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1 help in case of electric shock. Providing first aid in case of electric shock

electrical injury- damage to organs and systems of the body under the influence of electric current.

The first mention of death from electric current was registered in 1879 in France, Lyon, a carpenter died from a generator alternating current.
In developed countries, the frequency of cases of electric shock is on average about 2-3 cases per hundred thousand of the population.
Most often, young people of working age suffer from electric shock.
The death rate of men from electrical injuries is 4 times higher than that of women.

The effect of electricity on the human body

Electric current has a thermal, electrochemical and biological effect on a person.

thermal effect: electrical energy, meeting resistance with the tissues of the body, goes into thermal energy and cause electrical burns. Mostly burns occur at the point of entry and exit of current, that is, in places of greatest resistance. As a result, the so-called labels or current signs. Thermal energy, converted from electrical energy, destroys and changes tissues on its way.
Electrochemical action:“gluing”, thickening of blood cells (platelets and leukocytes), movement of ions, change in the charges of proteins, formation of steam and gas, giving tissues a cellular appearance, etc.
Biological action: disruption of work nervous system, violation of the conduction of the heart, contraction of the skeletal muscles of the heart, etc.

What determines the severity and nature of electrical injury?

Defeat factors electric shock:

Type, strength and voltage

Alternating current is more dangerous than direct current. At the same time, low-frequency currents (about 50-60 Hz) are more dangerous than high-frequency ones. The frequency of the current used in everyday life is 60 Hz. With an increase in frequency, the current travels along the surface of the skin, causing burns, but is not fatal.
The most significant is the strength and voltage of the electric current.

The reaction of the body to the passage of alternating current
Current strength	How does the victim feel?
0.9-1.2mA	The current is barely perceptible
1.2-1.6mA	Feeling of goosebumps or tingling
1.6-2.8 mA	Feeling of heaviness in the wrist
2.8-4.5 mA	Stiffness in the forearm
4.5-5.0 mA	Convulsive contraction of the forearm
5.0-7.0mA	Spasmodic contraction of the shoulder muscles
15.0-20mA	Can't take my hand off the wire
20-40mA	Very painful muscle cramps
50-100mA	Heart failure
More than 200 mA	Very deep burns

High voltage current (more than 1000 volts) causes more severe damage. High voltage electric shock can occur even while being a step away from the current source (“voltaic arc”). As a rule, deaths occur precisely as a result of high-voltage lesions. Low voltage shocks are mostly domestic and fortunately the percentage of deaths from low voltage shocks is lower than with high voltage injuries.

The path of current through the body

The path that current takes through the body is called the current loop. The most dangerous is a full loop (2 arms - 2 legs), in this case, the current passes through the heart, causing malfunctions in its work up to its complete stop. The following loops are also considered dangerous: hand-head, hand-hand.

Current duration

The longer the contact with the current source, the expression of the lesion and the higher the probability of death. Under the action of a high voltage current, due to a sharp contraction of the muscles, the victim can be immediately thrown away from the current source. At lower voltages, muscle spasm can cause a prolonged grip on the conductor with the hands. With an increase in the time of exposure to current, the resistance of the skin decreases, therefore, contact of the victim with the current source should be stopped as soon as possible.

Environmental factors

The risk of electric shock increases in damp and damp rooms(bathrooms, baths, dugouts, etc.).

The outcome of an electrical injury also largely depends on age and body condition at the moment of defeat

Increase the severity of the lesion: childhood and old age, fatigue, exhaustion, chronic diseases, alcohol intoxication.

Degrees of electric shock

Electrical Hazard or the consequences of an electric shock

System	Effects
Nervous system	Possible: loss of consciousness of varying duration and degree, loss of memory of past events (retrograde amnesia), convulsions. In mild cases, possible: weakness, flickering in the eyes, weakness, dizziness, headache. Sometimes nerve damage occurs, which leads to impaired motor activity in the limbs, impaired sensitivity and tissue nutrition. Possible violation of thermoregulation, the disappearance of physiological and the appearance of pathological reflexes. The passage of electric current through the brain leads to loss of consciousness and the appearance of convulsions. In some cases, the passage of current through the brain can lead to respiratory arrest, which often causes death from electric shock. Under the action of a high voltage current on the body, a deep disruption of the central nervous system can develop with inhibition of the centers responsible for respiration and cardiovascular activity, leading to "imaginary death", the so-called "electrical lethargy". This is manifested by imperceptible respiratory and cardiac activity. If resuscitation in such cases is started on time, in most cases they are successful.
The cardiovascular system	Cardiac disorders in most cases are functional in nature. Violations manifest themselves in the form of various failures of the heart rhythm (sinus arrhythmia, an increase in the number of heart contractions - tachycardia, a decrease in the number of heart contractions - bradycardia, heart blockade, extraordinary heart contractions - extrasystole;). The passage of current through the heart can cause a violation of its ability to contract as a whole, causing the phenomenon of fibrillation, in which the cardiac muscle fibers contract separately and the heart loses its ability to pump blood, which equates to cardiac arrest. In some cases, electric current can damage the wall of blood vessels, leading to bleeding.
Respiratory system	The passage of electric current through the respiratory center located in the central nervous system can cause inhibition or complete cessation of respiratory activity. In case of high voltage shock, bruises and ruptures of the lungs are possible.
sense organs	Tinnitus, hearing loss, tactile disturbance. Tympanic membrane ruptures, middle ear injuries with subsequent deafness (in case of exposure to high voltage current) are possible. When exposed to bright light, damage to the visual apparatus can occur in the form of keratitis, choroiditis, cataracts.
striated and smooth muscles	The passage of current through the muscle fibers leads to their spasm, which can be manifested by convulsions. Significant contraction of skeletal muscles by electric current can lead to fractures of the spine and long bones. Spasm of the muscular layer of the vessels can lead to an increase in blood pressure or the development of myocardial infarction due to spasm of the coronary vessels of the heart.
Causes of death: The main causes of death in electrotrame: cardiac arrest and respiratory arrest as a result of damage to the respiratory center.
Long-term complications: The action of electric current can cause long-term complications. Such complications include: damage to the central and peripheral nervous system (inflammation of the nerves - neuritis, trophic ulcers, encephalopathy), cardiovascular system (disturbances in heart rhythm and conduction of nerve impulses, pathological changes in the heart muscle), the appearance of cataracts, hearing loss, etc. Electrical burns can heal with the development of deformities and contractures of the musculoskeletal system. Repeated exposure to electric current can lead to early arteriosclerosis, obliterating endarteritis, and persistent vegetative changes.

Electric shock sign or electrotag

electrotag- areas of tissue necrosis at the points of entry and exit of electric current. Occur as a result of the conversion of electrical energy into thermal energy.
The form	Color	Characteristic features	A photo
Rounded or oval, but may be linear. Often there is a ridge-like elevation along the edges of the damaged skin, while the middle of the mark seems to be slightly sunken. Sometimes it is possible to peel off the top layer of the skin in the form of blisters, but without liquid inside, unlike thermal burns.	Usually lighter than the surrounding tissue - pale yellow or grayish white.	Complete painlessness of the marks, due to damage to the nerve endings. Deposition of conductor metal particles on the skin (copper - blue-green, iron-brown, etc.). When exposed to a low voltage current, metal particles are located on the surface of the skin, and when a high voltage current is applied deep into the skin. The hair in the area of the marks is twisted in a spiral, retaining its structure.
Electrical burns are not always limited to marks on the skin. Quite often, damage to deeper tissues occurs: muscles, tendons, bones. Sometimes lesions are located under apparently healthy skin.

Help with electric shock

The consequences of electric shock largely depend on the provision of timely assistance.

Should I call an ambulance?

There are cases of sudden death within a few hours after electric shock. Based on this, any victim of an electric shock must necessarily be taken to a specialized hospital, where, if necessary, emergency assistance can be provided.

Electric shock relief steps

Stop the effect of current on the victim following the established rules. Open the electrical circuit with a circuit breaker or switch, or remove the plug from the socket. Remove the current source from the victim using insulating objects (wooden stick, chair, clothing, rope, rubber gloves, dry towel, etc.). You should approach the victim in rubber or leather shoes on a dry surface or under your feet. rubber mat or dry boards.

In the case of a current source above 1000 volts, special safety measures must be taken to save the victim. To do this, it is necessary to work in rubber shoes, rubber gloves, use insulating pliers for the appropriate voltage.
If necessary, drag the victim out of the “step voltage” zone of action (at a distance of up to 10 m), holding him by the belt or dry clothes, while not touching open parts of the body.

Determine the presence of consciousness

Take it by the shoulders, shake it (do not do it if you suspect a spinal injury), ask loudly: What's wrong with you? Do you need help?

Assess the state of cardiac and respiratory activity. And, if necessary, perform resuscitation measures, according to the ABC algorithm (closed heart massage, artificial lung ventilation (mouth-to-mouth breathing)).

ABC algorithm	What to do?	How to do?
BUT	Free up the airways	It is necessary to make a number of techniques that allow you to move the root of the tongue from the back wall and thus remove the obstacle in the way of the air flow. The palm of one hand is placed on the forehead, with 2 fingers of the other hand they raise the chin, pushing the lower jaw forward and upward, while tilting the head back. (if you suspect a spinal injury, do not throw your head back)
AT	Check for breath	Bend over to the victim's chest and determine if there are respiratory movements of the chest. If it is visually difficult to determine whether there is breathing or not. To the mouth, to the nose, you can bring a mirror, which will fog up in the presence of breathing, or you can bring a thin thread, which will deviate in the presence of breathing.
FROM	Determine if the pulse	The pulse is determined on the carotid artery, fingers bent at the phalanges.
On the present stage medicine, it is recommended to start resuscitation from point C - indirect heart massage, then A- release of the airways and B- artificial respiration.
If respiration and pulse are not detected, it is necessary to start resuscitation measures: Indirect cardiac massage, 100 compressions per minute for chest(with an amplitude for adults of 5-6 cm and with full expansion of the chest after each pressing). For manipulations, the patient must lie on a flat hard surface. The point of placement of the hands during the massage should be located on the chest between the nipples, the shoulders should be directly above the palms, and the elbows should be fully extended. Mouth to mouth breathing 2 breaths every 30 chest compressions. If it is impossible to perform mouth-to-mouth breathing, only chest compressions can be performed. CPR should continue until the ambulance arrives. The optimal time to start resuscitation is 2-3 minutes after cardiac arrest. The practical limit of resuscitation is 30 minutes, with the exception of victims who are in cold temperatures. The effectiveness of resuscitation is assessed by the color of the skin of the victim (rosination of the face, the disappearance of cyanosis).
Medical treatment. If the measures are unsuccessful for 2-3 minutes, 1 ml of 0.1% adrenaline is administered (intravenously, intramuscularly or intracardiac), calcium chloride solution 10% - 10 ml, strophanthin solution 0.05% - 1 ml diluted in 20 ml 40% solution glucose.
In the presence of breathing, the victim must be given a stable lateral position and wait for the arrival of an ambulance.

4. Dry gauze or contour dressings should be applied to the burned surfaces. The imposition of ointment bandages is contraindicated.

5. If the victim is conscious, it is possible to give painkillers (analgin, ibuprofen, etc.) and / or a sedative (valerian tincture, persen, ankylosing spondylitis, etc.) if necessary before the arrival of the ambulance.

6. The victim should be transported only in the prone position and warmly covered.

Treatment in the hospital

All victims with symptoms of shock are hospitalized in the intensive care unit.
Victims without signs of electrical or burn shock with limited electrical burns are hospitalized in the surgical ward. According to indications, toilet burn wounds, dressings, drug treatment (cardiac and antiarrhythmic drugs, vitamins, etc.) are carried out. If necessary, complex surgical interventions are carried out to restore the integrity and functional ability of damaged tissues and organs.
Victims without local lesions, even in a satisfactory condition, need to be hospitalized in a therapeutic department for further observation and examination. Since there are cases of belated complications, both from the cardiovascular system (cardiac arrest, cardiac arrhythmias, etc.), and from other systems (nervous, respiratory, etc.).
People who have suffered an electrical injury often need long-term rehabilitation. Since the action of electric current can cause long-term complications. Such complications include: damage to the central and peripheral nervous system (inflammation of the nerves - neuritis, trophic ulcers, encephalopathy), cardiovascular system (disturbances in heart rhythm and conduction of nerve impulses, pathological changes in the heart muscle), the appearance of cataracts, hearing loss, as well as impaired functions of other organs and systems.

Electric shock protection

The best protection against electric shock is "head on shoulders". It is necessary to clearly know all the requirements and safety rules when working with electric current, use the necessary personal protective equipment and be extremely careful when performing any work on electrical installations.

Remedies:

Insulating pads and stands;
Dielectric carpets, gloves, galoshes, caps;
Portable grounding;
Tools with insulating handles;
The use of screens, partitions, cameras for protection against electric current;
Use of special protective clothing (type Ep1-4);
Reduce the time spent in the danger zone;
Posters and safety signs.

Safety requirements

Approach live parts only at a distance equal to the length of the insulating part of electrical protective equipment.
It is mandatory to use an individual shielding set of clothing when working in open switchgear with a voltage of 330 kV and above.
In electrical installations with voltages above 1000V, it is necessary to use dielectric gloves when working in electrical devices above 1000V.
In conditions of an approaching thunderstorm, all work in switchgears should be stopped.

PLAN-SUMMARY

SUBJECT: Medical Training

TOPIC: First aid for electric shock and thermal injury

LESSON OBJECTIVES:

Learn first aid for electric shock and thermal injury.

VENUE: classroom

METHOD OF CONDUCT: lecture

MAIN DOCUMENTS AND LITERATURE USED IN THE DEVELOPMENT OF THE SUMMARY:

Textbook "Training of firefighters - rescuers". Medical training under the editorship of Doctor of Medical Sciences V.I. Dutova (Moscow 2010).

LOGISTICS AND TECHNICAL SUPPORT:

Educational board - 1 unit;

Video projector - 1 unit;

I. Preparatory part – 5 minutes………………………………………………………… p.2

II. Main part – 30 minutes……………………………………………………………….. page 2

1. study question………………………………………………………………. page 2

2. educational question……………………………………………………………….… p.6

III. Final part – 10 minutes....…………………………………………………… p.8

Preparatory part

Checks of trainees, according to the list;

Checks at the trainees' means of material support for classes ( study guides, workbooks (notebooks), pens, etc.);

II.Main part

First aid for electric shock

Features of electric current

There are six main features of electric current:

Lack of organoleptic manifestations - invisibility, noiselessness. Absence appearance, color, smell, etc.

The ability of current energy to be converted into other forms of energy.

The possibility of causing many types of injuries - electrical, mechanical, thermal, chemical.

The possibility of damage at the site of application and throughout the path of electricity through tissues and organs.

The possibility of remote defeat, arc contact.

The speed, instantaneous spread of the lesion.

Distinguish between direct and alternating current. Today, the use of alternating current with a frequency of 50 Hz to 300 GHz is common.

Let's analyze this range in more detail:

Industrial frequency current, 50 Hz, is used in industrial and domestic electrification systems;

Low frequency current, 3-300 kHz - in radio broadcasting, during melting, welding, heat treatment of metals;

Medium frequency current, 0.3-3.0 MHz - in broadcasting, with inductive heating of metals and other materials;

High frequency current, 3.0-30 MHz - in radio broadcasting, television, medicine, when welding polymers;

Very high frequency current, 30-300 MHz - in radio broadcasting, television, medicine, when welding polymers;

Ultra-high frequency current, 0.3-3.0 GHz - in radar, in multichannel radio communications, in radio astronomy, in radio spectroscopy, in radio navigation, in radio relay communications, in telecommunications, in flaw detection, in geodesy, in physiotherapy, in sterilization and cooking and etc.;

Ultra high frequency current. 3-30 GHz;

Extremely high frequency current, 30-300 GHz.

Various electrical installations are powered by three-phase current, voltage 380/200V, and lighting– single-phase current with voltage 220/127V.

Current can be applied:

On a four-wire network with an isolated neutral;

On a four-wire network with a solidly grounded neutral;

On a three-wire network with an isolated neutral;

On a three-wire network with a solidly grounded neutral.

An isolated neutral is a transformer or generator neutral that is not connected to a grounding device or connected through a large resistance commensurate with the insulation resistance of the phase wires.

Figure 1. Diagram of the location of dangerous points on the human body.

Networks with isolated neutral are used in cases where it is possible to control and maintain high level insulation of wires and when the capacitance of the network relative to the ground is insignificant (slightly branched networks not exposed to aggressive environments, which are under the constant supervision of qualified personnel - networks of small enterprises, mobile electrical installations, etc.)

A dead-earthed neutral is a transformer or generator neutral connected directly to a grounding device or through a low resistance.

Networks with dead-earthed neutral are used with considerable length and branching, when it is impossible to provide a high level of insulation (high humidity, aggressive environment, etc.), it is impossible to control and maintain a high level of insulation, or when capacitive currents due to high branching reach dangerous values for humans (networks of large industrial enterprises).

Phase wires A, B, C are called linear wires, the voltage between any two of them is 380V.

The degree of danger and the possibility of electric shock depend on the conditions of inclusion in the network.

1. The most dangerous is the touch of a person to two different phases that are energized. The person is turned on to the full line voltage in the network and the strength of the current passing through the person.

At the same time, in a matter of fractions, a breakdown of the skin occurs and the body closes electrical circuit. Especially dangerous is the passage of current near vital organs: the heart, chest, liver, and so on, which can cause heart fibrillation, loss of consciousness and death.

With a two-phase touch, the current passing through a person is practically independent of the network neutral mode. Therefore, a two-phase contact is equally dangerous both in a network with an isolated and with a grounded neutral (if the line voltages of these networks are equal).

2. With simultaneous contact of a person with a linear and neutral wire, single-phase switching takes place.

The first and second cases are still very dangerous, and because the current passes through the shortest way through the hands and vital organs of a person, paralyzing their work. It should be noted that a person touching different wires with two hands rarely occurs, more often with one hand, i.e. with single-phase switching.

Figure 2. The degree of danger and the possibility of electric shock depend on the conditions of inclusion in the network

The nature and types of electrical injuries, the severity of the lesion. First aid technique for electric shock

Electrical injuries include local injuries and electric shocks.

Local injuries:

Electric burn - current, arc. The first of them occurs at low (relatively) voltages of the mains, leading to the conversion of current into heat. Arc burn is one of the severe ones. It occurs in those cases when an electric arc with a thermal energy of more than 35,000 C is formed between the current conductor and the human body;

Electrical signs - appear at the point of contact with a current conductor. Spots of a rounded (oval) shape of gray (pale yellow) color;

Metallization of the skin - damage by metal particles. Melted in an electric arc that penetrates the skin, eyes (this is very dangerous!). The lesions are very painful;

Electrophthalmia - damage to the membranes of the eyes by ultraviolet rays, accompanied by severe pain, pain in the eyes, loss of vision (temporary);

Mechanical injuries - skin ruptures, fractures, ruptures of arteries, veins, ligaments, dislocations. Occur due to involuntary sharp convulsive muscle contractions. Falls from a height when exposed to electricity also lead to injury.

Electric shocks

- convulsive muscle contraction with impaired breathing and palpitations due to a sharp excitation of body tissues by electric current.

Electric shock can result from:

Human exposure to variable or direct current at home and at work;

As a result of being struck by lightning or being exposed to an electroshock device.

First aid in case of damage with voltage up to 1000 V:

Disconnect the victim, not forgetting about your own safety:

Figure 3. Disconnecting the power source

Turn off or isolate the current source;

Figure 4. Pulling the casualty by the collar. Rescuer in dielectric gloves and boots, operates with one hand

Pull the free edge of dry clothes with one hand, it is better to put the other hand in your pocket or behind your back so as not to accidentally grab the victim with both hands;

Discard the wire with a dry non-conductive object, placing a rubber mat under the wire;

Cut the wire with an object with an insulated handle. The wire of each phase is cut separately, at different levels!!!

2 Check breathing and pulse on the carotid artery.

3 Perform defibrillation (electrical defibrillator) and cardiopulmonary resuscitation as early as possible

Paralysis of the muscles can be observed up to 30 minutes after the action of the current, so resuscitation must be carried out for a long time.

The risk of cardiac arrest persists for 10 days after an electric shock, and is significantly increased in people with chronic heart disease.

In all cases, despite the possible general satisfactory condition, the absence of visible bodily injuries, it is necessary to provide the victim with complete rest, not to be allowed to move.

Possible sudden deterioration due to burns internal organs and tissues along the current, disorders of organs and systems that develop during the first day or in the coming weeks.

First aid for heat injuries

Heat stroke is a life-threatening condition that occurs when a person's body is exposed to elevated temperature, in conditions of high humidity, dehydration and a violation of the body's thermoregulation process. Most often, heat stroke develops during heavy physical work in conditions of high temperature and humidity. environment. Less often, heat stroke occurs due to prolonged exposure to direct sunlight in hot weather. Regardless of the cause that caused heat stroke, you should immediately seek qualified medical help to prevent its complications (shock, damage to the brain and internal organs, death).

Causes of heat stroke:

The main cause of heat stroke is exposure to the body high temperature in conditions high humidity environment.

Also, heat stroke can occur as a result of wearing warm and synthetic clothing that prevents the body from generating heat.

Excessive alcohol consumption can cause heat stroke, because. alcohol interferes with thermoregulation.

Hot weather. If you are not accustomed to the effects of high temperatures on the body, limit your physical activity for at least a couple of days in case of a sudden change in temperature. Heavy exercise in the open sun is a serious risk factor for developing heat stroke.

Some medicines also increase the risk of heat stroke. Medications that increase the risk of heat stroke include vasoconstrictors, diuretics, antidepressants, and antipsychotics.

Which people are most at risk of developing heat stroke?

Anyone can get heat stroke, but some people, due to their physiological characteristics, are at greater risk of getting heat stroke than others. Those most at risk for heatstroke are:

Children and the elderly. In newborns, thermoregulatory processes are not fully developed, so they have an increased risk of heat stroke. . In the elderly, thermoregulation weakens with age, which also leads to an increased risk of heat stroke. Pregnant women are also at risk for heatstroke.

genetic predisposition. Some researchers believe that there are people with genetic characteristics of the body that increase the risk of heat stroke (congenital absence of sweat glands, cystic fibrosis).

Heat injury symptoms:

High body temperature (40 C and above) is the main symptom of heat stroke.

Heatstroke often causes thirst.

Absence of sweating. In heatstroke caused by hot weather, the skin becomes hot and dry to the touch. And with heat stroke caused by strenuous physical work, the skin is usually moist, sticky.

During heatstroke, the skin often turns red.

There is lethargy, fatigue, weakness, drowsiness, shortness of breath..

With heat stroke, the heart rate rises sharply, breathing quickens.

Also, with heat stroke, a throbbing headache, tinnitus can develop.

Less commonly, heat stroke causes symptoms such as: convulsions, hallucinations, loss of consciousness, as well as weakening of the heart and breathing.

When the human body is exposed to high temperatures, heat cramps can develop. Heat cramps are a precursor to heat stroke. The first signs of heat cramps are: profuse sweating, fatigue, thirst, muscle cramps in the abdomen, legs and arms. To prevent the first signs of heat stroke, such as muscle cramps, it is recommended to drink plenty of fluids, combine physical activity with rest, and work in a well-ventilated or air-conditioned room.

Complications of heat stroke:

As a result of heat stroke, a complication such as shock can develop. The first signs of shock in heat stroke are: a weak pulse (low blood pressure), blue lips and nails, the skin becomes cold and wet, loss of consciousness. All these changes in the body lead to the development of edema of the internal organs and the brain. Edema, in turn, leads to irreversible damage to internal organs and the brain and death.

First aid for heat stroke:

Take the victim to a cool place, to fresh air.

Remove tight clothing, untie tie, remove shoes.

For more severe cases: Wrap with a damp sheet (the water should be cold, but not icy), cold compress on the head.

Douse with cool water and blow with air. fanning the victim with a fan, newspaper.

Heatstroke occurs not only as a result of dehydration, but also as a result of the loss of salts through sweat. Therefore, in case of heat stroke, it is recommended to drink 1 liter of water with the addition of 2 teaspoons of salt.

Ice packs can also be applied to the neck, back, armpits, and groin to lower body temperature.

Monitor the pulse, the general condition of the victim. In the absence of the effect of treatment - hospitalization.

If you have heat stroke, do not drink alcoholic drinks and drinks with a high caffeine content (tea, coffee, cappuccino), as these drinks violate the thermoregulation of the body.

Final part

The leader of the lesson answers the questions of the trainees that arose during the lesson.

Putting in order the educational base;

Lesson conclusions;

The leader of the lesson conducts a short survey on the topic covered;

The assignment is for self-study.

Assistance to the victim should not replace assistance medical staff and should be provided before the arrival of the doctor. If the victim is in contact with live parts, it is necessary to quickly release him from the action of electric current. Touching a live person is life-threatening. Therefore, you need to quickly turn off the part of the installation that the victim touches. To release the victim from the wire, use dry clothes, a board or some other object that does not conduct electricity or take hold of his clothes (if it is dry), while avoiding touching metal objects and open parts of the body.

Further it is necessary: - to lay the victim on his back on a hard surface; - check the presence of breathing in the victim (determine by the rise of the chest, fogging of the mirror, etc.); - check for a pulse on the radial side at the wrist or on the carotid artery on the anterolateral surface of the neck; - find out the state of the pupil, a wide pupil indicates a sharp deterioration in the blood supply to the brain; - calling a doctor by phone 03 is obligatory in all cases.

If the victim is conscious after fainting, he should be placed in a comfortable position, covered with clothes, ensure complete rest, continuously monitoring breathing and pulse.

If the victim is unconscious, but with steady breathing and pulse, it should be even and comfortable to lay down, unfasten clothing, create an inflow fresh air, bring a cotton swab with ammonia to your nose, spray your face with water and ensure complete rest. If the victim is not breathing well (very rarely and convulsively), he should do artificial respiration and heart massage.

In the absence of signs of life, the victim cannot be considered dead, because. death is apparent. Artificial respiration should be carried out continuously until the arrival of a doctor. First aid should be provided immediately and, if possible, at the scene. From the moment of cardiac arrest, no more than 3-5 minutes should pass.

The method of artificial respiration is that the assisting person exhales from his lungs into the lungs of the victim directly into the mouth. The victim is laid on his back, his mouth is opened, foreign objects are removed from his mouth, the victim's head is thrown back, placing one hand under the back of the head, and with the other hand, press on the victim's forehead so that the chin is in line with the neck. Kneeling, you need to forcefully inhale air into the victim's mouth through gauze or a handkerchief, covering his nose. Inhalation lasts 5-6 seconds, or 10-12 times per minute. The chest of the victim should expand, and after the release of the mouth and nose, it should fall on its own. When spontaneous breathing resumes, artificial respiration should be continued for some time until the victim is fully conscious. Excessive compression of the chest should be avoided due to the possibility of fracture of the ribs. At the same time, an external heart massage should be performed in the absence of a pulse.

External (indirect) heart massage is performed by rhythmic contractions of the heart through the anterior chest wall with pressure on the lower part of the sternum. Repeating pressure with a frequency of 60-70 times per minute. The assisting person, having determined the lower third of the sternum, should put the upper edge of the palm on it, put the second hand on top and press on the victim’s chest, slightly helping by tilting his body. Pressing should be done with a quick push so. To advance the lower part of the sternum by 3-4 cm towards the spine, and in obese people - by 5-6 cm.

Every 5-6 pressures - one blow. If one person is helping, you should alternate after 2 deep breaths - 10-12 pressures for a heart massage.

At proper conduct artificial respiration and heart massage, the following signs of recovery appear in the victim: - improvement in complexion - the appearance of independent breathing more and more uniform - constriction of the pupils - the appearance of an independent pulse.

Means and methods for eliminating fires and fires

Causes of fires in computer classes: - sudden voltage drops; - a short circuit in the wiring when the breaker is not turned off; - a fire in the adjacent auditorium; - short circuit in the socket; - during work, students can bridge the network with a pin or hairpin; - not protected wiring.

When a fire is detected, each employee must:

Call the fire brigade immediately on 01.
Turn off the light and power supply.
Remove the source of ignition from the fire
Reduce air access to the combustion zone by isolating the hearth with a fire-retardant cloth, fire-extinguishing powder, sand, chemical or air-mechanical foam.
To eliminate the fire in the display classes of the department, carbon dioxide fire extinguishers are used. CO2 fire extinguishers OS are designed to extinguish the fires of various objects, including el. installations energized up to 380 V. To actuate carbon dioxide fire extinguisher it is necessary to remove the fire extinguisher from the bracket, turn the bell in the direction of the fire, open the valve by turning the flywheel, directing carbon dioxide into the fire.
To eliminate a small-scale fire, fire extinguishers OHP-10 are used. To activate the fire extinguisher, bring it to the fire at a jet length distance (6-4 m) and put it vertically on the floor. I turn the handle on the lid "!" up to failure. The fire extinguisher is lifted with one hand by the handle, and with the other they are picked up by the bottom and turned over (with a spray towards the fire). Be careful not to get the foam in your eyes. If this happens, rinse your eyes clean water. OHP-10 fire extinguishers cannot be used when the equipment is energized.
Powder fire extinguishers "Moment" are used to eliminate all types of fires. This fire extinguisher can work in the cold. The fire extinguisher is mounted with a bracket head down. When catching fire, the fire extinguisher must be taken by the body at the bottom, removed from the bracket, brought to the hearth, shaken and hit with the head on a hard surface, direct a stream of powder to a burning object.
In the event of a fire in an electrical installation, immediately turn off the power to the equipment and use non-conductive fire extinguishing agents (sand, powder fire extinguishers, flame retardant cloth).
When extinguishing clothes on a person, you need to act taking into account the specific circumstances. You can not allow sudden movements and run in burning clothes, the flame from this only intensifies. When removing smoldering clothing residues, take emergency measures to cool body parts; stand under running water for at least 10 minutes, apply a thick layer of cloth moistened with water, plastic bag with snow or broken ice. Prior to medical attention, isolate the surface of the burn with an aseptic bandage or a clean soft cloth moistened with alcohol.
Smoking in the premises is strictly prohibited.

1.1. First aid for electric shock. Damage prevention. Emergency medical care for victims

In case of natural disasters, industrial accidents, malfunctions of electrical appliances, exposure to lightning and other accidents, people may be struck by electric current - electrical injuries.

They cause pain, convulsive muscle contractions, disruption of the activity of nerve centers, respiratory and circulatory organs. There may also be instant death. At the site of contact with the source of damage, so-called current signs appear, sometimes burns of varying degrees, up to charring and burning of individual parts of the body. The severity of electrical injury depends on the magnitude and degree of current exposure, the ways it passes through the body.

Electric shocks are possible due to unauthorized overcoming of electrified wire fences used for the protection and defense of various objects, including military ones.

Electric shock occurs not only from touching a source of electricity, but also when approaching high voltage installations at a distance sufficient to form a spark or a voltaic arc.

First aid for electrical injury. A person who has been energized must first of all be freed from the effects of electric current as soon as possible (Fig. 1). If it is impossible to turn off the current with a switch, a knife switch, or unscrew electrical plugs, you need to cut the wires with an ax with a wooden handle or a tool whose handle is wrapped in insulating material. Cord-twisted wires to avoid short circuit and the burn should be crossed one at a time, at some distance from each other.

Rice. 1. Releasing the victim from the action of electric current

You can remove the wires or conductive part of an object under voltage with a dry board, stick, pole, dry roll of an overcoat and other objects.

When an electric current passes through the body of the victim into the ground, you need to move a dry board or other insulating material under his feet. It is very important to take precautions so that you yourself do not get under stress. In this case, it is advisable to use rubber gloves and rubber shoes.

Severe injuries are often found in victims of lightning - detachment of limbs, crushing of bones, paralysis of limbs, etc. The appearance of a sinuous, branched pattern of a reddish color on the skin is characteristic.

After releasing the victim from the action of the current, in case of respiratory arrest and palpitations, it is necessary to immediately begin a closed heart massage and expiratory breathing “from mouth to mouth” or “from mouth to nose”. The success of resuscitation is determined by the timeliness of the start of these activities - they should be carried out, as a rule, no later than 1-2 minutes after the electric shock.

If breathing and heartbeat are preserved, but the victim is unconscious, he needs to unfasten his clothes, provide fresh air, let him smell ammonia or spray his face with water and, in a lateral stabilized position, evacuate the victim to medical institution.

The victim, who is conscious, must be laid down, not allowed to remain on his feet, as complications associated with severe circulatory and metabolic disorders are possible. A sterile bandage is applied to the burned areas of the body. The victim should be protected from cold.

For an objective assessment of the severity of the condition and the appointment of further treatment, it is necessary to call a doctor to the scene of the incident as soon as possible.

Prevention of electrical injuries consists in the exact fulfillment of safety requirements during the installation, operation and repair of electrical installations and electrical appliances.

1.2. First aid for drowning. Warning. Emergency medical care for victims

Drowning is usually observed as a result of neglecting the rules of bathing. The causes of drowning may be the inability to swim, malaise, overwork, previous overheating, alcohol intoxication, fear of a person in the water. Sometimes even good swimmers drown due to overestimation of their capabilities. Drowning occurs when crossing water barriers, natural disasters associated with floods and a large rise in water.

When rescuing a drowning person, first of all, you should take care of your own safety. A drowning person is characterized by convulsive, not always sufficiently conscious movements, which can pose a serious danger to the rescuer.

You should swim up to a drowning person from behind and, grabbing him by the hair or armpits, turn him face up so that he is above the water. The victim must be pulled out of the water as soon as possible, freed from clothing that makes it difficult to breathe (unfasten the collar, waist belt, etc.).

After that, the rescuer lays the victim with his stomach on the thigh of his leg bent at the knee, face down, so that the head of the victim is below the body, cleans the oral cavity from silt, sand, mucus. Then, by vigorous pressure on the body, the lungs and stomach are freed from water. No more than 20–30 seconds should be spent on cleansing the respiratory tract and freeing them from water. (Fig. 2).

Rice. 2. Removal of water from the respiratory tract

If the victim is not breathing, it is necessary, without wasting a minute, to begin resuscitation.

It is possible to restore the life of the victim if the person has been under water for no more than 5 minutes, and assistance was immediately provided to him. However, there are cases when, due to a spasm of the larynx, the lungs do not fill with water, while the heart continues to work for some time. In these cases, salvation is possible even after a person stays under water for half an hour.

It should be remembered that artificial respiration and closed heart massage are only priority measures.

To determine the severity of the condition and further treatment, it is necessary to call a doctor without delay and, if possible, quickly transport the victim to a medical institution, where resuscitation should be continued in full.

1.3. First aid for a fall from a height. Warning. Emergency medical care for victims

When falling from a height, the easiest injury to the victim may be a bruise.

Swelling quickly appears at the site of the bruise, and bruising (bruising) is also possible. When large blood vessels rupture under the skin, accumulations of blood (hematomas) can form.

In case of injury, first of all, it is necessary to create rest for the damaged organ. It is necessary to apply a pressure bandage to the bruised area, to give this area of the body an elevated position, which helps to stop further hemorrhage into the soft tissues. To reduce pain and inflammation, cold is applied to the site of injury - an ice pack, cold compresses.

When falling from a height, open bleeding wounds often appear in various parts of the body. They can cause most deaths due to acute blood loss, so the first measures should be aimed at stopping the bleeding in any possible way (pressing the vessel, pressure bandage, and with severe arterial or venous bleeding, applying a tourniquet, etc.). An equally important task of first aid is to protect the wound from contamination and infection. Proper handling wounds prevents the development of complications in the wound and reduces the time of its healing by almost 3 times.

Wound treatment should be carried out with clean, preferably disinfected hands. When applying an aseptic dressing, you should not touch those layers of gauze with your hands that will be in direct contact with the wound.

The wound can be protected by a simple application of an aseptic bandage (bandage, individual bag, scarf). The skin around the wound is lubricated with 5% iodine tincture, loose foreign bodies are removed from the wound.

When providing first aid to a patient with a penetrating wound of the chest, it is necessary to stop the communication of the pleural cavity with the external environment as soon as possible using a sealing bandage.

The wound should not be washed with water - this contributes to infection. Cauterizing antiseptic substances should not be allowed to enter the wound surface. The wound should not be covered with powders, ointment should not be applied to it, cotton wool should not be applied directly to the wound surface - all this contributes to the development of infection in the wound.

Another result of a fall can be a fracture. A fracture is a break in the integrity of a bone.

Fractures are divided into closed (without damage to the skin) and open, in which there is damage to the skin in the fracture zone. A fracture is characterized by: a sharp pain that increases with any movement and load on the limb, a change in the position and shape of the limb, a violation of its function (inability to use the limb), the appearance of swelling and bruising in the fracture zone, shortening of the limb, pathological (abnormal) bone mobility.

The main task of first aid for bone fractures is to immediately immobilize bone fragments by immobilizing the limb (limb immobilization). This is done by applying a tire. The tire can be standard (service) or made from improvised material (boards, pieces of plywood, sticks, weapons, etc.).

Basic first aid measures for bone fractures

creating immobility of the bones in the fracture area;
implementation of measures aimed at combating or preventing shock;
organization of immediate delivery of the victim to a medical institution.

The rapid immobilization of the bones in the area of the fracture - immobilization reduces pain and is the main point in the prevention of shock. Immobilization of the limb is achieved by the imposition of transport splints or splints made of improvised solid material.

Splinting should be carried out directly at the scene of the incident and only after that the patient should be transported.

In case of an open fracture, an aseptic bandage must be applied before immobilization of the limb. When bleeding from a wound, methods of temporarily stopping bleeding should be applied (compressive bandage, tourniquet, etc.), an anesthetic from a syringe tube of an individual first-aid kit should be introduced.

1.4. First aid for backfilling with soil. Warning. Emergency medical care for victims

Victims who find themselves under the rubble of buildings, defensive structures, etc., may have various injuries, as well as be in a state of acute hypoxia from suffocation caused by blockage of the respiratory tract by dust, earth, lack of air, compression of the chest and neck.

After carefully removing the victim from under the collapse, his mouth and nose are cleaned and, if necessary, resuscitation is carried out. After restoration of spontaneous breathing in the victim, if necessary, anti-shock measures are taken, bandages are applied, fractures are immobilized, and then evacuation to a medical institution.

Particular attention is paid to identifying the fact of prolonged compression of the victim. A peculiar complex of disorders, called compression syndrome, arises and develops as a result of prolonged (over 3 hours) compression of soft tissues - more often the lower extremities. This syndrome develops after the resumption of blood circulation upon release from prolonged tissue compression. The severity of the condition of the victims depends on the extent of damage to the soft tissues and the duration of being under the rubble. Paleness, sometimes cyanotic spots, is observed on the limbs that have undergone prolonged compression. The general condition of the victims in the beginning usually does not cause concern. However, after a few hours, a bluish-purple color of the limb appears, blisters filled with bloody contents appear on the skin. Subsequently, tissue necrosis is noted. The absorption of poisonous decay products of damaged tissues leads to a sharp deterioration in the general condition of the victims, especially the kidney function is significantly reduced. Complete cessation of urine output is possible.

In the case of establishing signs of prolonged compression, the victims are considered as seriously affected, regardless of their condition. Providing them with medical care begins with the rapid elimination of compression, tight bandaging (from the foot) and transport immobilization of the injured limb. It is necessary to enter an analgesic from a syringe tube. In case of severe injuries of the limb, a tourniquet is applied.

2. First aid kit at the workplace and how to use it

Inventory of the first aid kit (Order of the Ministry of Defense of the Russian Federation No. 30 of 2002)

Item name	unit of measurement	Quantity	Best before date	Note
Personal protective equipment
Dressing package medical individual sterile
General medicines
Ammonia 10% solution, 1 ml. in an ampoule with a braid (ammonia)
Validol 0.006 tablet, 10 pcs. per pack (menthol solution in methyl isovalerate)	package
Iodine 5% solution, 1 ml. in a braided package (iodine tincture)
sodium bicarbonate
Nitroglycerin 0.0005 tablet, 40 pcs. per pack (nitroglycerin)	package
dressings and suture materials, adhesive plasters
Bandage gauze medical sterile size 5mX10cm.
Bandage elastic tubular medical type "Regelast" No. 1 (for a brush)
Bandage elastic tubular medical type "Regelast" No. 2 (for the foot)
Bandage elastic tubular medical type "Regelast" No. 3 (for the foot)
Cotton wool medical hygroscopic sterile 100 gr. in a pack
Medical scarf (dressing)
Bandage small medical sterile
Medical supplies
Medical pin
Medical items, devices and surgical instruments
Hemostatic rubber tourniquet
Rubber syringe with soft tip No. 6 (capacity 180 ml)
Apparatus, devices for general anesthesia and intensive care
Breathing tube TD-1.02	Set

Household appliances used at home can become a source of electrical injury in case of malfunction or violation of the rules of operation. Timely first aid will help to avoid serious consequences in case of electric shock. In some situations, immediate resuscitation may be required. Compliance with safety rules when working with mechanisms included in the network will prevent most accidents.

Nature of electric shock

Electric shock is a short-term or long-term effect of electricity on the human body, causing a pathological change in the functional processes in the organs. Electrical injuries are distinguished by the strength of the lesion and the source of occurrence. A discharge of current can be obtained in the following cases:

neglect of safety precautions;
violation of the integrity of the electrical wiring insulation;
uncontrolled natural discharge - lightning.

Signs of electric shock

Having found a person lying unconscious, by a number of signs it is possible to determine whether an electrical injury caused such a condition or not. So, with the defeat of an electric discharge, the following characteristic features are found:

the body clearly shows a wound from the point of entry of the electric arc;
pulse uneven, breathing intermittent;
bluish skin and lips.

Electric current affects the human body as a whole in a shock type, leading to respiratory and circulatory disorders.

Of course, the presence of a bare wire nearby will serve as a clear sign of electric shock. The electric arc leaves a deep burn at the place of its entry into the body, disrupting the work of all organs lying in the way. As a result of such a powerful concentrated effect in the affected person:

dizzy;
spastic phenomena are observed in the vocal cords;
convulsive reduction of limbs;
fainting state.

In some cases, short-term cardiac arrest or myocardial infarction is possible.

The first fatal electric shock was received in 1879.

First aid: procedure

Under standard conditions, a 50 V electric shock will avoid unpleasant consequences, however, in conditions of high humidity, even such a low voltage of 12 V can become a source of severe damage. Seeing how another person is shocked, the first thing to do is to exclude his further contact with the current source. The victim himself cannot unclench the muscles and release the faulty cable or device, so the procedure for disconnecting is as follows:

Unplug the appliance from the socket or disconnect it by cutting the cable. Do not touch the power plug with bare hands. This manipulation is carried out with the help of improvised objects made of wood or fabric, or by putting on rubber gloves. To de-energize the wires, use pliers or an ax, trying to break the connection. If a person is struck by the so-called step tension, then a dry wooden surface, separating it in this way from the ground.
If it is impossible to de-energize the source of damage, they try to pull the person over the edge of the clothing. Under no circumstances should you touch his skin.- an uncontrolled discharge will go to the unfortunate rescuer and both of them will need emergency help. This measure is possible at a voltage of less than 400 V, if it is in the range of 400–1000 V, then special items are used - an insulating rod and tongs.
The state of shock from an electrical injury is accompanied by severe hallucinations, therefore, the victim is not able to adequately assess his condition. The rescuer should do this himself.

Healthy and physically strong people tolerate the effects of electric current more easily than sick and weakened people.

The brain and heart muscle are the most vulnerable parts of the human body due to electric shock. Therefore, immediately after the de-energization of the victim, you should begin to provide emergency care. The procedure for this depends on the general condition of the patient. If a person is conscious, then the following manipulations are sequentially carried out with him until the ambulance arrives:

Placed on a hard surface.
Provide peace.
The places around the burns are lubricated with a 5% solution of iodine or manganese.
A sterile dry bandage is applied to the wound.
Pain is relieved with aspirin or analgin tablets.
To restore the rhythm of the heartbeat and relieve the state of panic, dilute 30 drops of valerian tincture in water and give the victim a drink.

Electric injury statistics in the Russian Federation show that fatal electric shocks account for 2.7% of the total number of deaths.

If the victim is unconscious, then the procedure will be somewhat different:

Remove tight clothing.
Bring to consciousness with the help of cotton wool soaked in ammonia.
Warm.
Treating wounds.
Relieve pain and restore peace of mind.

If the victim is at a height, his release from the effects of current can cause him to fall from a height. Therefore, you must first take measures to prevent injury.

If, after an electrical injury, a person does not regain consciousness, and the pulse ceases to be felt on the carotid artery, they proceed to resuscitation procedures without waiting for the arrival of the ambulance team.

resuscitation

The main resuscitation action is associated with the restoration of the normal rhythm of breathing and heartbeat. For this, an indirect heart massage and artificial respiration are performed. Traditionally, for the latter method, the mouth-to-mouth option is used, but if the muscles of the mouth are in severe spasm and it is impossible to open it, then the mouth-to-nose option is used. Massage is alternated with air inhalation according to the following algorithm:

The head of the victim is thrown back, freeing the mouth from foreign objects, mucus, etc.
The lips are covered with a special nozzle, and the nose is clamped.
Hands are placed in the area of the solar plexus, placing one palm over the other.
The sequence is followed: 1 deep exhalation into the human oral cavity - 5 pushes with straight arms - 1 exhalation - 5 pushes, etc.

If consciousness has not been restored by the time the medical team arrives, then they begin to carry out such manipulations, using additional equipment if necessary:

artificial lung ventilation apparatus;
defibrillator for planting heart muscle.

After five minutes, in the absence of a result, doctors inject a solution of adrenaline, strophanthin and glucose subcutaneously, intramuscularly or intravenously. When consciousness is restored, anti-shock drugs are given and transported to the hospital.

5% of patients in burn centers get burns when they come into contact with electricity.

Electrical Precautions

The risk of electric shock and the severity of the consequences increase in a humid environment, during rain or snowfall

Safety rules when working with electrical appliances prohibit:

use the device if sparking is observed when it is turned on;
approach sagging or broken wires at a distance closer than 10 m;
use faulty sockets and switches;
touch the switched on devices with wet hands or use them by touching metal surfaces;
close to transformers, distribution devices etc.;
leave unused devices plugged into the outlet;
carry out electrical work under voltage;
leave children alone near sockets and switches;
extinguish a fire from a faulty electrical wiring with water - you can get a discharge transmitted through a stream of water;
wipe the dust on the devices included in the network.

Electrical appliances around a person can become a source of electric shock. In most cases, they rarely end in death, causing a short-term disorder in the functioning of a number of organs. It is enough to provide emergency assistance in time to return a person from a state of imaginary death to consciousness.