Basic principles of first aid. First aid. Basics of nursing

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ABSTRACT
conducting civil defense classes

Subject number 7.  Rendering the first medical care. Basics of nursing.
Purpose:

1. To teach trainees to provide first aid in emergency situations.
2. Train trainees on the technique of artificial respiration and indirect heart massage.
3. Improve skills in the basic rules of first aid in emergency situations.

Time spending:  2 hours
Method:  practical lesson
A place:  class GO
Methodical literature:

1. “Civil Defense” by V.G. Atamanyuk, L.G.Shirshev, N.I. Akimov; High school in 1986.
2. "Civil Defense" N.P. Olovyashnikov; High school in 1979.
3. "Formations of civil defense in the fight against natural disasters" A.T. Altunin; Moscow STROYIZDAT 1976.
4. “Methodological manual on medical and sanitary training” M. I. Gogolev; Moscow "Education" 1985.
5. Library of the journal "Military knowledge" Issue number 3; Moscow 1998

Lesson plan:
1. Basic rules for first aid in emergency situations. Rules and techniques for artificial respiration and indirect heart massage.
2. First aid for bleeding and injuries. Ways to stop bleeding. Types of dressings. Rules and techniques for dressing wounds.
3.   First aid for fractures. Methods and methods of immobilization using tabular and improvised means. Means and rules of transportation and transportation of victims.
4. First aid for bruises and sprains.
5. First aid for chemical and thermal burns
6. First aid for frostbite, fainting, electric shock, heat and sunstroke. Rules assisting the drowning man.
Used concepts:
Immobilization  creation of immobility of bone fragments by fixing the limbs with the help of a splint or improvised means.
Bleeding  outpouring of blood from blood vessels  due to their damage

I. First aid - the simplest urgent measures necessary to save the life and health of the victim in case of injuries, accidents, etc. Pp It appears on a scene before arrival of the doctor or delivery of the victim in hospital.
General measures Pp .:
1. Remove the victim from the situation that caused the accident (for example, remove crushed from under the debris), eliminate the effect of a harmful factor (for example, give access to fresh air with carbon monoxide poisoning, remove from the current source during electric shock, etc.);
2. Eliminate the harmful effects of the situation (move into the room, and if necessary in a cool place, warm, etc.);
3. To provide the necessary assistance (to make a dressing for injuries, to put a splint on a fracture, to drag a limb for bleeding, etc.);
4. Deliver the victim to a hospital or call an ambulance for him.
First aid is provided at the site of injury, and its appearance is determined by the nature of the injuries, the condition of the victim and the specific situation in the emergency area.
Remember! With strong arterial bleeding  of the injured limbs, only 30 seconds were allotted to stop it, in order to prevent blood loss incompatible with life. As we see, seconds and minutes solve for each victim the eternal question “to be or not to be?

Ii.Wound   - It is damage to the integrity of the skin of the body, mucous membranes as a result of mechanical action. Signs of injury are always there: pain, diverging edges of the wound and bleeding. Any wound should be closed, as various microorganisms penetrating through it can cause purulent complications  skin and underlying tissues internal organs. Treatment of abrasions, pricks, small cuts consists in lubricating the affected area with 5% iodine solution or 2% brilliant green solution and applying a sterile dressing. Small wounds, scratches, pricks, cuts can be moistened with BF-6 glue, which has a disinfecting property. Contaminated skin should be cleaned with pieces of gauze moistened with cologne, alcohol or gasoline. It should be well remembered that in no case should the wash itself be washed.
For applying dressings, they are used as service means, mass-produced by the industry (bandages and napkins sterile and non-sterile in packages, dressing bags are individual PPI), and from scrap materials (pure cotton fabrics and products from them).
The treatment of deeper and more extensive wounds is basically the same, but they are usually accompanied by bleeding. Depending on what a wounded blood vessel, there are three types of bleeding: arterial, venous and capillary. Depending on the type of bleeding apply different ways  its stopping.
When arterial bleeding scarlet blood from the wound beats fountain. In case of venous bleeding, dark-colored blood flows from the wound in a small stream. Capillary bleeding is characterized by the fact that blood leaks out with small drops from damaged tissues.
There are temporary and permanent ways to stop bleeding. The first are used at the scene in order of mutual aid, the second in medical institutions. It is necessary to know well the temporary methods of stopping bleeding, which include: pressing a bleeding vessel with a finger to the bone above the injury site, maximum flexion of the limb in the joint and imposition of a tourniquet or twist.
The method of manual pressing of the bleeding vessel to the bone is applied for the short time required to prepare a tow or pressure bandage. This is most easily done where the artery passes near or above the bone.
Bleeding from the head wound can be stopped or reduced by pressing the temporal artery on the injured side, which runs 1-1.5 cm in front of the auricle, where it can easily detect its pulsation. When bleeding from a wound located on the neck, the carotid artery is pressed on the injured side below the wound. Pulsation of this artery can be detected on the side of the trachea (respiratory neck). When the wound is high on the shoulder, close shoulder joint  or in the armpit, stop the bleeding by pressing the subclavian artery in the fossa above the collarbone. In the case of bleeding from the middle part of the shoulder, the brachial artery is compressed, for which the assisting fist is placed in the armpit and tightly fixed there by pressing the affected shoulder to the body. When bleeding from a wound in the forearm, the brachial artery is pressed against humerus at the inner surface of the biceps with four fingers. The effectiveness of pressure is checked by pulsation of the radial artery. Bleeding from the hand should be stopped by pressing the radial or ulnar artery. To stop the bleeding when the thigh is injured, you can press the femoral artery in the upper thigh. When bleeding from the lower leg, the popliteal artery should be pressed with both hands. The thumbs are placed on the front surface of the knee joint, and the rest of the fingers grope for the artery in the popliteal fossa and are pressed against the bone. It should be borne in mind that pressing the artery to the bone requires considerable effort, and the fingers quickly get tired. Even a physically very strong person cannot do this for more than 15 to 20 minutes.
A pressure bandage is applied to small bleeding arteries and veins: the wound is closed with several layers of sterile gauze, bandage or pads from an individual dressing bag. A layer of cotton wool is put on top of sterile gauze and a circular bandage is applied, and the dressing material, tightly pressed against the wound, squeezes the blood vessels and helps to stop the bleeding.
However, in case of severe bleeding, a tourniquet should be applied to stop it. Harness overlay is mainly used for large vessels of the limbs.
The method of its imposition is as follows:
- to give (if possible) an injured limb an exalted position;
- put a napkin on the exposed part of the limb, above the wound, make several moves of the bandage or use any other padding (the victim's clothes, handkerchief, etc.);
- strongly stretched tourniquet put on the limb above the wound on the gasket so that the first 1-2 turns of the tourniquet stop bleeding;
- secure the end of the harness with a hook and chain;
- place a note under the bundle in which to mark the date and time of application of the bundle;
- put an aseptic dressing on the wound;
- check the correctness of applying a tourniquet (to stop bleeding the absence of a pulse on the peripheral arteries, pale skin color):
- in the winter time, wrap the limbs with a imposed rope with cotton wool, clothes.
Instead of a standard rubber band, which may not always be at hand, a piece of cloth, a bandage, and a trouser belt can be used. The method of applying a twist-bundle is the same as when applying a twist. A twist is applied above the wound, its ends are knotted with a loop and a stick is inserted into the loop, by means of which the twist is tightened until it stops. bleeding and fix with a bandage.
In cases where there is nothing at hand, a temporary stop of bleeding can be accomplished by maximal flexion of the limb in the joint.
It must be remembered that the harness can be used for a period of not more than 2 hours, because otherwise the limb is deadened. At the earliest opportunity the harness is removed. If this is not possible, then after 1.5-2 hours it is necessary to slightly release the tourniquet for 1-2 minutes until the skin is red and tighten again.
Venous and capillary bleeding quite successfully stops the imposition of a pressure bandage.
After stopping the bleeding, the skin around the wound is treated with a solution of iodine, brilliant green, alcohol, vodka, or, in extreme cases, cologne. A cotton swab or gauze pad moistened with one of these fluids is smeared on the skin from the edge of the wound. They should not be poured into the wound, as this, firstly, will increase the pain, and secondly, damage the tissue inside the wound and slow down the healing process. If the wound is foreign bodyin no way should it be removed.
After completion of all manipulations, the wound is closed with a sterile dressing. A sterile dressing (individual dressing bag, sterile bandage, a clean scarf, a piece of linen, ironed with a hot iron on both sides) is applied, without touching your hands, directly on the wound and the place adjacent to it.
Minor skin lesions can be sealed with a piece of bactericidal adhesive tape, and on top of it you can put another piece of adhesive plaster, 0.5 cm wider than the former on each side. This bandage is tight and well-healing wounds.
After the dressing is applied and the patient is temporarily stopped bleeding, the victim must be sent to the hospital for the initial surgical treatment of the wound and the final stop of the bleeding.

Iii.  Fracture called partial or complete violation of the integrity of the bone as a result of impact, compression, compression, bending. At full fracture, bone fragments are displaced relative to each other, with an incomplete fracture on the bone. Fractures are closed, if the skin above them is intact, and open with a violation of the skin. Severe pain at the moment of injury and after it, change in the shape and shortening of the limb, and the appearance of mobility at the injury site should be considered typical common signs of bone fractures.
When rendering first aid, one should strive to move the broken leg or arm as little as possible; one should ensure the rest of the limb by inserting a tire made of an improvised material, or, if available, a standard one. For tires, any solid materials are suitable: boards, plywood, sticks, branches, etc. Splinting a limb will only be beneficial if the principle of immobilization of three joints is observed.
In case of a hip fracture, tires are pinned on the inner surface from the foot to the perineum to create rest for the injured leg from the outside, from the foot to the armpit. However, if there is nothing at hand, southernly pinning the injured limb to a healthy one.
Splinting of the upper limbs for fractures of the shoulder and forearm bones is done as follows. Bending the injured arm in the elbow joint and putting a palm to the chest, impose a splint from the fingers to the opposite shoulder joint on the back. If there is no tire on hand, then you can pin the injured arm to the body or hang it on a headscarf, on the raised floor of the jacket.
All types of tires are applied to clothing, but they must first be covered with cotton and covered with a soft cloth.
In victims with open fractures and bleeding, a tourniquet or twist should first be applied, a sterile dressing should be applied to the wound, and only then can a tire be applied.
With fractures of the spinal bones and pelvis, severe pain appears, sensitivity disappears, and paralysis of the legs appears. On a soft stretcher such a patient cannot be transported, only on a hard, smooth surface. For this purpose, a shield is used (a wide board, a sheet of thick plywood, a door removed from hinges, etc.), which is laid on a stretcher. Very carefully the patient is lifted by several people, in one step, holding the clothes on the team.
The patient on the shield is placed on his back, somewhat spreading his legs to the sides, placing a thick roller under his knees from a folded blanket or thick clothes ("frog posture"),
A person with a fracture of the cervical spine is transported on his back with a roller under the shoulder blades. The head and neck should be secured by covering them with soft objects on the sides.

Iv.Dislocation  - This is the displacement of the ends of the bones in the joints relative to each other with the collapse of the articular sac. Most often occurs in the shoulder, less often in the hip, ankle and elbow joints as a result of an unsuccessful fall or injury. Characterized by severe pain, stiffness of the joint, changing its shape.
Dislocation cannot be reset independently, as this will only aggravate the suffering of the victim and aggravate the injury. When the shoulder joint is dislocated, the arm is placed on the kerchief or tightly fitted to the body.
Sprains and ruptures of the ligaments of the joints result from abrupt and fast movements that exceed the physiological mobility of the joints. Most often suffer ankle, wrist, knee joints. There is a sharp pain in the joint during movement, swelling, bruising of the ligaments. First aid is reduced to tight bandaging by applying a pressure bandage, a compress (cold) and creating rest of the limb. The most common injuries in emergency situations and in everyday life are bruises.
Bruises are damage to tissues and organs without compromising the integrity of the skin and bones. The degree of damage depends on the impact force of the area of ​​the damaged surface and part of the body, its significance for the organism. It is natural to imagine that a hammer blow to the finger is less dangerous than a blow to the head. The main signs of bruises include pain, swelling and bruising at the site of contact with the injuring object. The choice of first aid methods depends on the location and severity of the damage. The hurt limb creates complete peace, an exalted position is attached, a tight pressure bandage is applied to the site of the bruise, a cold compress or a bubble with ice can be put. Inside, pain relievers are prescribed to reduce pain (amidopirin tablets with analgin 1 tablet 2-3 times a day).
The head bruise is very serious in its consequences, as it can be accompanied by concussion and contusion of the brain. Signs of concussion of the brain include loss of consciousness at the scene of the accident, nausea and vomiting, and slowing of the pulse.
The victim is given complete rest, a cold compress, ice in a bubble on his head. With all possible precautions, the patient should be referred to a hospital as soon as possible. For transportation, they put his back on the shield, and his head on a soft pillow. To fix the neck and head, a collar of soft fabric is put on the neck of the roller. If the head bruise is accompanied by injury of the skin, then various types of headbands in the form of a “cap” or “bridle” are applied to the wound.
Chest injuries are most common in car accidents and catastrophes, during falls during earthquakes, storms, hurricanes and other events. They can be accompanied by rib fractures. At the site of injury, in addition to pain, swelling and bruising, during examination, fragments of ribs are identified that can injure the skin and damage the lungs (increased pain during breathing, hemoptysis, shortness of breath), the development of pneumothorax is possible. The victim should be given a half-sitting position, put a circular bandage on the exhalation with a bandage or a towel to fix the fragments of the ribs. With open pneumothorax, an airtight dressing is applied.
Bruises of the joints are characterized by severe pain, swelling, movement in the damaged joint is limited. A tight pressure bandage is applied, and the victim must be referred to a medical institution to prevent more serious damage.

V. Burns  . One of the most commonly occurring types of traumatic injuries is burns. They arise as a result of hot fluid coming into contact with the body, flame, or contact of the skin with red-hot objects. Depending on the temperature and duration of its effect on the skin, burns of varying degrees are formed.
First-degree burns are damages to the stratum corneum of skin cells, which are manifested by reddening of burned areas of the skin, slight edema, and burning pains that pass rather quickly.
In case of second degree burns, the stratum corneum is completely damaged. Burnt skin of intense red color, bubbles appear, filled with clear liquidfelt sharp pain. Third-degree burns are formed when the deeper layers of the skin are damaged. On the skin in addition to blistering crusts form scabs. Charred skin. subcutaneous tissue and underlying tissues up to the bones are typical for fourth-degree burns.
The course and severity of burns, as well as the time of recovery, depend on the origin of the burn and its degree, the area of ​​the burned surface, the characteristics of first aid to the injured and many other circumstances. The most severe burns are caused by a flame, since the flame temperature is several orders of magnitude higher than the boiling point of liquids.
It is necessary to quickly remove the victim from the fire zone. If a person’s clothing caught fire, you should immediately remove it or throw a blanket, coat, tags, overcoat, thereby stopping the access of air to the fire.
After the flame has been knocked down from the victim, sterile gauze or simply clean dressings from the improvised material should be applied to the burn wounds. In this case, one should not tear off the stuck clothes from the burned surface; it is better to cut them off with scissors.
A victim with extensive burns should be wrapped in a clean, freshly smoothed sheet. In no case should bubbles appear. Dressings should be dry, the burn surface should not be lubricated with various fats, egg white. This can cause a person even greater harm, as dressings with any fats, ointments, oils, coloring substances only pollute the burn surface, contribute to the development of wound suppuration. Coloring disinfectants "darken" the wound, so if they are used by a doctor in a hospital, it is difficult to determine the degree of burn and start the correct treatment.
In recent years, due to the constant and widespread use of chemicals in industry, agriculture and in the home, cases of chemical burns have become more frequent. Chemical burns  arise as a result of exposure to the skin and mucous membranes of concentrated inorganic and organic acids, alkalis, phosphorus. Some chemical compounds in the air, in contact with moisture or other chemicals that ignite or explode, cause thermochemical burns. Pure phosphorus self-ignites in the air, easily sticks to the skin and causes also thermochemical burns.
Gasoline, kerosene, turpentine, ethyl alcohol, ether often cause skin burns when, by mistake, are used for compresses during treatment catarrhal diseasesespecially in children.
Chemical burns are also caused by some plants (buttercup, hellebore, dope, snowdrop, etc.) used as compresses for the treatment of radiculitis, arthritis, and polyarthritis, especially during the flowering period of these plants.
Thanks to the timely and proper first aid to the victim at the scene, deep tissue damage and the development of general poisoning are eliminated or prevented. Clothes soaked in a chemical compound must be quickly removed, cut right at the scene of an accident to the victim or his surroundings. Chemicals on the skin should be washed off with a large amount of water from the tap until the specific smell of the substance disappears, thereby preventing its effect on the body tissues.
Do not flush chemical compounds that are flammable or explode when in contact with water. In no case can not be treated - the affected skin is moistened with water with tampons, napkins, as this chemical compounds even more rubbed into the skin.
A bandage with a neutralizing, disinfecting agent or a clean and dry bandage is applied to the damaged skin. Ointment (vaseline, fat, oil) dressings only accelerate the penetration into the body through the skin of many fat-soluble chemicals (eg, phosphorus). After applying the dressing, you need to try to eliminate or reduce the pain, for which you should give the insider an anesthetic. As a rule, acid burns are usually deep. A dry scab forms on the site of the burn. If the acid gets on the skin, wash the affected areas with plenty of water, then wash them with a 2% solution of baking soda and soapy water to neutralize the acid and apply a dry dressing. When skin is affected by phosphorus and its compounds, the skin is treated with a 5% solution of copper sulphate and then with a 5-10% solution of baking soda. First aid for alkali burns is the same as for acid burns, with the only difference being that alkalis are neutralized with a 2% solution boric acid, solutions of citric acid, table vinegar.

Vi.Frostbite It occurs only with prolonged exposure to low ambient temperatures, in contact with cold metal in cold weather, liquid or compressed air or dry carbon dioxide. But not necessarily frostbite can occur only in the cold. There are cases when frostbite occurred at air temperature and above 0 ° С with high humidity and strong wind, especially if a person has wet clothes and shoes. Predispose to frostbite as a general weakening of the body due to overstrain, fatigue, hunger and alcohol intoxication. Most often exposed to frostbite toes and hands, auricles, nose and cheeks.
It is necessary to restore the blood circulation of frostbitten parts of the body as quickly as possible by grinding them and gradually warming them. It is advisable to bring the victim into a warm room at room temperature and continue rubbing the frostbitten part of the body. If the cheeks, nose and ears are white, it is enough to rub them with a clean hand until they become red and tingling and burning. It is best to rub the frostbitten part with alcohol, vodka, cologne or any wool cloth, flannel, soft glove. It is impossible to rub with snow, as the snow does not warm, but even more cools the frozen parts and damages the skin.
Shoes with feet should be removed very carefully, so as not to hurt frostbitten toes. If it is not possible to do this effortlessly, then the shoes will be ripped open with a knife along the seam of the tops. Simultaneously with rubbing the victim should be given hot tea, coffee.
After the frostbitten limb is frozen, it must be wiped dry, rubbed with alcohol or vodka, apply a clean, dry dressing and warm the limb with cotton wool or a cloth. If the blood circulation is poorly restored, the skin remains bluish, it is necessary to assume a deep frostbite and immediately send the victim to the hospital.
Shock and faint. In case of extensive injuries, fractures, burns, the victim may experience shock, i.e. a sharp decline in strength and inhibition of all vital functions of the body. Shock arises from overvoltage nervous system due to severe pain irritations, blood loss and for other reasons. Shock is accompanied by a sharp decline in cardiac activity, as a result of which the pulse weakens and sometimes is not heard at all. The face becomes gray, with sharp features, covered with cold sweat. The amazed person is indifferent to the surrounding, although his consciousness remains unchanged. He does not react to external irritations, not even touching the wound and the movement of the injured limb.
Those who are in a state of shock need immediate help. First of all, you need to eliminate the pain. If possible, you should enter painkillers (promedol, morphine, pantopon) and apply hearty camphor, caffeine. It is necessary to warm the injured person, cover him with a blanket, to overlap the heaters, to give strong tea, wine, in a cold season to bring in a warm room.
If the diseased, in a state of shock, does not damage the abdominal organs, it is recommended to give water to drink, dissolving one teaspoon of baking soda and 1/2 teaspoon of table salt in 1 liter.
Fainting   - sudden short-term loss of consciousness. The cause of fainting are big blood loss, nervous shock (fear, fear), fatigue. Fainting is characterized by blanching of the skin, lips, cooling of the extremities. Cardiac activity is weakened, the pulse is barely detectable. Fainting is sometimes very short, lasting only a few seconds. In other cases, fainting does not go away after 5-10 minutes or more. Prolonged fainting is life threatening.
To assist the affected person, move it to an open place where fresh air flows freely, give a horizontal position, and raise the legs above the head to cause blood rush to the head. To facilitate breathing, the affected person is freed from the constraining clothing: unbuttoning or incising the collar, bra, removing the belt and so on.
In order to remove a person from fainting, it is necessary to sprinkle his face with cold water or to give liquid ammonia, slowly bringing a piece of cotton or the tip of a handkerchief soaked in alcohol to his nose. Ammonia rubbed also whiskey.
Solar and heat strokes. Overheating of the head in the sun can lead to sunstroke. The first signs of sunstroke are redness of the face and severe headaches. Then nausea, dizziness, blackening of the eyes and finally vomiting appear. A person falls into an unconscious state, he has shortness of breath, his heart activity weakens.
Heatstroke - A painful condition resulting from overheating of the whole body. The reasons for this overheating can be high external temperatures, thick clothing that retards the evaporation of the skin, and increased physical work. Heat strokes do not occur only in hot weather. They are in hot shops, in baths, when working in protective overalls and too stuffy rooms. When the body overheats, a person appears lethargy, fatigue, dizziness, headachedrowsiness. The face turns red, breathing is difficult, the body temperature rises to 40 ° C. If the causes of overheating are not eliminated, a heat stroke occurs. The person loses consciousness, falls, turns pale, the skin becomes cold and becomes covered with sweat. In this state, the affected may die.
Both with sun and heat stroke, the affected person should be laid in the shade in the open air and the same measures should be carried out as with fainting. If the affected person does not breathe, artificial respiration must be performed.
Electric shock If you are exposed to uninsulated electrical wires, a person may be shocked by an electrical current. In this case, he may experience a short-term or prolonged loss of consciousness, accompanied by respiratory arrest and cardiac upset. Burns occur at the points of entry and exit of current. In some cases, electric shock causes instant death.
To help the affected person, first of all, it is necessary to stop further exposure of the current to him, turning off the switch, throwing off the wire with a dry stick or pulling the affected person out. In this case, you can not touch any wire or struck with bare hands. If there are no rubber gloves, the assisting person must wrap his hands with a piece of clothing, a dry cloth, if possible, it is advisable to wear rubber shoes or stand on a dry board. Pulling off the victim, you need to take it not for the body, but for the clothes. If the affected person is unconscious, but breathes on his own, do the same as with a swoon. In places where burns have formed from contact with current, they apply a sterile bandage. If the affected person does not breathe, artificial respiration is performed immediately.
Help drowning man. After removing the drowning person from the water, you should put his belly down on his knee or on the clothes folded by a roller, log and several times press his hands on his back to remove water from respiratory tract. Then, with a finger wrapped in a handkerchief, one should open the injured lips, open the mouth, clean the nose and throat of foam, dirt and mud. After that, lay it on your back, throw back your head as much as possible, stretch out your tongue and make sure that it does not catch on. Then you should immediately begin to conduct artificial respiration.

VII.Nursing   consists in creating and maintaining sanitary and hygienic conditions in the room where he is being held, setting up a comfortable bed and keeping it clean, providing the patient with help during the toilet, eating and other items of the body, maintaining the patient's good mood and organizing his leisure time .
The role of proper and caring care in the recovery of patients is extremely large. In some diseases, caring for them is even more important than treatment. Not without reason, often instead of the usual “cured” they say about the patient that he was “exited.”
The volume of sanitary treatment of patients is determined by the doctor after the examination. In the course of her first examine the hair and, if necessary, produce their haircut. Toenails and arms are cut short. Depending on the condition of the patient, the body is washed in the shower or in the bath. Doing pains make them worn out.
The room in which the patient is located must be constantly heated (20-22 ° C), have good day and evening lighting, ventilation and a ventilation window. The room should be as much free space as possible.
It is better to put the patient's bed perpendicular to the wall so that it can be approached from three sides. The surface of the mattress should be flat. On the bed you need to put a sheet, two pillows and a blanket with a duvet cover. In case of incontinence of urine and feces, an oilcloth is put on the sheet and the top is covered with a sheet that is replaced more often than the sheet. To give the patient's body a semi-sitting position in bed, a doubled mattress, a thick blanket are placed under the front quarter of the mattress, a roller or pillow is placed under the bent knees, and a footboard is placed from the board or box to prevent the patient's body from slipping. Under the bed put the ship and urinal. On the table (stool) near the bed place the most necessary things: a desk lamp, a glass, a bowl.
Patient's room must be systematically aired. The duration of airing depends on the season, but even in winter it should be at least 30 minutes 3-4 times a day. At the time of airing in the winter the patient must be well covered. Room cleaning should be wet.
At least once a week it is necessary to wash the patient's body in the shower or in the bath. Severely ill patients are wiped with water with alcohol or vinegar. In the mornings and for the night, the patients wash with warm water, and the seriously ill patients wipe their face and hands with a wet wrung towel.
Special care is required for the skin on the back, buttocks, sacrum, thighs and elbows of seriously ill patients, where blood circulation is disturbed due to prolonged lying and ulceration of ulceration appears, which is difficult to treat. To prevent the occurrence of pressure sores, it is necessary to remove the folds on the sheet and often change the position of the patient to turn him over on his side, trying to keep his back and buttocks less in contact with the bed.
The caregiver should monitor him properly, that is, be able to count the pulse, measure the temperature, determine the frequency of breathing.
Pulses are oscillations of the artery wall created by a wave of blood due to the work of the heart. Usually, the pulse is felt on the patient's palmar surface at the base of the thumb along the radial artery. A healthy person has 60 to 80 beats per minute. If the number of beats is less than 60, then the pulse is slowed, and if more than 80 is speeded up.
The temperature of the patient is measured twice a day for 10 minutes: in the morning and in the evening before meals or 2 hours after meals. The thermometer readings are recorded in the temperature sheet.
Observe breathing imperceptibly for the patient, with his calm state. In a healthy person, as already noted, there are 16 - 18 respiratory movements per minute. Rapid and shallow breathing is called shortness of breath, and if breathing becomes difficult, this means that the patient suffocates. When choking the skin due to oxygen starvation become bluish. If in this case the immediate help is not provided to the patient, he may die.

Synopsis developed:
Engineer for Civil Defense and Emergencies
Object of Economics Full Name

BASES OF MEDICAL AID

First aid for injuries and poisonings

General care for the injured and sick

Chapter 6

FIRST AID

DAMAGE AND POISONING

In this chapter, the main materials on various injuries and first aid provided by medical staff or persons trained in civil defense and life safety are systematized. Concepts, signs of possible complications, examples of assistance and methods of evacuation are given.

The main tasks in the provision of first aid are:

Determining the severity of the condition of the injured;

Carrying out the simplest medical and evacuation sorting for mass lesions;

Providing emergency care to save lives;

Prevention of complications.

Life-saving measures include: temporary hemostasis, artificial respiration, closed heart massage. Measures to prevent complications are: anesthesia, the imposition of sterile dressings, transport immobilization. First aid is possible if the necessary funds are available. There are sets of such means, for example, a driver's first-aid kit, but quite often any means by which first aid can be given are used.

Damage to human organs and tissues occurs as a result of different kinds  traumatic power and firearms. There are closed and open types of damage.

6.1. Closed damage

Closed injuries develop as a result of excessive mechanical stress on the body. In this case, deep-seated tissues are damaged, but the integrity of the integuments (skin and mucous membranes) is preserved.

Closed injuries include bruises, sprains and subcutaneous ligament ruptures, sprains, closed fractures; closed injuries of the organs of the chest and abdominal cavity (bruises of organs, subcapsular ruptures, complete ruptures, crush injuries); brain damage (concussions, bruises, compression).

6.1.1. Bruises

Bruises- damage to tissues and organs of the body with a blunt object, without compromising the integrity of the skin. Usually damaged small blood and lymphatic vessels, subcutaneous fat, muscle.

Signs of bruises:pain (of varying intensity), swelling, bruising, impaired function of the damaged organ. If a large vessel is damaged, hematoma (accumulation of blood) is possible; if the arterial vessel is damaged, the hematoma can be pulsating, it increases with each contraction of the heart. In case of extensive bruising and hematoma, due to their resorption or suppuration, a local (in the area of ​​the bruise) or a general rise in temperature occurs.

First aidaims to reduce pain, swelling and bruising. Necessary equipment: a bandage, an ice-bubble or a hot-water bottle with cold water, a roller made from improvised means to provide an elevated position, 5% alcohol solution of iodine, cotton wool.

Sequencing:

lubricate the skin in the area of ​​injury with 5% alcohol solution of iodine (to prevent germs from the skin in the underlying tissue);

put a pressure bandage;

ensure the elevated position of the injured part of the body;

apply cold (ice or cold water bubble, snow in a plastic bag, etc.) to the injury site.