(1) On-site rescue Disaster accident scenes are generally chaotic, and organization and command are particularly important. Temporary on-site rescue teams should be quickly formed to provide unified command and strengthen front-line rescue at disaster accident sites. This is the key to ensuring successful rescue. One of the measures. Avoid panic, shorten the time from injury to rescue as much as possible, and emphasize that improving basic treatment techniques is the most important issue in providing on-site rescue in disaster accidents. Be good at applying existing advanced scientific and technological means to embody the rescue principle of "three-dimensional rescue and rapid response" and improve the success rate of rescue. The principle of on-site rescue is to first save lives and then treat injuries, first to treat serious injuries and then to minor injuries, first to rescue and then to save, and to get out of the accident scene as soon as possible. Everyone should take their own responsibilities and cooperate with each other to avoid delaying the rescue opportunity. On-site rescue personnel should pay attention to their own protection. (2) The first batch of medical personnel entering the scene to evacuate the injured should promptly classify the injured in the disaster accident, conduct pre-evacuation medical treatment, designate the evacuation, and the ambulance personnel can assist in the evacuation, so that the injured can receive necessary medical treatment in the shortest possible time. treat. Moreover, it is necessary to ensure uninterrupted rescue of the critically injured during the evacuation. (3) Hospital rescue: The injured in critical disaster accidents should be sent to hospitals for treatment as soon as possible, and the injured in certain special injuries should be sent to specialized hospitals. 3. Principles of on-site rescue (1) Self-rescue and mutual rescue 1. Emergency call for help When an emergency disaster occurs, you should call 120, 999, 110 as soon as possible to call an ambulance, or the local medical department responsible for emergency rescue. 2. First save lives and then treat injuries, first treat serious injuries and then minor injuries. During the rescue work of an accident, do not be confused by the cries of the lightly injured due to confusion or interference, so that the critically injured are the last to be rescued and are in a dying state. Or have already lost their lives, so we must adhere to the general principle of saving lives first and then treating injuries. 3. Rush first and then save, and save while you are still alive, and get away from the accident scene as soon as possible, especially the scene where a fire can cause an explosion, to avoid explosions or poisoning by harmful gases, and to ensure the safety of rescuers and the injured. 4. Classify first and then send the injured. Regardless of whether the injury is minor or severe, or even severe bleeding, severe lacerations, internal organ damage, or brain injury, if the injured are rushed to the hospital without examination and any medical emergency treatment, the consequences will be very serious. Therefore, we must insist on classifying the injuries first and gathering the injured to rescue areas with the same signs. Some injuries need to be stabilized before they can be evacuated. 5. Medical staff focus on rescuing, while other staff focus on rescuing. They should each bear their own responsibilities and cooperate with each other to avoid delaying the rescue opportunity. Usually the medical staff who arrive at the scene first should be responsible for organizing and directing the on-site rescue. 6. Eliminate the mental trauma of the wounded. All life-threatening stimuli can cause strong psychological effects on people, thereby affecting behavioral activities. The strong stimulation of disasters makes it difficult for some people to adapt mentally. According to statistics, about 3/4 of people suffer from the so-called disaster syndrome of varying severity. Sometimes they lose their normalcy, show a sense of fear, and easily believe in rumors. The mental trauma caused by disasters to the injured is obvious. In addition to on-site rescue and early treatment of the wounded, timely evacuation of the wounded may often alleviate this mental trauma to a certain extent. 7. Rescue measures for injured surfaces: Use techniques such as hemostasis, bandaging, fixation, and transportation. 8. Acute poisoning caused by asphyxiating gas is characterized by suddenness, rapidity and high fatality. Its mechanism is generally believed to be related to acute reactive laryngospasm, reactive bulbar central paralysis or respiratory center paralysis. Rescue personnel should wear protective equipment and perform rescue operations correctly to reduce mortality. 9. Try your best to protect the accident scene (2) On-site injuries, casualty classification and setting up rescue area signs 1. Pay attention to the classification of the injured 2. Set up rescue area signs. This can reduce the blindness of rescue, save time, and more accurately classify the injuries. Organized rescue operations separately and quick access to the "green life safety channel" will help maximize the role of limited medical staff and devote rescue efforts to the wounded who need rescue most. The use of colorful flags to show the location of the rescue area is of great significance and value at the mixed site. Its purpose is to facilitate the accurate delivery of the wounded carried by the stretcher from the classification team to the corresponding rescue team, and also to facilitate the transport of the wounded (Figure 6-1). Category I injury rescue area is displayed with a red flag; Category II injury rescue area is displayed with a yellow flag; Category III injury rescue area is displayed with a green flag; Category 0 injury rescue area is displayed with a black flag.
(3) Transport of the wounded Casual transport is the process of transporting the wounded to a hospital with better medical technology after preliminary treatment on site. When transporting the injured, appropriate transport methods and transporters should be selected according to the specific situation. When carrying the wounded, the movements should be light, agile and coordinated. For transporting the injured who have a long journey, it is necessary to find suitable transportation that is light and has less vibration. Changes in the condition should be closely observed along the way and first aid treatment should be provided if necessary. After the injured person is sent to the hospital, the person accompanying him should explain his condition to the medical staff and introduce the first aid treatment process to facilitate further treatment after admission. 1. Understand the evacuation indications ① The injured and sick should be evacuated under any of the following circumstances: Those whose lives are not in danger during evacuation; those whose injuries have been stabilized after surgery; those who should have received all the medical treatment that should be implemented; those whose injuries have changed; Those whose fractures have been fixed and whose body temperature is below 38.5°C ② Evacuation will be postponed for those who suffer from one of the following conditions: Shock symptoms have not been corrected, those with unstable condition have craniocerebral trauma and intracranial hypertension, and those with possible cerebral herniation have cervical spinal cord injuries. Those with respiratory dysfunction, those with unstable conditions after surgery in the chest or abdomen, those with fractures whose fixation is uncertain or have not been properly handled. 2. In order to correctly grasp the evacuation indications, both the sending unit and the evacuation medical team must check whether the evacuation conditions are met. No one will be sent back later. While triaging, on-site ambulance personnel provide basic life support to the injured and, if necessary, advanced life support. (4) Principles of on-site first aid for patients with complex injuries 1. Accurately determine the severity of the injury. Not only should the involved parts of the injury be quickly identified, but it should also be determined whether the injury directly threatens the patient's life, which requires priority treatment. The order of rescue is generally cardiothoracic trauma-abdominal trauma-craniocerebral injury-limbs, spinal injuries, etc. 2. Remove the injured person from the scene quickly and safely. During transportation, keep the respiratory tract open and the body in a proper position. 3. In case of cardiac and respiratory arrest, perform cardiopulmonary resuscitation immediately. 4. Immediately apply pressure bandage to patients with Lianjia chest. For open pneumothorax, large dressings should be used to seal the chest wall wound. For red force pneumothorax, use a syringe to exhaust accidental injuries. , emergencies generally occur in turbulent and unsafe scenes, and it takes more than ten minutes or even longer for professionals to arrive at the scene. Therefore, as the "first witness", you must first assess the scene situation, pay attention to safety, judge the condition of the injured, prioritize the injuries and illnesses, and carry out on-site rescue as soon as possible without losing any opportunity. The purpose of on-site rescue is to save lives and reduce injuries and disabilities. Under the most important and basic premise of saving lives and preventing further deterioration of injuries, we must also pay attention to reducing the occurrence of disability, alleviating the pain as much as possible, and paying attention to psychological care for those who are conscious, so as to provide better care for the injured in the future. Lay a good foundation for comprehensive physical and mental recovery. In short, we must remember the principle of on-site rescue: save lives first, treat injuries later.