splints are being bandaged. The top part of the external splint should be attached by wide bandage, a zone belt or a towel to body.
At shin fracture first aid is the same as and at hip fracture.
Giving the first aid at collarbone fracture it is necessary to suspend a hand on a kerchief first of all, then to sew two cotton-gauze rings, to put them on victims' hands and to move to the humeral joints, shoulders of the victim should be taken away back as much as possible, the rings should be tied up behind, over shovels.
At pelvis fracture the wounded should be laid on a back, feet are bend in knees and a curtailed or pillow coat should be put under the knee joints., in order to reduce intensity of stomach muscles .
At spine damage the victim should be put on a firm laying (a board, plywood, a door etc.) - on back or stomach, depending on in what position he is. the victims should be lifted very cautiously, involving for this purpose three-four persons, avoiding any concussions and backbone bends.
At rib fracture a hard circular bandage should be put on a chest.
At jaw fractures a mouth needs to be covered, and then the jaw should be fixed with sling [four-tailed] bandage.
Burns are the damages caused by thermal action of a heat (a flame, hot steam, boiled water) or caustic chemical substances (strong acids, alkalis).
Such burns are distinguished:
• I degree burns when on the burnt place there is a reddening and the pain is felt;
• II degree burns when on a burn place there are bubbles;
• III degree burns is characterised by the death of the top layers of a skin;
• at IV degree burns not only a skin, but also tissues: sinews, muscles bones are affected

 Burns of any degree which area is more than 30 % of a surface of a body are dangerous to a life.
Rendering the first aid at burns consists of, first of all, suppression of the ignited clothes on the victim. He should be poured over with water and if there isn't any water , throw over him a blanket, a jacket or a coat, to stop oxygen access. Then the burnt part of a body should be released from clothes. If it is necessary clothes are cut, the parts of clothes which have stuck to a body do not tear away, and they are cut off around and left on a place. Burned blisters shouldn't be cut off or torn away. At extensive burns after the removal of clothes it is better to turn the victim in a pure bed-sheet, then it is necessary to take measures against a shock and to direct him to a medical institution.
At burns of separate parts of a body the skin round a burn needs to be wiped with alcohol, cologne, water, and a dry sterile bandage should be put on a burnt surface. To grease the burnt surface with fat or any ointment isn't allowed.
At small burns of I degree on the reddened skin it is necessary to impose the gauze napkin moistened with alcohol, at first time burning and morbidity will amplify a little, but soon the pain will abate, reddening will decrease.
At burns II and furthermore III and IV degrees the victim, after rendering the first aid, should be taken to a medical institution.
In the result of nervous system overstrain in connection with strong painful irritations, blood loss at wounds and fractures, and also burns quite often there comes a sharp decline of forces and decrease in all vital functions of an organism. Breath becomes hardly appreciable, superficial, the person turns pale, pulse becomes frequent and is badly probed, the victim becomes indifferent to surrounding and, despite a strong trauma, does not groan, does not complain of pains and does not ask about help though he stays in conscious. Such condition is called a shock.
First aid at a shock consists first of all in pain elimination. At fractures, for example, one imposing of the splints has favorable influence on the general condition of the victim because the elimination of mobility in the place of a fracture reduces pain. If there is a possibility it is necessary inject sedatives and to use cardiacs - camphor, caffeine. The victim should be warmed: covered with a blanket, to impose with hot-water bottles if there is no damage of an abdominal cavity, to give him hot sweet strong tea, wine, in a cold season to bring it in a warm place.
Faint - is a condition developing because of a nervous shock, a fright, big blood loss. Faint signs are:
• turning sharp pale;
• cold sweat;
• easing of heart activity;
• consciousness loss.
For rendering help it is necessary to unbutton a collar at the victim, to remove a belt, to take him out on an open place where fresh air freely arrives Victims feet need to be raised above a head. As a result of it blood supply of a brain improves and in most cases the victim comes to consciousness. If the faint is deep and consciousness does not come back, the victim should be give to smell liquid ammonia, to spray cold water on breast and face.
At electric trauma first of all it is necessary to stop the further influence of an electric current on a person. For this purpose it is necessary to switch off a current or to remove a wire from a body amazed, strictly observing thus safety precautions regulations. The person who is under a current shouldn't be touched with not protected hands. To reject a wire - only by means of a dry stick, a board or a hand protected by a rubber glove. Under feet it is necessary to put a dry board or glass, in extremis the victim can be dragged from wires for clothes.
 Not to be traumed, it is necessary to put on dry gloves or to wind hands with dry rags.
After current deenergizing (removals of a wire from a body) the victim is laid on a back, a body is slightly raised, a belt and a collar are unbuttoned. Being in a faint bring to conscious. If victim's breath has stopped artificial ventilation should be done. Then at the burnt places bandages are put.
The person affected by a current, shouldn't be dug in the earth or covered with earth. It is not useless, but also is harmful, as wounds and the burnt places become soiled, the organism is cooled and the breath is at a loss.
In the result of long influence of negative temperature on not protected parts of a body there can be congelation.. Congelation can be even at positive temperature, but if you have damp clothes or footwear.
three degrees of congelation are distinguished :
• I degree is characterised by pallor and loss of sensitivity of the freezed places;
• at II degree the skin becomes blue and the blisters filled with blood are formed;
• at III degree cyanosis and tissues death is observed.
At I degrees congelation it is necessary to pound the freezed parts of a body till the redness of a skin and to grease with iodine, and then animal fats (goose fat or vaseline).
At П and Ш congelation degree is necessary to thaw the freezed parts of a body . Clothes are cut, th e freezed one is being cautiously pounded in a cool place. Only after the victim will come in consciousness, he should be put to a warm place, allowed to drink in the beginning cold tea or wine. A sterile bandage is put on blisters and sick limbshould be put in a vertical position that improves outflow of blood and often rescues the freezed limb from death.
At snake bite first of all limb is drawn above a sting, probably closer to a wound. Then, not stopping a bleeding, a poison should be deleted from a wound, squeezing out blood from a sting place. It is not recommended to suck away poison: through cracks in a mouth or on lips poison quickly gets into blood and can cause poisoning. It's better to put on the place of a sting wet cups. The cup is held 1-3 minutes. After a 2-minute break wet cups are put again and so another 3-4 times. the Wound is washed out with alcohol and cauterised with a strong manganese solution or with a tip of the heated knife. Libms should not be drawn for more than 30 minutes.
After animal bite blood from a wound deletd the same way, the wound is washed out by a strong solution of manganese or alcohol.
In the result of heavy damages of a human body or drawning there can happen a clinical death . The clinical death is a heavy infringement of ability to live of an organism which is characterised by the termination of process of breath and cardiac arrest. As a rule at first breath stops , and cardiac functions are working still for some time. In case of clinical death it is necessary to do immediately resuscitation actions.
At drawning as soon as possible to take the victim out of water. To clear a mouth with a point finger. To release respiratory ways from water for what to throw the victim through a knee, the person downwards and to put some blows between shovels. After that to spend resuscitation.
At refusal of warm or respiratory activity it is possible to return the majority of people by a life! In 5-6 minutes in the result of oxygen starvation of a brain there will come irreversible changes, in which result vital activity it will be impossible to restore in general, or the nervous system will be hard damaged, and the person will need a lot of time for restoration. Thus chances of deducing a person from clinical death decrease with each minute.
Here it would be desirable to quote again a bodyguard manual. «... Do not call to emergency if there are people around. Let them do it.
Ask about the help anyone, neighbours, people who surround you, make terrible noise - you cannot lose
Time! Operate in a following order.
• Examine the victim. Do not try to grope pulse or to hear heart beat! Pulse can be very weak, threadlike, and not be probed. Lift an eyelid and look at a pupil. If it wide, and does not react to light, it means, that not enough oxygen arrives to brains. Use reaction of a pupil for the control of your actions in the course of resuscitation.
• Put the victim on a back. Put curtailed clothes under victim's feet so that they were above his head. It gives additional inflow of blood. Unbutton or tear clothes on breast.
• Open a victim's mouth. Check up, whether tongue has sunk down. Often sunk down tongue breaks breath. If it so, pull out it.
• If you are alone, do simultaneously artificial ventilation and indirect heart massage . If together, one does heart massage , another - artificial ventilation.
• Fold your hands, having rested them on victim's breast in the field of heart almost in the middle of the basis of palms. Three-four strong pressing on heart area, one-two breaths. We inhale air to the victim in a mouth, a small pause, when we press on thorax we help to release air. Do not stop for a minute! Even if it seems to you, that your actions do not bring success! Heart massage should be carried out very strong pushes. Let even you break one-two ribs.
• Check from time to time victim's pupil . Narrowing of a pupil and its reaction to light is a successful indicator.
• If the victim did not begin to breathe and heart began working, continue before the arriving of emergency. They have powerful preparations. You pump over his blood and sate it with oxygen even if the victim has not revived , the stock of time for the qualified resuscitation strongly increases.
The conclusion.
The main conclusion from all stated material is that each civilised person should possess skills in rendering the first medical help. Thus degree of civilisation of people directly depends with the ability to help at any time and in any place
The quantity of technics surrounding us increases very quickly. Energy consumption of a separate unit of technics though decreases, but the total quantity increases thanks to increase in its quantity. Civilisation influence inevitably deforms a habitat of dwelling of the person. Even small infringement of "a civilised order», for example power cutoff, water supply, can lead to catastrophic consequences.
Daily in traffic accidents such quantity of people, as in the small local military conflict die. The quantity of motor transport on roads of our country increases with every year. Today the number of cars in Ukraine has exceeded 5,5 million, it's almost 2 times more than 5 years ago. In the result of traffic accidents (road accidents) more than 34 thousand people sustain injuries , about 9 thousand - die. Such sad statistics testifies that in many cases in the absence of necessary preparations in vehicles first-aid kits the first medical aid has been rendered out of time or not enough. Technogenic accidents and natural cataclysms occur not so often, but their consequences are, as a rule, worse.
The quantity of wounded in the result of these emergencies is much more, than victims who died in first minutes. A great number of fatal outcomes are related to badly wounded people, who has not been rendered the first help in time .
Natural development of a situation was that the state begin to pay more attention to a first aid question. For example, in 1998 requirements to filling the automobile first-aid set have changed. All drivers should pass each three years retraining and training of the pre-medical help. In high schools the subject connected with health protection is included.

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