Chapter 5 – FIRST AID

 

In any case a person gets injury it is necessary to deliver him to medical establishment or call an ambulance.

Before doctors come person needs the first (pre-medical) aid quality of which frequently ensures his life.

Everyone has to know how to stop bleeding, make a bandage, make artificial respiration and external heart massage.

If a person doesn’t have external life indication (there is no breathing, absent pulse etc) that doesn’t mean yet that the person died and it is not necessary to apply some measures to reanimate his life.

In heavy injuries sharply moving of the person is not allowed at all because it can cause a shock.

Transporting a person it is necessary to treat him very carefully, not to let his body or extremities move. It is important as soon as possible to find somebody to help and transfer him on stretcher made from any available material. Lifting and putting him on stretcher should be coordinated with partners.

If there’s suspect for spine and also lower jaw fracture person should be laid face down. Transporting of such person, however possible, is carried out on a stretcher either on an even support or any even place in a car. It is necessary to go carefully avoiding shaking.

There’re penetrating and non-penetrating wounds known. Penetrating wounds are most dangerous, as they can hit internal organs and bones.

Penetrating wounds can induce internal bleeding. Giving the first aid on wounds it is necessary to know the following rules:

don’t wash out a wound with water, or use ointments, as this can deliver dirt from the surface of the skin that can fester;

don’t wipe a contamination from a wound;

don’t take off the wound clots of blood, that can induce bleeding;

before giving the first aid wash the hands up.

For giving a first aid the individual packages are used to make a bandage for a wound, and if an individual package is unavailable, it is necessary to use a pure fabric and to drop iodine solution on it as well as the spot around the wound. Don’t spill iodine on the wound or fabric on it cause that can make a burn.

Bleeding is the most frequently met complication of heavy injury. Cardiovascular system of an adult person contains 5..5.5 litters of blood. For 1 hour heart transfers about 350 litters. That’s why when the bleeding is intensive a person can have significant blood loss very fast, and that results in death.

Bleeding can be arterial and venous. Arterial bleeding is extremely hard to stop and is the most dangerous. The indication of arterial bleeding is a force flow of blood of brightly red color, and indication of venous is a flow of deep-cherry color.

Bleeding should be stopped whatever intensity it has. If bleeding is not intensive, it is enough to make a tight bandage, and work the wound out with iodine solution.

If bleeding is intensive the other methods are applied. In some cases bleeding can be stopped bending extremity in joints. They plug in a hollow place of joint flexion, that is above the wound, with tampon from any fabrics. Then joint is bent. When it’s done an artery blood coming to wound is pressed.

This method can’t be applied for fracture on wounded extremity, therefore they use a special rubber tourniquet for bandaging. A tourniquet is put over the cloth, the pulse doesn’t have to be felt. Tourniquet can be kept in warm season not longer than for 2 hours, and in cold - 1 hour. After that it is necessary to remove it for 10 minutes to recover a blood circulation. Giving the first aid on intensive bleeding venous are necessary to press by fingers.

Bleeding in internal organs is very dangerous. When that happens face turns white, loss of consciousness is observed. In this case place of the injury should be applied with ice or cold water. If there’s suspicion on abdominal cavity bleeding, do not give anything to drink.

On nose bleeding it’s necessary to sit a person down and slightly incline backward his head, put on his nose bridge and neck a cold bandage.

Bone fracture, joint dislocation and ligament sprain is followed by strong pain, that sharply strengthens when an attempt to change positions of the damaged part of body is taken. Therefore first of all it is necessary to let extremity take the most comfortable position.

If the fracture is open contamination can get into a wound. The wound should be bandaged.

If the spine fracture happened it’s necessary very carefully to put under the back some board or to turn a person face down. Body inflection is suppressed, as it can damage spinal cord.

Falling down and the impacts frequently are causes of heavy damages of skull and concussion. The indication of a skull injury is ear bleeding and vomiting. The indication of concussion is headache, sickness, vomiting, loss of consciousness. If there’s no loss of consciousness «concussion of the brain» is not medically diagnosed.

A person should be placed on his back, then it’s necessary to bandage the head and put cold lotion onto the head. Before doctors come a person should have full rest given.

The fracture and dislocation of clavicle is followed by a sharp pain, which strengthens on shoulder joint movement. It is necessary to plug a under-shoulder hollow with tampon from a soft fabric or cotton wool and fix with bandage the arm bent to right angle to the body.

On extremity injuries irrespective of whether a fracture or the dislocation occurred the hurt body part should be placed so it would be in full rest condition. It is necessary to bandage to the arm (leg) a splint or stick to fix the hurt place.

The burns are thermal (fire, steam, boiling water), chemical (acid), electrical (electric current, electric arc).

Three degrees of burns are known:

I degree - reddening;

II degree - reddening, bladder containing liquid;

III degree - deadening and tearing away of a tissue.

It’s prohibited to remove the damaged wear that stuck to the skin from the burned parts of the body, and the bandage (sterile) is to be put over the cloth. Nothing is allowed to wipe out from a wound, because skin can be injured. On chemical burns a wound should be washed out with plenty of water.

Frostbite is reffered to thermal injuries too. On frostbite blood vessels get damaged first of all and blood circulation is infringed. To recover blood circulation open body parts are warmed up by rubbing, beginning on the frost and then in a warm room. Snow is not allowed to rub, cause it will damage a skin.

Rubbing is carried out with cotton wool penetrated with spirit or vodka until the skin gets redden, and then it‘s bandaged. If bladders appeared do not rub just make a bandage and take a person to the hospital.

Unconsciousness has the following indications are giddiness, sickness, darkening in eyes, weakness. A person should be laid so that his head would be lower the body to ensure blood flowing to the brain. Give to drink water and smell liquid ammoniaspirit. Cold lotions must not be applied to the head.

Overheating organism is followed by disorder of functioning of all the organs. When body temperature rises to 41 deg Ñ despite of medical efforts 50 % of people die.

A person loses consciousness, there’s no sweating, skin gets dry, frequently there’s a nose bleeding, sickness and vomiting. It is necessary to lay a person on the cool place so that the head would be higher the body, give him to smell liquid ammoniaspirit and apply the cold lotion to his head. In case of stop breathing it is necessary to do the artificial respiration and external massage of heart.

The problem to prevent poisoning with gas became very actual in consequence of accumulation in an environment about 6,000,000 of various toxic substances, and about 60,000 of them are used in household activities.

The most widespread hazardous gases are carbon monoxide, acetone, chlorine and other.

Carbon monoxide is extracted on fuel combustion.

Poisoning has three degrees:

I degree occurs when 20..30 % of oxygen is substituted by carbon dioxide. Symptoms are headache, giddiness, face reddening;

II degree occurs when 30..35 % of oxygen is substituted by carbon dioxide. Symptoms are the loss of consciousness, violation of sight, person can not leave the room himself;

III degree occurs in presence in the air of carbon oxide what substitutes 35 % of oxygen. On it the person loses consciousness and dies.

The first aid on poisoning with gases. It is necessary to take a person immediately out of polluted area, take his cloth off, put him on even surface, warmly to cover, give him to smell liquid ammoniaspirit and drink milk.

There’re two types of drowning: the «blue» type, when water gets inside and fills the lungs, and «pale» type, when there’s no water in lungs. The blue type is more frequently happening when the person doesn’t dive under water but struggles for life and swallows water during it. When water is in lungs (lungs inflating), there’s a foam going through the mouth and nose.

For blue type it is necessary at first to remove water from respiratory tract and lungs. A drowned person is put over the knee the rescuer face down. The rescuer opens with one hand a mouth of drowned and with the other presses repeatedly and periodically on his back. After water going out is finished it is necessary to lay a person on back and make artificial respiration and external massage of heart.

The pale type occurs in cases when people don’t try struggle for the life and deep under water at once. Frequently it happens in an unconscious condition. The person chokes form oxygen absence. In this case it is necessary at once to begin reanimation measures - artificial respiration and external massage of heart. When a drowned person starts to breath, it is necessary to make him smell liquid ammoniaspirit.