In this chapter, the structure and scope of first aid are reviewed, the main provisions of United States legislation in the issues of first aid and liability for leaving in danger are defined. The stages of rendering first aid for various types of injuries and pathological conditions, such as: bleeding, fractures, burns, frostbite, drowning, poisoning, terminal states are considered. The fundamentals of desmurgy, immobilization with special and improvised means, ways of transporting the victims are presented.
After studying this chapter, the student must:
• the main regulations governing the procedure for the provision of first aid;
• The procedure for first aid actions, as defined in Annex 2 to the order of the Ministry of Health and Social Development of the USA of May 4, 2012, No. 477н "On the approval of the list of conditions in which first aid is provided and the list of first aid measures" ; (hereinafter - Ministry of Health Order No. 477n);
• the procedure for calling emergency doctors and interacting with them;
• the key concepts of the chapter, the etiology and pathogenesis of the pathological conditions described in it;
• stages of first aid in case of injuries and pathological conditions;
• the basics of desmurgy, immobilization and ways of transporting the victims;
be able to
• correctly inform the ambulance dispatcher;
• Step by step first aid;
• monitor the effectiveness of ongoing activities;
• interact with emergency doctors;
• the main methods of providing first aid;
• the main methods of desmurgy and immobilization;
• the main means of transporting the victim;
• the main methods of monitoring the condition of the victim.
Basic concepts: first aid, first aid, emergency medical care, shock, traumatic shock, bleeding, wound, fracture, burn, frostbite, terminal condition, clinical death , drowning, electric trauma, poisoning, desmurgy, immobilization, transportation of the injured, first-aid kit, individual anti-chemical package, individual dressing package, sanitary treatment.
Structure and volume of first aid
First aid can and should be provided by any person (in the absence of medical workers) next to the victim. The amount of first aid includes the implementation of mandatory and urgent measures aimed at preserving the life of the victim, before the arrival of a doctor or paramedic.
Citizens provide first aid in proportion to their knowledge, skills and capabilities. Timely call of appropriate specialists is considered as an obligatory element of first aid. For failure to provide assistance and leaving the victim in danger US Criminal Code provides for a different degree of responsibility, from administrative to criminal.
In Art. 125 of the United States Criminal Code, "Leaving in Danger" it is written that "deliberate abandonment without the assistance of a person who is in a life-threatening or health-threatening state and is deprived of the opportunity to take measures for self-preservation in infancy, old age, illness or due to his helplessness, in cases where the perpetrator had the opportunity to help this person and was is obliged to show concern for him, or he himself placed him in a state of danger for life or health - is punishable by a fine of up to eighty thousand rubles or in the amount of the wage or other income of the convicted person for a period up to months, or by compulsory works for a period from one hundred twenty to one hundred eighty hours, or correctional labor for up to one year, or imprisonment for up to three months, or imprisonment for up to one year .
Unlike first aid, medical care is subject to compulsory licensing (first medical aid, first aid, first aid, etc.), as it is a kind of medical activity.
In order for the first aid provided by an accidental witness of an accident (by a layman) to be consistent and maximally effective, the following procedure is recommended (see Ministry of Health Order No. 477n).
1. Activities to assess the situation and provide a safe environment for first aid:
1) Identify threats to your life and health;
2) identification of threats to the life and health of the victim;
3) elimination of threatening factors for life and health;
4) the termination of the damaging factors on the victim;
5) estimate the number of victims;
6) extraction of the victim from the vehicle or other hard-to-reach places;
7) moving the victim.
2. Call emergency medical services, other special services whose employees are required to provide assistance in accordance with federal law or with a special rule.
3. Determining the presence of consciousness in the victim.
4. Measures to restore airway patency and determine signs of life in the victim:
1) head tilt with chin lift;
2) extension of the lower jaw;
3) determining the presence of breathing with the help of hearing, sight and touch;
4) determining the presence of blood circulation, checking the pulse on the main arteries.
5. Activities to conduct cardiopulmonary resuscitation before the appearance of signs of life:
1) pressure on the victim's sternum;
2) Artificial breath "mouth to mouth";
3) artificial mouth-to-nose breathing;
4) artificial respiration using an artificial respiration device.
6. Measures to maintain airway patency:
1) giving a stable lateral position;
2) throwing back the head with a chin lift;
3) extension of the lower jaw.
7. Measures for a review of the victim and temporary stoppage of external bleeding:
1) a review of the patient for bleeding;
2) finger compression of the artery;
3) overlapping the bundle;
4) maximum flexion of the limb in the joint;
5) direct pressure on the wound;
6) application of a pressure bandage.
8. Measures for a detailed examination of the victim in order to identify signs of injuries, poisoning and other conditions threatening his life and health, and for first aid in case of detection of these conditions:
1) conducting a head scan;
2) carrying out a neck examination;
3) carrying out a breast examination;
4) conducting a back examination;
5) examination of the abdomen and pelvis;
6) Examination of limbs;
7) application of dressings for injuries of various areas of the body, including occlusive (sealing) in the wound of the chest;
8) immobilization (using improvised means, autoimmobilization, using medical devices);
9) fixation of the cervical spine (manually, by the means of using it, using medical devices;
10) stopping the exposure of dangerous chemicals to the victim (washing the stomach by taking water and causing vomiting, removing from the damaged surface and rinsing the damaged surface with running water);
11) local cooling for injuries, thermal burns and other effects of high temperatures or heat radiation;
12) Thermal insulation with frostbites and other effects of low temperatures.
9. Giving the victim optimal body position.
10. Monitoring the victim's condition (consciousness, breathing, circulation) and providing psychological support.
11. The transfer of the injured brigade to ambulance, other special services whose employees are obliged to provide first aid in accordance with federal law or with a special rule.
Before providing first aid to the victim, it is necessary to comply with item 1 of this recommendation - to provide security to the victim, himself and others. This is necessary because in a number of cases it may turn out that instead of helping you, you yourself will be in great need of it. It should also be noted that the implementation of paragraph 2 is always and always for everyone, including in such cases when a person for one reason or another can not provide first aid. Failure to comply with this clause is criminal and immoral.
Emergency call order
Before calling for emergency medical care, it is necessary to clarify information important to doctors:
• the exact address of the scene;
• number of victims, sex, age;
• the nature of the damage;
• give your name, first name and patronymic, your phone (can be updated as you move forward);
• Talk to the dispatcher only after he has finished the conversation himself.
1. In the event of an interruption of conversation with the dispatcher, the address of the scene and the nature of the damage are firstly called.
2. One victim needs one ambulance; with two injured - two cars, etc.
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