The volume of the first medical aid:

• Temporary stop of external bleeding by all available means: application of arresting bleeding tourniquet(standard and improvised),a pressure bandage, finger compression of blood vessels;

• Elimination of asphyxia by removing mucus, blood, soil and possible alien bodies from the upper respiratory tract, definite position of the body (in tongue retraction, vomiting, profuse nasal bleeding) and artificial ventilation off the lungs (mouth-to-mouth, mouth-to-nose breathing, S-shaped tube, etc.);

• The closed massage of heart;

• Introduction of pain-killers with the help of a syringe - tube;

• Application of aseptic bandage to the wound and burn surface, application of occlusive bandage in penetrating wounds of the chest by using rubberized coating of the first aid pack;

• Immobilization of the injured area of a body in the simplest ways by using listed and improvised objects;

• Putting on a gas mask while being in the contaminated area;

• Introduction of antidotes to the affected by toxic agents;

• Partial sanitary treatment;

• Antibiotics, sulfa drugs, antivomiting preparations, from individual first aid pack-2.

4. Premedical aid.

Premedical (medical attendant’s) help is provided by personnel of medical attendant teams and nurses of doctor-nurse teams. It is rendered in order to fight with life-threatening consequences of injuries and prevent severe complications. It compliments the first medical aid and includes:

• Elimination of asphyxia (introduction of air-way, artificial ventilation of the lungs with the help of portable devices, oxygen inhalation);

• The control of correctness and expediency of tourniquet application at a proceeding bleeding;

• Repeated introduction of pain-killers, antibiotics;

• Application and correction of incorrectly applied bandages;

• Improvement of immobilization by using listed and improvised objects;

• Warming up of the wounded, casualties, overcooled, extricated from the water, giving them hot drinking (except the wounded into the abdomen);

• Realization of partial sanitary processing by improvised means, intake of radioprotective preparations, introduction of antidotes in acute chemical poisonings.

5. The first doctor’s aid.

The first doctor’s aid is characterized by a complex of medico-prophylactic measures carried out by the physicians at the first stage of medical evacuation and directed on elimination or easing of consequences of life-threatening injuries, prophylaxis of possible complications and preparation of casualties to evacuation.

Depending on real conditions and possibilities of the medical formation or establishment, the measures of the first medical aid are divided into two groups:

- Urgent measures;

- Measures, which performance can be deferred.

The optimal term of rendering the first doctor’s aid are the first 4-6 hours from the moment of injury. The increase of this time is directly proportional to the quantity of lethal outcomes.

The urgent measures are be carried out in cases threatening the life of the wounded and patients. They include:

• Control of external bleeding (tight tamponade of a wound with application of skin sutures, suture of a vessel in a wound, clamping a bleeding vessel, control of correctness and expediency of tourniquet application, and tourniquet application by indications);

• Fight with a shock (introduction of pain-killers and cardio-vascular preparations, novocaine blockade, transport immobilization, transfusion of blood or blood-substitutes in severe shock or significant blood loss, etc.);

• Elimination of acute respiratory insufficiency (sucking off the mucus, vomiting masses and blood from the upper respiratory ways, introduction of air-way, suture of the tongue, tracheostomy, excision or suture of drooping flaps of the soft palate and lateral parts of the larynx, artificial ventilation of the lungs, inhalation of oxygen, steams of ethyl alcohol in lung edema, application of occlusive bandage in open pneumothorax, puncture or thoracoscentesis in strained pneumothorax);

• The closed massage of heart;

• Transport immobilization (or its improvement) in bone fractures and vast injuries off the soft tissues, application of sling-like transport splint in jaw fractures;

• Excision of the extremity hanging on the flap of the soft tissues;

• Catheterization or capillary puncture of the bladder in retention of urine;

• Urgent therapeutic aid (control of initial response to external radiation, introduction of antidotes, etc)

• Introduction of antibiotics under the indications.

The measures of the first doctor’s aid which can be deferred includes:

• Remaking of bandages and improvement of transport immobilization;

• Conducting of novocaine blockade and introduction of pain-killers in injuries of moderate severity;

• Administrating of antibiotics, tetanus anatoxin, antitetanus and antigangrenosus serums and other medicines, delaying and preventing the infection in the wound;

The complete volume of the first doctor’s aid includes urgent measures and measures, which realization can be deferred.

The reduction of volume of the first doctor’s aid is carried out at the expense of measures of the second group.