Category Archives: First aid knowledge

Nursing care of large hemorrhage

Nursing care of large hemorrhage

Nursing care of large hemorrhage
1, internal bleeding: head, thorax, and abdomen by a violent blow or injured, there is internal bleeding, the injured were rushed to hospital for treatment.
If there is doubt that the bleeding of the injured in the treatment to do the following:
1, fasting and prohibition of drinking water.
2, the patient lie down, keep quiet, covered with a light quilt warm.
3, head to the side, keep breathing smooth.
4, immediately rushed to the hospital.
2, trauma, hemoptysis, hematemesis and bleeding: should call an ambulance to the hospital for treatment as soon as possible. As a result of pale skin, cold sweats, shortness of breath and shock, that in critical condition, should pay attention to.
How to measure body temperature
The common methods of body temperature measurement are three kinds of methods, the method of oral measurement, the measurement of the armpit and the measurement of the anus. No matter what kind of measurement method, the measurement should be in the temperature of the mercury column in the table below 35 degrees celsius.
Method of measuring body temperature
L, underarm measurements method dry patients under your armpit sweat, thermometer gently released the axilla in patients, the mercury ends in axillary top, let patients clamping axillary. After five to ten minutes out, in the light distribution at the cross with thermometer, and slowly rotating, observation of horizontal position of the mercury column where the scale. Under normal temperature, the body temperature was 36 ~ 37.
. measurement of oral disinfection and drying temperature table, the head of mercury in a thermometer side put in patients with tongue, let patients with closed lips (Note: do not bite, do not speak, to avoid temperature table is crushed or shedding), 3 minutes, remove, view method is Alexandrine method. Normal person’s oral temperature is 37.2 ~ 36.2.
3 anus measurement method to measure the temperature of the anus to use a special purpose of the anus thermometer, the general family less, more for children. When the temperature is measured, the thermometer will slowly be inserted into the anus 4 ~ 3 cm, the time of measurement is better to extend slightly. 1 minutes of measurement, 3 minutes, 3 minutes, 5 minutes. Wash the thermometer with soap and water after use. But diarrhea, constipation, children do not use this method.
Note
1 if you have a fever in the afternoon, you must add the temperature 1 times during the night, second days after getting up in the morning, and then add the temperature 1 times. Interruption and treatment.
2 to measure the body temperature to be recorded, provided to the doctor, so that the doctor for the correct diagnosis and treatment.
3, after the use of the thermometer, the best use of 75% alcohol disinfection. The patient with infectious disease should be disinfected with a thermometer.

How to stop bleeding

How to stop bleeding

How to stop bleeding
Adult weight per kilogram of about 80 ml of blood. Body weight is 60 kg, the body blood is about 4800 ml.. A large amount of bleeding, blood vessels within the circulation of blood, the body is in a state of ischemia and hypoxia condition if the bleeding is too much, there will be life-threatening, must be blood transfusion. If the amount of bleeding accounted for 15% to 25% of the whole body blood, there will be hemorrhagic shock and bleeding volume accounted for 25% to 40% of the whole body blood, it is more dangerous, to rapid blood transfusion. In addition to blood transfusion, the bleeding is also very important.
1 stop the bleeding point oppression hemostasis method with the fingers of the blood supply artery to stop bleeding. The compression point is called the stop point. The bleeding point should be closer to the heart than the wound. Specific hemostasis points are as follows:
(1) the thumb pressed in the scalp in front of the upper ear bones, usually can touch the arterial pulse.
1, the superficial temporal artery point to massage the ear in front of the root of the zygomatic arch.
2, massage the posterior auricular artery oppression point between ear and mastoid.
3, occipital artery point to the mastoid pressure inside the root.
(2) the face of the thumb press Chin (Chin) in the middle of the lower margin of the L in front of the chewing muscles, normal people can touch the pulse of the artery.
(3) neck thumb flexion in the posterior cervical, the other 4 finger in the back of the neck, to force the direction of thumb of oppression.
(4) in the chest and under the armpit: the thumb is placed on the top of the clavicle, forced to press.
(5) of the wrist: the 4 fingers on the inside of the arm, and the brachial artery in the depression of the muscle.
(6) hand: thumb pressing on the inside of the wrist, the direction of the head of the bone force. Finger bleeding, available acupressure hemostasis.
(7) of the lower extremity: the heel of your hand pressed in the thigh roots bulky muscles Sag (the midpoint of the groin slightly below), to the head direction force oppression, or with both hands finger.
(8) foot: the anterior and posterior tibial artery of the anterior tibial artery.
Anterior tibial artery point for fibular head medial 2,5 cm to internal and external ankle front line midpoint of posterior tibial artery pressure point is between the calcaneal tuberosity and the medial malleolus.
2 direct compression hemostasis method (bleeding site of oppression)
(1) the use of sterile gauze or clean fabric, paper, etc., and then press.
(2) the injured arm or the lower limb is higher than the heart.
(3) with a bandage tightly wound, but not too tight, to prevent tissue necrosis.
The 3 packing method is suitable for the large and deep wounds of the neck and arms.
(1) first, the use of the tool will be sterile gauze in the wound, to stop the bleeding can be more than a piece of gauze.
(2) press the gauze.
(3) with a bandage or a triangle, the neck is wrapped around the upper arm.
4, tourniquet applies only to extremity arterial hemorrhage, generally used in compression bandage is invalid. If no special tourniquet, triangular scarf, scarf, tie, towel can also throw a generation.
(1), a strip of 5 centimeters wide (too narrow, too narrow, of the injured nerve and artery) is folded into a long strip of the wound.
(2) folded into small pieces and placed in the compression of the arterial blood vessels of a handkerchief.
(3) a tourniquet cannot be embedded in the joints, can be tied at the top of the. If applying a tourniquet is not too thick, underwear parts of the belt can be tied in the underwear outside.
(4) tourniquet wound in the arm or on the old, tight around 2 weeks, half a knot.
(5) put a strong stick in the 20-30 cm long knot. Lay a solid knot in the bar.
(6) twist stick tightening tourniquet, until the bleeding so far.
(7) if the bleeding has stopped, the excess available tourniquet or other items to stick strip fixed in place.
Standard pressure tourniquet upper limb 33.3 ~ 40000 kPa, lower 53.3 ~ 66700 PA.
Note
1 small and narrow rope, with a band can destroy the subcutaneous tissue and nerve, prohibit the use of!
2 pen will do mark on the patient’s forehead at the tourniquet or write with tourniquet time, rushed to the hospital. Principle of dagger should be as short as possible to tie tight tourniquet time, the length of not more than three hours, if more than 1 hour should be relaxed 1 ~ 2 minutes, to prevent the necrosis of the distal limb ischemia.

Configuration of home emergency case

Configuration of home emergency case

Configuration of home emergency case
In our daily life, in addition to the need to master the necessary emergency measures, the family should also often every one of the first aid box, this will bring a lot of convenience to your life.
Configuration method
1, home to prepare some sterile gauze, bandages, plasters, trousers and so on, these things often used in emergency. If there are conditions, the best preparation has a length of 1 meters of the big triangle.
2 thermometer is the need to prepare the gage. Medical scissors, tweezers corresponding to complete disinfection, before use water or alcohol.
3. Configuration tincture of iodine, gentian violet, red syrup, burn ointment, eye ointment, antipruritic oil cooler, Shangshi Zhitong ointment and band aid and 75% alcohol substandard drugs.
4 configurable antipyretic, analgesic, anti diarrhea, anti carsick, general anti-inflammatory drugs and digestive medicine etc..
Note
1 the configuration of the family first aid kit should be based on the specific conditions of the family members, should vary from person to person. Such as antipyretic drugs, the best configuration of adults with children and with two, because of the different kinds of the dose and drug for children and for adults.
2 patients with general disease in the use of drugs, can be in accordance with the instructions of the method and dosage. Children, the elderly, the frail or have a special condition of the patient, when taking the drug should follow the doctor’s advice.
3 family emergency medicine should be regularly checked and replaced, to be placed in the ventilation and shade, so as not to lose efficacy, or deterioration of the human body cause damage.
How to judge venous bleeding and arterial bleeding
To observe the wound bleeding and bleeding color. From the wound continued to gush dark red blood for venous bleeding, venous bleeding will not appear a lot of bleeding; arterial bleeding, the wound spray red blood, and the pulse of the intermittent injection synchronized with the pulse, a short time can make a large amount of blood flow within the.

Cardiopulmonary resuscitation program

Cardiopulmonary resuscitation program

Cardiopulmonary resuscitation program
Breathing, shake the patient, if there is no response, can choke people, at the same time, Hegu rescue measures. Time no more than 10 seconds.
Call for help
To identify patients with loss of consciousness. Should immediately call the people around to help and call the phone 120″.
Supine position (CPR)
Assistance in support of patients with head and neck, on the other hand bypass patients with shoulder, integral turning of the body, making it to supine pillow on a hard surface, straighten the legs to rescue. If the patient is in a coma, they should move according to the normal movement.
There is no doubt that there is a neck and spine injury, and can not be moved when the head and neck and body.
Unobstructed respiratory tract
Clean up the mouth of the foreign body, such as rejection, blood, teeth etc..
There are several ways to open the airway:
1, head and neck lifting method: hand in hand in another patient’s forehead to the neck, head back.
2. Please look up and have a look and jaw lift: upward lift neck method cannot open the airway can be removed in neck in food, middle finger placed in the mandibular and elevates the lower Lai first teeth bite and fetal so far. For infants and young children, it is not too much to the head back, only with an index finger to raise their jaw.
3 both hands to lift the hands to grasp the mandibular angle will be brought under the chin.
For respiratory tract obstruction cause cervical deformity or suspected with cervical spine injury, although not the right move can lead to permanent paralysis in, but respiratory tract obstruction can immediately lethal. Therefore, emergency first step is still the mandible in the palm, open airway.
For the consciousness not clear, also can be pulled out to open the tongue.
Check for breath
Rescuers were close to the nose and ear, head to the side ipsilateral chest, no more than 5 seconds.
1, with the eyes of the patient’s chest, there is no ups and downs.
2 use the ear to listen to the respiratory tract has no air flow through.
3 use the painting department to feel the respiratory tract has no gas discharge. The patient has ups and downs, but ears to listen to the cheek and feel no gas through the nasal cavity can be judged as no breathing. Note, if the patient is still breathing, should take a coma.
Line artificial respiration
Don’t waste time looking for someone or a loose clothing, unless the patient’s breathing stops due to the neck is caused by a bunch of! But should immediately carry out artificial respiration, breathing stops after 6 minutes to perform artificial respiration, the possibility of recovery is very small.
1 mouth to mouth breathing
(1) open the airway and hold the patient’s nose. Under the condition of open airway, the patient’s nose is pinched by the hand of the pressure, and a deep breath.
(2) blowing. In strict patient’s mouth slowly blowing hard 1 ~ 5 seconds, 2 times better. Don’t let the gas leak from the patient’s mouth. The chest for effective blow ups and downs. The first time after blowing the chest back to the original position is second times of blow. After blowing fast with mouth out, let go of the nostrils, whether patients.
(3) patients hold the nose, then blowing.
(4) for upward lift jaw, raising the upper and lower teeth to bite the fetal mandible, pinch the nose blowing. 2 mouth to nose breathing in patients with facial injuries may not blowing the gas in the mouth, mouth to nose blowing way can.
2, mouth to nose artificial respiration
Patients with facial injuries may not blowing the gas in the mouth, mouth to nose blowing way can.
Take a deep breath and use the mouth to the patient’s nose, the patient’s jaw raised to make its mouth closed, forced to blow people in the nasal cavity, and then remove their mouths, the patient’s mouth opened with a hand to make gas overflow.
3 mouth to mouth breathing
If severe injury for infants and children, please blow mouth to nose. The amount of blowing to children above the navel abdominal area should be expanded. Should pay attention to the implementation of artificial respiration
(1) the first artificial respiration blowing two.
(2) the pulse is checked after two consecutive artificial respiration.
(3) single site recovery, 15 times per chest compressions, two blowing mouth, namely 152 double recovery chest compressions each 5 times of a blowing mouth, namely 1 5 heartbeat breathing when every 5 seconds a blowing mouth, blowing per minute 12 to 16 times.
Check for a pulse
Check the pulse time should be less than 5 seconds. The ambulance was placed on the forehead of the patient to keep the airway open, while the other hand gently touched the carotid artery or femoral artery (mostly carotid). The infant neck is short and fat, should check the elbow artery or femoral artery.
Have a pulse duration of mouth to mouth breathing until the ambulance arrived. Pulselessness used to open the airway, repeatedly perform artificial respiration and heart pressing.

Cardiac compression
L, precordial percussion once confirmed cardiac arrest, immediately to the “hollow fist. In the press position in 30 ~ 50 cm in height, with 50 Newton power vertically thumped the area before the heart is 1 ~ 2 times. , this method is effective for 1 minutes of cardiac arrest.
2 to find the heart of the rescue of the patients on the side of the chest, hand food, in the middle of the ribs from the beginning (as shown in the direction of the arrow) to the abdomen of the central (Jian Tu) moved to the lower end of the chest, take the middle and lower 1/3 junction (Jian Tu on the 2 cross refers) for the heart press.
3 palm root on the press area, both hands overlap and tilt, the fingers without compression of chest wall.
4. Treatment arms stretched straight and perpendicular to the ground, shoulder, elbow and wrist in a straight line, using the power of the upper body weight and arm muscles, shoulder, smooth, rules, vertical downward pressing force, adult in the compression depth for 4 ~ 5 cm, children for 2 ~ 3 cm. Press to the lowest point when there should be a significant pause, relax when the palm not to leave the chest wall, until the chest back to the original can be completely relaxed, and in this position repeatedly press.
5 pressing speed is 80 ~ 100 times / min, the compression time and relaxation time is equal to the rhythm.
6 newborn infants, infants press one hand back, the other hand two fingers oppression of the chest to do heart compression, 110 to 100 times per minute, the child is small, the faster the press frequency, the pressure from 2 to 3 cm. Press to relax completely, both hands remain in place, can not leave the chest wall.
Preschool children should be single hand pressing, pressing the frequency of 100 to 80 times per minute, the pressure from the distance of 4 ~ 3 cm.
Newborns, infants, preschool children with chest compressions and respiratory ratio is 5 times more than 1 times (51).
.7. cardiac compression and mouth to mouth breathing to continue to the full recovery of respiratory and pulse or medical personnel to reach.
Transfer medical institution
At the same time, the need to continue to carry out emergency senior life support.

Learn to judge critical emergency

Learn to judge critical emergency

Learn to judge critical emergency
Learn to judge the emergency is to really make the dying persons can get site timely and necessary emergency rescue. At the same time as soon as possible to inform the first aid center, first aid station, near the medical institutions of the pediatrician or family doctor to come to the emergency, so as not to delay the disease.
Emergency performance is dying but differ in thousands of ways, has its own characteristics, in general can be from the following four aspects to identify.
Look at the overall situation of the patient
Patient’s condition. At a glance, such as severe trauma, bleeding, giving a person with the feeling of dying, some need to be carefully identified, because it may give people a false impression.
The general need to distinguish patients sanity. It is usually called concepts or gently patient body, observe whether there is reaction. Was still awake patients in the call and will gently push the eyes open or have other effects. If no response is that patients, loss of consciousness, is in critical condition. The patient suddenly fell to the ground, call it should not, then the situation is very serious, need to actively rescue. In addition to the patient’s mind, others such as the patient’s complexion, limb whether activity can reflect the severity of the illness. Pale or purple, cold sweat, limbs can not move, lips, nail cyanosis, are critical illness.
Severe trauma, in addition to pay attention to determine whether there is active bleeding, but also special attention to identify the head, spine injury, because these injuries may endanger life or cause serious sequelae.

Examination of the patient’s pupil
The pupil also called black eye pupil, is located in the central. Under normal circumstances, the pupils of the eyes are large, round (cataract, glaucoma, keratitis except), encountering strong light will rapidly shrinking, again a few minutes gradually return to original (with the flashlight suddenly irradiation a pupil can be observed pupillary reaction).
When the patients with brain injury, cerebral hemorrhage, severe drug poisoning, pupils may narrow as the tip size may also extend to the edge of the black eye, to light not responsive or unresponsive sometimes because of brain edema and hernia of the smallest in the pupils of the eyes, the change of pupil suggests the severity of brain lesions. In the rescue, the doctor also often observe the pupil changes in order to understand the disease is in the improvement or deterioration.
When the patient’s pupil is gradually enlarged and fixed, the light reflex disappears, it indicates that the patient has been in a “clinical state of death.
Check the heartbeat, pulse
Heartbeat is the existence of the phenomenon of life, the normal heart beats per minute 60-80 with breathing stops, the heart stops, or is the heartbeat, breathing at the same time to stop. Heartbeat is reflected in the wrist is the pulse. The heart stopped and the pulse was too. The heartbeat is very weak or irregular, the pulse is also touched or not easy to touch.
Severe acute myocardial infarction, arrhythmia, and severe trauma, bleeding and other life-threatening, heart rate or faster, more than 100 times per minute, or 40 times per minute, to 50 times or irregular, suddenly and then slowly, suddenly strong and weak. When the heartbeat is above these cases, often the heart for help signal, should pay special attention to. There are other ways to check the heartbeat. Such as observation of the left-hand side of the chest and heart beat, or by the side of the hand on the chest wall hit, but in weak heartbeat or stop when this method is invalid. Equipped with a stethoscope to try its heartbeat. In the folk, indirect method of inspection is to touch the pulse of the heart. The most common touch is the radial artery at the wrist. When the patient is dying, weak pulse, it is not easy to touch, can be replaced by a method of touch the carotid pulse and femoral artery pulsation. The former is located in the neck on both sides of the flat of his Adam’s apple, which is located in the middle thigh. Critical if unable to ascertain heart whether to stop pulse in the Qing, do not repeatedly check delay time, and should actively carry out cardiopulmonary resuscitation (CPR) or by other methods timely rescue.
Respiratory activity
Breathing is a sign of the existence of human life. The baby born first cry, which started the new life of the first breath. Since then, breathing with the entire life of the people, until the last moment of life.
Normal people breathe 12 ~ 18 times per minute. Critically ill patients breathe faster (30 to 40 times per minute), light or irregular, tidal breathing (tidal breathing is a kind of abnormal breathing form, it is the two process is a shallow breathing, breathing shallow slow two breathing pause), the second tidal breathing sustained 5 ~ 30 seconds, so repeatedly, similar to the tide of the lake falls, a serious respiratory function. A similar situation can occur when the individual elderly in deep sleep. Before the patient died, breathing slowly (6 to 8 times per minute), irregular, a sigh, until the breath stops. In the event of an electric shock, breathing is usually stopped suddenly.
Check breathing, usually observe the patient heart undulating situation, so that is not breathing. But when the patient has been in a very failure, critical, respiratory movement was weak, chest heaving imperceptible. In this case, we can use a thin slice of leaf, or cotton, silk wadding, a piece of paper and so on, put in front of the nostrils of patients, observation of blade with the breath flowing to determine the presence of respiratory, breathing is normal. If you find that the breath stops, the artificial respiration should be performed immediately.
In short, the identification of the above four aspects of the situation, to help us understand the extent of the patient’s critical. In addition, there are many other ways to judge the disease, but in an emergency situation, the non professional staff can not grasp the patient’s condition, after the initial judgment, should immediately take a simple and feasible rescue measures, and call the emergency center.