First aid for emergency conditions. First aid for emergencies and acute diseases. Poisoning with stimulant drugs

Angina pectoris.

Angina pectoris

Symptoms:

Tactics nurse:

Actions	Rationale
Call a doctor	To provide qualified medical care
Calm and comfortably seat the patient with legs down	Reducing physical and emotional stress, creating comfort
Unbutton tight clothing, ensure airflow fresh air	To improve oxygenation
Measure blood pressure, calculate heart rate	Condition monitoring
Give nitroglycerin 0.5 mg, nitromint aerosol (1 press) under the tongue, repeat the drug if there is no effect after 5 minutes, repeat 3 times under the control of blood pressure and heart rate (BP not lower than 90 mm Hg).	Relieving spasm coronary arteries. The effect of nitroglycerin on coronary vessels begins in 1-3 minutes, maximum effect of the tablet is at 5 minutes, duration of action is 15 minutes
Give Corvalol or Valocardin 25-35 drops, or valerian tincture 25 drops	Removing emotional stress.
Place mustard plasters on the heart area	In order to reduce pain, as a distraction.
Give 100% humidified oxygen	Reduced hypoxia
Monitoring pulse and blood pressure.	Condition monitoring
Take an ECG	In order to clarify the diagnosis
Give if pain persists - give a tablet of 0.25 g of aspirin, chew slowly and swallow

1. Syringes and needles for intramuscular and subcutaneous injections.

2. Drugs: analgin, baralgin or tramal, sibazon (seduxen, relanium).

3. Ambu bag, ECG machine.

Assessment of achievements: 1. Complete cessation pain

2. If the pain persists, if this is the first attack (or attacks within a month), if the primary stereotype of the attack is violated, hospitalization is indicated cardiology department, intensive care

Note: if occurred while taking nitroglycerin, severe headache, give a validol tablet sublingually, hot sweet tea, nitromint or molsidomine orally.

Acute myocardial infarction

Myocardial infarction- ischemic necrosis of the heart muscle, which develops as a result of disruption of coronary blood flow.

It is characterized by chest pain of unusual intensity, pressing, burning, tearing, radiating to the left (sometimes right) shoulder, forearm, scapula, neck, lower jaw, epigastric region, pain lasts more than 20 minutes (up to several hours, days), can be wavy (it intensifies, then it subsides), or increasing; accompanied by a feeling of fear of death, lack of air. There may be violations heart rate and conductivity, blood pressure instability, taking nitroglycerin does not relieve pain. Objectively: pale skin or cyanosis; cold limbs, cold sticky sweat, general weakness, agitation (the patient underestimates the severity of the condition), motor restlessness, thread-like pulse, may be arrhythmic, frequent or rare, muffled heart sounds, pericardial friction rub, increased temperature.

atypical forms (variants):

Ø asthmatic– attack of suffocation (cardiac asthma, pulmonary edema);

Ø arrhythmic- rhythm disturbances are the only clinical manifestation

or predominate in the clinic;

Ø cerebrovascular- (manifested by fainting, loss of consciousness, sudden death, acute neurological symptoms such as stroke;

Ø abdominal- pain in the epigastric region, which can radiate to the back; nausea,

vomiting, hiccups, belching, severe bloating, tension in the anterior abdominal wall

and pain on palpation in the epigastric region, Shchetkin’s symptom -

Bloomberg negative;

Ø low-symptomatic (painless) - vague sensations in the chest, unmotivated weakness, increasing shortness of breath, causeless increase in temperature;

Ø with atypical irradiation of pain in – neck, lower jaw, teeth, left hand, shoulder, little finger ( upper - vertebral, laryngeal - pharyngeal)

When assessing the patient's condition, it is necessary to take into account the presence of factors risk of ischemic heart disease, the first appearance of painful attacks or a change in habitual

Nurse tactics:

Actions	Rationale
Call a doctor.	Providing qualified assistance
Observe strict bed rest (place with head elevated), reassure the patient
Provide access to fresh air	In order to reduce hypoxia
Measure blood pressure and pulse	Condition monitoring.
Give nitroglycerin 0.5 mg sublingually (up to 3 tablets) with a 5-minute break if blood pressure is not lower than 90 mm Hg.	Reducing spasm of the coronary arteries, reducing the area of necrosis.
Give an aspirin tablet 0.25 g, chew slowly and swallow	Prevention of blood clots
Give 100% humidified oxygen (2-6L per minute)	Reducing hypoxia
Pulse and blood pressure monitoring	Condition monitoring
Take an ECG	To confirm the diagnosis
Take blood for general and biochemical analysis	to confirm the diagnosis and perform a tropanin test
Connect to heart monitor	To monitor the dynamics of myocardial infarction.

Prepare instruments and preparations:

1. Intravenous system, tourniquet, electrocardiograph, defibrillator, cardiac monitor, Ambu bag.

2. As prescribed by the doctor: analgin 50%, 0.005% fentanyl solution, 0.25% droperidol solution, promedol solution 2% 1-2 ml, morphine 1% IV, Tramal - for adequate pain relief, Relanium, heparin - for the purpose of prevention recurrent blood clots and improvement of microcirculation, lidocaine - lidocaine for the prevention and treatment of arrhythmia;

Hypertensive crisis

Hypertensive crisis - sudden rise individual blood pressure, accompanied by cerebral and cardiovascular symptoms (disorders of the cerebral, coronary, renal circulation, autonomic nervous system)

- hyperkinetic (type 1, adrenaline): characterized by a sudden onset, with the appearance of an intense headache, sometimes of a pulsating nature, with a predominant localization in the occipital region, dizziness. Excitement, palpitations, trembling throughout the body, tremors of the hands, dry mouth, tachycardia, increased systolic and pulse pressure. The crisis lasts from several minutes to several hours (3-4). The skin is hyperemic, moist, diuresis is increased at the end of the crisis.

- hypokinetic (2 types, norepinephrine): develops slowly, from 3-4 hours to 4-5 days, headache, “heaviness” in the head, “veil” before the eyes, drowsiness, lethargy, the patient is lethargic, disorientation, “ringing” in the ears, transient visual impairment , paresthesia, nausea, vomiting, pressing pain in the heart, such as angina (pressing), swelling of the face and pasty legs, bradycardia, mainly diastolic pressure increases, pulse decreases. The skin is pale, dry, diuresis is reduced.

Nurse tactics:

Actions	Rationale
Call a doctor.	In order to provide qualified assistance.
Reassure the patient
Maintain strict bed rest, physical and mental rest, remove sound and light stimuli	Reducing physical and emotional stress
Place the head in a high position and turn your head to the side when vomiting.	For the purpose of blood outflow to the periphery, prevention of asphyxia.
Provide access to fresh air or oxygen therapy	In order to reduce hypoxia.
Measure blood pressure, heart rate.	Condition monitoring
Place mustard plasters on the calf muscles or apply a heating pad to the legs and arms (you can put the hands in a bath with hot water)	For the purpose of dilating peripheral vessels.
Place a cold compress on your head	To prevent cerebral edema, reduce headaches
Provide intake of Corvalol, motherwort tincture 25-35 drops	Removing emotional stress

Prepare drugs:

Nifedipine (Corinfar) tab. under the tongue, ¼ tab. capoten (captopril) under the tongue, clonidine (clonidine) tab., & anaprilin tab., amp; droperidol (ampoules), furosemide (Lasix tablets, ampoules), diazepam (Relanium, Seduxen), dibazol (amp), magnesium sulfate (amp), aminophylline amp.

Prepare tools:

Device for measuring blood pressure. Syringes, system for intravenous infusion, tourniquet.

Assessment of what has been achieved: Reduction of complaints, gradual (over 1-2 hours) decrease in blood pressure to the normal value for the patient

Fainting

Fainting This momentary loss consciousness, developing due to a sharp decrease in blood flow to the brain (several seconds or minutes)

Causes: fear, pain, sight of blood, blood loss, lack of air, hunger, pregnancy, intoxication.

Pre-fainting period: feeling of lightheadedness, weakness, dizziness, darkening of the eyes, nausea, sweating, ringing in the ears, yawning (up to 1-2 minutes)

Fainting: no consciousness, pale skin, decreased muscle tone, cold extremities, rare, shallow breathing, weak pulse, bradycardia, blood pressure - normal or reduced, pupils constricted (1-3-5 minutes, prolonged - up to 20 minutes)

Post-syncope period: consciousness returns, pulse, blood pressure return to normal , Possible weakness and headache (1-2 minutes – several hours). Patients do not remember what happened to them.

Nurse tactics:

Actions	Rationale
Call a doctor.	In order to provide qualified assistance
Lay without a pillow with your legs raised at 20 - 30 0 . Turn your head to the side (to prevent aspiration of vomit)	To prevent hypoxia, improve cerebral circulation
Provide a supply of fresh air or remove it from a stuffy room, give oxygen	To prevent hypoxia
Unbutton tight clothing, pat cheeks, spray cold water face. Give a cotton swab with ammonia a whiff, rub your body and limbs with your hands.	Reflex effect on vascular tone.
Give tincture of valerian or hawthorn, 15-25 drops, sweet strong tea, coffee
Measure blood pressure, control respiratory rate, pulse	Condition monitoring

Prepare instruments and preparations:

Syringes, needles, cordiamine 25% - 2 ml IM, caffeine solution 10% - 1 ml s/c.

Prepare drugs: aminophylline 2.4% 10 ml IV or atropine 0.1% 1 ml s.c., if fainting is caused by transverse heart block

Assessment of achievements:

1. The patient regained consciousness, his condition improved - consultation with a doctor.

3. The patient’s condition is alarming - call emergency help.

Collapse

Collapse- this is a persistent and long-term decrease in blood pressure due to acute vascular insufficiency.

Causes: pain, trauma, massive blood loss, myocardial infarction, infection, intoxication, a sharp decline temperature, change in body position (standing up), standing up after taking antihypertensive drugs and etc.

Ø cardiogenic form - for heart attack, myocarditis, pulmonary embolism

Ø vascular form– for infectious diseases, intoxication, critical decrease in temperature, pneumonia (symptoms develop simultaneously with symptoms of intoxication)

Ø hemorrhagic form - with massive blood loss (symptoms develop several hours after blood loss)

Clinic: general state severe or extremely severe. First, weakness, dizziness, and noise in the head appear. Worried about thirst, chilliness. Consciousness is preserved, but patients are inhibited and indifferent to their surroundings. The skin is pale, moist, cyanotic lips, acrocyanosis, cold extremities. BP less than 80 mm Hg. Art., pulse is frequent, thread-like", breathing is frequent, shallow, heart sounds are muffled, oliguria, body temperature is reduced.

Nurse tactics:

Prepare instruments and preparations:

Syringes, needles, tourniquets, disposable systems

Cordiamine 25% 2ml IM, caffeine solution 10% 1 ml s/c, 1% 1ml mezatone solution,

0.1% 1ml adrenaline solution, 0.2% norepinephrine solution, 60-90 mg prednisolone polyglucin, reopoliglucin, saline.
Assessment of achievements:

1. Condition has improved

2. The condition has not improved - be prepared for CPR

Shock - a condition in which there is a sharp, progressive decrease in all vital functions of the body.

Cardiogenic shock develops as a complication of acute myocardial infarction.
Clinic: in a patient with acute heart attack myocardium, severe weakness appears, skin
pale, moist, “marbled”, cold to the touch, collapsed veins, cold hands and feet, pain. Blood pressure is low, systolic about 90 mm Hg. Art. and below. The pulse is weak, frequent, “thread-like”. Breathing is shallow, frequent, oliguria

Ø reflex form (pain collapse)

Ø true cardiogenic shock

Ø arrhythmic shock

Nurse tactics:

Prepare instruments and preparations:

Syringes, needles, tourniquet, disposable systems, cardiac monitor, ECG machine, defibrillator, Ambu bag

0.2% norepinephrine solution, mezaton 1% 0.5 ml, saline. solution, prednisolone 60 mg, reopo-

liglucin, dopamine, heparin 10,000 units IV, lidocaine 100 mg, narcotic analgesics (Promedol 2% 2ml)
Assessment of achievements:

The condition has not worsened

Bronchial asthma

Bronchial asthma - chronic inflammatory process in the bronchi, predominantly of an allergic nature, the main clinical symptom is an attack of suffocation (bronchospasm).

During an attack: a spasm of the smooth muscles of the bronchi develops; - swelling of the bronchial mucosa; formation of viscous, thick, mucous sputum in the bronchi.

Clinic: the appearance of attacks or their increase in frequency are preceded by exacerbations inflammatory processes in the bronchopulmonary system, contact with an allergen, stress, meteorological factors. The attack develops at any time of the day, most often at night in the morning. The patient develops a feeling of “lack of air”, he takes a forced position with support on his hands, expiratory shortness of breath, unproductive cough, auxiliary muscles are involved in the act of breathing; there is retraction of the intercostal spaces, retraction of the supra-subclavian fossa, diffuse cyanosis, puffy face, viscous sputum, difficult to separate, noisy breathing, wheezing, dry wheezing, audible at a distance (remote), boxed percussion sound, pulse is frequent, weak. In the lungs - weakened breathing, dry wheezing.

Nurse tactics:

Actions	Rationale
Call a doctor	The condition requires medical attention
Reassure the patient	Decrease emotional stress
If possible, find out the allergen and separate the patient from it	Termination of exposure causative factor
Sit down with emphasis on your hands, unfasten tight clothing (belt, trousers)	To make breathing easier heart.
Provide fresh air flow	To reduce hypoxia
Offer to hold your breath voluntarily	Reducing bronchospasm
Measure blood pressure, calculate pulse, respiratory rate	Condition monitoring
Help the patient use a pocket inhaler, which the patient usually uses no more than 3 times per hour, 8 times a day (1-2 puffs of Ventolin N, Berotek N, Salbutomol N, Bekotod), which the patient usually uses, if possible, use a metered-dose inhaler with spencer, use nebulizer	Reducing bronchospasm
Give 30-40% humidified oxygen (4-6l per minute)	Reduce hypoxia
Give warm fractional alkaline drink(warm tea with soda on the tip of a knife).	For better sputum removal
If possible, make hot foot and hand baths (40-45 degrees, pour water into a bucket for the feet and a basin for the hands).	To reduce bronchospasm.
Monitor breathing, cough, sputum, pulse, respiratory rate	Condition monitoring

Features of the use of freon-free inhalers (N) - the first dose is released into the atmosphere (these are alcohol vapors that have evaporated in the inhaler).

Prepare instruments and preparations:

Syringes, needles, tourniquet, intravenous infusion system

Medicines: 2.4% 10 ml aminophylline solution, prednisolone 30-60 mg mg IM, IV, saline solution, adrenaline 0.1% - 0.5 ml s.c., suprastin 2% -2 ml, ephedrine 5% - 1 ml.

Assessment of what has been achieved:

1. Choking has decreased or stopped, sputum is released freely.

2. The condition has not improved - continue the measures taken until the ambulance arrives.

3. Contraindicated: morphine, promedol, pipolfen - they depress breathing

Pulmonary hemorrhage

Causes: chronic lung diseases (EBD, abscess, tuberculosis, lung cancer, emphysema)

Clinic: cough with the release of scarlet sputum with air bubbles, shortness of breath, possible pain when breathing, decreased blood pressure, pale, moist skin, tachycardia.

Nurse tactics:

Prepare instruments and preparations:

Everything you need to determine your blood type.

2. Calcium chloride 10% 10ml i.v., vikasol 1%, dicinone (sodium etamsylate), 12.5% -2 ml i.m., i.v., aminocaproic acid 5% i.v. drops, polyglucin, rheopolyglucin

Assessment of achievements:

Reducing cough, reducing the amount of blood in sputum, stabilizing pulse, blood pressure.

Hepatic colic

Clinic: intense pain in the right hypochondrium, epigastric region (stabbing, cutting, tearing) with irradiation to the right subscapular region, scapula, right shoulder, collarbone, neck area, jaw. Patients rush about, moan, and scream. The attack is accompanied by nausea, vomiting (often mixed with bile), a feeling of bitterness and dry mouth, and bloating. The pain intensifies with inspiration, palpation of the gallbladder, positive symptom Ortner, possible subicteric sclera, darkening of urine, increased temperature

Nurse tactics:

Prepare instruments and preparations:

1. Syringes, needles, tourniquet, intravenous infusion system

2. Antispasmodics: papaverine 2% 2 - 4 ml, but - spa 2% 2 - 4 ml intramuscularly, platiphylline 0.2% 1 ml subcutaneously, intramuscularly. Non-narcotic analgesics: analgin 50% 2-4 ml, baralgin 5 ml IV. Narcotic analgesics: promedol 1% 1 ml or omnopon 2% 1 ml i.v.

Morphine should not be administered - it causes spasm of the sphincter of Oddi

Renal colic

It occurs suddenly: after physical exertion, walking, bumpy driving, or drinking copious amounts of fluid.

Clinic: sharp, cutting, unbearable pain in the lumbar region, radiating along the ureter to the iliac region, groin, inner surface thighs, external genitalia lasting from several minutes to several days. Patients are tossing about in bed, moaning, screaming. Dysuria, pollakiuria, hematuria, sometimes anuria. Nausea, vomiting, fever. Reflex intestinal paresis, constipation, reflex pain in the heart.

Upon inspection: asymmetry of the lumbar region, pain on palpation along the ureter, positive Pasternatsky's sign, tension in the muscles of the anterior abdominal wall.

Nurse tactics:

Prepare instruments and preparations:

1. Syringes, needles, tourniquet, intravenous infusion system

2. Antispasmodics: papaverine 2% 2 - 4 ml, but - spa 2% 2 - 4 ml intramuscularly, platiphylline 0.2% 1 ml subcutaneously, intramuscularly.

Non-narcotic analgesics: analgin 50% 2-4 ml, baralgin 5 ml IV. Narcotic analgesics: promedol 1% 1 ml or omnopon 2% 1 ml i.v.

Anaphylactic shock.

Anaphylactic shock- this is the most dangerous clinical variant of an allergic reaction that occurs when administered various substances. Anaphylactic shock can develop if it enters the body:

a) foreign proteins (immune sera, vaccines, organ extracts, poisons);

insects...);

b) medications (antibiotics, sulfonamides, B vitamins...);

c) other allergens (plant pollen, microbes, food products: eggs, milk,

fish, soy, mushrooms, tangerines, bananas...

d) with insect bites, especially bees;

e) in contact with latex (gloves, catheters, etc.).

Ø lightning form develops 1-2 minutes after administration of the drug -

characterized by rapid development clinical picture acute ineffective heart, without resuscitation it ends tragically in the next 10 minutes. Symptoms are scant: severe pallor or cyanosis; dilated pupils, lack of pulse and pressure; agonal breathing; clinical death.

Ø shock moderate severity , develops 5-7 minutes after drug administration

Ø severe form, develops within 10-15 minutes, maybe 30 minutes after administration of the drug.

Most often, shock develops within the first five minutes after the injection. Food shock develops within 2 hours.

Clinical options anaphylactic shock:

Typical shape: feeling of heat “swept with nettles”, fear of death, severe weakness, tingling, itching of the skin, face, head, hands; a feeling of a rush of blood to the head, tongue, heaviness behind the sternum or compression of the chest; pain in the heart, headache, difficulty breathing, dizziness, nausea, vomiting. At lightning-fast form patients do not have time to make complaints before losing consciousness.
Cardiac option manifested by signs of acute vascular insufficiency: severe weakness, pallor of the skin, cold sweat, pulse is “thready”, blood pressure drops sharply, in severe cases consciousness and breathing are depressed.
Asthmoid or asphyxial variant manifests itself as signs of acute respiratory failure, which is based on bronchospasm or swelling of the pharynx and larynx; chest tightness, coughing, shortness of breath, and cyanosis appear.
Cerebral variant manifests itself as signs of severe cerebral hypoxia, convulsions, foaming from the mouth, involuntary urination and defecation.

5. Abdominal option manifested by nausea, vomiting, paroxysmal pain V
stomach, diarrhea.

Hives appear on the skin, in some places the rashes merge and turn into a dense pale swelling - swelling Quincke.

Nurse tactics:

Actions	Rationale
Ensure that a doctor is called through an intermediary. The patient is not transportable, assistance is provided on the spot
If anaphylactic shock develops during intravenous administration medicinal product
Stop drug administration, maintain venous access	Reducing the allergen dose
Give a stable lateral position, or turn your head to the side, remove the dentures
Raise the foot end of the bed.	Improving blood supply to the brain, increasing blood flow to the brain
	Reduced hypoxia
Measure blood pressure and heart rate	Condition monitoring.
At intramuscular injection: stop administering the drug by first pulling the piston towards you. If an insect bites you, remove the sting;	In order to reduce the administered dose.
Provide intravenous access	For administering drugs
Give a stable lateral position or turn your head to the side, remove the dentures	Prevention of asphyxia with vomit, tongue retraction
Raise the foot end of the bed	Improving blood supply to the brain
Access to fresh air, give 100% humidified oxygen, no more than 30 minutes.	Reduced hypoxia
Apply cold (ice pack) to the injection or bite area or apply a tourniquet above	Slowing down the absorption of the drug
Apply 0.2 - 0.3 ml of 0.1% adrenaline solution to the injection site, diluting them in 5-10 ml of saline. solution (diluted 1:10)	In order to reduce the rate of absorption of the allergen
At allergic reaction for penicillin, bicillin - administer penicillinase 1,000,000 units intramuscularly
Monitor the patient’s condition (BP, respiratory rate, pulse)

Prepare instruments and preparations:

tourniquet, ventilator, tracheal intubation kit, Ambu bag.

2. Standard set of drugs “Anaphylactic shock” (0.1% adrenaline solution, 0.2% norepinephrine, 1% mezatone solution, prednisolone, 2% suprastin solution, 0.05% strophanthin solution, 2.4% aminophylline solution, saline . solution, albumin solution)

Medication assistance for anaphylactic shock without a doctor:

1. Intravenous administration of adrenaline 0.1% - 0.5 ml per physical session. r-re.

After 10 minutes, the injection of adrenaline can be repeated.

In the absence of venous access, adrenaline
0.1% -0.5 ml can be injected into the root of the tongue or intramuscularly.

Actions:

Ø adrenaline increases heart contractions, increases heart rate, constricts blood vessels and thus increases blood pressure;

Ø adrenaline relieves spasm of bronchial smooth muscles;

Ø adrenaline slows down the release of histamine from mast cells, i.e. fights allergic reactions.

2. Provide intravenous access and begin fluid administration (physiological

solution for adults > 1 liter, for children - at the rate of 20 ml per kg) - replenish the volume

fluid in the vessels and increase blood pressure.

3. Administration of prednisolone 90-120 mg IV.

As prescribed by a doctor:

4. After stabilization of blood pressure (BP above 90 mm Hg) - antihistamines:

5. For bronchospastic form, aminophylline 2.4% - 10 i.v. In saline solution. When on-
in the presence of cyanosis, dry wheezing, oxygen therapy. Possible inhalations

alupenta

6. For convulsions and strong excitement– IV sedeuxene

7. For pulmonary edema - diuretics (Lasix, furosemide), cardiac glycosides (strophanthin,

korglykon)

After recovery from shock, the patient is hospitalized for 10-12 days.

Assessment of achievements:

1. Stabilization of blood pressure and heart rate.

2. Restoration of consciousness.

Urticaria, Quincke's edema

Hives: allergic disease , characterized by a rash of itchy blisters on the skin (swelling of the papillary layer of the skin) and erythema.

Causes: medicines, serums, food products...

The disease begins with unbearable skin itching on various parts of the body, sometimes on the entire surface of the body (on the torso, limbs, sometimes on the palms and soles of the feet). Blisters protrude above the surface of the body, from pinpoint sizes to very large ones; they merge, forming elements of different shapes with uneven, clear edges. The rash may persist in one place for several hours, then disappear and reappear in another place.

There may be fever (38 - 39 0), headache, weakness. If the disease lasts more than 5-6 weeks, it becomes chronic form and is characterized by a wavy flow.

Treatment: hospitalization, withdrawal of medications (stop contact with the allergen), fasting, repeated cleansing enemas, saline laxatives, Activated carbon, polypefan inside.

Antihistamines: diphenhydramine, suprastin, tavigil, fenkarol, ketotefen, diazolin, telfast...orally or parenterally

To reduce itching - intravenous solution of sodium thiosulfate 30% -10 ml.

Hypoallergenic diet. Make a note on the title page of the outpatient card.

Conversation with the patient about the dangers of self-medication; when applying for honey. With this help, the patient must warn the medical staff about drug intolerance.

Quincke's edema- characterized by swelling of the deep subcutaneous layers in places with loose subcutaneous tissue and on the mucous membranes (when pressed, no pit remains): on the eyelids, lips, cheeks, genitals, back side hands or feet, mucous membranes of the tongue, soft palate, tonsils, nasopharynx, gastrointestinal tract (clinic acute abdomen). If the larynx is involved in the process, asphyxia may develop (restlessness, puffiness of the face and neck, increasing hoarseness, “barking” cough, difficult stridor breathing, lack of air, cyanosis of the face); with swelling in the head, the process involves meninges(meningeal symptoms).

Nurse tactics:

Actions	Rationale
Ensure that a doctor is called through an intermediary. Stop contact with the allergen	To determine further tactics for providing medical care
Reassure the patient	Relieving emotional and physical stress
Find the sting and remove it along with the poisonous sac	In order to reduce the spread of poison in tissues;
Apply cold to the bite site	A measure to prevent the spread of poison in tissue
Provide access to fresh air. Give 100% humidified oxygen	Reducing hypoxia
Put it in your nose vasoconstrictor drops(naphthyzin, sanorin, glazolin)	Reduce swelling of the mucous membrane of the nasopharynx, make breathing easier
Pulse control, blood pressure, respiratory rate	Pulse control, blood pressure, respiratory rate
Give cordiamine 20-25 drops	To maintain cardiovascular activity

Prepare instruments and preparations:

1. System for intravenous infusion, syringes and needles for IM and SC injections,
tourniquet, ventilator, tracheal intubation kit, Dufault needle, laryngoscope, Ambu bag.

2. Adrenaline 0.1% 0.5 ml, prednisolone 30-60 mg; antihistamines 2% - 2 ml of suprastin solution, pipolfen 2.5% - 1 ml, diphenhydramine 1% - 1 ml; fast-acting diuretics: lasix 40-60 mg IV in a stream, mannitol 30-60 mg IV in a drip

Inhalers salbutamol, alupent

3. Hospitalization in the ENT department

Before medical assistance at emergency conditions And acute diseases

Angina pectoris.

Angina pectoris- this is one of the forms of coronary artery disease, the causes of which can be: spasm, atherosclerosis, transient thrombosis of the coronary vessels.

Symptoms: paroxysmal, compressive or pressing pain behind the sternum, loads lasting up to 10 minutes (sometimes up to 20 minutes), passing when the load stops or after taking nitroglycerin. The pain radiates to the left (sometimes right) shoulder, forearm, hand, shoulder blade, neck, lower jaw, epigastric region. It may manifest itself as atypical sensations such as lack of air, difficult-to-explain sensations, or stabbing pains.

Nurse tactics:

Life sometimes brings surprises, and they are not always pleasant. We get into difficult situations or become their witnesses. And often we are talking about the life and health of loved ones or even random people. How to act in this situation? After all quick action, correct rendering emergency assistance can save a person's life. What are emergency conditions and emergency medical care, we will consider further. We will also find out what assistance should be provided in case of emergency conditions, such as respiratory arrest, heart attack and others.

Types of medical care

Rendered medical care can be divided into the following types:

Emergency. It turns out that there is a threat to the patient’s life. This may be during an exacerbation of any chronic diseases or during sudden acute conditions.
Urgent. It is necessary during a period of acute chronic pathology or in the event of an accident, but there is no threat to the patient’s life.

Planned. This is the implementation of preventive and planned measures. Moreover, there is no threat to the patient’s life even if the provision of this type of assistance is delayed.

Emergency and urgent care

Emergency and emergency medical care are very closely related to each other. Let's take a closer look at these two concepts.

In case of emergency, medical care is required. Depending on where the process occurs, in case of emergency, assistance is provided:

External processes that arise under the influence of external factors and directly affect a person’s life.
Internal processes. Result pathological processes in organism.

Emergency care is a type of primary health care that is provided during an exacerbation of chronic diseases, in acute conditions that do not threaten the patient’s life. It may turn out to be day hospital, and in an outpatient setting.

Emergency assistance should be provided in case of injuries, poisoning, acute conditions and diseases, as well as in accidents and in situations where assistance is vital.

Emergency care must be provided in any medical institution.

First aid in emergency situations is very important.

Major emergencies

Emergency conditions can be divided into several groups:

Injuries. These include:

Burns and frostbite.
Fractures.
Damage to vital organs.
Damage to blood vessels with subsequent bleeding.
Electric shock.

2. Poisoning. Damage occurs inside the body, unlike injuries, it is the result of external influences. Disruption internal organs if untimely emergency care is not given, it can lead to death.

Poison can enter the body:

Through the respiratory system and mouth.
Through the skin.
Through the veins.
Through mucous membranes and through damaged skin.

Treatment emergencies include:

1. Acute conditions of internal organs:

Stroke.
Myocardial infarction.
Pulmonary edema.
Acute liver and kidney failure.
Peritonitis.

2. Anaphylactic shock.

3. Hypertensive crises.

4. Attacks of suffocation.

5. Hyperglycemia in diabetes mellitus.

Emergency conditions in pediatrics

Every pediatrician must be able to provide emergency care to a child. It may be required in case of a serious illness or accident. IN childhood A life-threatening situation can progress very quickly, since the child’s body is still developing and all processes are imperfect.

Pediatric emergencies that require medical attention:

Convulsive syndrome.
Fainting in a child.
Comatose state in a child.
Collapse in a child.
Pulmonary edema.
State of shock in a child.
Infectious fever.
Asthmatic attacks.
Croup syndrome.
Continuous vomiting.
Dehydration of the body.
Emergency conditions in diabetes mellitus.

In these cases, emergency medical services are called.

Features of providing emergency care to a child

The doctor's actions must be consistent. It must be remembered that in a child, disruption of the functioning of individual organs or the entire body occurs much faster than in an adult. Therefore, emergency conditions and emergency medical care in pediatrics require a quick response and coordinated actions.

Adults should ensure that the child remains calm and fully cooperate in collecting information about the patient's condition.

The doctor should ask the following questions:

Why did you seek emergency help?
How was the injury sustained? If it's an injury.
When did the child get sick?
How did the disease develop? How did it go?
What medications and remedies were used before the doctor arrived?

The child must be undressed for examination. The room should be normal room temperature. In this case, the rules of asepsis must be observed when examining a child. If it is a newborn, a clean robe must be worn.

It is worth considering that in 50% of cases when the patient is a child, the diagnosis is made by the doctor based on the information collected, and only in 30% - as a result of the examination.

At the first stage, the doctor must:

Assess the degree of impairment of the respiratory system and the functioning of the cardiovascular system. Determine the degree of need for emergency therapeutic measures according to vital signs.
It is necessary to check the level of consciousness, breathing, the presence of seizures and cerebral symptoms and the need for emergency measures.

It is necessary to pay attention to the following points:

How the child behaves.
Lethargic or hyperactive.
What an appetite.
Condition of the skin.
The nature of the pain, if any.

Emergency conditions in therapy and assistance

The health care professional must be able to quickly assess emergency conditions, and emergency medical care must be provided in a timely manner. Correctly and quickly diagnosed is the key to a quick recovery.

Emergency conditions in therapy include:

Fainting. Symptoms: pale skin, skin moisture, muscle tone is reduced, tendon and skin reflexes are preserved. Blood pressure is low. There may be tachycardia or bradycardia. Fainting conditions may be caused by the following reasons:

Failure of the cardiovascular system.
Asthma, different kinds stenosis
Brain diseases.
Epilepsy. Diabetes mellitus and other diseases.

The assistance provided is as follows:

The victim is placed on a flat surface.
Unbutton clothes and provide good air access.
You can spray water on your face and chest.
Give it a sniff ammonia.
Caffeine benzoate 10% 1 ml is administered subcutaneously.

2. Myocardial infarction. Symptoms: burning, squeezing pain, similar to an angina attack. Painful attacks are wave-like, decrease, but do not stop completely. The pain gets stronger with each wave. It may radiate to the shoulder, forearm, left shoulder blade or hand. There is also a feeling of fear and loss of strength.

Providing assistance is as follows:

The first stage is pain relief. Nitroglycerin is used or Morphine or Droperidol with Fentanyl is administered intravenously.
It is recommended to chew 250-325 mg of Acetylsalicylic acid.
Need to measure arterial pressure.
Then it is necessary to restore coronary blood flow.
Beta-adrenergic blockers are prescribed. During the first 4 hours.
Thrombolytic therapy is carried out in the first 6 hours.

The doctor’s task is to limit the extent of necrosis and prevent the occurrence of early complications.

It is necessary to urgently hospitalize the patient in an emergency medicine center.

3. Hypertensive crisis. Symptoms: headache, nausea, vomiting, feeling of “goose bumps” in the body, numbness of the tongue, lips, hands. Double vision, weakness, lethargy, high blood pressure.

Emergency assistance is as follows:

It is necessary to provide the patient with rest and good air access.
For type 1 crisis, take Nifedipine or Clonidine under the tongue.
At high blood pressure intravenously "Clonidine" or "Pentamine" up to 50 mg.
If tachycardia persists, use Propranolol 20-40 mg.
For type 2 crisis, Furosemide is given intravenously.
For convulsions, Diazepam or Magnesium sulfate is administered intravenously.

The doctor’s task is to reduce the pressure by 25% of the initial value during the first 2 hours. In case of a complicated crisis, urgent hospitalization is necessary.

4. Coma. May be of different types.

Hyperglycemic. It develops slowly and begins with weakness, drowsiness, and headache. Then nausea, vomiting appears, the feeling of thirst increases, and skin itching occurs. Then loss of consciousness.

Urgent Care:

Eliminate dehydration, hypovolemia. Sodium chloride solution is administered intravenously.
Insulin is administered intravenously.
For severe hypotension, a solution of 10% “Caffeine” is administered subcutaneously.
Oxygen therapy is administered.

Hypoglycemic. It starts off sharp. The humidity of the skin is increased, the pupils are dilated, blood pressure is reduced, the pulse is increased or normal.

Emergency assistance includes:

Ensuring complete peace.
Intravenous administration of glucose.
Correction of blood pressure.
Urgent hospitalization.

5. Spicy allergic diseases. TO serious illnesses may include: bronchial asthma and angioedema. Anaphylactic shock. Symptoms: the appearance of skin itching, excitability, increased blood pressure, feeling of heat. Then loss of consciousness and respiratory arrest, heart rhythm failure are possible.

Emergency assistance is as follows:

Place the patient so that the head is lower than the level of the legs.
Provide air access.
Release Airways, turn your head to the side, protrude your lower jaw.
Introduce "Adrenaline", repeated administration is allowed after 15 minutes.
"Prednisolone" IV.
Antihistamines.
For bronchospasm, a solution of "Eufillin" is administered.
Urgent hospitalization.

6. Pulmonary edema. Symptoms: shortness of breath is pronounced. Cough with white or yellow sputum. The pulse is increased. Convulsions are possible. Breath is bubbling. Moist rales are heard, and in serious condition"dumb lungs"

We provide emergency assistance.

The patient should be in a sitting or semi-sitting position, legs down.
Oxygen therapy is carried out with antifoam agents.
Lasix is administered intravenously in saline solution.
Steroid hormones such as Prednisolone or Dexamethasone in saline solution.
"Nitroglycerin" 1% intravenously.

Let us pay attention to emergency conditions in gynecology:

Disturbed ectopic pregnancy.
Torsion of the pedicle of an ovarian tumor.
Apoplexy of the ovary.

Let's consider providing emergency care for ovarian apoplexy:

The patient should be in a supine position, with her head raised.
Glucose and sodium chloride are administered intravenously.

It is necessary to monitor indicators:

Blood pressure.
Heart rate.
Body temperature.
Respiratory frequency.
Pulse.

Cold is applied to the lower abdomen and urgent hospitalization is indicated.

How are emergencies diagnosed?

It is worth noting that the diagnosis of emergency conditions should be carried out very quickly and take literally seconds or a couple of minutes. The doctor must use all his knowledge and make a diagnosis in this short period of time.

The Glasgow scale is used when it is necessary to determine impairment of consciousness. In this case they evaluate:

Opening the eyes.
Speech.
Motor reactions to painful stimulation.

When determining the depth of coma, the movement of the eyeballs is very important.

In acute respiratory failure, it is important to pay attention to:

Color of the skin.
Color of mucous membranes.
Respiration rate.
Movement during breathing of the muscles of the neck and upper shoulder girdle.
Retraction of intercostal spaces.

Shock can be cardiogenic, anaphylactic or post-traumatic. One of the criteria may be a sharp decrease in blood pressure. In case of traumatic shock, the following is determined first:

Damage to vital organs.
The amount of blood loss.
Cold extremities.
"White spot" symptom.
Decreased urine output.
Decreased blood pressure.
Violation of acid-base balance.

The organization of emergency medical care consists, first of all, in maintaining breathing and restoring blood circulation, as well as in delivering the patient to medical institution without causing additional harm.

Emergency care algorithm

Treatment methods are individual for each patient, but the algorithm of actions in emergency conditions must be followed for each patient.

The operating principle is as follows:

Restoring normal breathing and blood circulation.
Help with bleeding is provided.
It is necessary to stop seizures of psychomotor agitation.
Anesthesia.
Elimination of disorders that contribute to disruption of the heart rhythm and its conductivity.
Carrying out infusion therapy to eliminate dehydration.
Decrease in body temperature or increase.
Carrying out antidote therapy for acute poisoning.
Enhance natural detoxification.
If necessary, enterosorption is performed.
Fixing the damaged body part.
Correct transportation.
Constant medical supervision.

What to do before the doctor arrives

First aid in emergency situations consists of performing actions that are aimed at saving human life. They will also help prevent the development possible complications. First aid in case of emergency conditions should be provided before the doctor arrives and the patient is taken to a medical facility.

Algorithm of actions:

Eliminate the factor that threatens the health and life of the patient. Assess his condition.
Accept Urgent measures to restore vital functions: restoring breathing, performing artificial respiration, cardiac massage, stopping bleeding, applying a bandage, and so on.
Maintain vital functions until the ambulance arrives.
Transport to the nearest medical facility.

Acute respiratory failure. It is necessary to carry out artificial respiration “mouth to mouth” or “mouth to nose”. We tilt our head back, the lower jaw needs to be moved. Cover your nose with your fingers and do deep breath into the victim's mouth. You need to take 10-12 breaths.

2. Heart massage. The victim is in a supine position. We stand on the side and place our palm on top of our chest at a distance of 2-3 fingers above the lower edge of the chest. Then we apply pressure so that rib cage shifted by 4-5 cm. 60-80 pressures must be applied within a minute.

Let's consider the necessary emergency care for poisoning and injuries. Our actions in case of gas poisoning:

First of all, it is necessary to remove the person from the gas-polluted area.
Loosen tight clothing.
Assess the patient's condition. Check pulse, breathing. If the victim is unconscious, wipe his temples and give him a sniff of ammonia. If vomiting begins, it is necessary to turn the victim's head to the side.
After the victim has been brought to his senses, it is necessary to carry out inhalation pure oxygen so that no complications arise.
Next, you can drink hot tea, milk or slightly alkaline water.

Help with bleeding:

Capillary bleeding is stopped by applying a tight bandage, which should not compress the limb.
We stop arterial bleeding by applying a tourniquet or squeezing the artery with a finger.

It is necessary to treat the wound with an antiseptic and contact the nearest medical facility.

Providing first aid for fractures and dislocations.

In case of an open fracture, it is necessary to stop the bleeding and apply a splint.
It is strictly forbidden to correct the position of the bones or remove fragments from the wound yourself.
Having recorded the location of the injury, the victim must be taken to the hospital.
It is also not allowed to correct a dislocation on your own; you cannot apply a warm compress.
It is necessary to apply cold or a wet towel.
Provide rest to the injured part of the body.

First aid for fractures should occur after the bleeding has stopped and breathing has normalized.

What should be in a medical kit

In order for emergency care to be provided effectively, it is necessary to use a first aid kit. It should contain components that may be needed at any moment.

An emergency first aid kit must meet the following requirements:

All medicines, medical instruments, as well as dressing must be in one special case or box that is easy to carry and transport.
A first aid kit should have many sections.
Store in a place easily accessible to adults and out of the reach of children. All family members should know about her whereabouts.
You need to regularly check the expiration dates of medications and replenish used medications and supplies.

What should be in the first aid kit:

Preparations for treating wounds, antiseptics:

Brilliant green solution.
Boric acid in liquid or powder form.
Hydrogen peroxide.
Ethanol.
Alcohol iodine solution.
Bandage, tourniquet, adhesive plaster, dressing bag.

2. Sterile or simple gauze mask.

3. Sterile and non-sterile rubber gloves.

4. Analgesics and antipyretic drugs: “Analgin”, “Aspirin”, “Paracetamol”.

5. Antimicrobials: "Levomycetin", "Ampicillin".

6. Antispasmodics: “Drotaverine”, “Spazmalgon”.

7. Heart medications: Corvalol, Validol, Nitroglycerin.

8. Adsorbing agents: “Atoxil”, “Enterosgel”.

9. Antihistamines: “Suprastin”, “Diphenhydramine”.

10. Ammonia.

11. Medical instruments:

Clamp
Scissors.
Cooling pack.
Disposable sterile syringe.
Tweezers.

12. Antishock drugs: “Adrenaline”, “Eufillin”.

13. Antidotes.

Emergency conditions and emergency medical care are always highly individual and depend on the person and specific conditions. Every adult should have an understanding of emergency care in order to be able to help their loved one in a critical situation.

Having witnessed an accident, many of us may become confused, give up, and then shed bitter tears that we could not do anything. Editorial "So simple!" I am convinced that every conscientious person must know how to behave if trouble happens.

High quality first aid for emergencies, and most importantly, the ability to perform it competently and without trembling in the fingers, can save the life of both a loved one and a random passerby. All in your hands!

First aid can be provided by any person who is near the victim at a critical moment. This is an important skill - an elementary but indispensable skill for every person. In one of the situations below, it can become a real lifeline for the victim.

Emergency assistance

Fainting

Fainting is an unpleasant condition familiar to many. A short-term and sudden loss of consciousness occurs due to cerebrovascular accident. The reasons for this are completely different: fear, jar of Hearts, physical exhaustion or insufficient fresh air in the room. How to recognize trouble and provide the victim with the necessary first aid?

Symptoms

Fainting may be preceded by the following indicative symptoms: dizziness, nausea, severe weakness, blurred vision, tinnitus, numbness in the extremities.
When loss of consciousness occurs, the victim falls. This, by the way, is not without reason: in a horizontal position, the blood supply to the brain improves and after some time the patient safely regains consciousness without outside help.
The victim's airways are usually clear, but breathing is shallow and infrequent.
A weak and rare pulse is felt.
The skin is pale and cold sweat may occur.

First aid

The victim must be placed on his back in the so-called Trendelenburg position when the legs are raised at an angle of 45°, and the head and shoulders are below the level of the pelvis. If it is not possible to place the patient on the couch, it is enough to raise the legs above ground level.
It is necessary to immediately unfasten the squeezing parts of clothing: collar, belt, tie.
If an unpleasant situation occurs indoors, you need to open the windows and let in fresh air.
You can place a wet and cold towel on the victim’s forehead or moisten the face with cold water, pat the cheeks or rub the ears.
If vomiting occurs, lay the victim's head to one side. This will help prevent vomit from entering the respiratory tract.
The most effective and well-known way to combat fainting is ammonia. Inhaling ammonia vapor usually helps restore the victim to consciousness.
Do not lift the patient under any circumstances after returning to consciousness! Call an ambulance immediately, because fainting can be a consequence of a serious illness, and the victim in any case needs a professional examination.

Heart attack

Myocardial infarction is one of the forms coronary disease heart disease, which occurs as a result of necrosis of a section of the heart muscle due to disruption of its blood supply. A heart attack occurs when a coronary artery of the heart is blocked by a blood clot.

The causes of the disease are different: atherosclerosis, hypertonic disease, spasm of the coronary arteries, diabetes, obesity, alcoholism. If a heart attack occurs, high-quality first aid in the first minutes of a heart attack can save the victim’s life!

Symptoms

First and main symptom heart attack - severe squeezing pain behind the sternum, which extends to left shoulder, shovel, hand. The pain syndrome can last more than 15 minutes, sometimes lasts for hours or even days.
The victim is restless, and there is a fear of death.
Nausea and vomiting are possible, the face and lips may become bluish, and sticky sweat occurs.
There may be shortness of breath, cough, difficulty breathing, and a feeling of lack of air. The airways are usually clear. Breathing is frequent and shallow.
The pulse is weak, fast, sometimes intermittent. Possible cardiac arrest.

First aid

The first thing to do is call an ambulance.
If the person is conscious, it is necessary to sit him in a chair with a backrest or give him a semi-lying position, bending his knees, and allow him to calm down.
It is necessary to unfasten tight clothing, loosen the pressure of the collar or tie.
It is likely that if problems with cardiovascular system This is not the first time for the victim, he may have medications with him: nitroglycerin, aspirin, validol, etc. Nitroglycerin is a drug that helps relieve pain during an angina attack.
If the pain does not subside within 3 minutes after taking nitroglycerin, it means that the victim is having a real heart attack, which cannot be relieved with medication. This indicative symptom will help distinguish serious problem from a simple attack of angina.
If you have aspirin on hand and the patient is not allergic to it, you should let him chew 300 mg of the drug. Just chew it! This way the medicine will work much faster.
It is necessary to carefully monitor the victim's breathing and heart function. In the event of cardiac arrest, immediate treatment must be started. resuscitation measures. Carrying them out before the ambulance arrives increases the patient’s chances of survival many times over!
In the first seconds of ventricular fibrillation it can be effective precordial stroke. Two sharp, intense blows with a fist are delivered from a height of 30–40 cm to the sternum at the border of its middle and lower third. If there is no pulse in the carotid artery after two beats, you should immediately proceed to chest compressions and artificial respiration.

This video clearly describes everything stages of implementation cardiopulmonary resuscitation victims not only of a heart attack, but also of other emergency conditions!

Stroke

Stroke is damage to brain tissue and disruption of its functions caused by impaired cerebral circulation. The causes of a vascular accident can be different: insufficient blood supply to one of the areas of the brain, cerebral hemorrhage, thrombosis or embolism associated with diseases of the blood, heart, and blood vessels.

How to identify first signs of stroke, everyone needs to know in order to provide timely assistance, because every minute counts!

Symptoms

Sudden causeless headache.
The appearance of weakness in the muscles, numbness of half or individual parts of the body (arm, leg, face).
Visual disturbances and double vision may occur.
There may be a sudden loss of balance and coordination, nausea and loss of consciousness.
Speech disturbances or slowing often occur, and the affected person may have a sagging corner of the mouth or a dilated pupil on the affected side.
If you notice the above symptoms, act immediately!

First aid

It is necessary to immediately call an ambulance - a stroke victim needs immediate professional help.
If the patient is unconscious, it is necessary to check whether he can breathe. If you find breathing problems, clear the patient's airways by laying him on his side and cleaning the mouth.
Move the patient to a comfortable position. Many people say that it is strictly forbidden to touch or move a stroke victim, but this is a myth!
If possible, it is necessary to measure blood pressure and record the readings.
If the patient is conscious, it is necessary to find out how long ago the stroke occurred. In the first 3 hours after the onset of a stroke, the patient can undergo emergency therapy - thrombolysis.
This procedure involves intravenous injection of a drug that dissolves the blood clot that is blocking cerebral artery. In this way, brain disorders can be eliminated or significantly reduced.
Do not give water or food to the patient.
Under no circumstances should you give medications to a patient! Reducing blood pressure is also not recommended. Hypertension in the first hours of a vascular accident is the norm associated with adaptation of the brain.

Epileptic seizure

An epileptic seizure may look quite frightening, but in fact it does not require immediate attention. medical intervention. Nevertheless, everyone should know the symptoms of an epileptic attack and simple rules for treating a patient!

Symptoms

Most often, an attack begins with an aura. Pre-epileptic the aura can be olfactory, visual or auditory, when the patient feels unusual smells, sounds or sees complex images. Sometimes during an aura, a patient with epilepsy can warn others about an impending attack, thus protecting himself.
Often from the outside it seems that the attack began for no reason at all - the patient screams and falls unconscious.
Breathing becomes difficult, lips turn blue.
Convulsions occur. The limbs tense and relax, twitching randomly.
Sometimes patients may bite their tongue or cheeks.
The pupils do not respond to light stimuli.
Possible spontaneous bowel movements, vomiting, profuse salivation. Foam may appear at the mouth.

First aid

The first thing you need to do is calm down yourself. If the patient has indicated a possible seizure, make sure that if he falls there is no danger (sharp corners, hard objects, etc.)
If the patient is not in danger during a seizure, do not touch or move him. Be there for you throughout the attack.
Do not try to restrain the victim in an attempt to stop the seizure. This will not help him in any way, but it may cause unwanted injuries.
Be sure to note the time of the onset of the seizure. If the attack lasts longer than 5 minutes, you must call an ambulance. A prolonged attack can cause permanent damage to brain cells.
Important! Do not put foreign objects into the patient's mouth. Many people believe that during epileptic seizure a person's tongue may become stuck. Alas, this is a serious misconception. All muscles, including the tongue, are in hypertonicity during an attack.
Under no circumstances should you try to open a person’s jaws and place a hard object between them. There is a risk that during the next stress the patient will either bite you, or get a dental injury, or may choke on debris from an object.
When the attack stops, place the patient in a comfortable position. Make sure that breathing is back to normal: check that the airways are clear (they may be blocked by food debris or dentures).
If the patient is injured during an attack, all wounds must be treated.
Until the person is completely back to normal, he should not be left unattended. If a seizure is followed by another or an epileptic attack occurs for the first time, the patient needs hospitalization.

Only timely and competently provided first, and then qualified medical care. And if, God forbid, a friend, colleague or a random passer-by is overtaken by trouble, each of us must know what to do.

There is an opinion among people: “if I feel ill somewhere on the street or in transport, any medical organization is obliged to provide me with free medical care.” Is this really true? Let's consider this situation from a legal point of view.

In accordance with current legislation Emergency medical care is provided when sudden acute diseases, conditions, exacerbation of chronic diseases, posing a threat to the patient's life.

Emergency medical assistance is provided to citizens medical worker and medical organization (regardless of the form of ownership, including private medical clinic ), carrying out medical activities based on license immediately and free of charge.

Denial of in this case may be qualified under Article 124 of the Criminal Code of the Russian Federation “Failure to provide assistance to a patient without good reasons a person obliged to provide it in accordance with the law or with a special rule." Responsibility lies directly with the medical worker, and not with the organization.

In addition, the victim and/or his relatives, if the guilt of the medical organization and specific perpetrators is established by the court, has the right to demand payment of damages due to harm to the health or death of the victim caused by the inaction of these persons.

When providing emergency medical care, a citizen is not required to present compulsory medical insurance policy (Clause 2 of Article 11 of the Law of November 21, 2011 N 323-FZ; Clause 1 of Clause 2 of Article 16 of the Law of November 29, 2010 N 326-FZ).

The main criterion for emergency medical care is the presence of life-threatening conditions.

A life-threatening condition is a health hazard that is dangerous to human life, causing a disorder of the vital functions of the human body, which cannot be compensated by the body on its own and usually ends in death.

It is in these conditions that medical organizations are obliged to provide medical care. Providing emergency medical care (“without obvious signs threats to the patient's life") are in charge medical organizations Excluded. It is understood that emergency medical care must be provided on an outpatient basis or by ambulance within the framework of the State Guarantee Program for free medical care, i.e. medical organizations participating in the implementation of this program.

Emergency care is provided for sudden acute illnesses, conditions, exacerbation of chronic diseases that are life-threatening to the patient (in case of accidents, injuries, poisoning, complications of pregnancy and other conditions and diseases). At the moment, it is worth focusing on the doctor’s understanding of the urgency of the situation, the presence of a threat to the patient’s life and the urgency of action.

Only a medical professional (i.e., a doctor or nurse, not an administrator) can determine the presence of a threat, so in such a situation the doctor must see the patient outside of the appointment.

In any case, the employee must call an ambulance.

If it is possible to provide first aid (before the ambulance doctors arrive), such assistance should be provided.

Reasons for calling an ambulance in emergency form(i.e. there is a threat to life) are:

a) disturbances of consciousness that pose a threat to life;

b) breathing problems that pose a threat to life;

c) disorders of the circulatory system that pose a threat to life;

d) mental disorders accompanied by the patient’s actions that pose an immediate danger to him or other persons;

d) sudden pain syndrome posing a threat to life;

f) sudden dysfunction of any organ or organ system that poses a threat to life;

c) declaration of death (except for the opening hours of medical organizations providing medical care on an outpatient basis).

Emergency medical care- a set of measures medical nature aimed at treating life-threatening conditions.

Main stages and methods of providing emergency medical care

Emergency medical care can be provided by any trained people: from doctors of all specialties to employees of rescue services and internal affairs. They also include paramedics and specially trained volunteers.

Providing self- and mutual assistance can also be included in general stage. But, officially, it is considered medical care only for the military.

Emergency medical care can begin anywhere. The main criterion is, in addition to the natural victim himself, the presence of at least one person trained for this.

There are several levels in the process of providing emergency medical care. For emergencies and disasters, they are considered as stages.

first aid. Conducted by non-medical personnel trained for this purpose: firefighters, police, emergency services, specially trained volunteers.
first aid. It is provided by junior and middle medical staff. Paramedics are also considered equal to them.
first medical aid. Doctors from a wide range of specialties participate in its provision. Most often these are emergency doctors and resuscitators.
specialized medical care - doctors of narrow specialties.

Legal documents and legislation

In Russia, as almost throughout the world, emergency medical care is provided free of charge.

In the early stages, starting from the end of the 19th century, this prerogative was in the hands of private and public organizations, such as the red cross, the society of girls of mercy, etc. Only at the dawn of the last century, the first government agencies for emergency medical care. And these were ambulances. At the beginning they had a paramedic and an orderly, and then medical staff.

After the First World War and the Revolution, the first fully equipped ambulance units were established in Soviet Russia. And the experience of World War II resulted in the creation of stages in the provision of emergency medical care. But, until the beginning of the last decade of the last century, there was no single document that would regulate emergency care.

The creation of a federal law on medical care, where the first legal norms were outlined in Chapter 39, on “...Emergency Medical Care,” formed the basis for future bills. Including the current law on the protection of the health of citizens of the Russian Federation of 2012.

Major emergencies

The main criterion for an emergency condition is the time until death occurs. In case of emergency, failure to provide medical care can lead to death in the next few hours and days.

The main emergency conditions include:

poisoning
injuries to parts of the body that are significant.
acute diseases of vital organs.

Not providing medical care

Failure to provide emergency medical care by the person(s) required to do so is a criminal offense.

There are only two situations in which these individuals may not provide emergency medical care:

a person is unable, for some reason beyond his control, to fulfill his duties. This could be an injury to the “rescuer” himself or some other condition that prevents him from performing his official duties.
terminal conditions caused by serious illnesses and injuries incompatible with life. In peacetime, this terminal state in cancer patients with clinical group 4. The latter applies to emergency situations and disasters, when there is a large number of victims per unit providing medical care, exceeding its functional capabilities. This measure was taken for more efficient work medical workers at the source of the disaster.