Algorithm for using an automatic external defibrillator (AD). Placing the victim in the “emergency medical recovery” position

There are various options for a lateral stable position, each of which should ensure that the victim’s body is positioned on its side, the free outflow of vomit and secretions from the oral cavity, and the absence of pressure on the chest (Fig. 19):

1. remove the victim’s glasses and put them in a safe place;

2. kneel next to the victim and make sure that both legs are straight;

3. move the victim’s arm closest to the rescuer to the side to a right angle to the body and bend it at the elbow joint so that the palm is turned upward;

4. Move the victim’s second hand across the chest, and hold the back of the palm of this hand against the victim’s cheek closest to the rescuer;

5. With your other hand, grab the victim’s leg farthest from the rescuer, just above the knee and pull it up so that the foot does not come off the surface;

6. holding the victim’s hand pressed to his cheek, pull the victim’s leg and turn him to face the rescuer into a side position;

7. bend the victim’s thigh to a right angle at the knee and hip joints;

9. check for normal breathing every 5 minutes;

10. transfer the victim to a lateral stable position on the other side every 30 minutes to avoid positional compartment syndrome.

Rice. 19.

Typical mistakes when carrying out basic and advanced resuscitation measures

Delay in starting CPR and defibrillation, loss of time on secondary diagnostic, organizational and treatment procedures.

Lack of a single leader, presence of outsiders.

Incorrect technique of chest compressions (infrequent or too frequent, superficial compressions, incomplete relaxation of the chest, breaks in compressions when applying electrodes, before and after applying a shock, when changing rescuers).

Incorrect artificial respiration technique (airway patency is not ensured, air tightness is not ensured, hyperventilation).

Lost time searching for intravenous access.

Multiple unsuccessful attempts at tracheal intubation.

Lack of accounting and control of ongoing treatment measures.

Premature cessation of resuscitation measures.

Weakening of control over the patient after restoration of blood circulation and breathing

FEATURES OF RESUSCITATION MEASURES IN CHILDREN

Scheme 2.

The BRM algorithm for children has the following differences from the algorithm for adults:

BRM start with 5 artificial breaths. Only if the child has lost consciousness in front of witnesses and no one else is around, you can start BRM with 1 minute of chest compressions and then go for help;

When performing artificial respiration, a baby (child under 1 year old) should not straighten his head; You should cover the baby’s mouth and nose with your lips at the same time (Fig. 28);

Rice. 28.

After performing 5 initial artificial breaths, check for signs of restoration of spontaneous circulation (movements, cough, normal breathing), pulse (in infants - on the brachial artery, in older children - on the carotid artery; pulse on the femoral artery - in both groups), spending This should take no more than 10 seconds. If signs of restoration of spontaneous circulation are detected, artificial respiration should be continued if necessary. If there are no signs of spontaneous circulation, begin chest compressions;

Perform chest compressions on the lower part of the sternum (find the xiphoid process and move one finger width higher), to 1/3 of the depth of the child’s chest. In infants - with two fingers in the presence of one rescuer and using the circular method in the presence of two rescuers. In children older than one year - with one or two hands (Fig. 29-30);

Rice. 29.

Rice. thirty.

Continue CPR in a 15:2 ratio;

When providing assistance for airway obstruction by a foreign body, abdominal thrusts are not used due to the high risk of internal organ damage in infants and children;

Technique for performing back blows on infants: hold the child in a position with his back up, while his head should be pointing down; the rescuer sitting on the chair must hold the baby, placing him on his lap; support the baby's head by placing the thumb on the corner of the lower jaw and one or two fingers of the same hand on the other side of the jaw; do not squeeze the soft tissues under the lower jaw; apply up to five jerky blows between the shoulder blades with the base of the palm, directing the force of the blows cranially;

Technique for performing back blows in children over 1 year of age: blows will be more effective if the child is given a position in which the head is located below the body; a small child can be placed above the knee with the leg bent across, just like an infant; if this is not possible, bend the child’s torso forward and hit the back while standing from behind; If blows to the back are ineffective, you should move on to performing chest thrusts.

Chest thrusts in infants: Place the baby on his back so that the head is lower than the body. This is easily achieved by placing the free hand along the child's back, with the fingers covering the back of the head. Lower the hand holding the child below your knee (or over your knee). Determine the place where the pressure will be applied (lower part of the sternum, approximately one finger above the xiphoid process). Perform five chest thrusts; the technique resembles an indirect cardiac massage, but is performed more abruptly, sharply and at a slower pace. Chest thrusts in children over 1 year old - according to the usual method.

The advanced resuscitation algorithm for children has the following differences from the algorithm for adults:

Use any air ducts with great care, since a child’s soft palate can be easily injured;

Tracheal intubation should be performed by an experienced specialist, since children have anatomical features of the larynx. Typically, uncuffed endotracheal tubes are used in children under 8 years of age;

If it is impossible to provide intravenous or intraosseous routes of drug administration, the intratracheal route should be used (adrenaline 100 mcg/kg, lidocaine 2-3 mg/kg, atropine 30 mcg/kg, diluted in 5 ml of saline);

Adrenaline in children is administered intravenously or intraosseously at a dose of 10 mcg/kg (maximum single dose 1 mg); amiodarone – 5 mg/kg;

Defibrillation:

Electrode size: 4.5 cm in diameter for infants and children weighing less than 10 kg; 8-12 cm in diameter - for children weighing more than 10 kg (over 1 year);

If, with the standard arrangement of electrodes, they overlap each other, the electrodes should be placed in an anteroposterior position;

Discharge power – 3-4 J/kg;

Synonyms: posture of bringing to life, position for ensuring life.

For an unconscious person, the most dangerous position is on the back. He can die because of complete nonsense, the muscles are not controlled, so the tongue sinks in and blocks the airways.

(Example: in our city, before a football match, a teenage fan lost consciousness and died for this very reason, right in front of a crowd of onlookers.)

Blood or other liquids (vomit, etc.), entering the larynx, cause a reflex cessation of breathing.

(Example: one of the rescue services in our country was organized at the expense of a man who lost his 15-year-old only daughter in a car accident. The girl died due to reflexive respiratory arrest caused by nosebleeds)

Various objects in the mouth (chewing gum, dentures, broken teeth, food) can also block the airways.

A person lying on his side risks significantly less. Therefore, it is necessary to place the unconscious person in a safe position. The method proposed here is not original. But it is easy to remember, easy to perform and gives very good results.

Positive aspects of a safe position:

The tongue cannot block the airway.

Free flow of fluid from the mouth and nose.

A bent arm and leg provide a stable position and prevent a possible rollover back onto your back.

The hand supports and protects the head.

Creating a safe position is most easily done in five steps.

1. Lay the victim on his back, ensure patency of the airway. Straighten your legs. Bring the arm closest to you at a right angle to the body.

2. Move the victim's hand farthest from you across the chest and place the back of it against the victim's cheek. It is advisable to hold your hand “fingers to fingers”, which ensures a clear fixation. Hold your hand until the end of the rollover to the side position.

3. Bend the victim's leg farthest from you at the knee. The foot should be on the surface of the ground.

4. Using your bent leg as a lever, gently turn the victim onto his side. Do this smoothly and calmly. The rotation of the body should not be sharp. This requires absolutely no effort. A fragile girl will easily turn over a hefty man in this way.

5. Place your thigh perpendicular to your body for stability. Remove your hand from under the victim's head. Ensure patency of the airway using the method already described, tilting your head slightly back. Make sure the victim is breathing. In this case, you can bring the back of your hand to the victim’s mouth and nose; the delicate skin will feel even faint breathing.

Once in a safe position, it is advisable to call an ambulance and monitor the condition until it arrives. If you are forced to leave, for example, to call an ambulance. Place rolled-up clothing or something else on the victim's back to prevent them from unconsciously rolling onto their back.

The “restorative” or stable lateral position is used in unconscious victims with spontaneous breathing in order to prevent tongue retraction and asphyxia. There are several modifications of the “restorative position”, none of them is preferable. The position should be stable, close to natural lateral, without compression of the chest.

Sequencing

1) remove the victim’s glasses and straighten his legs;
2) sit on the side of the victim, bend his arm, which lies closer to you, at a right angle to the body;
3) take the palm of the victim’s other hand in your palm and place his hand under his head;
4) with your other hand, grab the victim’s knee farthest from you and, without lifting the leg from the surface, bend the knee joint as much as possible;
5) using your knee as a lever, turn the victim onto his side;
6) check the stability of the victim’s position and the presence of breathing.

Obstruction (blockage) of the upper respiratory tract by a foreign body is most often associated with food intake.

In case of partial blockage The upper respiratory tract is characterized by coughing, severe difficulty in breathing, noisy breathing, cyanosis (blue discoloration) of the skin, and the victim often wraps his arms around his neck (“a universal symptom of respiratory stress”). The victim, as a rule, is able to independently cough up a foreign body.

In case of complete blockage upper respiratory tract (asphyxia), the victim’s breaths and coughing are ineffective, and rapid loss of voice and consciousness occurs. The victim needs immediate help.

First aid

If the victim is breathing on their own, monitor the effectiveness of their breathing and encourage them to cough. If the victim is conscious, but his weakness progresses, breathing and coughing weaken and stop, apply a series of 5 pushes between the shoulder blades:

1. stand to the side and slightly behind the victim;
2. Grasp the victim under the upper shoulder girdle with one hand and tilt him forward;
3. Using the edge of your second palm, apply 5 pushes between the victim’s shoulder blades.

Do not try to deliver all 5 pushes at once! Monitor the removal of the foreign body from the victim’s mouth after each push!

If thrusting between the shoulder blades was not effective, perform the “Heimlich maneuver” - applying abdominal thrusts:

1. stand behind the victim and clasp him with your arms around the body under the upper shoulder girdle at the level of the upper abdomen;
2. supporting the body, tilt the victim forward;
3. fold one of your hands into a fist and place it with your thumb towards the body along the midline of the body in the middle of the distance between the navel and the xiphoid process of the sternum (costal angle), fix the fist on top with your other hand;
4. apply a series of 5 sharp intense pushes in the direction from below - up and from outside - inward to the diaphragm, achieving the removal of the foreign body.

If abdominal thrusts are ineffective for a conscious victim, combine 5 thrusts between the shoulder blades.

If the victim has lost consciousness, it is necessary to begin basic life support measures according to the rules described above (section 4-7):

1. carefully lay the victim on a flat surface;
2. immediately call an ambulance (03.112);
3. if the victim is unable to breathe spontaneously, immediately begin chest compressions in a ratio with artificial breaths (30:2);
4. Before artificial breaths, check the victim’s oral cavity and remove possible foreign bodies under visual control.

Obstruction of the upper respiratory tract by a foreign body in an obese victim or a pregnant woman

Technique of jerking pressure on the chest in a standing or sitting position:

1. stand behind the victim, place your foot between his feet, clasp his chest at the level of the armpits; place the hand of one hand, clenched into a fist, with the thumb on the middle of the sternum, clasp it with the hand of the other hand; perform jerking movements along the sternum towards yourself until the foreign body comes out;
2. If the victim loses consciousness, immediately begin basic resuscitation.

The pictures show the technique of pushing the sternum in a lying position for obese victims and pregnant women.

At the scene of the incident and during transportation, the victim must be given an optimal (advantageous) position that affects the function of vital organs. This situation depends on the type of injury and the severity of the victim’s condition:

In victims who are unconscious due to traumatic brain injury, poisoning, cerebrovascular accident, etc., there is always a danger of tongue retraction, and due to suppression of cough and swallowing reflexes, blockage of the airways with vomit, saliva, sputum, foreign bodies, blood (especially if the victim is on his back). This inevitably leads to impaired lung function in the form of asphyxia (suffocation). To prevent this, the victim must be immediately placed in a stable lateral (drainage) position (Fig. 9).

Fig.9 Drainage position to prevent asphyxia

1. Remove the victim's glasses (if any).
2. Kneel at the victim's side. Make sure his legs are straight and his arms are at his side.
3. Take the victim's arm closest to you at a right angle to the body, bend it at the elbow so that the palm is directed upward.
4. Place the hand farthest from you diagonally on the victim’s chest; Place the back of the victim’s hand on the victim’s cheek closest to you.
5. With your other hand, grab the victim’s leg farthest from you, under the knee; Turn the victim toward you so that the victim's bent knee and foot rest on the ground.
6. Straighten the victim's head so that the airway remains clear. If necessary, adjust the position of the palm on which the patient's head rests so that the airway remains clear.
7. Monitor the victim's breathing.

Before turning the body, to prevent the risk of displacement of the cervical vertebrae (if they are fractured), it is advisable to fix the cervical spine with a cervical splint (Fig. 10).

Fig. 10 Neck splint

The “frog” position is used if injury to the pelvis or lower extremities is suspected. The victim is placed on his back with his limbs apart and half-bent at the knee and hip joints, which rest on a bolster in the popliteal region (Fig. 11).

Fig. 11 “Frog” position for injury to the pelvis and lower extremities

A patient with spinal injuries is placed in a supine position with a cushion placed on them (Fig. 12).

The horizontal position of the body with the legs elevated by 30 - 40 cm is used for massive blood loss and ongoing internal bleeding (Fig. 14).

The manual of the Ministry of Emergency Situations of Russia will help participants in road accidents and eyewitnesses of a heart attack in a sick person not to get confused in a difficult situation. The book also lists algorithms for providing first aid for traumatic injuries and emergency conditions. Such as external bleeding from injuries, abdominal wounds, penetrating chest wounds, bone fractures and thermal burns, as well as hypothermia and frostbite. Readers will learn how to behave correctly in order to actually help someone who has been electrocuted, or has swallowed water in a river, or perhaps has become a victim of serious poisoning. The manual also contains recommendations for help in case of injuries and chemical burns of the eyes, bites of poisonous snakes, insects, as well as heat and sunstroke.

1. Priority actions when providing first aid to sick and injured people

First of all, assistance is provided to those who are suffocating, who have profuse external bleeding, a penetrating wound to the chest or abdomen, who are unconscious or in serious condition.

	Make sure that you and the victim are not in danger. Use medical gloves to protect the victim from body fluids. Carry (lead) the victim to a safe area.
	Determine the presence of a pulse, spontaneous breathing, and the reaction of the pupils to light.
	Ensure patency of the upper respiratory tract.
	Restore breathing and cardiac activity by using artificial respiration and chest compressions.
	Stop external bleeding.
	Apply a sealing bandage to the chest for a penetrating wound.

Only after stopping external bleeding and restoring spontaneous breathing and heartbeat, do the following:

2. Procedure for performing cardiopulmonary resuscitation

2.1. Rules for determining the presence of a pulse, spontaneous breathing and the reaction of the pupils to light (signs of “life and death”)

Proceed to resuscitation only if there are no signs of life (points 1-2-3).

2.2. Sequence of artificial ventilation

	Ensure patency of the upper respiratory tract. Using gauze (handkerchief), remove mucus, blood, and other foreign objects from the mouth using a circular motion of your fingers.
	Tilt the victim's head back. (Lift your chin while holding the cervical spine.) Do not perform this if you suspect a fracture of the cervical spine!
	Pinch the victim's nose with your thumb and forefinger. Using a mouth-device-mouth artificial lung ventilation device, seal the mouth cavity and make two maximum, smooth exhalations into his mouth. Allow two to three seconds for each passive exhalation of the victim. Check whether the victim’s chest rises when inhaling and falls when exhaling.

2.3. Rules for closed (indirect) cardiac massage

The depth of chest compression should be at least 3-4 cm, 100-110 compressions per minute.

	- for infants, massage is performed using the palmar surfaces of the second and third fingers; - for teenagers - with the palm of one hand; - in adults, the emphasis is placed on the base of the palms, the thumb is directed towards the head (legs) of the victim. The fingers are raised and do not touch the chest.
	Alternate two “breaths” of artificial pulmonary ventilation (ALV) with 15 pressures, regardless of the number of people performing resuscitation.
	Monitor the pulse in the carotid artery, the reaction of the pupils to light (determining the effectiveness of resuscitation measures).

Closed cardiac massage should only be performed on a hard surface!

2.4. Removal of a foreign body from the respiratory tract using the Heimlich maneuver

Signs: The victim suffocates (convulsive breathing movements), is unable to speak, suddenly becomes cyanotic, and may lose consciousness.

Children often inhale parts of toys, nuts, and candies.

	Place the baby on the forearm of your left hand, and clap the palm of your right hand 2-3 times between the shoulder blades. Turn the baby upside down and pick him up by the legs.
	Grab the victim from behind with your hands and clasp them in a “lock” just above his navel, under the costal arch. Press sharply with force - with your hands folded into a “lock” - into the epigastric region. Repeat the series of pressures 3 times. For pregnant women, apply pressure to the lower parts of the chest.
	If the victim is unconscious, sit on top of the hips and sharply press on the costal arches with both palms. Repeat the series of pressures 3 times.
	Remove the foreign object with your fingers wrapped in a napkin or bandage. Before removing a foreign body from the mouth of a victim lying on his back, he must turn his head to the side.

IF, DURING RESUSCIVATION, INDEPENDENT BREATHING, HEARTBEAT DOES NOT RECOVER, AND THE PUPILS REMAIN WIDE FOR 30-40 MINUTES AND THERE IS NO HELP, IT SHOULD BE CONSIDERED THAT THE BIOLOGICAL DEATH OF THE VICTIM HAS OCCURRED.

3. Algorithms for providing first aid to victims of traumatic injuries and emergency conditions

3.1. First aid for external bleeding

	Make sure that neither you nor the victim is in danger, put on protective (rubber) gloves, and take the victim out of the affected area.
	Determine the presence of a pulse in the carotid arteries, the presence of spontaneous breathing, and the presence of pupillary reaction to light.
	If there is significant blood loss, place the victim with his legs elevated.
	Stop the bleeding!
	Apply a (clean) aseptic dressing.
	Keep the injured part of the body immobile. Place a cold pack (ice pack) on the bandage over the wound (sore area).
	Place the victim in a stable lateral position.
	Protect the victim from hypothermia by giving plenty of warm, sweet drinks.

Pressure points of arteries

3.2. Methods for temporarily stopping external bleeding

Clamp the bleeding vessel (wound)

Finger pressure on the artery is painful for the victim and requires great endurance and strength from the person providing assistance. Before applying a tourniquet, do not release the pinched artery so that bleeding does not resume. If you start to get tired, ask someone present to press your fingers on top.

Apply a pressure bandage or pack the wound

Apply a hemostatic tourniquet

A tourniquet is an extreme measure to temporarily stop arterial bleeding.

	Place a tourniquet on a soft pad (elements of the victim’s clothing) above the wound as close to it as possible. Place the tourniquet under the limb and stretch.
	Tighten the first turn of the tourniquet and check the pulsation of the vessels below the tourniquet or make sure that the bleeding from the wound has stopped and the skin below the tourniquet has turned pale.
	Apply subsequent turns of the tourniquet with less force, applying them in an upward spiral and capturing the previous turn.
	Place a note indicating the date and exact time under the tourniquet. Do not cover the tourniquet with a bandage or splint. In a visible place - on the forehead - make the inscription “Tourniquet” (with a marker).

The duration of the tourniquet on the limb is 1 hour, after which the tourniquet should be loosened for 10-15 minutes, having previously clamped the vessel, and tightened again, but not more than for 20-30 minutes.

Stopping external bleeding with a tourniquet (a more traumatic way to temporarily stop bleeding!)

	Place a tourniquet (tourniquet) made of narrowly folded available material (fabric, scarf, rope) around the limb above the wound on top of clothing or placing the fabric on the skin and tie the ends with a knot so that a loop is formed. Insert a stick (or other similar object) into the loop so that it is under the knot.
	Rotating the stick, tighten the tourniquet (tourniquet) until the bleeding stops.
	Secure the stick with a bandage to prevent it from unwinding. Every 15 minutes, loosen the tourniquet to avoid necrosis of the limb tissue. If bleeding does not return, leave the tourniquet loose, but do not remove it in case rebleeding occurs.

3.3. First aid for abdominal wounds

	Prolapsed organs should not be placed into the abdominal cavity. Drinking and eating are prohibited! To quench your thirst, wet your lips.
	Place a roll of gauze bandages around the prolapsed organs (to protect the prolapsed internal organs).
	Apply an aseptic bandage over the rollers. Without pressing the prolapsed organs, apply a bandage to the abdomen.
	Apply cold to the bandage.
	Protect the victim from hypothermia. Wrap yourself in warm blankets and clothes.

3.4. First aid for penetrating chest wounds

Signs: bleeding from a wound on the chest with the formation of blisters, air being sucked through the wound.

	If there is no foreign object in the wound, press your palm against the wound and close the access of air to it. If the wound is through, close the entry and exit wound holes.
	Cover the wound with an airtight material (seal the wound), secure this material with a bandage or plaster.
	Place the victim in a half-sitting position. Apply cold to the wound using a cloth pad.
	If there is a foreign object in the wound, secure it with bandage rolls, a plaster or a bandage. It is prohibited to remove foreign objects from the wound at the scene of the incident!

Call (by yourself or with the help of others) an ambulance,

3.5. First aid for nosebleeds

Causes: nose injury (blow, scratch); diseases (high blood pressure, decreased blood clotting); physical stress; overheating.

	Sit the victim down, tilt his head slightly forward and let the blood drain. Squeeze your nose just above your nostrils for 5-10 minutes. In this case, the victim must breathe through his mouth!
	Invite the victim to spit out the blood. (If blood enters the stomach, vomiting may occur.)
	Apply cold to the bridge of your nose (wet handkerchief, snow, ice).
	If the bleeding from the nose does not stop within 15 minutes, insert rolled gauze swabs into the nasal passages.

If the bleeding does not stop within 15-20 minutes, refer the victim to a medical facility.

3.6. First aid for broken bones

Call (on your own or with the help of others) an ambulance.

3.7. Rules for immobilization (immobilization)

Immobilization is mandatory. Only if there is a threat to the injured rescuer is it permissible to first move the injured person to a safe place.

	Immobilization is performed by immobilizing two adjacent joints located above and below the fracture site.
	Flat, narrow objects can be used as an immobilizing agent (splint): sticks, boards, rulers, rods, plywood, cardboard, etc. The sharp edges and corners of the splints should be smoothed using improvised means. After application, the splint must be secured with bandages or adhesive tape. For closed fractures (without damaging the skin), a splint is applied over clothing.
	For open fractures, do not apply a splint to places where bone fragments protrude.
	Attach the splint along its entire length (excluding the level of the fracture) to the limb with a bandage, tightly, but not too tightly, so as not to interfere with blood circulation. In case of a fracture of the lower limb, apply splints on both sides.
	In the absence of splints or improvised means, the injured leg can be immobilized by bandaging it to the healthy leg and the arm to the body.

3.8. First aid for thermal burns

Call (on your own or with the help of others) an ambulance. Ensure that the victim is transported to the burn department of the hospital.

3.9. First aid for general hypothermia

Call (on your own or with the help of others) an ambulance.

If there are signs of your own hypothermia, fight sleep, move; use paper, plastic bags and other means to insulate your shoes and clothes; look for or build a shelter from the cold.

3.10. First aid for frostbite

In case of frostbite, use oil or Vaseline; rubbing frostbitten areas of the body with snow is prohibited.

Call (on your own or with the help of others) an ambulance and ensure that the victim is transported to a medical facility.

3.11. First aid for electric shock

Call (on your own or with the help of others) an ambulance.

	Determine the presence of a pulse in the carotid artery, the reaction of the pupils to light, and spontaneous breathing.
	If there are no signs of life, perform cardiopulmonary resuscitation.
	When spontaneous breathing and heartbeat are restored, place the victim in a stable lateral position.
	If the victim regains consciousness, cover and warm him. Monitor his condition until medical personnel arrive; repeated cardiac arrest may occur.

3.12. First aid for drowning

Call (on your own or with the help of others) an ambulance.

3.13. First aid for traumatic brain injury

Call (on your own or with the help of others) an ambulance.

3.14. First aid for poisoning

3.14.1. First aid for oral poisoning (when a toxic substance enters the mouth)

Call an ambulance immediately. Find out the circumstances of the incident (in case of drug poisoning, present the medicine wrappers to the arriving medical worker).

If the victim is conscious

If the victim is unconscious

Call (on your own or with the help of others) an ambulance and ensure that the victim is transported to a medical facility.

3.14.2. First aid for inhalation poisoning (when a toxic substance enters the respiratory tract)

Signs of carbon monoxide poisoning: pain in the eyes, ringing in the ears, headache, nausea, vomiting, loss of consciousness, redness of the skin.

Signs of household gas poisoning: heaviness in the head, dizziness, tinnitus, vomiting; severe muscle weakness, increased heart rate; drowsiness, loss of consciousness, involuntary urination, pale (blue) skin, shallow breathing, convulsions.

Call an ambulance.

4. Algorithms for providing first aid for acute diseases and emergencies

4.1. First aid for a heart attack

Signs: acute pain behind the sternum, radiating to the left upper limb, accompanied by “fear of death,” palpitations, shortness of breath.

Call and instruct others to call an ambulance. Provide fresh air, unfasten tight clothes, and give a semi-sitting position.

4.2. First aid for damage to the organs of vision

4.2.1. If foreign bodies enter

Ensure that the victim is transported to a medical facility.

4.2.2. For chemical burns to the eyes

The victim should only move hand in hand with an accompanying person!

In case of acid contact You can wash your eyes with a 2% solution of baking soda (add baking soda to a glass of boiled water on the tip of a table knife).

In case of contact with alkali you can wash your eyes with a 0.1% solution of citric acid (add 2-3 drops of lemon juice to a glass of boiled water).

4.2.3. For eye and eyelid injuries

The victim should be in a lying position

Ensure that the victim is transported to a medical facility.

4.3. First aid for poisonous snake bites

Limit the mobility of the affected limb.

If consciousness does not recover for more than 3-5 minutes, call (on your own or with the help of others) an ambulance.

4.6. First aid for heatstroke (sunstroke)

Signs: weakness, drowsiness, thirst, nausea, headache; increased breathing and increased temperature, loss of consciousness are possible.

Call (by yourself or with the help of others) an ambulance.