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OCCUPATIONAL SAFETY AND HEALTH
Instruction on labor protection for the operator of the boiler room. Full document
Occupational Safety and Health / Standard instructions for labor protection Safe Operation 1. General requirements for labor protection 1.1. The labor safety requirements set forth in this Standard Instruction apply to persons performing the work of a cylinder filler (receiver). 1.2. To work as a filler (receiver) of cylinders, persons who have reached the age of 18, who have been assigned a qualification category, who have passed a medical examination and instructed in labor safety, are allowed. 1.3. Instruction on labor safety and training in safe methods and methods of work are mandatory for all employees and newcomers to work, including those undergoing industrial practice. 1.4. When performing work, the filler (receiver) of cylinders may come into contact with hazardous and harmful production factors.
1.5. The filler (receiver) of the cylinders must be aware of the possible contact with harmful and dangerous production factors: when working in the workshop - harmful chemicals, the microclimate of the premises. 1.6. There are 3 classes of conditions and nature of work: Grade 1 - optimal conditions. The adverse impact on human health of dangerous and harmful production factors is excluded. Grade 2 - acceptable conditions. The level of hazardous and harmful production factors does not exceed the established hygienic standards. A slight change in health is possible, which is restored during regulated rest during the working day or by the beginning of the next shift. Grade 3 - dangerous and harmful working conditions. The level of hazardous and harmful production factors exceeds hygienic standards, which can lead to a persistent decrease in efficiency or health problems. Contact with dangerous and harmful production factors can lead to injuries or to the development of various occupational diseases with damage to the cardiovascular, respiratory, nervous systems, liver, kidneys, etc. 1.7. When performing work, in accordance with the type of hazardous and harmful production factors, the filler (receiver) of the cylinders is obliged to use personal protective equipment (overalls, safety shoes, safety devices: glasses, a respirator, headphones, etc.) with the obligatory observance of personal hygiene rules. 1.8. When performing the assigned work, the filler (receiver) of the cylinders should not leave his workplace without the permission of the foreman or take part in the production of work not assigned to him. During work, it is not allowed to smoke, use open fire, eat, be distracted by conversations and extraneous affairs. 1.9. Along with the requirements of this Instruction, the filler (receiver) of cylinders must comply with: (01) the requirements set out in the tariff and qualification characteristics for the level of theoretical and practical knowledge of an employee of the relevant qualification; (02) the technological process of the work performed; (03) rules for the technical operation of equipment, fixtures, tools with which he works or which he serves; (04) internal labor regulations. 1.10. When staying on the territory of the enterprise (ship repair plant), it is prohibited: (01) walk on the carriageway and railroad tracks; (02) to cross railway tracks near a moving train; (03) crawl under the wagons and through the automatic coupler of a standing train; (04) to pass through the area of work of cranes during the production of cargo work. 1.11. The filler (receiver) of the cylinders must immediately inform the master about all the noticed malfunctions of the equipment, devices. 1.12. When performing manual auxiliary operations, it is allowed to carry a load weighing up to 20 kg for men and up to 10 kg for women. In other cases, the cargo must be moved using mechanisms and devices. 1.13. The workers are allowed to carry out work with the help of lifting machines controlled from the floor and hang the load on the hook of these machines after they have been instructed and tested their skills in operating machines and slinging loads. 1.14. The filler (receiver) of the cylinders must know the Rules for the provision of first aid in case of accidents (Appendix) and be able to provide it. 1.15. In case of accidents, it is necessary to provide first aid to the victim, call a doctor and report the incident to the foreman or head of the workshop (section), if possible, preserving the situation at the scene for investigation. 1.16. The requirements of the Instruction on labor protection are mandatory for the employee. Failure to comply with these requirements is considered as a violation of labor discipline. 2. Labor protection requirements before starting work 2.1. When performing dangerous, unfamiliar or rarely performed work, the filler (receiver) of the cylinders must receive targeted safety training from the foreman. 2.2. The workplace must be clean and lit in accordance with sanitary standards. Passages, places near the equipment must be free from foreign objects. 2.3. Before starting work, it is necessary to put work clothes in order, prepare serviceable personal protective equipment, inspect tools, equipment, lifting equipment, and determine their readiness for use. The tool (hammers, keys, etc.) must be made of a material that does not cause a spark during operation. 2.4. It is possible to work on the site only with properly functioning ventilation, which ensures normal working conditions in accordance with the requirements of sanitary standards. 3. Labor protection requirements during work 3.1. Cylinders filled with gas must be installed in a vertical position in special racks, firmly fixed in them with collars (chains or straps sheathed in fabric), tightly attached to the filling ramp and protected from sunlight. 3.2. Filled cylinders with shoes on them must be stored in an upright position. To protect against falling, cylinders must be installed in specially equipped nests, cages or protected by a barrier. 3.3. Cylinders installed indoors must be at least 1 meter away from radiators and other heating appliances. The floors in the rooms should be with a non-slip surface made of materials that exclude sparking. 3.4. Joint storage of cylinders with acetylene (gases - substitutes for acetylene) and oxygen in the same room is prohibited. 3.5. Cylinders with compressed gases that do not have shoes may be placed on the floor or ground in an inclined position with the valve raised, preventing them from rolling. 3.6. Cylinders with non-toxic gases can be stored both in special rooms and in the open air. When stored in open areas, it is allowed to stack cylinders with shoes in stacks with gaskets made of rope, wooden beams or rubber between horizontal rows. The height of the stack should not exceed 1,5 meters. Cylinder valves must point in the same direction. 3.7. Places for installation of cylinders in open areas must be fenced. Warning signs with the text: "OXYGEN. OIL DANGEROUS", "ACETYLENE. FLAMMABLE", "FLAMMABLE GAS. FLAMMABLE" must be posted on the fences. To protect the cylinders from sunlight and precipitation, white visors should be installed above them. 3.8. Leaks of oxygen and acetylene are not allowed. If a gas leak is detected in the room, work should be immediately stopped and can only be resumed after the leaks have been eliminated, the gas leaks have been carefully checked for gas tightness, and the room has been ventilated. 3.9. Checking the tightness of connections on pipelines is allowed only by washing. 3.10. It is forbidden to repair gas pipelines and fittings under pressure, as well as to tighten the bolts and nuts of flange connections of pipelines. 3.11. Opening and closing of valves on networks, ramps and cylinders should be done slowly, without jerks and bumps. 3.12. Warming of frozen acetylene and oxygen pipelines should be carried out only with steam or hot water. The use of open flames or electrical heating is prohibited. 3.13. Cylinders for oxygen and combustible compressed gases - substitutes for acetylene, accepted from consumers, must have a residual pressure in the cylinder of at least 0,049 MPa (0,5 kgf / sq. cm), and dissolved acetylene - at least 0,049 MPa (0,5 kgf / sq. cm) and not more than 0,098 MPa (1 kgf / sq. cm). 3.14. If it is impossible due to a malfunction of the valves to release gas from the cylinders at the place of consumption, they are returned to the station. The release of gas from such cylinders must be carried out with special precautions. 3.15. It is forbidden for the filler (receiver) of cylinders to remove caps from cylinders by blows of a hammer, chisel or other means capable of generating a spark. 3.16. When monitoring the pressure in the cylinder, the outlet of the valve (cock) must be directed to a safe place. 3.17. Inspection of cylinders is carried out in order to detect corrosion, cracks, dents and other damages on their walls (to determine the suitability of cylinders for further operation). Cylinders must be thoroughly cleaned before inspection. 3.18. The voltage of permanently installed local lighting fixtures should not exceed 42 V. For internal inspection of cylinders, it is allowed to use factory-made electric fixtures with a voltage not exceeding 12 V. The fittings of the fixture and the plug connection must be explosion-proof. 3.19. Gas cylinders must be subject to periodic surveys at filling plants or filling stations. 3.20. It is forbidden to fill with gas cylinders that have not passed the next survey, with faulty valves, grease stains, shells, corrosion, cracks, dents and other damage, as well as cylinders that do not have passport data or color and inscriptions do not correspond to this gas. Cleaning and painting of gas-filled cylinders is prohibited. 3.21. The filler (receiver) of the cylinders must timely check the serviceability of the valves, instrumentation and safety devices. 3.22. Repair of equipment, communications, cylinders, fittings, instrumentation, safety devices and their elements during operation is not allowed. 3.23. Pressure gauges must have a red line on the division corresponding to the permitted working pressure. Pressure gauges cannot be used if there is no seal or stamp, the check period is overdue, the pressure gauge needle does not return to the zero mark of the scale when it is turned off, the glass is broken or there are other damages that may affect the correctness of its readings. 3.24. Transportation and storage of cylinders with a capacity of more than 12 liters must be carried out with screwed caps. 3.25. Transportation of cylinders filled with gas must be carried out on spring transport or on autocars in a horizontal position, with gaskets between the cylinders. As gaskets, wooden blocks with cut-out nests for cylinders can be used, as well as rope or rubber rings with a thickness of at least 25 mm (two rings per cylinder) or other gaskets that protect cylinders from impacts. All cylinders during transportation must be stowed with valves in one direction. 3.26. It is allowed to transport cylinders in special containers, as well as without containers, in a vertical position, always with gaskets between them and fasteners from a possible fall. 3.27. When loading, unloading, transporting and storing cylinders, measures must be taken to prevent falling, damage and contamination of cylinders. 3.28. The movement of gas cylinders on the site must be carried out on trolleys specially adapted for this purpose or using other special devices. Workers involved in the movement (transportation) of cylinders must be trained and instructed. Do not carry gas cylinders by hand. 4. Labor protection requirements when filling oxygen cylinders 4.1. Entrance to the filling compartment for persons not working in it is prohibited. 4.2. Persons with clothes, shoes, hands, as well as tools or parts contaminated with oil or fats are not allowed to work at the oxygen station and in the filling department. Careful control must be established for cleanliness and the absence of traces of oil on parts of apparatus and machines in contact with oxygen, on valves, gaskets and other parts of filling ramps. 4.3. When working in the filling compartment, it should not be allowed to saturate the clothing of the service personnel with oxygen in order to avoid its possible ignition. 4.4. During the filling of cylinders, it is forbidden to leave the equipment of the filling department unattended. 4.5. The connecting pipes, union nuts, valves and safety valves of the filling rail must be kept in good condition and have no gas leaks. 4.6. To measure oxygen pressure, only oxygen manometers with a blue body color and the inscription on the dial: "OXYGEN. OIL DANGEROUS" should be used. 4.7. Spare parts of the equipment located at the oxygen station should be stored in special cabinets to protect them from contamination with fats and oils. 4.8. Repair of oxygen pipelines is allowed only after purging them with nitrogen. 4.9. When installing equipment, fittings and pipelines in contact with oxygen, contamination with fats or oils is not allowed. If such contamination is found, parts, fittings and pipes must be checked before installation and, if necessary, degreased. 5. Labor protection requirements when filling acetylene cylinders 5.1. Access to the acetylene station by unauthorized persons is prohibited. 5.2. Before connecting the cylinders to the rail, it is necessary to check the condition of the gaskets in the annular grooves of the valves, the unusable gaskets must be replaced. 5.3. When filling the cylinders, it is not allowed to heat them above 40°C. In cases of cylinder heating above the specified temperature, they must be disconnected from the ramp, removed from the filling compartment and cooled. After that, the cylinders must be sent to a repair shop for inspection. 5.4. In the premises of acetylene distribution plants, it is allowed to store filled cylinders in an amount not exceeding 16 hours of operation of the plant. 5.5. If the number of filled and empty acetylene cylinders does not exceed 80 pieces, they can be placed in one room, while the storage places for empty and filled cylinders must be separated by a barrier at least 1,5 meters high. 5.6. In equipment, pipelines and devices operating in an acetylene environment, parts made of copper or copper alloys containing more than 70% copper should not be used, and silver solder should not be used. 5.7. To measure the pressure of acetylene, only acetylene manometers with a white body color and the inscription "ACETYLENE. FLAMMABLE" on the dial should be used. 5.8. Storage of acetone is allowed only in the room where acetonation of cylinders is carried out. 5.9. It is forbidden to install electric clocks, telephones and other electrical appliances in explosive premises of acetylene stations. Metal platforms and stairs should be covered with rubber mats. 6. Labor protection requirements in emergency situations 6.1. Work must be stopped in the following cases: (01) when the gas pressure rises above the allowed one; (02) failure of safety valves or pressure gauge; (03) upon detection of cracks, bulges, significant thinning of the walls, gaps in the cylinders; (04) in the event of a fire. 6.2. In case of ignition of combustible substances, it is necessary to use a fire extinguisher, sand, earth or cover the fire with a tarpaulin or felt. Filling with water fuel and non-disconnected electrical equipment is prohibited. 6.3. In all cases of detection of a fire or its signs (smoke, smell of burning), the filler (receiver) of the cylinders must immediately call the fire brigade, report to the foreman and leave the danger zone. 6.4. If you find the slightest signs of poisoning or irritation of the skin, mucous membranes of the eyes, upper respiratory tract, you must immediately stop work, inform the master and contact the first-aid post. 7. Labor protection requirements at the end of work 7.1. At the end of the work, the filler (receiver) of the cylinders must: (01) put in order the workplace, tools, devices and put personal protective equipment in the places provided for them; (02) put overalls and safety shoes in a personal closet for overalls, in case of contamination, hand over to the laundry (replace); (03) wash hands and face with warm soapy water or take a shower. Application (required). Rules for the provision of first aid to victims 1. General provisions 1.1. First aid is the simplest measures necessary to preserve the health and save the life of a person who has suffered a sudden illness or injury. The rescue of the victim in most cases depends on how quickly and correctly the first aid will be provided. 1.2. The essence of first aid is to stop the impact of traumatic factors, to carry out the simplest medical measures and to ensure the speedy transportation of the victim to a medical institution. 1.3. For the correct setting of first aid work, the following conditions must be met: (01) in each work shift, special persons should be assigned responsible for the condition and systematic replenishment of first aid supplies and devices stored in first aid kits; (02) in each work shift, people capable of providing first aid should be identified and trained; (03) care provided by a non-specialist should only be care provided before a doctor, and not instead of a doctor, and should include the following: temporary control of bleeding, dressing of a wound (burn), immobilization (immovable fixation) for severe injuries, resuscitation measures ( artificial respiration, closed heart massage), the issuance of painkillers and other drugs for well-known diseases, the transfer and transportation of victims; (04) the first aid kit must contain all the necessary medical equipment (according to the packaging manual) for first aid. 1.4. Signs of life and death of a person. 1.4.1. Signs of life: (01) heartbeat; the assisting person determines with his hand or by putting his ear (by ear) below the left nipple of the victim's chest; (02) the pulse is determined on the inside of the forearm, on the neck; (03) the presence of breathing is established by the movements of the chest, by moistening the mirror attached to the nose of the victim, or by the movement of cotton brought to the nasal openings; (04) pupil reaction to light. When a beam of light is directed, a sharp narrowing of the pupil occurs. Signs of life are unmistakable proof that immediate assistance can still save a person. 1.4.2. Signs of death. (01) Human death consists of two phases: clinical and biological. Clinical death lasts 5 - 7 minutes. A person does not breathe, there is no heartbeat, but there are still no irreversible changes in the tissues of the body. During this period, the body can still be revived. After 8 - 10 minutes, biological death occurs. In this phase, it is no longer possible to save the victim's life (due to irreversible changes in vital organs: the brain, heart, lungs). (02) Distinguish between doubtful signs of death and obvious cadaveric signs. Doubtful signs of death: the victim is not breathing; heartbeat is not determined; there is no reaction to a needle prick of a skin area; the reaction of the pupils to strong light is negative (the pupil does not narrow). Explicit cadaveric signs: clouding of the cornea and its drying; when squeezing the eye from the sides with fingers, the pupil narrows and resembles a cat's eye; rigor mortis (starts from the head 1 to 4 hours after death); body cooling; cadaveric spots (resulting from the flow of blood into the lower parts of the body). 2. Methods of resuscitation (revival) of victims of clinical death 2.1. Carrying out artificial respiration by the mouth-to-mouth or mouth-to-nose method. 2.1.1. Artificial respiration should be performed if the victim does not breathe or breathes with difficulty (rarely, convulsively) or if breathing gradually worsens regardless of the causes (electric shock, poisoning, drowning, etc.). 2.1.2. You should not continue to do artificial respiration after the appearance of independent. 2.1.3. When starting artificial respiration, the caregiver must: (01) if possible, lay the casualty on their back; (02) release the victim from clothing restricting breathing (remove the scarf, unfasten the collar, trouser belt, etc.); (03) free the victim's mouth from foreign objects; (04) with the mouth tightly closed, open it, push the lower jaw forward, doing this so that the lower teeth are in front of the upper ones (as shown in the figure - not shown). If it is not possible to open the mouth in this way, then carefully insert a board, a metal plate or a spoon handle, etc. between the back molars (at the corner of the mouth). and unclench your teeth; (05) stand to the side of the victim's head, put one hand under the neck, and with the palm of the other hand press on the forehead, tilting the head back as much as possible; (06) lean towards the victim's face, take a deep breath with an open mouth, completely tightly cover the victim's open mouth with his lips and exhale vigorously (at the same time covering the victim's nose with his cheek or fingers). Air can be blown through gauze, a scarf, a special device "air duct", etc. With tightly clenched jaws of the victim, it is necessary to take measures in accordance with paragraph 2.1.3, subparagraph (04), because artificial respiration by the mouth-to-nose method is carried out with the victim's mouth open; (07) in the absence of spontaneous breathing and the presence of a pulse, artificial respiration can be performed in the "sitting" or "vertical" position (on a support, on a mast, etc.); (08) observe the second interval between artificial breaths (the time of each breath of air is 1,5 - 2 s); (09) after restoration of spontaneous breathing in the victim (visually determined by the expansion of the chest), stop artificial respiration and put the victim in a stable lateral position (turning of the head, torso and shoulders is carried out simultaneously). 2.2. External cardiac massage. 2.2.1. External cardiac massage is performed during cardiac arrest, characterized by: (01) pallor or cyanosis of the skin; (02) absence of a pulse in the carotid arteries; (03) loss of consciousness; (04) cessation or disturbance of breathing (convulsive breaths). 2.2.2. Conductive external heart massage is required to: (01) lay the victim on a flat, hard base (floor, bench, etc.); (02) position yourself at the side of the victim and (if one person is assisting) make two quick, vigorous blows in the mouth-to-mouth or mouth-to-nose manner; (03) put the palm of one hand (usually the left) on the lower half of the sternum (stepping back 3 transverse fingers above its lower edge). Put the palm of the second hand on top of the first. The fingers of the hands do not touch the surface of the body of the victim; (04) press with quick jerks (arms are straightened at the elbow joints) on the sternum, shifting it strictly vertically down by 4-5 cm, with a pressure duration of no more than 0,5 seconds. and with an interval of pressing no more than 0,5 s; (05) for every 2 deep breaths, perform 15 chest compressions (with one person assisting); (06) with the participation of two people in resuscitation, carry out the "breathing-massage" ratio as 1:5 (ie, after deep inhalation, carry out five pressures on the chest); (07) when performing resuscitation by one person every 2 minutes, interrupt the heart massage for 2 - 3 seconds and check the pulse on the victim's carotid artery; (08) when a pulse appears, stop external cardiac massage and continue artificial respiration until spontaneous breathing appears. 3. First aid for injury 3.1. A wound is a damage to the integrity of the skin, mucous membrane or organ. 3.2. The first aid provider must remember that: (01) help should be provided with cleanly washed hands with soap or, if this cannot be done, lubricate the fingers with iodine tincture. Touching the wound itself, even with washed hands, is prohibited; (02) Do not wash the wound with water or medicines, fill it with iodine or alcohol, cover with powder, cover with ointments, put cotton wool directly on the wound. All of the above can interfere with wound healing, bringing dirt from the surface of the skin, thereby causing its subsequent suppuration; (03) do not remove blood clots, foreign bodies from the wound (because this can cause bleeding); (04) in no case should any tissues or organs protruding outwards be pressed into the inside of the wound - they must be covered from above with clean gauze; (05) do not wrap the wound with insulating tape; (06) with extensive wounds of the limbs, they must be immobilized (fixed motionless). 3.3. To provide first aid for injuries, you must: (01) open the individual package in the first aid kit (bag) (according to the instruction printed on its wrapper); (02) apply a sterile dressing to the wound (without touching the part of the dressing that is applied directly to the wound) and secure it with a bandage; (03) in the absence of an individual dressing bag, use a clean handkerchief, a clean cloth, etc.; (04) in the presence of disinfectants (iodine tincture, alcohol, hydrogen peroxide, gasoline), it is necessary to treat the edges of the wound with them; (05) give the victim painkillers. 3.4. If the wound is contaminated with earth, it is necessary to urgently consult a doctor (for the introduction of tetanus toxoid). 3.5. In case of moderate and severe injuries, it is necessary to deliver the victim to a first-aid post or medical institution. 3.6. In case of penetrating wounds of the chest cavity, it is necessary to transport the victims on a stretcher in the "lying" position with the head part raised or in the "semi-sitting" position. 3.7. With penetrating wounds of the abdomen, it is necessary to transport the victim on a stretcher in the "lying" position. 4. First aid for bleeding 4.1. Bleeding is the outflow of blood from a vessel as a result of an injury or complication of certain diseases. 4.2. There are the following types of bleeding: (01) capillary - occurs with superficial wounds, blood oozes in tiny droplets. To stop bleeding, it is enough to press a gauze swab to the wounded area or apply a slightly pressure sterile bandage; (02) venous - blood is dark red, flows out in an even stream; (03) arterial - blood of a scarlet color, is thrown upwards by a pulsating jet (fountain); (04) mixed - occurs when both veins and arteries bleed in the wound. This is observed with deep wounds. 4.3. When a vein is injured on a limb, the latter must be lifted up and then a pressure sterile bandage applied. If it is impossible to stop the bleeding with the above method, you should squeeze the blood vessels below the wound site with your finger, apply a tourniquet, bend the limb in the joint or use a twist. 4.4. Arterial bleeding can be stopped, just like venous bleeding. In case of bleeding from a large artery (with insufficient application of a pressure bandage), it is necessary to apply a tourniquet above the site of bleeding. 4.5. After applying a tourniquet or twist, you must write a note indicating the time of their application and put it in a bandage (under a bandage or tourniquet). 4.6. Keep the applied tourniquet for more than 1,5 - 2,0 hours. is not allowed, because this can lead to necrosis of the bloodless limb. 4.7. If pain occurs from the imposition of a tourniquet, it is necessary for 10-15 minutes. take off. To do this, before removing the tourniquet, they press the artery through which blood flows to the wound with a finger; dissolve the tourniquet should be slow; after 10 - 15 minutes, the tourniquet is applied again. 4.8. After 1 hour, even if the victim can endure the pain from the tourniquet, it should still be removed for 10-15 minutes. 4.9. In case of moderate and severe venous and arterial bleeding, the victims must be taken to a first-aid post or any medical institution. 4.10. In case of nosebleeds, the victim should be seated, put a cold lotion on the bridge of the nose, squeeze the nostrils with your fingers for 4-5 minutes. If the bleeding does not stop, it is necessary to carefully insert a dense gauze or cotton swab moistened with a 3% hydrogen peroxide solution into the bleeding nostril, leaving the end of the gauze strip (cotton) outside, for which after 2,0 - 2,5 hours you can remove the swab. If it is impossible to stop the bleeding of the victim, it is necessary to deliver to the first-aid post (in the "sitting" position) or call the medical staff to him. 4.11. First aid for mixed bleeding includes all of the above activities: rest, cold, pressure bandage (tourniquet). 5. First aid for burns 5.1. Burns are: (01) thermal - caused by fire, steam, hot objects, sunlight, quartz, etc.; (02) chemical - caused by the action of acids and alkalis; (03) electrical - caused by the action of an electric current. 5.2. According to the severity of burns are divided into: (01) 1st degree burns - characterized by redness and swelling of the skin; (02) 2nd degree burns - blisters form on the skin; (03) 3rd degree burns - characterized by the formation of scabs on the skin as a result of necrosis of the superficial and deep layers of the skin; (04) 4th degree burns - charring of skin tissues occurs, damage to muscles, tendons and bones. 5.3. Providing first aid to victims of thermal and electrical burns must: (01) remove the victim from the zone of the heat source; (02) extinguish burning parts of clothing (throw any cloth, blanket, etc., or smother the flame with water); (03) give the victim painkillers; (04) put a sterile dressing on the burned areas, in case of extensive burns, cover the burn surface with clean gauze or an ironed sheet; (05) for eye burns, apply cold soaks from a solution of boric acid (1/2 teaspoon of acid to a glass of water); (06) deliver the victim to the first-aid post. 5.4. The person providing first aid for chemical burns must: (01) if solid particles of chemicals come into contact with the affected areas of the body, remove them with a swab or cotton; (02) immediately flush the affected area with plenty of clean cold water (for 10 to 15 minutes); (03) in case of skin burns with acid, make lotions (bandage) with a solution of baking soda (1 teaspoon of soda per glass of water); (04) in case of skin burns with alkali, make a lotion (bandage) with a solution of boric acid (1 teaspoon per glass of water) or with a weak solution of acetic acid (1 teaspoon of table vinegar per glass of water); (05) if liquid or acid vapor gets into the eyes or mouth, rinse them with plenty of water and then with a solution of baking soda (1/2 teaspoon per glass of water); (06) if splashes or vapors of alkali get into the eyes or mouth, rinse the affected areas with plenty of water and then with a solution of boric acid (1/2 teaspoon per glass of water); (07) if acid or alkali enters the esophagus, give no more than 3 glasses of water to drink, lay down and cover the victim warmly; (08) in severe cases, take the victim to a medical center or any medical institution. 5.5. It is forbidden: (01) touching burned areas of the body with hands; (02) lubricate with ointments or sprinkle powders on burned areas of the skin and mucous surfaces; (03) burst bubbles; (04) remove various substances adhering to the burnt place (mastic, rosin, resins, etc.); (05) to tear off clothes and shoes from the burned area. 6. First aid for general hypothermia and frostbite 6.1. Frostbite is tissue damage caused by exposure to low temperatures. 6.2. With mild frostbite (blanching and redness of the skin, up to loss of sensitivity), the first aid provider must: (01) move the casualty to a warm room as soon as possible; (02) give the victim hot tea, coffee, hot food; (03) put the frostbitten limb in a warm bath (basin, bucket) at a temperature of 20°C, bringing it to the temperature for 20 - 30 minutes. up to 40°C (in case of contamination, wash the limb with soap). 6.3. With a slight frostbite of limited areas of the body, the latter can be warmed with the help of the warmth of the hands of the first aid provider. 6.4. In case of severe frostbite (appearance of blisters on the skin, necrosis of soft tissues), the caregiver must: (01) urgently transfer the victim to a warm room; (02) treat the skin around the blisters with alcohol (without piercing them); (03) put a sterile dressing on the frostbitten part; (04) give the victim hot tea, coffee; (05) apply general body warming (warm wraps, heating pads, etc.); (06) transport the victim to a first-aid post or medical facility. 6.5. It is forbidden to rub frostbitten parts of the body with snow, alcohol, apply a hot heating pad. 7. First aid to the victim from the action of electric current 7.1. The first aid provider must: (01) release the victim from the action of electric current, observing the necessary precautions (when separating the victim from live parts and wires, it is imperative to use dry clothes or dry objects that do not conduct electric current); (02) within 1 min. assess the general condition of the victim (determination of consciousness, color of skin and mucous membranes, breathing, pulse, pupil reaction); (03) in the absence of consciousness, lay the victim down, unbutton the clothes, create an influx of fresh air, bring a cotton swab moistened with a solution of ammonia to the nose, carry out general warming; (04) if necessary (very slow and spasmodic breathing, weak pulse) start artificial respiration; (05) carry out resuscitation (revitalization) measures until the function of vital organs is restored or until obvious signs of death appear; (06) if the victim vomits, turn his head and shoulders to the side to remove the vomit; (07) after resuscitation, provide the victim with complete rest and call the medical staff; (08) if necessary, transport the victim on a stretcher in the prone position. 8. First aid for injuries: fractures, dislocations, bruises, sprains 8.1. Violent damage to the body, caused by external influences, resulting in impaired health, is called trauma. 8.2. Seriously injured persons must not be carried until a doctor or other qualified person has arrived, unless they must be removed from a hazardous area. 8.3. A fracture is a break in the integrity of a bone. 8.4. Fractures are characterized by: (01) sharp pain (worse when trying to change position); (02) bone deformity (due to displacement of bone fragments); (03) swelling of the fracture site. 8.5. There are open (violation of the skin) and closed (the skin is not broken) fractures. 8.6. The caregiver for fractures (dislocations) should: (01) give the victim painkillers; (02) with an open fracture - stop bleeding, treat the wound, apply a bandage; (03) provide immobilization (creation of rest) of the broken bone with standard splints or available materials (plywood, boards, sticks, etc.); (04) in case of a fracture of a limb, apply splints, fixing at least two joints - one above, the other below the fracture site (the center of the splint should be at the fracture site); (05) in case of fractures (dislocations) of the shoulder or forearm, fix the injured arm in the physiological position (bent at the elbow joint at an angle of 90°) by placing a dense ball of cotton wool or a bandage in the palm, hanging the arm to the neck on a kerchief (bandage); (06) in case of fracture (dislocation) of the bones of the hand and fingers to a wide splint (the width of the palm and a length from the middle of the forearm to the fingertips), bandage the hand by putting a ball of cotton wool or bandage into the palm, hang the hand to the neck with a scarf (bandage ); (07) in case of a fracture (dislocation) of the femur, apply an external splint from the armpit to the heel, and an internal splint from the perineum to the heel (if possible, without lifting the limb). Transport the victim on a stretcher; (08) in case of fracture (dislocation) of the bones of the lower leg, fix the knee and ankle joints of the affected limb. Transport the victim on a stretcher; (09) in case of a fracture (dislocation) of the collarbone, put a small piece of cotton wool into the armpit (on the side of the injury) and bandage the arm bent at a right angle to the body; (10) in case of damage to the spine, carefully, without lifting the victim, slip a wide board, thick plywood, etc. under his back. or turn the victim face down without bending the torso. Transportation only on a stretcher; (11) for broken ribs, bandage the chest tightly or pull it off with a towel while exhaling; (12) in case of a fracture of the pelvic bones, slip a wide board under the back, put the victim in the “frog” position (bend the legs at the knees and spread them apart, and move the feet together, put a roller of clothes under the knees). Transport the victim only on a stretcher; (13) apply "cold" to the fracture site (rubber ice pack, cold water bottle, cold packs, etc.) to reduce pain. 8.7. Any attempts to independently compare bone fragments or reduce dislocations are prohibited. 8.8. In case of a head injury (may be observed: headache, loss of consciousness, nausea, vomiting, bleeding from the ears), it is necessary: (01) lay the casualty on his back; (02) fix the head on both sides with soft rollers and apply a tight bandage; (03) if there is a wound, apply a sterile dressing; (04) put "cold"; (05) provide peace; (06) when vomiting (unconscious), turn the victim's head to the side. 8.9. With bruises (characterized by pain and swelling at the site of the bruise), it is necessary: (01) apply cold to the injury site; (02) apply a tight bandage; (03) create peace. 8.10. When stretching ligaments, you must: (01) fix the injured limb with bandages, splints, improvised materials, etc.; (02) provide rest to the injured limb; (03) apply "cold" to the injury site. 8.11. When squeezing the victim with a weight, it is necessary: (01) free him from gravity; (02) provide assistance depending on the damage. 9. First aid for shock 9.1. Shock (insensibility) - the state of the body as a result of impaired circulation, respiration and metabolism. This is a serious reaction of the body to injury, representing a great danger to human life. 9.2. The signs of shock are: (01) pallor of the skin; (02) clouding (up to loss) of consciousness; (03) cold sweat; (04) dilated pupils; (05) acceleration of breathing and pulse; (06) drop in blood pressure; (07) in severe cases, there may be vomiting, ashy complexion, cyanosis of the skin, involuntary feces and urination. 9.3. The first aid provider must: (01) provide the necessary assistance, corresponding to the type of injury (stop bleeding, immobilize the fracture site, etc.); (02) wrap the victim in a blanket, laying him horizontally with his head slightly lowered; (03) when thirsty (excluding abdominal injuries), give the victim some water to drink; (04) call for qualified medical assistance immediately; (05) transport the casualty on a stretcher to the hospital with extreme care. 10. First aid in case of foreign bodies entering human organs and tissues 10.1. If a foreign body enters the respiratory throat, it is necessary: (01) ask the victim to make several sharp coughing shocks; (02) inflict 3-5 short blows with a brush on the interscapular region with the head tilted down or in the prone position; (03) grasp the victim from behind, clasping the hands between the xiphoid process of the sternum and the navel and apply 3 to 5 quick pressures on the victim's abdomen. 10.2. If a foreign body (mote) gets into the eye, it is necessary to rinse the eye with a stream of water (from a glass using cotton wool or gauze), directing the latter from the corner of the eye (temple) to the inner corner of the eye (toward the nose). 10.2.1. Do not rub your eyes. 10.2.2. In case of severe injuries, it is necessary to put a sterile bandage on the eye and urgently deliver the victim to a first-aid post or medical institution. 10.3. If foreign bodies get into soft tissues (under the skin, nails, etc.), it is necessary: (01) remove the foreign body (if there is confidence that this can be done); (02) treat the injection site of the foreign body with iodine solution; (03) apply a sterile dressing. 11. First aid for poisoning 11.1. In case of gas poisoning (acetylene, carbon monoxide, gasoline vapors, etc.), the victims feel: headache, "knocking in the temples", "ringing in the ears", general weakness, dizziness, drowsiness; in severe cases, there may be an excited state, respiratory failure, dilated pupils. 11.1.1. The caregiver must: (01) withdraw or remove the victim from the gassed area; (02) unfasten clothing and let in fresh air; (03) lay the victim down with legs raised (in case of carbon monoxide poisoning, strictly horizontally); (04) cover the victim with a blanket, clothing, etc.; (05) bring a cotton swab moistened with a solution of ammonia to the nose of the victim; (06) give plenty of liquid to drink; (07) when breathing stops, begin artificial respiration; (08) urgently call for qualified medical assistance. 11.2. In case of chlorine poisoning, it is necessary: (01) rinse eyes, nose and mouth with a solution of baking soda (1/2 teaspoon per glass of water); (02) give the victim sips of warm water; (03) send the victim to the first-aid post. 11.3. In case of poisoning with spoiled foods (headaches, nausea, vomiting, abdominal pain, general weakness may occur), it is necessary: (01) give the victim 3 to 4 glasses of water or a pink solution of potassium permanganate to drink, followed by induction of vomiting; (02) repeat washing 2-3 times; (03) give the victim activated charcoal (tablets); (04) give the victim warm tea to drink; (05) lay down and cover the casualty warmly; (06) in case of respiratory failure and cardiac arrest, start artificial respiration and external heart massage; (07) deliver the victim to the first-aid post. 11.4. First aid for poisoning with caustic substances. 11.4.1. In case of poisoning with strong acids (sulfuric, hydrochloric, acetic) and strong alkalis (caustic soda, caustic potassium, ammonia), burns of the mucous membrane of the oral cavity, pharynx, esophagus, and sometimes the stomach occur. 11.4.2. Signs of poisoning are: severe pain in the mouth, pharynx, stomach and intestines, nausea, vomiting, dizziness, general weakness (up to fainting). 11.4.3. In case of acid poisoning, you must: (01) give the victim inside every 5 minutes a tablespoon of soda solution (2 teaspoons per glass of water) or 10 drops of ammonia diluted in water; (02) give the victim milk or egg whites shaken in water to drink; (03) if breathing is disturbed, give artificial respiration; (04) deliver the victim to the first-aid post. 11.4.4. In case of poisoning with strong caustic alkali, the victim must: (01) to drink little by little cold water acidified with acetic or citric acid (2 tablespoons of 3% vinegar solution per glass of water); (02) give inside vegetable oil or egg white shaken with water; (03) apply mustard plaster to the epigastric region; (04) deliver the victim to the first-aid post. 12. First aid for fainting, heat and sunstroke 12.1. Fainting is a sudden, short-term loss of consciousness (from a few seconds to a few minutes). 12.1.1. Fainting can occur as a result of: fright, severe pain, bleeding, a sharp change in body position (from horizontal to vertical, etc.). 12.1.2. With fainting, the victim is observed: profuse sweat, cold extremities, weak and frequent pulse, weakened breathing, pallor of the skin. 12.1.3. When providing first aid for fainting, you must: (01) lay the victim on his back, lower his head, raise his legs; (02) unfasten clothing and let in fresh air; (03) wet face with cold water; (04) bring a cotton swab moistened with a solution of ammonia to the nose; (05) lightly pat on the cheeks; (06) after removing the victim from fainting, give the victim strong tea, coffee; (07) in case of repeated fainting, call for qualified medical assistance; (08) transport the casualty on a stretcher. 12.2. Heat stroke and sunstroke occur as a result of a significant overheating of the body and, as a result, a significant rush of blood to the brain. 12.2.1. Overheating is facilitated by: elevated ambient temperature, high humidity, waterproof (rubber, tarpaulin) clothing, hard physical work, violation of the drinking regime, etc. 12.2.2. Heat and sunstroke are characterized by: general weakness, feeling hot, redness of the skin, profuse sweating, palpitations (pulse rate 100-120 beats per minute), dizziness, headache, nausea (sometimes vomiting), fever up to 38-40 °C. In severe cases, confusion or complete loss of consciousness, delirium, muscle cramps, respiratory and circulatory disorders are possible. 12.2.3. For heat and sunstroke, you need to: (01) immediately move the casualty to a cool room; (02) lay the victim on his back with a pillow under his head (clothing, etc.); (03) remove or unfasten clothing; (04) moisten the head and chest with cold water; (05) put cold packs or ice on the head (forehead, parietal region, occiput), inguinal, subclavian, popliteal, axillary regions (places of concentration of many vessels); (06) while remaining conscious, give strong cold tea or cold salted water to drink; (07) in case of respiratory and circulatory disorders, carry out the full range of resuscitation measures (artificial respiration and external heart massage). 13. First aid for pain and convulsive conditions 13.1. For pain in the heart area, helping the victim, you must: (01) create complete peace; (02) lay the patient down and raise his head; (03) give (under the tongue) a tablet of validol, nitroglycerin, sedatives; (04) urgently call for qualified medical assistance; (05) if pain persists, carry out transportation on a stretcher. 13.2. For abdominal pain not related to eating or drinking, the first aid provider should: (01) lay the victim horizontally; (02) put "cold" on the abdomen; (03) exclude: physical activity, taking fluids, food by the victim; (04) urgently call for qualified medical assistance; (05) in case of severe pain, transport the victim to the first-aid post or medical institution on a stretcher. 13.3. In a seizure (may be accompanied by loss of consciousness, foam on the lips, wheezing, involuntary urination), the first aid provider should: (01) support the patient's head; (02) insert a bandage, spoon, etc. into the oral cavity (between the teeth); (03) free from clothing the area of the neck and chest; (04) apply a cold compress to the forehead; (05) after the seizure is over, put the patient in the "on the side" position; (06) urgently call for qualified medical assistance; (07) carry out transportation on a stretcher. 14. First aid for drowning 14.1. After removing the victim from the water, the first aid provider must: (01) put the victim belly down on a bent knee so that the lower part of the chest rests on it, and the upper body and head hang down; (02) with one hand press on the chin or raise the head (so that the mouth is open) and with vigorous pressure (several times) on the back with the other hand to help remove water; (03) after stopping the flow of water, lay the victim on his back and clean the mouth; (04) start artificial respiration; (05) in the absence of a pulse, dilated pupils, perform an external heart massage; (06) when breathing occurs, bring a piece of cotton wool soaked in a solution of ammonia to the nose; (07) when conscious, give the victim a tincture of valerian (20 drops in 1/2 cup water) to drink; (08) change the victim into dry clothes, give him strong tea; (09) keep the casualty warm; (10) provide the victim with complete rest; (11) call for qualified medical assistance. 15. First aid for bites 15.1. With the bites of poisonous insects and snakes appear: dizziness, nausea, vomiting, dryness and bitter taste in the mouth, rapid pulse, shortness of breath, drowsiness (in especially severe cases, there may be convulsions, loss of consciousness and respiratory arrest). 15.2. Burning pain, redness and swelling of the skin occur at the site of the bite. 15.3. The first aid provider must: (01) lay the casualty in a horizontal position; (02) put a sterile dressing on the wound (preferably with ice); (03) fix the affected limb by bandaging it to a service splint (improvised means) or to the body; (04) give the victim a large amount of liquid (partially), 15 - 20 drops of valerian tincture in 1/2 cup of water; (05) for bites from poisonous snakes (especially cobras), in the first minutes, apply a tourniquet to the limb above the bite; (06) to monitor the condition of the victim; (07) in severe cases, urgently call for qualified medical assistance; (08) transport the casualty in the prone position. 15.4. It is forbidden: (01) cauterize the bite site; (02) give the victim alcohol; (03) suck the poison out of the wound. 15.5. The first aid provider for animal bites should: (01) treat the skin around the wound (scratch) with a solution of iodine tincture; (02) apply a sterile dressing to the wound; (03) send (accompany) the victim to a medical facility. 16. Transportation of casualties 16.1. Transportation of the victim should be as quick, safe and gentle as possible. 16.2. Depending on the type of injury and the available means (personnel, improvised), the transportation of the victims can be carried out in different ways, maintenance, carrying out, transportation by transport. 16.3. Transport the wounded up or down should always be head up. 16.4. It is necessary to lay the victim on a stretcher from the side opposite to the injured part of the body. 16.5. When transporting on a stretcher, you must: (01) ensure that the casualty is in a correct and comfortable position; (02) so that when carried on the hands, the helpers go "out of step"; (03) lift and place the injured person on the stretcher in concert (on command); (04) in case of fractures and severe injuries, do not carry the victim to the stretcher on your hands, but place the stretcher under the victim (the fracture site must be supported). 16.6. The correct position of the victims during transportation: (01) the position "lying on the back" (the victim is conscious). Recommended for wounds of the head, spine, limbs; (02) position "lying on the back with legs bent at the knees" (put a roller under the knees). Recommended for open wounds of the abdominal cavity, for fractures of the pelvic bones; (03) the position "lying on the back with the lower limbs raised and the head down". Recommended for significant blood loss and shock; (04) prone position. Recommended for spinal injuries (unconscious); (05) "semi-sitting position with outstretched legs". With neck injuries and significant injuries of the upper limbs; (06) "semi-sitting position with bent legs" (put a roller under the knees). With injuries of the genitourinary organs, intestinal obstruction and other sudden illnesses, injuries of the abdominal cavity and injuries of the chest; (07) position "on the side". Recommended for severe wounds, when the victims are unconscious; (08) "sitting position". Recommended for minor injuries of the face and upper limbs.
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