Emergency care for burn shock. Providing first emergency medical aid for burns Pre-hospital emergency aid for burns

1. For first-degree burns without the formation of blisters and preserved integrity of the skin, apply cold to the burn site or place it under running cold water for 5-10 minutes. Treat the burned surface with alcohol, cologne or vodka.

2. For II-IV degree burns with damage to the skin, treat the burn surface with foaming aerosols or cover with a sterile (clean) sheet or napkin.

3. Place ice packs, snow bags, or cold water on top of a clean cloth.

4. Give the victim 2-3 tablets of analgin.

5. Before arrival and during a long wait for an ambulance, give plenty of warm fluids.

Remember! Unacceptable!

1. Lubricate the burn surface with fat, sprinkle with starch or flour, and remove any remaining clothing from the damaged surface.

2. Open burn blisters.

3. Bandage the burned surface tightly and apply a bandage.

4. Wash away dirt and grime from damaged skin.

5. Treat the damaged skin surface with alcohol, iodine and other alcohol-containing solutions.

Providing emergency care for chemical burns.

In case of damage by any aggressive liquid (acid, alkali, solvent, special fuel, oils, etc.):

1. Immediately remove clothing soaked in the chemical;

2. Rinse thoroughly under running cold water or milk, soapy water, and a weak solution of baking soda.

Phosphorus, When it gets on the skin, it flares up and causes a double burn - chemical and thermal. Immediately immerse the burned area in cold running water for 10-15 minutes, remove pieces of phosphorus with a stick, and apply a bandage.

If it gets on your skin quicklime, Under no circumstances should it be allowed to come into contact with moisture - a violent chemical reaction will occur, which will intensify the injury. Remove the lime with a dry cloth and treat the burn with vegetable or animal oil.

Remember!

1. Do not use strong and concentrated solutions of acids and alkalis for a neutralization reaction on the victim’s skin.

2. A person who has received burns needs to drink water more often (in small portions): dissolve a teaspoon of salt or baking soda in 1 liter of water.

3. For disinfection purposes, iron the cloth applied to the burn, soak it in vodka, or hold it over the fire.

Frostbite and hypothermia

Signs of frostbite of the extremities: the skin is pale, hard and cold, there is no pulse at the wrists and ankles, loss of sensation, when tapping with a finger there is a “wooden” sound.

Providing emergency assistance:

1. Take the victim to a room with a low temperature.

2. Do not remove clothes and shoes from frostbitten limbs.

3. Immediately cover the injured limbs from external heat with a cooled insulating bandage with plenty of cotton wool and blankets and clothing. You cannot speed up the warming of frostbitten parts of the body. Warmth should arise inside with the restoration of blood circulation.

4. Give plenty of warm drinks, small doses of alcohol. Make it move. Feed me.

5. Give 1-2 tablets of analgin.

6. Call a doctor.

Remember! It is forbidden!

1. Rub frostbitten skin.

2. Place frostbitten limbs in warm water or cover them with heating pads.

3. Lubricate the skin with oils or Vaseline.

Signs of hypothermia: chills, muscle tremors, lethargy and apathy, delirium and hallucinations, inappropriate behavior (“worse than drunk”), blue or pale lips, decreased body temperature.

Providing emergency assistance for hypothermia:

1. Cover the victim and offer a warm, sweet drink or food high in sugar.

2. Give 50 ml of alcohol and deliver within 1 hour to a warm room or shelter.

3. When indoors, take off your clothes and dry your body.

4. Place the victim in a bath of water at 35-40°C (the elbow is tolerated). You can lie down next to him or surround him with a large number of warm heating pads (plastic bottles).

5. After a warming bath, be sure to put warm, dry clothes on the victim and cover with a warm blanket.

6. Continue giving warm, sweet drinks.

7. Call a doctor.

Poisoning

Carbon monoxide poisoning occurs from smoldering coals if the exhaust pipe is closed before the stove is completely heated. As long as red, unextinguished coals are visible, the exhaust pipe must not be closed!

Signs: pain in the eyes, ringing in the ears, headache, nausea, loss of consciousness.

Actions:

1. Get down on the floor (this gas is lighter than air and accumulates at the top), make your way to a window or door, open it wide.

2. Take a few deep breaths.

3. Help those who have lost consciousness. Take it out into the fresh air and pour cold water over your head. You can pour water with a few drops of ammonia into your mouth.

4. If the victim is breathing heavily, with effort, start mechanical ventilation and continue until the victim comes to his senses.

5. Place the victim in the pastel and warm him with heating pads.

6. Hold the victim’s attention, make him speak, sing, count. Don't let him forget for an hour.

Food and drug poisoning

Signs: weakness, drowsiness, nausea, vomiting, loose stools, cold sweat, dizziness, headache, increased heart rate, shortness of breath, convulsions, fever.

Giving help:

1. Call a doctor immediately. Present the medicine wrappers.

2. If the victim is conscious, give 10-20 crushed tablets or 1 tablespoon of activated carbon with water. In its absence - grated crackers, starch, chalk, tooth powder, charcoal.

3. Rinse the stomach, if your condition allows: give 300-400 ml of water at room temperature to drink and induce vomiting by pressing on the root of the tongue; repeat this procedure at least 10 times.

4. Give again 10-20 tablets of crushed activated carbon and a laxative (2 tablespoons of vegetable oil).

5. Lay the victim on his stomach and do not leave him unattended.

6. If there is no consciousness or pulse, begin resuscitation.

7. When the condition improves, give tea, provide warmth and peace.

Foreign bodies

Depending on their shape, all foreign bodies can be divided into three groups:

1. Wide and flat objects are classified as coin-shaped bodies. These are the coins themselves, and buttons similar to them, as well as any flat rounded plates.

2. Another group includes objects that are spherical or pea-shaped - dragees and monpensiers, all kinds of pellets and balls, as well as unchewed pieces of sausage, cucumbers, potatoes or apples.

3. The last group, which you should pay special attention to, includes foreign bodies that are shaped like a rocker arm. Most often these are pieces of kebab, bound with a thin but very durable fascial film.

This classification is of fundamental importance for determining first aid tactics.

Methods of providing emergency assistance:

Removing spherical objects. If a child chokes on a pea, a piece of apple or any other spherical object, then the most reasonable thing to do is turn the baby head down as quickly as possible and tap the back several times with your palm at the level of the shoulder blades. The so-called “Pinocchio effect” will work. If after 2-3 blows between the shoulder blades the foreign body does not fall out onto the floor, then you should immediately proceed to other methods of removing it.

If the child’s height and weight do not allow him to be lifted by the legs to the full length of the body, then it will be quite enough to bend the upper half of the body over the back of a chair, a bench or over one’s own thigh so that the head is as low as possible to the level of the pelvic part of the body. There is nothing complicated in these actions, and, as practice shows, they are quite effective.

Removing coin-shaped objects. If coin-shaped foreign bodies enter, especially when the foreign body has moved below the glottis, one cannot expect success from the previous method: the “piggy bank effect” will work. In this situation, you should resort to methods aimed at shaking the chest as soon as possible. It is necessary to force the foreign body to change its position. Most often, the foreign body ends up in the right bronchus. This will enable a person to breathe with at least one lung, and, therefore, SURVIVE.

There are several ways to shake the chest. The most common of these is tapping your back with your palm. The greatest effect occurs with short, frequent blows to the interscapular area. Blows to the back can only be applied with an open palm and in no case with a fist or the edge of the palm.

Another, more effective method is called "the way of American policemen." In itself it is quite simple and has two options.

First option It is carried out as follows: you need to stand behind the choking person, take him by the shoulders and, pulling him away from you at outstretched arms, sharply hit him with force against your own chest. The blow can be repeated several times.

Second option: stand behind the patient and wrap your arms around him so that your hands, folded into a lock, are below his xiphoid process, and then with a sharp movement press firmly under the diaphragm and hit your back against your chest. This will allow not only a strong shock, but also, due to a sharp displacement of the diaphragm, squeeze out the remaining air from the lungs, i.e. significantly increase the displacement of the foreign body.

Scheme for providing first aid if a foreign body enters the larynx or trachea:

1. Turn a child under 5 years old upside down and lift him by his feet.

2. Bend an adult over the back of a chair or your own thigh.

3. Strike several times with your palm between the shoulder blades.

4. In case of failure and with preserved consciousness, use one of the options for the “American police” method.

5. If you lose consciousness, turn the choking person on his side and hit him on the back several times with an open palm.

7. Even after successful removal of a foreign body, you must definitely consult a doctor.

Remember! Unacceptable!

1. Remove the foreign body (with fingers or tweezers).

2. Punch the spine.

3. Immediately open your hands when performing the “American police” method (a blow to this area can provoke sudden cardiac arrest).

Content

Such injuries cause a person to develop a severe general condition due to changes in blood composition, disruption of the central nervous system and the functions of internal organs due to intoxication. Timely and correct assistance will help reduce the damage from the burn to a minimum.

Classification of burns

The severity of the damage depends on several factors, including the height of the temperature, the duration of exposure to the harmful factor on the skin/mucous membranes, and the location of the injury. Especially serious damage is caused by steam and flame under pressure. More often people experience burns to the limbs and eyes, less often to the head and torso. The larger the surface of the damaged tissue and the deeper the damage, the higher the danger for the victim. Thus, a burn of 30% of the body surface is often fatal.

To provide first aid, it is important to know what type of burn was received. The speed and degree of tissue restoration of the patient after injury largely depends on how correctly pre-medical measures were chosen. Incorrect actions that do not correspond to the type of burn can aggravate the situation, further harming a person’s health.

According to the depth of the lesion

Minor burned areas of the body can be treated at home without resorting to medical help.

With large areas of burns, a large number of nerve endings are damaged and traumatic shock develops, so it is extremely important to go to the hospital in a timely manner.

There are the following degrees of injury from fire, electricity and chemicals:

1. First. These are superficial tissue injuries in which swelling, redness of the skin, and burning pain are observed. Symptoms disappear within 3-6 days, after which the dermis begins to renew itself through exfoliation. Pigmentation remains at the site of injury.
2. Second. Characterized by the appearance of blisters (blisters filled with liquid). In the damaged area, immediately or after some time, the surface layer of skin begins to peel off. The blisters burst, which is accompanied by intense pain. If tissue infection does not occur, healing occurs in approximately 2 weeks.
3. Third. Necrosis (necrosis) of the deep layers of the dermis occurs. After such burns, scars are sure to remain.
4. Fourth. This stage is characterized by necrosis and charring of deep-lying tissues. Damage may affect muscles, bones, subcutaneous fat, and tendons. Healing occurs very slowly.

By type of damaging factors

Providing first aid for a burn depends on the nature of the impact. There are several types of damaging factors by which burns are classified.

Type of burn injury	Impact factor	Possible consequences
Thermal	Contact with fire, boiling water, steam, hot objects.	As a rule, the hands, face, and respiratory tract are affected. When contacting boiling water, the damage is often deep. The steam can damage the respiratory tract; it does not leave deep damage on the skin. Hot objects (for example, hot metal) cause blisters and leave deep burns of 2-4 degrees of severity.
Chemical	Contact with the skin of aggressive substances - acids, caustic alkalis, salts of heavy metals.	Acids cause shallow lesions, with a crust appearing on the injured areas, which prevents the acid from penetrating deep into the tissue. Alkalies can leave deep damage to the skin. Zinc chloride and silver nitrate can only cause superficial lesions.
Electric	Contact with conductive materials.	Electrical trauma causes very serious, dangerous consequences. The current quickly spreads through tissues (through the blood, brain, nerves), leaves deep burns and causes disruption of organs/systems.
	Ultraviolet, infrared or ionizing radiation.	UV radiation is dangerous in the summer: injuries are shallow, but can be extensive, as a rule, they are grade 1-2. Infrared radiation provokes damage to the eyes and skin. The degree of damage depends on the duration and intensity of exposure to the body. Not only the dermis, but also nearby tissues and organs suffer from ionizing rays, although their damage is shallow.

First aid for burns

The first thing to do is to eliminate the damaging factor. After treating the affected areas of the body (the choice of method depends on the type of burn), an aseptic dressing should be applied to prevent infection of the body. First aid for burns also includes measures to prevent shock and transport the victim to a medical facility. It is extremely important to perform any actions carefully to avoid further tissue damage. First aid includes:

• extinguishing burning clothing;
• evacuation of a person from a dangerous zone;
• removing smoldering or heated clothing;
• careful removal of stuck things (they are cut off around the injury);
• applying an aseptic dressing (if necessary, even over the remaining piece of clothing).

The main task of the person who provides first aid is to prevent infection of the burn tissue. For this purpose, use a sterile bandage or an individual bag.

In the absence of these products, it is permissible to use clean cotton fabric, ironed or treated with an antiseptic (alcohol, vodka, potassium permanganate, etc.).

Pre-medical measures

The rules for providing first aid for burns provide for pre-medical measures only for grade 1-2 injuries. If the affected area covers an area of ​​more than 5 cm, multiple blisters are observed on the tissues, and the victim feels intense pain, you should immediately call an ambulance. For serious burn injuries of grade 2 or higher, or if more than 10% of the person’s body is damaged, urgently hospitalize. It is prohibited to do the following as part of first aid:

• move or carry the victim without first checking the pulse, breathing, presence of fractures, after loss of consciousness due to electric shock or other types of injuries;
• treat burned tissues with any available means (butter or sour cream), this will aggravate the situation, since fatty foods disrupt the heat transfer of the skin;
• clean the wound yourself in the absence of sterile bandages, cover the affected areas with fabrics with lint or cotton wool;
• apply a tourniquet without an open wound with serious blood loss (this measure will lead to tissue death and amputation of the limb);
• apply bandages without understanding how to do it correctly (if there is an urgent need, you can easily wrap the area of ​​the burn injury with sterile material without pulling the burned area tightly);
• puncture blisters (this will cause infection);
• tear off clothes stuck to the wound (dry tissues should first be soaked, or better yet, wait for the doctors to arrive).

First aid for thermal burns

Mild injuries can often be successfully treated at home, but only if first aid was provided correctly. When receiving thermal injuries, after the cessation of exposure to the traumatic factor, you need to:

1. Cool the injured area under running cold water (the procedure should last at least 10-20 minutes).
2. Treat the skin with an antiseptic (but not iodine), then lubricate it with an anti-burn agent.
3. Apply a sterile, loose bandage to the wound.
4. In case of intense pain, give the victim an anesthetic - Nurofen, Aspirin, Nimesil or others.
5. If necessary, transport the patient to a medical facility.

With chemical

First, it is imperative to determine what substance caused the damage to the skin/mucous membranes. First aid for chemical exposure includes the following measures:

1. The injured area is thoroughly washed with water for at least 15 minutes. The exception is when the burn is caused by substances that react with water, for example, quicklime.
2. If the tissues have been burned with a powdery substance, remove it with a dry cloth before washing.
3. An antidote is used (for alkaline exposure, it is recommended to use a weak solution of citric acid or vinegar; for lime burns, the skin is treated with fat or lard, the acid is neutralized with a soda solution).
4. If the victim has swallowed a chemical substance, be sure to perform gastric lavage.

With electric

First medical aid for burns consists of isolating the victim from the damaging factor, after which you should check the victim for breathing and pulse and call an ambulance. If there are no vital signs, you need to:

1. Perform a closed cardiac massage.
2. Breathe mouth-to-mouth or mouth-to-nose.
3. Carry out resuscitation measures until the ambulance arrives.
4. Superficial injuries caused by electric shock are treated in the same way as a thermal burn.

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Attention! The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and give treatment recommendations based on the individual characteristics of a particular patient.

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First aid for burns - types of lesions, step-by-step algorithm of pre-medical actions

Thus, thermal, electrical, solar, chemical and radiation burns are distinguished. Most often the skin, eyes and respiratory tract are burned.

Thermal skin burns

Thermal skin burns are the most common type of household burns.

Clinical manifestations

Based on the severity of skin damage and the depth of tissue damage, the following degrees of burns are distinguished:

I degree - persistent redness of the skin and severe pain are noted at the site of the lesion;
II degree - in the area exposed to high temperature, bubbles with transparent contents form, the affected area is very painful;
III degree - necrosis (necrosis) of all layers of the skin. Upon examination, a combination of deathly pale (dead) areas of skin, areas of redness and blisters is revealed; all types of sensitivity disappear in the burn area, there is no pain.
IV degree - not only the skin is subjected to necrosis, but also the tissues located underneath it (fatty tissue, muscles, bones, internal organs); upon examination, charring of the skin is revealed.
More often there is a combination of different degrees of burns. Their III and IV degrees refer to deep burns, are accompanied by aggravation of the general condition of the victim, require surgical intervention, and heal with the formation of deep scars. The severity of the victim’s condition depends on both the degree of the burn and the area affected. Second degree burns, covering more than 25% of the body surface, as well as third and fourth degree burns, covering more than 10% of the body surface, are extensive and are often complicated by the development of burn shock. The victim, who is in a state of burn shock, is restless, tries to escape, and is poorly oriented in what is happening; after some time, excitement is replaced by apathy, prostration, adynamia, and a drop in blood pressure. In children, people over 65 years of age, and weakened patients, burn shock can develop even with a smaller area of ​​damage.

First aid for thermal skin burns

The very first action should be to stop the impact of the thermal factor on the victim: it is necessary to take the victim out of the fire, put it out and remove his burning (smoldering) clothes. The burned areas of the body are immersed in cold water for 10 minutes, the person (if he is conscious) is given any painkiller - metamizole sodium, tramadol; in severe cases, narcotic analgesics (promedol, morphine hydrochloride) are administered. If the burned person is conscious and the burn surface is quite extensive, it is recommended to give him a solution of table salt and baking soda to drink in order to prevent dehydration.
First degree burns are treated with ethyl (33%) alcohol or a 3-5% solution of potassium permanganate and left without a bandage. For burns of II, III, IV degrees, after treating the burn surface, apply a sterile bandage to it. After these activities, all victims must be taken to the hospital. Transportation is carried out on a stretcher. For burns of the face, head, upper half of the body, the burned person is transported in a sitting or half-sitting position; for lesions of the chest, abdomen, front surface of the legs - lying on your back; for burns of the back, buttocks, back of the legs - lying on your stomach. If hospitalization in the near future for any reason is impossible, provide assistance to the victim on the spot: in order to anesthetize the burn surfaces, they are sprayed with a 0.5% solution of novocaine for 5 minutes (until the pain stops), bandages are applied to the burns syntomycin emulsion or streptocid ointment. They continue to feed him a solution of soda and salt, and periodically give him painkillers.

Chemical burns of skin and mucous membranes

The difference between chemical burns and thermal burns is that with chemical burns the damaging effect of the chemical on body tissue continues for a long time - until it is completely removed from the surface of the body. Therefore, an initially superficial chemical burn, in the absence of proper assistance, can turn into a third or fourth degree burn within 20 minutes. The main chemicals that cause burns are acids and alkalis.

Clinical manifestations
As a result of an acid burn, a scab (crust) of dead tissue is formed. When exposed to alkalis, wet necrosis (necrosis) of tissue occurs and a scab does not form. It is necessary to pay attention to these signs, since measures aimed at helping a victim with burns from acids and alkalis differ. In addition, if the patient is conscious and adequately perceives reality, be sure to check with him what substance he was in contact with. With chemical burns, as with thermal burns, there are 4 degrees of severity of tissue damage.

First aid for chemical and mucous skin burns

The victim is removed from clothing soaked in a damaging agent (acid or alkali), and the skin is washed with running water. There is a known case when a girl who worked in a chemical laboratory died from an acid burn simply because the man who was nearby was embarrassed to undress her. For burns caused by exposure to acid, apply sterile wipes moistened with a 4% solution of sodium bicarbonate to the burned surfaces; in case of alkali burn - sterile napkins moistened with a weak solution of citric or acetic acid (in enterprises where there is contact with alkalis or acids, the first aid kit must have a supply of these substances). The patient is given any painkiller and is urgently hospitalized in the nearest hospital (preferably in a hospital with a burn department).

Eye burns

(module direct4)

When the organ of vision is burned, isolated burns of the eyelids, conjunctiva or cornea, or a combination of these injuries, may occur. Eye burns, like skin burns, occur under the influence of various factors, the main of which are lesions associated with exposure to high temperatures, chemicals, and radiation. Eye burns are rarely isolated; as a rule, they are combined with burns of the skin of the face, head and torso.

Thermal burn of the eyes

The causes of thermal burns to the eyes are hot water, steam, oil, and open fire. As with skin burns, they are usually classified into 4 degrees of severity.

Clinical manifestations
With a first-degree eye burn, slight redness and slight swelling of the skin of the upper and lower eyelids and conjunctiva are noted. With a second degree burn to the eyes, blisters appear on the skin, and films consisting of dead cells appear on the conjunctiva and cornea of ​​the eye. A third degree burn affects less than half the area of ​​the eyelids, conjunctiva and cornea. The dead tissue looks like a white or gray scab, the conjunctiva is pale and swollen, and the cornea looks like frosted glass. With IV degree burns, more than half the area of ​​the eye is affected; the entire thickness of the skin of the eyelids, conjunctiva, cornea, lens, muscles and cartilages of the eye are involved in the pathological process. The dead tissue forms a scab of gray-yellow color, the cornea is white, similar to porcelain.

First aid
The substance that caused the burn is removed from the victim's face. This is done using a stream of cold water and a cotton swab. Continue to wash the eye with cold water for some time to cool it down. The skin around the eye is treated with ethyl (33%) alcohol, albucid is instilled into the conjunctival sac, and a sterile bandage is applied to the eye. After first aid is provided, the victim is urgently hospitalized in an eye clinic.

Chemical burns to the eyes

The cause of chemical burns is contact with the eyes of acids, alkalis, medicinal substances (alcohol tincture of iodine, ammonia, concentrated solution of potassium permanganate, alcohol), household chemicals (adhesives, paints, washing powders, bleaches). Chemical substances entering the eye have a pronounced damaging effect, penetrating deeper into the tissue the longer the contact continues.

Clinical manifestations
Chemical burns to the eyes are divided into 4 degrees according to the severity of damage, as with thermal injury. Their clinical signs are similar to thermal burns of the eyes.

First aid
The affected eye is opened, the eyelids are turned out, after which the eyes are washed with a stream of cool water, and pieces of the damaging agent are carefully removed from the conjunctiva. Then albucid is instilled into the palpebral fissure, a sterile bandage is applied to the damaged eye, and the victim is urgently hospitalized in an eye clinic.

Burns of the oral cavity, pharynx, esophagus

More often, chemical burns of these organs occur as a result of ingestion of acids and alkalis by mistake or due to a suicide attempt. The most common are burns caused by concentrated acetic acid. Less common thermal burns are the result of exposure to hot liquids (water, oil) or inhalation of hot steam.

Clinical manifestations
Burns of the oral cavity, pharynx and esophagus are accompanied by pain in the mouth, pharynx, and behind the sternum (along the esophagus). The pain intensifies when trying to speak or swallow; There is increased salivation, difficulty breathing (up to suffocation) and swallowing, and the inability to eat any food (both solid and liquid). Repeated vomiting may occur, and there is an admixture of scarlet blood in the vomit. An increase in body temperature and an excited state of the victim may be observed. When examining him, one notices the burnt skin on and around the lips and the red, swollen oral mucosa. In case of a chemical burn caused by vinegar essence, a specific vinegar smell emanates from the patient.

First aid for burns of the oral cavity, pharynx, esophagus

In case of chemical burns, the stomach is washed with a large amount of cool water (up to 5 l) through a tube. In case of a burn with hot water and oil (thermal), gastric lavage is not performed. If the victim is conscious, he is given to drink 10 ml of a 0.5% solution of novocaine (1 tablespoon), after which he is forced to swallow pieces of ice, vegetable oil in small portions and suck on an anesthetic tablet. The patient is urgently hospitalized in the hospital.

Thermal burns

First of all, stop exposure to damaging agents, cool the burn site and surrounding surface (directly or through clean linen, a rag) under running cold water at 20-25 ° C for 10 minutes (until the pain disappears).

Free the damaged area of ​​the body from clothing (do not remove clothing, it is necessary to cut it after it has cooled). Also

Do not remove clothing that is stuck to the skin. In case of burns to the hands, it is necessary to remove the rings from the fingers due to the risk of ischemia!

A wet aseptic bandage with furacillin (1:5000) or 0.25% novocaine is applied to the burn site (for extensive burns it is better to use a sterile sheet). Do not pop blisters! It is not recommended to treat wounds with any powders, ointments, aerosols, or dyes before the patient is admitted to the hospital. Anesthesia is performed according to indications (non-narcotic analgesics). It is important not to give the child anything to drink so as not to overfill the stomach before the upcoming anesthesia during the initial treatment of the wound in a hospital setting. The victim is hospitalized in the burn department.

Chemical burns

To remove aggressive liquid, rinse the burned surface with plenty of running water for 20-25 minutes (except for burns caused by quicklime and organic aluminum compounds). Use neutralizing lotions: for acids, phenol, phosphorus - 4% sodium bicarbonate; for lime - 20% glucose solution.

When inhaling smoke, hot air, or carbon monoxide, in the absence of disturbances of consciousness, the child is taken out into fresh air, mucus is removed from the oropharynx, an air duct is inserted, and then inhalation of 100% oxygen is started through an inhaler mask. With increasing laryngeal edema, impaired consciousness, convulsions and pulmonary edema after intravenous administration of atropine and diazepam (can be in the muscles of the floor of the mouth), the trachea is intubated, followed by transfer to mechanical ventilation.

Burns of the eyeball

Terminal anesthesia is performed with a 2% solution of novocaine (in drops), copious rinsing of the conjunctival sac (using a rubber bulb) with a solution of furacillin (1:5000); if the nature of the damaging substance is unknown - boiled water. Apply a bandage. The victims are hospitalized and transported in a prone position.

Emergency care for burn shock

Anesthesia is carried out for burns up to 9% by intramuscular injection of analgesics; with a burn area of ​​9-15% - 1% promedol solution 0.1 ml/year IM. (if the child is over 2 years old). For burn areas up to >15% - 1% promedol solution 0.1 ml/year (if the child is over 2 years old); fentanyl 0.05-0.1 mg/kg IM in combination with a 0.5% solution of diazepam 0.2-0.3 mg/kg (0.05 ml/kg) IM or IV.

In case of I-II degree of burn shock, infusion therapy is not carried out at the prehospital stage. At III- IV degree of burn shock (circulatory decompensation) access to the vein is performed and infusion therapy is carried out with 20 ml/kg for 30 minutes with solutions of rheopolyglucin, Ringer or 0.9% sodium chloride solution; Prednisolone 3 mg/kg is administered intravenously. Oxygen therapy is carried out through a mask with 100% oxygen. The victim is urgently hospitalized in the intensive care unit of a burn center or multidisciplinary hospital.

BLEEDING IN CHILDREN

PULMONARY BLEEDING

Causes of pulmonary hemorrhage: chest injuries; acute and chronic purulent inflammatory processes in the lungs (bronchiectasis, abscesses, destructive pneumonia), pulmonary tuberculosis; hemorrhagic thrombovasculitis; pulmonary hemosiderosis.

Clinical picture

Foamy bloody fluid, ichor and sometimes scarlet blood are released from the mouth and nose; vomit and stool do not change color. In the lungs, upon auscultation, an abundance of moist, predominantly fine-bubble rales are heard. The child suddenly turns pale, weakness and adynamia occur.

Urgent measures

The child is placed in a semi-sitting position; evaluate the color of the skin and mucous membranes, determine the nature of breathing, pulse, blood pressure; examine the nasopharynx; ensure free passage of the upper respiratory tract; oxygen therapy is started. The patient is urgently hospitalized in the surgical department.

GASTROINTESTINAL BLEEDINGS

Causes of gastrointestinal bleeding: ulcers and erosions, tumors, diverticula of the digestive tract, varicose veins of the esophagus or stomach.

Clinical picture

There may be vomit the color of “coffee grounds”, black stools, and less often the presence of scarlet blood in the vomit and stool. Their color is affected by the location of the bleeding. Severe pallor of the skin, dizziness, weakness, and abdominal pain appear. With significant blood loss, blood pressure decreases. In cases where bleeding occurs against the background of intussusception, thrombusculitis, or intestinal infection, it is accompanied by a detailed clinical picture of the underlying disease.

A child with any signs of gastrointestinal bleeding should be hospitalized according to the profile of the underlying disease. In case of massive bleeding, children are hospitalized in the surgical department. Before hospitalization, an ice pack or a cloth moistened with cold water is applied to the epigastric or umbilical area (depending on the location of the bleeding). Give a 5% solution of epsilon-aminocapriic acid 5 ml/kg with thrombin to drink. If blood pressure is reduced, then albumin or gelatinol 10 ml/kg is injected intravenously before transportation.