V. Reference basis of action

Method of imposition of an occlusal bandage at opened pneumothorax

1. About a wound a skin treat by solution of iodine.

2. A wadding-gauze bandage is put on a wound.

3. From above material lays (oilcloth, polyethylene tape and others like that) impenetrable for air and which on 4-5 cm anymore all sides of the wadding-gauze bandage.

4. The hermetically imposed material is fastened by a circular bandage.

Methods of temporal stop of bleeding

• Elevated position of extremity stops the capillary and insignificant phleborrhagia.

• Maximal bending of extremity in a joint or its taking – at bleeding from popliteal, femoral, distal part of humeral artery.

• Imposition of squeezing bandage – at the capillary or phleborrhagia especially at victims with the wounds of head and extremities.

• Tight tamponing of a wound – at bleeding from a nose, vagina, rectum, at deep wounds.

• Imposition of a clamp on a vessel – it is used during operative intervention.

• Digit pinning of vessel in a wound – it is used during operative intervention.

• Digit pinning of vessel on the extent – at the arterial bleeding before imposition of a tourniquet or garrot.

• Imposition of a tourniquet (garrot) – it is the arterial bleeding.

Choice of mean for transporting immobilization

• The damage of thigh and thurl – it is the Diterix’es distracted splint.

• The damage of shoulder, forearm, brush, shin, foot – there are the Cramer’s splint, Esmarh’s splint, pneumatics splint.

• The damage of collar-bone is the Dezo’s bandage.

• Damage of spine or break of bones of pelvis – there are the special stretchers with a hardcore, long boards or shield (victims are transported in position lying on the back), vacuum stretchers.

• Breaks of bones of skull, neck vertebrae – there are Elansky’s splint, wadding-gauze Shansa’s collar, tire Cramer’s splint

Vі. System of teaching tasks for verification of the final level of knowledge

Situational tasks

1. Name the stages of a medical first care to a victim with the syndrome of the prolonged compression.

Answer: in place of incident the adequate anaesthetizing by narcotic drugs is conducted, an elastic bandage is laid on extremity, immobilization by a transporting splint; a victim is quickly hospitalized in surgical department.

2. Name the stages of helping medical first to a victim with the penetrative wound to abdominal cavity.

Answer: to a victim lay on a wound an aseptic bandage (falling organs out do not set from an abdominal region!) and transport him in position lying in surgical department, during transporting anti shock therapy is conducted.

3. Name the stages of helping medical first to a victim with the penetrative wound of thorax.

Answer: in place of incident anaesthetizing, laying on of sterile occlusal bandage, portage of a victim is conducted in hospital in position «sit», anti shock therapy.

4. A woman, 40 years, was hammered by a passenger car. The state is extremely heavy. Consciousness is absent|. A pulse is frequent, to 100 shots in 1 min weak filling. There is anizocoria with the increase of left pupil and fixing of sight to the left. Hypodermal haematoma is in a frontoparietal area on the right. The hurt wound is in a cervical-parietal area on the left the bottom of which there is aponeurosis.

Define the volume of the first medical care.

Answer: the closed craniocerebral trauma and hurt wound of cervical-parietal area are at the suffering woman. Formation of intracranial or subdural haematoma is not eliminated. It is necessary quickly to transport in the neuro-surgical department in position lying, to watch after breathing, to turn a head on a side. An aseptic bandage is imposed on a wound.

5. To the man, 23 years, inflicted blow unknown. State is heavy. Consciousness is stored. Pulse is weak to 120 shots after 1 min At examination two stab-wounds defined in area of thorax at the level of the second intercostal space on the right on a middling-clavicle line. Wounds pull air.

Define the volume of the first medical care.

Answer: penetrated wound of right half of thorax is at the victim; it is necessary to enter anesthetic drugs, to impose an occlusal bandage, quickly to transport the victim in the surgical department in position «sit».

6. A man, 32 years, suffers when in an entrance the unknown explosive device has worked at home. Hi marked the brief loss of consciousness. Retrograde amnesia is not present. Pulse 84 blows in 1 min satisfactory properties. On-the-spot left neck in the projection of m. Sternocleidomastoideus there are three splinter wounds by a diameter 2x3 mm. The left half of neck is hydropic; a haematoma which does not pulsate and is gradually increased in a volume is marked.

Define the volume of the first medical care.

Answer: the damage of large bloods vessels is not eliminated (jugular veins, carotid). It is necessary to impose compact pressing aseptic bandage on the area of the wound. A victim it is immediately needed to deliver in the surgical department.

7. Man, 26 years, in a conflict situation received the penetrated wound by knife in a abdomen. The state gets worse progressively. The pallor of skin grows. A pulse is frequent, weak filling.

Define the volume of the first medical care.

Answer: to impose an aseptic bandage into place of the wound, it is possible to lay a cold on an abdomen, immediately to deliver in the surgical department in position lying. Anesthetic drugs are not entered. During transporting the anti shock therapy is conducted.

8. At a suffering man found out the cut-chopped wound on frontal-lateral surface of right thigh which he received during a fight. The massive bleeding of pulsating character defined from the wound. The wound is in middle third of thigh. What help must be given to a victim to arrival of brigade of first-aid?

Answer: in the beginning it is necessary to stop bleeding by the digit pinning of femoral artery for the extent, then to impose the garrot or tourniquet proximally from the place of the wound. On a wound an aseptic bandage is laid on.

9. At a victim after examination the brigade of first-aid sets a diagnosis is break of left thigh-bone in the lower third. Specify the method of transporting of such suffering in the surgical department.

Answer: a victim must be transported after imposition of Diterix’s splint.