2. The body temperature of normal adults is 36-37℃;
3. The pulse of normal adults is 60- 100 beats/min, which is even and powerful;
4. Normal adults breathe 16-20 times/minute, and the breathing time is equal;
5. Normal adult blood pressure ranges from140/90mmhg (18.6/12kpa) to 90/60 mmHg (12/8 kPa).
6. The pupil diameter of normal adults is 2-4mm, which is completely consistent with the circle;
Hand-held cardiopulmonary resuscitation (CPR)
Hand-to-hand cardiopulmonary resuscitation (CPR) is a rescue technique, which is not a patent of medical personnel, but a first-aid technique that people should be familiar with and master.
Hands-on CPR does not require any medical equipment. Hand-held cardiopulmonary resuscitation is mainly used for patients with sudden death. First, determine whether the patient died suddenly, including sudden loss of consciousness, disappearance of carotid pulse, spontaneous breathing stop, dilated pupils on both sides and so on.
Position: The patient lies on his back on the ground or on a wooden board, with no pillows and other items on his head. This is the correct posture for cardiopulmonary resuscitation. If the patient is prone, he should be turned to the supine position, with gentle manipulation, paying special attention to the head and neck, and must not use too much force. If the patient lies on a soft bed, his back should be padded with boards.
Conscious judgment: no response to the call, no response to the pinch of the middle and Hegu points, and dilated pupils on both sides, it can be concluded that the patient is unconscious.
Pat the injured person on the shoulder (or face) and shout in his ear: "Hello! What's wrong with you? " To test its response.
7. The total blood of normal adults accounts for about 7-8% of body weight.
What is sudden death?
A normal "healthy" person, or a person whose condition is basically stable, suddenly has a heartbeat and respiratory arrest, which is called sudden death.
The World Health Organization defines a case of death within 6 hours from onset to respiratory and cardiac arrest as sudden death. The cause of sudden death is mostly the acute attack of coronary atherosclerotic heart disease. 70% of sudden death caused by coronary heart disease occurred outside the hospital.
Sudden death patients lost consciousness, carotid artery fluctuation disappeared, spontaneous breathing stopped, and bilateral pupils dilated.
Patients with sudden death can be rescued and resurrected. Patients with sudden death should be given hands-free cardiopulmonary resuscitation immediately.
Effective cardiopulmonary resuscitation was performed within 4-6 minutes, and the rescue success rate was 50%.
Open the airway: raise your head and chin. First, clean up foreign bodies (vomit, blood clots, etc.). ) In your mouth, take out your false teeth, put your forefinger and middle finger on your chin with one hand, lift your chin and tilt your head back. After holding the neck with one hand, the degree of head back should be perpendicular to the ground with the line between chin and earlobe. Don't lean back too much.
Judging breathing: seeing, listening and feeling.
Look: whether there are ups and downs in the chest or abdomen.
Listen: Is there breathing sound in the nose and mouth?
Feeling: whether there is air escaping from the nose and mouth.
call for help
The wounded and sick did not respond to the beating and calling, indicating that they had lost consciousness. They immediately shouted for help in the same place: "Somebody! Help! "
If there are others, call the emergency number first and then participate in the on-site rescue.
The scene should try to organize the rescue work of the wounded and sick, and the ambulance personnel should work together.
Mouth-to-mouth artificial respiration: put your thumb and forefinger on your forehead to hold your nostrils, wrap your mouth around the patient's mouth, take a deep breath first, then blow twice, and don't use too much force when blowing. After blowing, the patient's chest fluctuates, indicating that artificial respiration is effective. If the carotid pulse disappears, it can be considered that the heartbeat stops (the carotid artery is located 2-3 cm next to the Adam's apple).
Extracardiac compressions:
Pressing position: in the middle of the chest, under the sternum 1/2.
Pressing frequency: 60- 100 times per minute.
Pressing depth: 3-5cm.
Pressing technique: place one hand under the sternum12, with the palm parallel to the sternum and the other hand overlapping on the back of the hand. Lift the two fingers crosswise, leave the chest wall, straighten the shoulders, and press down with shoulder arm strength.
Precautions:
1, cardiac compression should be performed continuously.
2, vertical downward force, don't swing from side to side.
3. Press down and relax.
4. Don't leave the chest wall when relaxing.
If breathing and heartbeat stop, artificial respiration and cardiac compression should be performed at the same time. When blowing, stop pressing. Don't blow when pressing the heart, the two can be done alternately.
Do it alone: according to the ratio of 15: 2, that is, blow twice first, and then press 15 times on your chest. It goes on and on until someone takes over.
Two people do it: according to the ratio of 5: 1, that is, one person blows one breath and one person presses the heart five times. Stop pressing when blowing. Don't blow when pressing the heart, the two can be done alternately. Until the professional emergency personnel arrive. Call 120 at the same time of self-help and mutual rescue.
On-site first aid
First witness (first responder):
The first-aid scene strongly calls for the "first witness", so what is the "first witness"? That is, after short-term training, I have mastered considerable medical knowledge and even obtained relevant training certificates.
The first-aid scene advocates the first witness for treatment. There are about 200 million people in the United States and 70 million people have received formal first aid training, accounting for about 4: 1. The emergency telephone number in America is 9 1 1, and defibrillators are equipped in public places in America. Norway has included CPR in middle school textbooks. In Germany, you can't stop bleeding, you can't dress up and you can't issue a driver's license. ...
First aid faces all levels of society and involves all corners of society. With the rapid development of modern human civilization and cardiovascular and cerebrovascular diseases, first aid is not only the treatment of bleeding, dressing and other trauma, but also the popularization of cardiopulmonary resuscitation, supplemented by the training of trauma rescue knowledge and skills.
As early as the end of 1980s and the beginning of 1990s, the international medical emergency community formally proposed to the society to carry out the universal training and teaching of "first witness" in order to race against time to rescue the patients whose lives were endangered by critical emergencies or accidental injuries.
In real life, most real cardiac emergencies and other critical emergencies occur outside the hospital, and on-site first aid is a race against time. Before the arrival of medical staff, the "first witness" shoulders a particularly important responsibility.
The purpose and principle of on-site first aid:
1, saving lives and reducing mortality.
2. Prevent the disease from getting worse.
3. Relieve pain, reduce accidental injuries and reduce disability rate.
1, calm and bold, careful and responsible, prioritize and decisively implement the treatment method.
2, first deal with critically ill patients, and then deal with lighter patients; For the same patient, the life should be treated first, and then the local part should be treated.
3. Observe the site environment to ensure the safety of yourself and the injured.
4. Make full use of existing manpower and material resources to assist in first aid.
How to dial the emergency number (120)?
The call for help should be simple and clear, and the language must be concise and accurate. Don't say anything important or irrelevant, so as not to delay precious time. The main contents are as follows:
1, patient's name, gender and age.
2. The most critical condition of the patient at present. Such as fainting to the ground, severe pain in precordial area, dyspnea, massive bleeding, etc. , onset time, process, medication, past history and factors related to this onset.
3. The detailed address and telephone number of the patient's home or site, and the exact address of waiting for the ambulance. It is best to choose a place with obvious eye-catching signs.
4. When accidents, accidents, emergencies, etc. occur. Causing a large number of casualties, it is necessary to explain the nature of the injury, such as poisoning, car accident, drowning, electric shock, etc. At the same time, the number of injured people, the waiting place, and the name and identity of the caller should be stated.
Key points of rescuing patients with angina pectoris
Symptoms:
Cerebrovascular accident (stroke)
Cerebrovascular accidents include: cerebral hemorrhage, subarachnoid hemorrhage, cerebral thrombosis and cerebral embolism.
Symptoms: Sudden attack, including dizziness, headache, vomiting, aphasia, salivation, angular deviation and hemiplegia, and severe coma and incontinence.
Self-help measures: lie on your side, don't move, and lift it smoothly if necessary;
Take off the denture, clean up the foreign body in the mouth and keep the respiratory tract unobstructed. Apply an ice pack or cold towel on the forehead of the patient to reduce intracranial pressure and keep warm;
Monitor vital indicators such as pupil, respiration, pulse and blood pressure, and take oxygen if possible;
Emergency call 120.
Prevent sudden death of the elderly
Sudden death refers to unexpected sudden death without any warning in advance. Some actual cases of sudden death mostly occur in the following situations:
Strenuous exercise: In our daily life, we will encounter cases of sudden death during running, swimming and other sports.
Syncope and fall: Some people get up at night to urinate and fall to bed and die. This is due to the increase of parasympathetic nerve excitability during sleep at night, and the sudden drop of abdominal pressure after urine is discharged at night, which slows down the speed of blood night's return to the heart from the inferior vena cava, reduces the blood in the heart and brain, and causes ischemia and fainting.
Furious people: patients with hypertension, hemangioma, etc. You shouldn't be furious, otherwise accidents will easily happen. This is because of intense stimulation, sympathetic nerve is highly excited, adrenal gland secretion increases, heartbeat accelerates rapidly, blood vessels spasm and pressure changes, which rupture the original hemangioma and hypertensive blood vessels.
Excessive fatigue: the elderly, especially those with a history of coronary heart disease and myocardial infarction, make myocardial ischemia and hypoxia more serious and lasting without rest, thus promoting sudden death.
Full bath: It is dangerous to take a bath after meals. This is because after meals, the blood in the body will be adjusted accordingly to meet the needs of digestion and absorption of food in the stomach. In addition, the small blood vessels in the whole body dilate after bathing, resulting in ischemia of heart and brain tissue and insufficient oxygen supply.
Constipation: the elderly eat less, exercise less, gastrointestinal peristalsis weakened, and constipation and sudden death are prone to occur when holding their breath and defecating is difficult. This is due to the sudden increase of chest and abdomen pressure, blocked blood circulation, coronary artery spasm and severe myocardial ischemia when holding your breath hard.
Emotional depression: elderly patients with tracheitis and pneumonia have too much sputum in the respiratory tract, weakened lung function, and are unable to expectorate, which makes sputum block the airway and suffocate. There are also sudden deaths due to acute pancreatic diseases or esophageal varices bleeding.
In view of the above situation, in order to prevent or reduce the occurrence of sudden death, the following measures should be taken:
(1) Because most sudden deaths occur on the basis of the original diseases, we should actively prevent and treat chronic diseases, such as hypertension and coronary heart disease. According to relevant data, about 50% of sudden death is caused by coronary heart disease.
(2) Avoid mental stress, mood swings and other factors that induce sudden death. Pay attention to physical and mental cultivation, arrange your own life, be good at eliminating troubles and controlling anger.
(3) Take medicine due to illness and avoid toxic reaction according to the doctor's advice. When you have insomnia at night, take some sedatives and sleeping pills, and don't overdo it.
(4) to participate in various activities, we should do what we can and never force it. When chest pain, palpitation, dizziness and dyspnea suddenly occur during running and other sports, you should stop exercising immediately.
(5) It is very important to learn some knowledge of health first aid and find and rescue in time.
(6) Furniture items such as daily activities places, guest rooms and bedrooms for the elderly should be properly arranged and placed, and attention should be paid to preventing tripping or slipping.
Tracheal foreign body
The patient has painful manifestations of asphyxia, which may include hoarseness, choking cough and breathing difficulties of different degrees. If you pull your neck frequently, you may appear pale and blue, and in severe cases, you may be unconscious and suddenly stop breathing and heartbeat.
On-site first aid:
Conscious people can take self-help and mutual rescue measures:
Cough hard and try to cough up the foreign body.
Self-fist impact method: lower your head, make a fist with one hand, put your thumb on the upper abdomen (above the navel), and squeeze the fist-clenched hand with the other hand for 3-5 times. You can also squeeze the upper abdomen with the back of the chair and the edge of the table and then relax.
Other people's fist impact method: others can stand behind the patient and put their arms around his waist to give first aid in the above way.
A child's tracheal foreign body can be patted on the scapula with his head down and his feet up with his palm.
Unconscious first aid methods:
Abdominal fist impact method: the patient lies on his back with his legs together. The rescuer kneels on the outside of his legs, puts his palm above his navel, and quickly hits his abdomen forward and down. Observe repeatedly, if there is a foreign body in your mouth, take it out quickly.
Call 120 while saving each other.
Carbon monoxide poisoning (harmful gas poisoning)
Causes of carbon monoxide poisoning:
Insufficient fuel combustion produces colorless and odorless co, and doors and windows are closed;
In the process of industrial production, excessive co is produced;
Improper use of fuel water heater;
Long-term use of air conditioning, air circulation;
After the fire broke out, toxic gas was produced at the scene;
Heat with fuel for a long time, rinse, roast and burn food.
Symptoms:
1, mild: dizziness, headache, fatigue, general malaise, nausea and vomiting;
2. Moderate: In addition to the above symptoms, facial flushing has red lips, irritability, rapid pulse and sweating;
3, severe: coma, convulsions, respiratory heartbeat stop.
On-site first aid:
Open doors and windows or leave the scene to breathe fresh air;
Unbutton clothes to make the respiratory tract unobstructed, take oxygen conditionally and keep warm;
The coma patient's head leans to one side, and there are convulsions and acupuncture at Renhe point;
Breathing and heartbeat stopped, hands-free cardiopulmonary resuscitation (CPR) was performed immediately and 120 was dialed.
Send the patient to the hyperbaric oxygen chamber to promote the dissociation of carboxyhemoglobin and the excretion of carbon monoxide.
Nine taboos of family first aid
Family is a warm harbor, but there will be all kinds of small accidents at any time. How to accurately judge and implement first aid in the first time has become the knowledge we must master.
First, avoid taking painkillers for acute abdominal pain: so as not to cover up the condition and delay the diagnosis, you should go to the hospital as soon as possible.
Second, avoid abdominal injury and immediate reset after visceral prolapse: visceral organ prolapse must be completely disinfected by a doctor before resetting. Prevent infection from causing serious consequences.
3. Avoid ligating with tourniquet for too long: loosen tourniquet 1 minute every 1 hour, and make records to prevent ischemic necrosis of distal limbs caused by excessive ligation of limbs.
Fourth, coma patients should avoid lying on their backs: they should lie on their sides to prevent oral secretions and vomit from inhaling into the respiratory tract and causing suffocation. You can't feed or feed comatose patients.
5. Patients with cardiogenic asthma should not lie down: because lying down will aggravate the blood stasis in the lungs and the burden on the heart, aggravate asthma and endanger life. You should take a semi-recumbent position to make your lower limbs droop.
Sixth, patients with cerebral hemorrhage should not be active at will: if there is a paralyzed person who suddenly falls into a coma or has cerebral hemorrhage during the activity, it is likely to be cerebral hemorrhage. Moving at will make the bleeding worse. You should lie flat, raise your head and take it to the hospital at once.
Seven, small and deep wounds should not be wrapped casually: if stabbed by sharp weapons, it will make the wound lack oxygen, leading to the growth of anaerobic bacteria such as tetanus Bacillus. Debridement and disinfection should be done before dressing, and tetanus antitoxin should be injected.
Eight, diarrhea patients should not take antidiarrheal drugs indiscriminately: taking antidiarrheal drugs before anti-inflammatory will make it difficult to discharge toxins and aggravate intestinal inflammation. Anti-inflammatory drugs such as furazolidone, berberine and norfloxacin should be used before antidiarrheal drugs such as Yimengting.
Nine, the electric shock should not be rescued with bare hands: when someone is found to get an electric shock, the power supply should be cut off immediately, and the wires should be opened immediately with dry wooden sticks, bamboo poles and other insulators.
First, avoid taking painkillers for acute abdominal pain: so as not to cover up the condition and delay the diagnosis, you should go to the hospital as soon as possible.
Second, avoid abdominal injury and immediate reset after visceral prolapse: visceral organ prolapse must be completely disinfected by a doctor before resetting. Prevent infection from causing serious consequences.
3. Avoid ligating with tourniquet for too long: loosen tourniquet 1 minute every 1 hour, and make records to prevent ischemic necrosis of distal limbs caused by excessive ligation of limbs.
Fourth, coma patients should avoid lying on their backs: they should lie on their sides to prevent oral secretions and vomit from inhaling into the respiratory tract and causing suffocation. You can't feed or feed comatose patients.
5. Patients with cardiogenic asthma should not lie down: because lying down will aggravate the blood stasis in the lungs and the burden on the heart, aggravate asthma and endanger life. You should take a semi-recumbent position to make your lower limbs droop.
Sixth, patients with cerebral hemorrhage should not be active at will: if there is a paralyzed person who suddenly falls into a coma or has cerebral hemorrhage during the activity, it is likely to be cerebral hemorrhage. Moving at will make the bleeding worse. You should lie flat, raise your head and take it to the hospital at once.
Seven, small and deep wounds should not be wrapped casually: if stabbed by sharp weapons, it will make the wound lack oxygen, leading to the growth of anaerobic bacteria such as tetanus Bacillus. Debridement and disinfection should be done before dressing, and tetanus antitoxin should be injected.
Eight, diarrhea patients should not take antidiarrheal drugs indiscriminately: taking antidiarrheal drugs before anti-inflammatory will make it difficult to discharge toxins and aggravate intestinal inflammation. Anti-inflammatory drugs such as furazolidone, berberine and norfloxacin should be used before antidiarrheal drugs such as Yimengting.
Nine, the electric shock should not be rescued with bare hands: when someone is found to get an electric shock, the power supply should be cut off immediately, and the wires should be opened immediately with dry wooden sticks, bamboo poles and other insulators.
Emergency rescue of heatstroke
In midsummer, heatstroke is an emergency that seriously endangers human health and life. Zhong Shu generally manifests as sweating, thirst, dizziness, fatigue, tinnitus, chest tightness, palpitation, pale face, nausea and vomiting, decreased blood pressure and increased body temperature. Any delirium, restlessness, coma, convulsion, involuntary muscle shaking and dry skin without sweat are called moderate heatstroke.
Emergency treatment method:
Quickly move the patient to a cool or air-conditioned place and apply cold water or ice water towel to the patient's head, neck, armpit and thigh root. If possible, you can also use ice packs, ice pillows or ice cubes to cold compress the patient.
Rub with cold water or 30% alcohol until the skin turns red to promote heat dissipation;
Cold water brush, electric fan blowing;
Drink 0.3% brackish water or other cool drinks to prevent excessive loss of water and salt in the body. But be careful not to drink too much water in a short time, and generally do not exceed 1 hour 1000 ml of water;
At the same time, cooling oil and essential balm can be applied to acupoints in human body and posterior cranial fossa, and patients can take orally ten drops of water, Ren Dan, Huoxiang Zhengqi water (pills, powders) and other heatstroke prevention and cooling drugs. These are all good ways to treat heatstroke urgently.
Substitution of first aid supplies
It is difficult for anyone to predict when and where all kinds of acute diseases will occur. Even if a family first aid kit is prepared at ordinary times, it can't be taken with you to the scene of the accident. Here is a brief introduction to the use of first-aid supplies for emergency use.
Key operation points:
1. stockings: whether worn on feet or old, they can be used as bandages in first aid.
2. Ligation: It can be used as a fixed splint or tourniquet when fracture occurs.
3. Bath towel: It can be used as a triangle towel when the upper limb is fractured.
4. Handkerchiefs and handkerchiefs: It can be used to stop bleeding when bleeding, and can also be used for cold compress and wet compress.
6. When a fracture occurs, magazines, rulers, thick wrapping paper, umbrellas and crutches can all be used as splints.
First aid measures for frostbite
Frostbite is a common and frequently-occurring disease in winter in northern China, ranging from redness and itching to amputation. To this end, everyone should master some common sense of first aid for frostbite.
Protect the frostbitten area: after frostbite, protect the frostbitten area with a quilt and quickly escort the patient to a room with a room temperature of 20℃-30℃.
Alternately rewarming with 10℃ cold water and 38℃ warm water, and alternately soaking the frozen part for 20-30 minutes until the frozen part regains consciousness and the skin turns red, purple and soft. If shoes and socks, gloves, hands and feet are frozen together, they should be immersed in warm water together, and then separated with scissors after the frozen parts regain their feelings.
Chilblain cream: When chilblain has no blister erosion, camphor, chilblain tincture and pepper tincture can be applied to the affected area; For the severely wounded with ulcer, firstly, the wound was washed repeatedly with normal saline, neomycin cream was applied, and then bandaged with sterile gauze.
Avoid rubbing against snow and baking with fire. After frostbite, avoid rubbing with snow, soaking in ice water or baking directly with fire, which will aggravate the condition.
Sudden crush pain in the posterior sternum or precordial region is unbearable. There is a sense of suffocation. Typical angina attacks can spread to the left shoulder and left arm. Chest pain usually lasts for 5 minutes, and rarely exceeds 15 minutes.
Self-help measures: stop all activities, it is best to lie on your back, relax your mind and don't be too nervous.
Loosen buttons and belts, and keep warm; The chest can be wet compressed with a hot towel;
Sublingual administration of nitroglycerin tablets 1-2 tablets (do not swallow) 1-2 minutes can take effect; Or take isosorbide dinitrate 1-2 tablets, which usually takes effect in 5 minutes.
In severe pain, isoamyl nitrite (small glass tube medicine) can be broken and inhaled in front of nostrils, and the pain will be quickly relieved. Kneading Neiguan point also has analgesic effect.
Conditional oxygen inhalation;
Emergency call 120.