FIRST AID FOR ELECTRIC SHOCK

Defeat electric shock occurs when a current of 0.06 A or more passes through the human body. A current of 0.1 A is fatal for humans.
Human resistance to electric current is a variable value and depends on many factors, including human fatigue and mental state. The average value of this resistance is in the range of 20-100 kOhm. Under particularly unfavorable circumstances, it can drop to 1 kOhm. In this case, a voltage of 100 V and below will be dangerous for human life.
The amount of current passing through a person depends on the resistance of his body. At low voltages, resistance mainly depends on the condition of the skin. In the CIS, the calculated value of the electrical resistance of the human body is a resistance equal to 1.0 kOhm.
The resistance of the human body also depends on the frequency of the current. It happens to be the smallest at current frequencies of 6-15 kHz.
The passage of current through the heart is especially dangerous. A significant part of it passes through the heart along the following paths: right hand - legs - 6.7%; left hand - legs - 3.7; hand - hand - 3.3; leg - leg 0.4% of the total damaging current.
Direct current is less dangerous than alternating current. So, d.C. up to 6 mA is almost imperceptible. At a current of 20 mA, cramps appear in the muscles of the forearm. The alternating current is already felt at 0.8 mA. A current of 15 mA causes the muscles of the arms to contract.
The risk of injury from direct current and alternating current changes with increasing voltage. At voltages up to 220 V, alternating current is more dangerous, and at voltages above 500 V, direct current is more dangerous.
The more current flows, the less it becomes electrical resistance body and more current. If the action of the current is not quickly interrupted, death can occur.
The degree of damage is also significantly influenced by resistance at the place of contact of a person with the ground. In the case of the passage of current through the victim from the hand to the feet, the material and quality of the footwear is essential.
Electric current can cause serious injury, including cardiac arrest and respiratory failure. Therefore, you need to be able to provide assistance to the victim before the arrival of the doctor.

Release of the victim from the current.

First of all, it is necessary to quickly release the victim from the action of the electric current, i.e. disconnect the current circuit using the nearest plug connector, switch (switch) or by unscrewing the plugs on the shield.
If the switch is far from the scene of the incident, you can cut the wires or cut them (each wire separately) with an ax or other cutting tool with dry insulating handle.
If it is impossible to quickly break the circuit, it is necessary to pull the victim away from the wire or throw the broken end of the wire away from the victim with a dry stick.
It must be remembered that the victim himself is a conductor of electric current. Therefore, when releasing the victim from the current, the caregiver must take precautions so as not to be energized himself: put on galoshes, rubber gloves or wrap his hands in a dry cloth, put an insulating object under his feet - a dry board, rubber mat or, as a last resort, rolled dry clothing.
Pull the victim away from the wire by the ends of his clothing; you must not touch open parts of the body. When freeing the victim from the current, it is recommended to use one hand.
If it is on a ladder, stand, or other device, measures must be taken to prevent injury or fracture from a fall.
If a person is exposed to voltages above 1000 V, such precautions are not sufficient. It is necessary to contact a specialist who will immediately relieve stress.

First aid to the victim

First aid measures depend on the condition of the victim after release from the current.
To determine this condition, you must:
- immediately lay the victim on his back;
- unfasten clothes that are restricting breathing;
- check on the rise of the chest, whether he is breathing;
- check for the presence of a pulse (on the radial artery at the wrist or on the carotid artery in the neck;
- check the condition of the pupil (narrow or wide).
A wide immobile pupil indicates a lack of blood circulation in the brain.
Determination of the victim's condition should be carried out quickly, within 15 - 20 seconds.
1. If the victim is conscious, but before that he was fainting or was under an electric shock for a long time, then he must be provided with complete rest until the arrival of the doctor and further observation for 2-3 hours.
2. If it is impossible to quickly call a doctor, it is necessary to urgently deliver the victim to a medical institution.
3. In a serious condition or lack of consciousness, you need to call a doctor (ambulance) to the scene.
4. In no case should the victim be allowed to move: the absence of severe symptoms after the injury does not exclude the possibility of subsequent deterioration of his condition.
5. In the absence of consciousness, but still breathing, the victim must be comfortably laid down, an inflow fresh air, give ammonia to smell, spray with water, rub and warm the body. If the victim does not breathe well, very rarely, superficially, or, conversely, convulsively, like a dying person, artificial respiration should be given.
6. In the absence of signs of life (breathing, heartbeat, pulse), the victim cannot be considered dead. Death in the first minutes after the defeat is apparent and reversible with assistance. The affected person is threatened with the onset of irreversible death if he does not immediately receive assistance in the form of artificial respiration with simultaneous heart massage. This activity must be carried out continuously at the scene until the arrival of the doctor.
7. The victim should be carried only in cases where the danger continues to threaten the victim or the person providing assistance.

Artificial respiration

Artificial respiration begins immediately after release from the electric current and is carried out continuously until a positive result or indisputable signs of actual death (cadaveric spots and rigor mortis) appear. There have been cases when, after an electric shock, people were returned to life only after a few hours of continuous assistance. The doctor determines the feasibility of continuing the measures taken.
Before proceeding directly with the procedure, it is necessary to quickly release the victim from everything that constrains breathing: open the collar, loosen the belt, etc.; quickly free your mouth from mucus and foreign objects, such as removable dentures. If the jaws are tightly clenched as a result of spasms, four fingers of both hands are placed behind the corners of the lower jaw under the ears and, resting their thumbs on the jaw from below, push it forward so that the lower teeth are in front of the upper ones. If this method fails to open the mouth, carefully so as not to break the teeth, a plaque, metal plate, spoon handle or other similar object is inserted between the back molars and with their help the jaws are opened.
The technique of blowing air into the mouth or into us is as follows. The victim lies on his back. The caregiver before starting the artificial must ensure free passage of air into the lungs through the respiratory tract. The victim's head must be tilted back, for which they put one hand under the neck, and press on the forehead with the other hand. This ensures the departure of the root of the tongue from back wall larynx and restoration of airway patency. When the head is in this position, the mouth usually opens. If there is mucus in the mouth, wipe it off with a handkerchief or the hem of the shirt stretched over forefinger, once again check that there are no foreign objects in the mouth that must be removed, after which they begin to blow air into the mouth or nose. When air is blown into the mouth, the assisting firmly (it is possible through gauze or a handkerchief) presses his mouth to the victim's mouth, and with his face (cheek) or fingers of his hand on his forehead, he squeezes his nose to ensure that all the blown air flows into his lungs.
If it is impossible to completely cover the victim's mouth, air should be blown into the nose, while tightly closing the victim's mouth. Then the rescuer leans back and takes a new breath, and at this time the victim's chest drops and he makes a passive exhalation.
During artificial respiration, it is necessary to ensure that with each breath the victim's chest expands, and also carefully observe his face: if lips or eyelids move or a swallowing movement is noticed, check whether spontaneous inhalation will occur; if after a few moments of waiting it turns out that the victim is not breathing, artificial respiration is immediately resumed.
Air is blown every 5-6 seconds, which corresponds to a breathing rate of 10-12 times per minute. After each inhalation ("inhalation"), the victim's mouth and nose are freed to allow air to escape freely from his lungs.

External (indirect) heart massage

External (indirect) heart massage supports blood circulation both in case of a stopped heart and in case of a disturbed rhythm of its contractions.
For chest compressions, the victim should be placed on his back on a hard surface (bench or floor). Expose his chest: all the embarrassing clothes, the belt are unfastened or removed. The caregiver stands on the side of the victim so that he can bend over him (if the victim is lying on the floor, kneel next to him). Having determined the location of the lower third of the sternum, place the base of the palm (pad) of the extended hand on it. The palm of the other hand is placed over the first and rhythmically pressed on the lower edge of the sternum.
It is necessary to press on the sternum with sharp jerks: in this case, the sternum is displaced down (towards the back) towards the spine by 3-5 cm. The heart is compressed, and blood is squeezed out of its cavity into the blood vessels. The pressure must be repeated about 1 time per second.
You should beware of pressure on the ends of the ribs, as this can lead to their fracture. Do not press below the edge of the sternum on soft tissues: this can damage the organs located in the abdominal cavity, and primarily the liver.
A prerequisite for providing the body with oxygen in the absence of heart function is artificial respiration simultaneously with heart massage. Since pressure on the chest makes it difficult to expand during inhalation, air is blown in during a pause, which is specially observed every four to six pressure on the sternum.
As a rule, two specially trained persons should carry out the revival, each of whom can alternately perform artificial respiration and heart massage, changing each other every 5-10 minutes. This is less tiring than continuously performing the same procedure (especially heart massage).
In extreme cases, help can be provided by one person who alternates artificial respiration and heart massage in the following order: after two or three deep blows of air into the mouth (or nose) of the victim, he performs 15 pressure on the sternum (heart massage), after which again produces two or three deep blows of air and begins to massage the heart, etc.
As a result of the correct implementation of artificial respiration and heart massage, the victim shows signs of improvement: the gray-earthy complexion with a bluish tinge is replaced by pinkish; independent, more and more uniform respiratory movements begin to be established; the pupils are narrowed. Narrow pupils indicate a sufficient supply of oxygen to the brain, and the beginning of dilation indicates a deterioration in blood supply. Then more effective measures, for example, raise the victim's legs by 40-60 cm to promote better blood flow to the heart from the veins of the lower body. To maintain the legs in a raised position, a bundle is placed under them.
Artificial respiration and massage are carried out until spontaneous breathing appears and the activity of the heart is restored. However, the appearance of weak breaths, even in the presence of a pulse, does not provide grounds for stopping artificial respiration. The restoration of the work of the heart is judged by the appearance of its own, not supported by massage, a regular pulse. To check, the massage is interrupted for 2-3 seconds, and if the pulse is not detected, the massage is immediately resumed.
After the first signs of improvement appear, external heart massage and artificial respiration are continued for another 5-10 minutes, so that the blowing coincides in time with your own inhalation.

Electrical injury - damage resulting from exposure to electric current great strength or a discharge of atmospheric electricity (lightning).

The main cause of accidents caused by electric current is violations of safety regulations when working with household electrical appliances and industrial electrical installations. Most of lesions are caused by alternating current of industrial frequency (50 Hz). Electrical injury occurs not only when the human body comes into direct contact with the current source, but also during arc contact, when a person is near an installation with a voltage of more than 1000 V, especially in rooms with high air humidity.

Electric current causes local and general disturbances in the body. Local changes are manifested by tissue burns at the points of exit and entry of electric current. Depending on the condition of the affected person (wet skin, fatigue, exhaustion, etc.), the strength and voltage of the current, various local manifestations are possible - from loss of sensitivity to deep burns. When exposed alternating current with a force of 15 mA, the victim has convulsions (the so-called non-letting current). In case of injury by a current of 25-50 mA, breathing stops. Due to the spasm of the vocal cords, the victim cannot scream and call for help. If the action of the current does not stop, after a few minutes the heart stops as a result of hypoxia and the victim dies. The condition of the injured person at the time of the electrical injury can be so severe that he outwardly differs little from the deceased: pale skin, wide pupils that do not respond to light, lack of breathing and pulse - “imaginary death”. Local damage caused by lightning is similar to damage caused by industrial electricity. Dark blue spots often appear on the skin, reminiscent of tree branches ("lightning marks"), which is caused by vasodilation. When struck by lightning, general phenomena are more pronounced. Development of paralysis, deafness, dumbness and respiratory arrest are characteristic.

First aid.One of the main points in first aid is the immediate cessation of the electric current. This is achieved by turning off the current (by turning the knife switch, switch, plug, broken wires), electrical wires from the victim (with a dry rope, stick), grounding or shunting wires (connect two current-carrying wires together). Touching an injured person with unprotected hands when the electric current is not disconnected is dangerous. Separating the victim from the wires ( fig. 9.1.), you must carefully inspect it. Local injuries should be treated and covered with a bandage as for burns.

Figure: Moving the victim away from the source of electric current with a dry stick.

In case of injuries accompanied by mild general phenomena (fainting, short-term loss of consciousness, dizziness, headache, pain in the heart), first aid consists in creating peace and delivering the patient to a hospital. It must be remembered that the general condition of the victim can sharply and suddenly deteriorate in the coming hours after the injury: there are blood supply disturbances to the heart muscle, phenomena of secondary shock, etc. Similar conditions are sometimes observed even in the affected person with the mildest general manifestations (headache, general weakness); therefore, all persons who have received an electrical injury must be hospitalized. As a first aid, pain relievers (0.25 g of amidopyrine, 0.25 g of analgin), sedatives (ankylosing spondylitis, valerian tincture), heart remedies (Zelenin drops, etc.) can be given.

In severe general phenomena, accompanied by a disorder or respiratory arrest, the development of a state of "imaginary death", the only effective measure First aid is immediate rescue breathing, sometimes for several hours at a time. With a beating heart, artificial respiration quickly improves the patient's condition, skin covering acquires a natural color, a pulse appears, blood pressure begins to be determined. The most effective mouth-to-mouth artificial respiration (16-20 breaths per minute).

After the victim regains consciousness, he must be drunk (water, tea, compote, but not alcoholic drinks and coffee), warmly covered.

In cases where careless contact with the electrical wire occurred in hard to reach place - on a power transmission tower, on a pole - it is necessary to start providing assistance with artificial respiration, and in case of cardiac arrest, inflict 1-2 blows on the sternum in the heart area and take measures to quickly lower the victim to the ground, where effective resuscitation can be carried out.

First aid for cardiac arrest should be started as early as possible, that is, in the first 5 minutes, when the cells of the brain and spinal cord are still living. Help consists in the simultaneous implementation of artificial respiration and external heart massage. Heart massage and artificial respiration are recommended to continue until full recovery their functions or the appearance of obvious signs of death. If possible, cardiac massage should be combined with the introduction of cardiac drugs.

The victim is transported in the supine position. During transportation, close supervision of such a patient should be ensured, because at any time, he may experience respiratory arrest or cardiac arrest, and one must be ready to provide quick and effective assistance on the way. When transporting victims who are unconscious or with incompletely restored spontaneous breathing to a medical institution, artificial respiration cannot be stopped.

It is strictly forbidden to bury someone struck by lightning in the ground! Burying in the ground creates additional unfavorable conditions: it worsens the victim's breathing (if any), causes cooling, impedes blood circulation and, which is especially important, delays the time for providing effective assistance.

Victims who do not go into cardiac arrest after being struck by lightning have a good chance of survival. When several people are struck by lightning at the same time, assistance must be provided first to the injured who are in a state of clinical death, and only then to others who have preserved signs of life.

Prevention of lightning damage: in case of a strong thunderstorm, turn off the TV, radio, stop telephone conversations, close the windows. Can't be in open areas or hide under lonely standing trees, stand near the masts, pillars.

It is necessary to stop the effect of the burn injury factor as soon as possible:

· Extinguish the flame (water, fire extinguisher, etc.);

To reduce pain and subsequent tissue damage, cool the burn site in the first 20 minutes after injury, use cold: cool with ice or other means, water with a running cold water or apply a cloth that has been moistened with it (remember that in young children, prolonged cooling can cause life-threatening hypothermia);

· In case of electrical burns, the source should be removed from the victim with a non-conductive object (wood, rubber, etc.);

· In case of chemical damage, the agent should be diluted with abundant and prolonged water irrigation;

In case of burns with viscous substances (resin, tar, etc.), which are difficult to wash off due to their viscous nature, the resin must first be cooled by rinsing with cold water and brought to a solid state, then the substance itself is removed (carefully so as not to cause secondary mechanical damage ), you can use mineral oil and petroleum jelly for the purpose of partial moistening and softening of the solidified substance (the addition of sorbitant (polysorbate) can accelerate the process of removing a viscous substance by an emulsifying action);

If the injured, on whom the clothes have caught fire, are standing or running, lay them down, because the flame is blown up on the run, and the vertical position of the body contributes to damage to the face, hair, respiratory organs;

• clothes that have adhered to the burned skin are not torn off, but, if necessary, are trimmed around the wounds;

· Clothes that are not burnt, not wet, do not smolder - it is better not to take them off;

· The burned ones must be warmed up, given water (better - with liquid with table salt and baking soda).

The basic principles of providing first aid to those burned at the site of injury (emergency doctor's actions):

· It is necessary to take into account the prevalence and depth of the burn, the presence of combined and combined lesions, concomitant pathology (first of all, it is necessary to stop external bleeding and stabilize fractures in case of mechanical injury);

· The place of the burn is covered with an aseptic bandage, and for widespread burns it is better to wrap the burned one in a clean sheet;

· Inject parenterally (if impossible - per os) painkillers (narcotic analgesics, except for small children and cases of contraindications - the clinic of "acute abdomen", complex diagnostically complex trauma, bleeding, etc.);

With burns of more than 10% b.t. it is necessary to establish venous access as soon as possible (catheterize the peripheral, or, if necessary, the central vein) and begin infusion therapy with saline solutions;

In a state of clinical death as a result of cardiac arrest or breathing (except for cases when the injury is clearly incompatible with life), it is necessary to carry out resuscitation measures (clear the upper respiratory tract, lay the injured person on the floor, conduct a closed heart massage, mechanical ventilation (by hardware method, with impossibility - by blowing air "mouth to mouth" or "mouth to nose");

With severe airway obstruction (with TIT with laryngospasm, bronchorhea, edema), naso- or orotracheal tracheal intubation, mechanical ventilation may be required;

With a frequent pulse of weak filling, low blood pressure, use cardiac, inotropic drugs, glucocorticoids;

If you suspect carbon monoxide poisoning:

· Take the victim to fresh air;

· Free the neck and chest from clothing;

· Bring ammonia to the nose;

· Oxygen therapy, and if necessary - mechanical ventilation, chest compressions;

If there are no conditions for starting anti-shock therapy on the spot, then the victim must be urgently transported to the nearest hospital;

At the site of the injury, it is often necessary to immediately resolve the issue of the need for subsequent transportation of victims:

With small surface burns (up to 10% of the body), with a satisfactory condition and the ability of the injured to move independently, they are sent to the nearest trauma center or clinic;

In case of burns in adults more than 10% p.t. or in children and the elderly more than 5% p.t. there is a need for inpatient treatment and transportation to the burn department, where they will be provided with specialized medical care, anti-shock therapy (if it is impossible or far distance - transportation to the surgical department of the nearest hospital);

· Indications for inpatient treatment are also:

· Burns received at work, during mass injuries and emergencies;

· Burns of the respiratory system, face and neck;

· Burns of functionally and cosmetically important areas (hand, foot, large joints, perineum);

· Burns that are combined or combined with other types of injuries;

· Burns, which are obtained against the background of concomitant severe diseases of the cardiovascular, endocrine, nervous systems, lungs, liver, kidneys;

Before and during transportation:

· Infusion therapy (saline solutions, 5% glucose, plasma-aminter - approximately 1000 ml / hour in adults, 400 ml / hour in children, until more accurate estimates of the area of \u200b\u200bburns and fluid requirements are made);

· To control urine output - bladder catheterization;

· For gastric decompression - nasogastric tube;

· Pain relief;

Warming;

· In the departments of the surgical profile of district or city hospitals, it is possible to carry out complex anti-shock therapy in full, followed by treatment of burned with superficial burns on an area of \u200b\u200bup to 20% of the body;

· Victims with more widespread and deeper burns at the end of the stage of OR are transported to specialized departments of regional hospitals, to regional or republican burn centers;

· In the presence of a specialized brigade of the regional center for emergency medical care, which includes a combustiologist and resuscitator of the IT department for severely burned patients, early transportation of those burned at the stage of OR from local non-core medical institutions to a specialized IT department for severely burned or to the burn department of the regional burn center is possible.

The system of staged treatment of burned in mass injuries implies the following provisions:

· The volume of medical care, the procedure for evacuation and the choice of medical measures depend not only on medical indications, but mainly on the circumstances that have developed as a result of mass trauma (the presence of foci of massive sanitary losses, the sufficiency of the number of medical forces and means);

· Construction of a system of medical and evacuation measures is implemented with the maximum reduction in the number of stages of medical evacuation;

· Clear diagnostics of combined and combined lesions with burns;

· Clear organization and consistency in the provision of surgical care for combined lesions;

· Objectification of the assessment of the severity of the injury and the condition of the injured is provided by the introduction of prognosis criteria;

· Maintaining a unified approach to the treatment of burn wounds;

Giving priority to medical activities emergency care, OR treatment and correction of possible blood loss at all stages of medical evacuation;

· Bringing specialized surgical care to the advanced stages of evacuation;

· A significant role in the treatment of victims of massive injuries with burns at all stages of evacuation should be played by resuscitation and anesthetic care.

It is dangerous to work in electrical installations. Despite the multi-layered protection against erroneous actions of workers when performing switching and renovation works, the risk of being energized still remains. It is especially great for newly hired workers and, oddly enough, for experienced workers with many years of experience. The latter is explained by the dulling of the sense of danger and excessive confidence in their own capabilities.

First aid in case of electric shock should be carried out immediately, because the correctness and speed of action are the means of preserving human life and health. All those working in electrical installations, regardless of their position and occupation, are trained in rescue techniques under the guidance medical worker... Resuscitation methods are being worked out on special mannequins. First aid for electric shock is a topic that is necessarily included in the list of questions in electrical safety exams.

Techniques and means for release from electric current

The human body is a good conductor of electric current. His resistance is not constant, but depends on a number of factors, among which not only the state environment (heat or humidity), but also the processes taking place inside.

With an electric shock, the muscles reflexively contract. The more current passes through the body, the stronger the contraction occurs, and at a certain value, called the non-letting limit, a person is not able to independently release a bare wire or bus under tension. Therefore, first aid for electric shock begins with interrupting the path of current passing through the victim's body. In this case, any available funds and ways.

But before that, using the means of communication, it is imperative to take measures to notify the operational management service of the electrical installation about what happened, where and with whom. They will provide a call to the scene of a medical team and will rush to help themselves. If there is no operational service in the electrical installation, medical assistance is called independently.

Most effective method interrupt the current through the human body - turn off part of the electrical installation. However, shutdown tools are not always available. You can create a short circuit on the tires by throwing a metal object on them so that sparks and an arc do not harm either the rescuer or the victim. In other cases, it is recommended using the means individual protection: dielectric gloves, galoshes, boots, operating rods - tear off the victim from the conductors, for which he is holding. When energized, the victim must be dragged to a safe distance from the place of damage, also using protective equipment.

Assessment of the victim's condition

After the electric current no longer threatens you or the victim, it is required to assess his clinical condition. To do this, find out:

• is the victim conscious;
• does he breathe;
• does he have a pulse.

If the victim is unconscious, but he has a pulse and breathing (even if they are unstable), he must be put on his stomach, cleaned oral cavity with a napkin or handkerchief, and put something cold on your head - a lump of snow or a special cooling bag from the first aid kit. In this position, he must remain until medical assistance arrives.

The presence of a pulse is checked on the carotid artery. In its absence, precious time cannot be wasted on checking the presence of breathing - clinical death has occurred, and the time goes by minutes. It is required to start resuscitation immediately.

Resuscitation measures

Before resuscitation begins, turn the injured worker onto his back. The chest is released from clothes, his belt at the waist is unfastened. The head is tilted back, for which a roller of rolled clothes or soft improvised means is placed under the neck. The jaw should be pushed forward. All these measures are necessary so that the tongue does not block the larynx and does not interfere with air penetration into the lungs. Otherwise, artificial respiration will become ineffective.

Resuscitation begins with a punch in the sternum area opposite the heart. Sometimes this action allows you to start it right away. The pulse is monitored, if it does not appear, resuscitation is continued.

The rescuer is located on the right side of the victim. He places the palms of his hands crosswise one under the other. An indirect heart massage is performed: the chest is pressed at a frequency of 50 - 80 times per minute. The force of pressing should be such that the sternum sags inward by 3-4 cm. You cannot press too much - the ribs should not be broken, otherwise the whole point in resuscitation will disappear. The victim will receive internal injuries, and his death will be inevitable.

If resuscitation occurs with the participation of only one rescuer, then heart massage has to be alternated with artificial respiration. Pressures on the chest are counted, after 15 pressings, two forced breaths of air are made into the lungs.

To do this, the rescuer holds the victim's nose with his left hand, throws his head back with his right hand, inhales air. Then, through a napkin, gauze or mouth-mask, which are part of the first-aid kit, previously placed on the victim's mouth, breathes air into the lungs. It is necessary to monitor the victim's sternum: it should rise. This suggests that the air did not enter the stomach, but the lungs.

After that, the rescuer continues indirect massage to the victim, alternating 15 presses on the sternum with two breaths of air. It is recommended to count the number of clicks aloud in order not to lose the rhythm, as well as to calm the person providing help. Monotonous counting allows you to suppress feelings of fear and anxiety and not lose control.

If two people are involved in resuscitation, then they carry out massage and artificial respiration in turn, being next to each other, on one side of the victim. After five pressures, two breaths are performed for artificial respiration. With the participation of three people, the third raises the victim's legs. This ensures that blood flows by gravity to the heart. The third lifeguard prepares to massage when the partner gets tired. The rescuer doing artificial respiration controls the victim's pulse in the pauses between breaths.

The complex of resuscitation measures continues until the doctors arrive. Only medical workers can give a conclusion that death has occurred and further resuscitation is pointless.

If breathing and pulse appear, the victim is turned over onto his stomach, if he is unconscious, a cold is applied to the head. When consciousness returns, leave him alone, but do not allow the victim to get up until medical attention arrives. Clinical death can occur again at any time, therefore, the victim of the electric current must be sent to the hospital under the supervision of doctors.

Electric shock is the defeat of the body by current, regardless of its strength. With electric shock, there is a concept of imaginary death. This means that visually a person does not show signs of life, but this state is only for the period of direct exposure to stress. Therefore, you need to start by stopping the flow of current.

If a person succumbed to the action of an electrical addition, in no case should he touch him with bare hands, it is necessary to stop the supply of voltage.

1. Ensure your own safety. If you need to remove the wire, wear any dry gloves (preferably rubber). To protect yourself from the transmission of current along the floor, shoes are suitable. Almost any with a rubber sole, so this is not a difficult task. Although the ground does not transmit current flow, when exposed to a high-voltage wire at close range, it can spread due to the high voltage strength.
2. Remove the wire from the victim, if necessary. Then pull the person by their clothes (not by the arm or leg) at a distance of at least 10 meters from the impact site. This is the right moment to call emergency doctors.
3. Now you need to find the pulse in the neck on the carotid artery. It is uncomfortable on the hand due to the fact that the vessel is smaller in diameter and you can not hear through gloves. If the victim is unconscious, check if there is a reaction of the pupils to light (when the upper eyelid is lifted, the diameter of the pupil changes).
4. If the above signs are missing, urgent cardiopulmonary resuscitation measures are needed (artificial respiration and chest compressions). When a person is conscious, the victim is given a position, lying on his side, the top must be covered with a blanket or jacket for warming. You cannot leave such a victim for a minute, but constantly monitor his condition until the doctor arrives. There are cases when, after successful resuscitation, cardiac arrest occurs again.

An electric shock is an unexpected shock to a caregiver. In order not to get confused, it should be noted under what conditions it is possible to receive an effect on the body of great stress.

First aid in one picture:

Release of the victim from the action of the current

1. If live parts, which are under great stress, are in the hands of a person, an uncontrolled maximum contraction of the muscles of the hands occurs. As a result, it is not always possible to pull the wire out of your hands.
2. When a simple touch happens, immediately remove the source or turn off the device. If the above means of self-defense are not observed, the impact will spread to the helping person even in to a greater extent... Nothing should be done until stress is removed.
3. More secure is to turn off the current, rather than just physically eliminate voltage contact with the body

Working at height is a special situation. When the current is turned off, it may fall, adding mechanical impact to the electrical shock. It is necessary to ensure maximum safety not only for yourself in such a situation, but also for the victim.

Carrying out the necessary rescue measures

The help algorithm was already indicated at the beginning.

Now you need to understand in more detail the resuscitation processes:

1. The victim must be laid on his side. You need to put something under your feet to stimulate the outflow of blood and not stop blood circulation. Next, release the chest from clothing.
2. Open a man's mouth and checkwhether the tongue has sunk if it was previously in the supine position. With a loss of consciousness, the position of the tongue is not controlled, therefore, there may be asphyxiation of the airway due to its sinking into the pharynx. If necessary, you need to pull it forward by hand and fix it with your finger. You will still have to turn over on your back for resuscitation.
3. If resuscitation is performed by 1 person, then a constant alternation of chest compressions and artificial respiration (through the nose or mouth) is required. If several people help, then resuscitation will be easier, but you cannot move away from the order. For every 2 breathing stimuli, there are 3-5 powerful clicks (not beats!) In the area of \u200b\u200bthe heart.
4. Even if vital body functions are not restored, you cannot stop stimulating the body. Thus, the body is pumped passively, tissue nutrition does not stop. It is also necessary to monitor the reaction of the pupil to light. If she was not there, but appeared, it is very good sign... This means that the events are being carried out successfully.

Maintaining vital functions

Resuscitation measures without signs of spontaneous breathing are the maintenance of vital functions.

In addition, you need to ensure the overall maintenance of the body:

1. If a person is cold to the touch, it needs to be covered.
2. Burnt areas must remain open, otherwise the pain will only be stronger.
3. Give a comfortable position.
4. For secondary trauma with bleeding, take emergency measures to stop it. It is important to remember that arterial bleeding is a pressurized stream of scarlet or bright red blood. Venous bleeding is pulsating, i.e. blood comes out in jerks and the color is dark. To stop, you need to put on 2 tourniquets. One directly to the cut, if possible. The second tourniquet is tied with arterial bleeding a certain distance above the focus, with venous bleeding below the site of injury.
5. For signs of limb fracture, you need to fix the tire. Any solid, even object to which an arm or leg is tied will do. It is recommended to move a person less if there is a possibility of a spinal fracture.
6. Dislocations do not need to be adjusted on their own without knowledgehow to do it correctly. This condition will suffer until the arrival of a specialist. Because if the bones and joints are not correctly adjusted, you can only aggravate the situation and provoke ligament ruptures or even a fracture.

Assessment of the victim's condition

An accurate assessment of the condition can only be determined by a doctor.

But preliminarily by common features you can distinguish between mild and severe damage:

1. First of allwhether the victim is conscious.
2. The presence of a pulse and its frequency.
3. Signs of spontaneous breathing and its severity (frequent superficial, normal, rare deep, with pathological murmur)
4. The severity of the pain syndrome from the degree of burn. After all, loss of consciousness can be due to painful shock.
5. Presence of secondary injuries (fall fractures, bruises, bleeding, etc.)

All data on these criteria must be reported to the ambulance team. Also, record the time of exposure to current and resuscitation.

What cannot be done?

When first aid is provided for electrical injury, you cannot:

1. Touch with bare hands a current source and its conductors, of the person himself.
2. Prohibited give the victim a sitting or standing position with a relatively normal state of consciousness.
3. Prohibited handle thermal current burns. Under no circumstances apply ointment, folk remedies medicine and ice.
4. Reception drugs at your own discretion is also prohibited. Specialists will provide assistance, and if it suddenly turns out that they have repeated the intake of a similar group of drugs, an overdose may occur. And this is an additional burden on the body. Moreover, it is necessary to clearly understand which of the pharmacological agents can be used in each individual case.
5. If there are no signs of life, you cannot leave the victim. He needs constant resuscitation measures even in the absence of consciousness to maintain blood supply, passive breathing.

Where can a person get an electrical injury?

The place and circumstance of the emergency determine the classification of electrical injuries.

Therefore, where a person may encounter this, it is more convenient to disassemble by it:

1. Manufacturing. The largest share among other types belongs to such injuries. In any enterprise, workers are faced with currents, so there are many options for hitting.
2. Natural. A lightning strike during a thunderstorm is a powerful electrical shock. More often than not, defeat is incompatible with life. However, the resuscitation measures remain the same.
3. Household. When a person is in a private house, and succumbed to an electric current, this is a household injury. But if a specialized electrician received an electrical injury in the same house, then this already applies to production.

You need to be prepared for the fact that in case of a domestic electric shock in the dark, to eliminate the effect of the current, you will have to urgently turn off the electric switch. Therefore, it is worth considering a flashlight so as not to provide assistance in the dark.

Regardless of the method of damage, the same pathological processes occur in the body.

What happens in the body during electrical injury?

human hand after electric shock

Firstly, there is the concept of lightning death, when the strength of the current and the time of its impact turned out to be greater than it was tolerated.

If a person managed to escape, the following processes occur in his body:

1. The first thing that can be seen is thermal burns. At the site of exposure to current, great amount heat, which destroys healthy tissue. It can be superficial and deep down to the bone. The very first ones are affected by the nerves, the walls of small body cavities (for example, the nose), the lens, etc. Burns tend not to spread to large areas of the body, but deep into the tissue.
2. The hallmark of defeat it is the current that is the appearance of a dense scab, which accurately repeats the outline of the cable or wire with which there was direct contact.
3. If the victim's clothing catches fire, typical fire burns occur.
4. To pathological conditions organ systems include: CNS disorder, seizures, loss of consciousness and speech, failure of blood circulation and respiration.

Now you need to dwell on some of the first aid points in more detail.

What should not be done to avoid getting hurt by electric shock?

Human health is in his own hands. It is necessary not only to observe all the instructions yourself, but also to bring them to the people around them.

Victim assistance should not replace the assistance of medical personnel and should be provided prior to the arrival of a doctor. If the victim comes into contact with live parts, you must quickly release him from the electric current. Touching an energized person is life-threatening. Therefore, you need to quickly turn off that part of the installation that the victim is touching. To release the victim from the wire, use dry clothing, a board or some other non-conductive object, or grab his clothing (if dry), while avoiding touching metal objects and exposed parts of the body.

Next, you need to: - lay the victim on his back on a hard surface; - check for the presence of breathing in the victim (determine by raising the chest, fogging the mirror, etc.); - check for the presence of a pulse on the radial side of the wrist or on the carotid artery on the anterolateral surface of the neck; - to 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 mandatory in all cases.

If the victim is conscious after fainting, he should be laid down in a comfortable position, covered with clothing, ensure complete rest, continuously observing breathing and pulse.

If the victim is unconscious, but with stable breathing and pulse, he should be laid flat and comfortably, unbuttoned clothes, create a flow of fresh air, bring a cotton swab to his nose with ammonia, spray your face with water and ensure complete rest. If the victim does not breathe well (very rarely and convulsively), he should be given 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 performed continuously until a doctor arrives. 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 caregiver exhales from his lungs into the lungs of the victim directly into the mouth. The victim is laid on his back, the mouth is opened, foreign objects are removed from the mouth, the victim's head is thrown back, putting 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. Getting on your knees, 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 victim's chest should expand, and after the release of the mouth and nose, it should descend 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 rib fracture. At the same time, external heart massage should be performed in the absence of a pulse.

External (indirect) heart massage is performed by rhythmic compression of the heart through the anterior chest wall when pressing on lower part sternum. Repeating the pressure at a frequency of 60-70 times per minute. The assisting person, having identified 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 like this. To move the lower part of the sternum 3-4 cm towards the spine, and in overweight people - 5-6 cm.

Every 5-6 pressures - one blow. If one person assists, it should be alternated after 2 deep blows - 10-12 pressures to massage the heart.

With proper artificial respiration and heart massage, the victim appears following signs revitalization: - improvement of complexion - the appearance of spontaneous breathing more and more even - constriction of the pupils - the appearance of an independent pulse.

Means and methods of elimination of ignitions and fires

Causes of fires in computer rooms: - sharp drops voltage; - short circuit in the wiring when the switch is not disconnected; - 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:

1. Call the fire brigade immediately by phone 01.
2. Disconnect the light and power supply.
3. Remove the ignition source from the fire,
4. Reduce air access to the combustion zone by insulating the hearth with a fire-retardant cloth, fire-extinguishing powder, sand, chemical or air-mechanical foam.
5. To extinguish a fire in the display classrooms of the department, carbon dioxide fire extinguishers are used. OU carbon dioxide fire extinguishers are designed to extinguish fires various subjects, including email. installations under voltage up to 380 V. To activate 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 handwheel, directing carbon dioxide to the fire.
6. OHP-10 fire extinguishers are used to eliminate small-scale fires. To activate the fire extinguisher, they bring it to the hearth of the fire at the distance of the jet length (6-4 m) and put it vertically on the floor - I turn the handle on the cover "!" up to failure. The fire extinguisher is lifted with one hand by the handle, and with the other it is picked up by the bottom and turned over (with a spray in the direction of the fire). Avoid getting foam in your eyes. If this happens, wash your eyes clean water... Fire extinguishers OHP-10 must not be used when the equipment is energized.
7. Powder fire extinguishers "Moment" are used to eliminate all types of fires. This fire extinguisher can work in cold weather. The fire extinguisher is attached using the bracket with the striker pointing down. When igniting, the fire extinguisher must be taken by the body at the bottom, removed from the bracket, brought to the hearth, shaken and hit with its head on a hard surface, direct a stream of powder onto the burning object.
8. In the event of a fire on an electrical installation, immediately disconnect the equipment and use non-conductive fire extinguishing agents (sand, dry powder extinguishers, fire retardant cloth).
9. When putting out clothes on a person, you need to act according to the specific circumstances. You should not allow sudden movements and run in burning clothes, the flame only intensifies from this. When removing smoldering remnants of clothing, take emergency measures to cool parts of the body; incubate for at least 10 minutes under running water, apply a thick layer of cloth moistened with water, a plastic bag with snow or broken ice... Before medical care isolate the burn surface with an aseptic bandage or clean soft clothmoistened with alcohol.
10. Smoking in the premises is strictly prohibited.