Steps/methods
1. On-site organization: the rescue team is organized temporarily and under unified command. In order to avoid panic, you should immediately put out the fire or eliminate all the causes of the fire, such as turning off the engine, cutting off the power supply, moving flammable materials, sending people to the emergency center for help, etc. Assign personnel to protect the scene of the accident and maintain order. Carry out self-help and mutual rescue, classify injuries and rescue them in time. 2. Classification of ambulances:
Timely rescue the wounded according to their priorities.
For critically ill patients and patients with cardiac arrest, cardiac compression and mouth-to-mouth resuscitation should be performed immediately.
If the injured person is found unconscious, it is recommended to remove dirt, vomit, dentures, etc. Take things from the mouth and nose of the injured person with handkerchiefs and fingers, and then let the injured person lie on his side or stomach to prevent the vomit from blocking the airway and causing suffocation.
If the internal organs of the injured are exposed from the wound, they can be covered with clean cloth, clean plastic bags and other items, and then bandaged. It is forbidden to insert them directly into the body cavity.
If it is suspected that the injured person has broken limbs, it can be bound and fixed with splints and wooden sticks. When moving the injured person, bend with the curve, and don't force the injured person's bent limbs to move in a straight line. If spinal injury is suspected, the injured person should be lifted horizontally when moving to avoid paraplegia. If neck injury is suspected, stabilize the head and strengthen the neck.
Stop bleeding immediately and bandage the bleeding person. If the limbs bleed, the bleeding site can be raised.
If open pneumothorax is found, it should be tightly sealed and bandaged. For patients with tension pneumothorax with dyspnea, a puncture exhaust or drainage tube can be placed at the intersection of the second rib and the clavicle midline if conditions permit. The fracture has healed. Those who have difficulty breathing, lack of oxygen, chest injury and chest wall floating (abnormal breathing movement) should be filled with clothes and cotton pads immediately. Proper pressure dressing to limit floating.
If the injured person's limb is stuck in a certain part of the car and there is a lot of bleeding, then the bleeding part should be bandaged to stop bleeding. If the limb is broken, the residual limb should be sent to the hospital with the wounded. It is best to put the broken fingers and toes in a clean plastic bag or wrap them in a clean cloth. If possible, put them in a warm bottle with ice. 3. Correctly handle:
In any case, ambulance personnel should pay special attention to prevent cervical dislocation and spinal cord injury, and pay attention to:
(1) Before moving or leaving the seriously injured, put a neck brace or fix the neck on the grass to prevent cervical dislocation, spinal cord injury and high paraplegia. At present, if there is no neck support, cardboard, rubber and thick canvas can be used to imitate the neck support, cut into two pieces and fixed with cloth strips.
(2) For the injured who fainted in the chair, after placing the neck brace, the neck and trunk can be fixed on the backrest, and then the chair can be removed together with the injured.
(3) For the critically ill and comatose wounded who are thrown up from their seats, they should put on a neck brace and bandage the wound. Then according to the principle of spinal injury, several people carry the wounded together. The movement should be gentle, supported by the waist and buttocks, and the strength of the carrier should be even, and it should be placed flat on the board or stretcher. After the first aid, the wounded will be transported by ambulance in priority order. Never stop at the scene to transport critically ill patients, otherwise, due to the lack of special rescue equipment for other vehicles, most of the injured people adopt incorrect half-sitting, half-lying and side-lying postures. This aggravated their injuries and even killed them on the way.
Taking correct measures and nursing the wounded in time is the key to rescue the wounded. But in reality, it is often found that some people use some wrong rescue methods when rescuing the wounded, which is more common in places far away from towns.
Matters needing attention
1. Forced reduction during fracture
This is very dangerous, because the broken end will destroy the surrounding tissues, causing new injuries, bleeding and infection. The broken ends should be covered with clean cloth, and the limbs should be fixed to avoid relative movement. Remember to take as few patients as possible to prevent brain and spine injuries. When you have to carry them, you should put them flat, not on your back.
In addition, for some small closed injuries, subcutaneous bleeding, that is, common swelling and bruises, people are always used to rubbing, thinking that this can relieve pain. In fact, friction actually aggravates internal bleeding, and the bleeding blood makes the surrounding tissues more swollen and painful. The correct method is to give cold compress (within 24 hours after injury) to make local blood vessels contract, reduce nerve sensitivity and achieve analgesic effect.
2. Rub iodine and alcohol on the broken limb.
If your hand or finger is broken, try to keep it so that the doctor can replant it as much as possible. However, some people don't know how to protect amputation. If they scrub the severed limb with disinfectants such as iodine and alcohol, or soak the severed limb in alcohol or formalin for "thorough disinfection", the cells will be severely degraded and cannot be replanted. Don't soak the severed limb in low permeability or high permeability physiological saline to prevent tissue cells from breaking or shrinking. Do not heat the severed limb to keep warm, so as not to accelerate tissue degeneration and make replantation fail.
The correct treatment is: wrap the broken limb with sterile gauze or clean cloth, put it in a plastic bag or a non-porous plastic bag, and don't put anything else in the pocket, then tie it tightly. Freeze the ice around the pocket (or use popsicles or ice cream instead) to achieve the purpose of cold storage. Pockets must be strictly checked. If there is leakage or crack, ice water will penetrate into the broken limb, inevitably penetrate into the tissue, damage the cells, and lose the possibility of successful replantation.
3. Wrap the wound with dirty cloth.
It is a misunderstanding to think that if you don't dress the wound, you will get tetanus as soon as you catch the wind. Tetanus is caused by a wound infected with tetanus Bacillus. Tetanus is an anaerobic bacterium, which is easier to breed in an unventilated environment. If the unsterilized wound is tightly covered with airtight adhesive tape and plastic sheet, it will increase the possibility of tetanus. The purpose of dressing the wound is to stop bleeding and avoid further collision and pollution of the wound, so it cannot be wrapped with dirty cloth.
4. Apply medicine and liquid medicine to the wound.
In fact, sulfanilamide powder and Yunnan Baiyao can't stop bleeding and disinfect, but become foreign bodies in wounds, increasing the chance of pollution and hindering healing; Iodine coating will make the wound cell protein coagulate and necrosis, which is difficult to heal. Applying purple medicine and red medicine will blur the wound and make it inconvenient to observe the wound; The astringent effect of purple medicine is greater than disinfection. The surface of the wound coated with purple medicine is crusted, but there may be pus below. The disinfection effect of mercuric chloride is also very weak. It also contains mercury, which is absorbed by the human body through damaged tissues. If iodine is used at the same time, mercury will generate mercury iodide when it meets iodine, which is harmful to human body.
The correct way is to wash the wound and its surroundings with boiled light salt water at the early stage of injury. Superficial skin abrasions may wish to bask in the sun and do ultraviolet disinfection.
5. Stop bleeding with inelastic materials.
The tourniquet should be made of elastic material, not rubber tube, but tied with rope, thread and iron wire, which will cause ischemia and even necrosis of healthy tissue. The tightness of tourniquet should be appropriate to avoid bleeding. Insufficient blood supply to injured limbs can easily lead to infection, and too tight tourniquet or too long time can cause gangrene of limbs, toxic shock and even amputation.