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OCCUPATIONAL SAFETY AND HEALTH
Labor safety instructions for a shipbuilder. Full document
Occupational Safety and Health / Standard instructions for labor protection Safe Operation 1. General requirements for labor protection 1.1. The occupational safety requirements set out in these Standard Instructions apply to persons performing the work of a ship repairer and combining other professions with the profession of a ship repairer. 1.2. Persons who have reached the age of 18, who have been assigned a qualification category, who have undergone a medical examination and safety training are allowed to work as a ship repairman (hereinafter referred to as a mechanic). 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, a mechanic may come into contact with dangerous and harmful production factors.
1.5. The mechanic must be aware of possible contact with harmful and dangerous production factors:
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 the hygienic standards, which can lead to a persistent decrease in efficiency or to a health disorder. 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 dangerous and harmful production factors, the mechanic is obliged to use personal protective equipment (working clothing, safety shoes and safety devices: glasses, headphones, etc.) with mandatory adherence to personal hygiene rules. Overalls must be clean, in good condition, and fastened with all buttons. Safety shoes must be laced. When on ships, docks, or piers, wearing a protective helmet with a fastened chin strap is mandatory. 1.8. When performing the assigned work, the mechanic must not leave his workplace without the permission of the foreman or take part in the performance of work not assigned to him. Smoking and eating are not allowed during work. 1.9. 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. 1.10. While on board, it is prohibited: (01) descend or enter the holds and compartments of the ship without the permission of the master and without informing the officer in charge of the watch; (02) enter unlit holds and other ship spaces; (03) walking on beams, floors and stringers without secure flooring; (04) remove, rearrange fences, signs and other devices that ensure the safety of work; (05) stand or sit on the open holds coamings, bulwarks, railings, bollards, jump from berth to ship and back; (06) work at unprotected or uncovered mouths and openings; (07) to be in the places of ship work for persons not participating in the work; (08) smoking, using open flames, throwing burning and smoldering objects (cigarette butts, etc.) overboard; (09) carry out hot work in enclosed spaces without forced ventilation; (10) move along ship ladders without holding the handrails, go down or up vertical ladders if your hands are full of tools. The tool must be lowered (raised) at the plant end. Before descending into the hatch, you must check that its cover is secured in the open position. 1.11. Along with the requirements of this Instruction, the locksmith 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. 1.12. The mechanic must immediately inform the foreman about any noticed malfunctions of equipment or devices. 1.13. When performing manual auxiliary operations, men are allowed to carry a load weighing up to 20 kg. In other cases, the cargo must be moved using mechanisms and devices. 1.14. 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. 1.15. The mechanic must know the rules for providing first aid in case of accidents (Appendix) and be able to provide it. 1.16. 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. 1.17. 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, a mechanic must receive targeted instruction on occupational safety from a foreman. 2.2. When on a ship being repaired, the mechanic must familiarize himself with the diagram of escape routes from various rooms and compartments in the event of emergency situations. 2.3. Before starting work, it is necessary to put work clothes in order, prepare serviceable personal protective equipment, inspect equipment, lifting equipment and tools, determine their serviceability and readiness for execution. 2.4. The work site must be well lit and kept clean and tidy. The passages must be clear, the floor (deck), and flooring slabs must be clean and dry. The floor at the workbench should be covered with a grid. 2.5. The surface of the workbench should be covered with smooth iron. Local low-voltage lighting should be installed above the workbench. 2.6. The mechanic must receive hand-held, mechanized tools and technological equipment at special points (storerooms) through a responsible person who stores, receives, issues, tests, registers, inspects and monitors the compliance of tools and devices with safety requirements. 2.7. Hand tools and accessories must be in good working order and meet the following requirements: (01) files, rasps, scrapers, hammers and sledgehammers must be firmly set on wooden handles of appropriate dimensions; (02) the heads of hammers and sledgehammers should not be hardened, the surface of the head should be slightly convex; (03) tools for cutting and punching metal (chisels, crosscuts, barbs, notches, etc.) must not have hardening and cracks, the cutting edge must be undamaged, the side edges must be free of sharp edges and burrs, the length of the tool must be at least 150 mm, and when working with sledgehammers, they must have handles with a length of at least 700 mm; (04) wrenches must be undesigned jaws, with a working sliding mechanism and the correct size without the use of gaskets. It is forbidden to use wrenches and other objects to increase the leverage; (05) The cutting tool must be properly sharpened. Shanks and seats of the tool must not be damaged. Saws must be correctly set, free of cracks and other defects; (06) the vise should be well fixed on the workbench, the jaws of the vise and clamps should have a good (unworked) notch; (07) Clamps and manual jacks must have a serviceable thread of the lead screws and the stamp of the quality control department indicating the date of inspection and allowable load; (08) on the hoist and hoists there should be inscriptions about the permissible load capacity and the date of the next test; (09) pneumatic tool air hoses must be undamaged, securely fastened to the fitting, connected to each other using barbed nipples and secured with clamps; (10) electric and pneumatic grinders must have safety covers. 2.8. Portable lamps must be factory-made, with a voltage of no more than 42 V. In closed compartments, refrigerators, damp rooms, inside engine crankcases, boilers, turbine housings, only lamps with a voltage of no higher than 12 V should be used. 2.9. Before starting work on the machines, check: (01) serviceability of parts and mechanisms, reliability of fastening of the cutting tool (by external inspection); (02) the presence and strength of fastening of fences and protective devices; (03) operation of controls and brakes, idling. 2.10. Grinding machines must have serviceable wheels placed in protective covers, transparent screens, tool rests and be equipped with dust collection devices. The gap between the circle and the tool rest should not exceed 3 mm. 2.11. The power tool must have a complete hose cable with a plug, the wire insulation must not be damaged, the wire connection terminals must be securely closed. When working with a power tool with a voltage of more than 36 V, it is necessary to use dielectric gloves, rubber mats (galoshes). The power tool must be checked for a short to ground. 2.12. You can start working on scaffolding, scaffolding, decking and platforms only with the permission of the foreman after checking their strength and the presence of fencing. 2.13. To carry a hand tool to the place of work, a special box or bag is used. Carrying tools in pockets is not allowed. The box (bag) with the tool should be lowered into the hold or compartment at the plant end. When working at height, on gratings, grating decks, etc. tools and fasteners should be stored in boxes or bags. 2.14. Tools, fixtures, necessary material and parts for work should be located in a convenient and safe order for use. 2.15. To carry out hot work on ships, you must have a written permit from the fire department (VOHR). 3. Labor protection requirements during work 3.1. Safety requirements when working with pneumatic tools 3.1.1. To prevent vibration disease in those working with pneumatic hand tools, it is necessary:
3.1.2. Before connecting the hose to the tool, condensate must be drained from the air line. Blow out the hose with short-term slight pressure with compressed air, having previously connected it to the network. The air jet should only be directed upwards. 3.1.3. Connecting the hose to the mains and to the tool, as well as disconnecting it, can only be done when the valve on the air line is tightly closed. It is necessary to place the hose in such a way that it is impossible for vehicles to run into it and people to pass through it. 3.1.4. Exhaust outlets must be positioned so that exhaust air does not interfere with operation. 3.1.5. The parts processed by pneumatic tools must be tightly laid on special stops, gaskets to exclude the possibility of their movement during operation. 3.1.6. The plug-in tool is knocked out of the drilling machine with a special key in its horizontal position to the side, safe for the worker and others. 3.1.7. When working with a pneumatic chisel, hammer, pneumatic grinders and drilling machines, you must use safety glasses or a face shield. Protective screens are installed at areas where work with pneumatic tools is carried out. 3.1.8. If the air supply is interrupted or if work is interrupted even for a short time, the valve on the air line must be closed and the insertion tool must be removed. 3.1.9. If the tool malfunctions (when air is leaking, the trigger does not work, etc.), you must stop working and hand over the tool for repair. 3.1.10. When working with a pneumatic tool, it is prohibited: (01) direct a jet of air at people, on the floor or equipment, use compressed air to clean (blow off) overalls; (02) to allow spontaneous flight of the working tool during idle strokes; (03) allow kinks, entanglement of the hose, its intersection with cables, electrical cables, acetylene and oxygen hoses; (04) change working tools, perform adjustments and other types of maintenance work in the presence of compressed air in the hose; (05) remove the means of vibration protection and control of the working tool, noise silencer, casing of the working tool; (06) move from one place to another with a working tool; (07) to work in gloves with drilling and other rotating tools; (08) work with a defective tool, as well as independently disassemble, adjust and repair it; (09) using the worker's body weight to put additional stress on the tool. 3.2. Safety requirements when working with power tools 3.2.1. Upon receipt of the power tool, the mechanic must visually inspect its insulation and test it in idle operation. 3.2.2. During operation, the current-carrying wire (cable) must be protected from damage. Direct contact of the wire with hot, wet or oily surfaces is prohibited. 3.2.3. If the power tool suddenly stops (jamming), it should be immediately turned off. 3.2.4. Operation of the power tool is prohibited if the following malfunctions occur:
3.2.5. At the end of work, the power tool must be handed over to a person responsible for its good condition. 3.3. Safety requirements for working on machines 3.3.1. The parts to be processed on a drilling machine must be securely installed in a vice mounted on the machine table or secured with special clamping bolts. It is prohibited to hold the workpiece with your hands. You can remove and install parts only after the machine has completely stopped. 3.3.2. Cooling the drill when processing parts is allowed only with the help of a brush with a handle at least 250 mm long. 3.3.3. While working on the machines it is not allowed: (01) measure the workpiece; (02) put tools and parts on the machine; (03) remove (open) protective and safety devices; (04) lean close to the spindle and cutting tool; (05) stop the machine by pressing the spindle or chuck by hand. 3.3.4. When working on a guillotine, it is prohibited:
3.3.5. During work that involves flying chips or scale, when chopping metal, the mechanic must wear safety glasses. 3.4. Safety requirements for lifting and transport operations 3.4.1. During the installation (dismantling) of machine parts (frames, blocks, cylinders, shafts, turbine rotors, cylinder liners, pistons, etc.), it is allowed to use only proven standard installation hoisting and transport equipment (cranes, hoists, winches, other mechanisms) that have reliable braking devices. 3.4.2. A mechanic authorized to operate an electric hoist does not have the right to eliminate any of its malfunctions. 3.4.3. It is prohibited to suspend lifting mechanisms from pipelines and other ship structures not intended for this purpose. 3.4.4. Before using the electric hoist in operation, it is necessary to check that: (01) the mass of the lifted load does not exceed the lifting capacity of the electric hoist; (02) the testing period of the electric hoist has not expired; (03) the load rope is in good condition and correctly laid on the drum; (04) brakes, lift and travel stops are active and in good condition. 3.4.5. When lifting and moving parts, it is forbidden to leave them hanging or carry out repairs suspended. 3.4.6. Lever hoists must have a working locking device and an inscription with the test date. 3.4.7. When lifting parts and assemblies, you can only use slings that are in good working order and suitable for the load being lifted. It is forbidden to exceed the established load capacity of hoists and slings. 3.4.8. It is prohibited to use cargo slings in the following cases: (01) if the sling does not have a tag (ring) with a stamped characteristic; (02) if the line is spliced or has knots and pegs; (03) if there are 10% broken wires over a length of 8 diameters; (04) significant corrosion or deformation; (05) if the chain slings have deformations, cracks, poor quality welding, worn links; (06) if the angle between the branches of the general purpose lines coming from the hook exceeds 90°. Damaged slings identified during inspection should be removed from service. 3.4.9. You must not be in undesignated places, stand or walk under a raised load. 3.4.10. Long parts (shafts, pipes, etc.) should be lifted and lowered in a horizontal position. Lifting of parts in their vertical or inclined position can be carried out on the basis of a technological diagram approved by the chief engineer of the enterprise. 3.4.11. Raising, lowering or moving parts by several workers must be carried out in concert at the command of a designated senior person. 3.4.12. Before laying the shafts on the ship or in the workshop, safety cages made of wooden beams must be laid out so that the distance from the shaft to the cages does not exceed 200 - 250 mm. 3.4.13. Installation of the mechanism in place when it is in a suspended state should be carried out using guy ropes, tensioning them at the command of the installation manager. 3.4.14. If, when installing machine parts into place, they cannot be secured, they must be temporarily securely secured with hoists, ropes, jacks or other means. 3.4.15. Auxiliary mechanisms and heavy parts can be moved along the deck only with special devices designed for this purpose (hoists, winches, rosin blocks, etc.). 3.4.16. When working with a jack, you must:
When working with an electric jack, a mechanic must wear dielectric gloves and know the order and location of its connection. 3.4.17. To prevent the legs or heads of the jack from slipping, it is necessary to place a wooden spacer between its heads and the metal surface of the equipment being lifted. The base of the jack should rest against the wooden spacer with its tenons. In this case, directed loads not along the axis of the jack head and rod are not allowed. Do not install jacks on slippery or uneven surfaces. 3.4.18. The locksmith is prohibited from: (01) the use of jacks in the absence of a plane perpendicular to the direction of the working force for their support; (02) use electric jacks in rooms with an increased risk of electric shock; (03) place bricks, round and random wooden spacers under the jack; (04) operate if oil seeps between the body and the jack piston at full load; (05) work with a hydraulic jack if the jack sinks when lifting the load or if its piston seizes; (06) stand against the safety plug of the hydraulic jack; (07) use the jack for operations with loads exceeding the load capacity specified for the jack; (08) use jacks whose screw or nut threads are worn more than 20%; (09) leave the mechanism hanging or raised on jacks without placing stable wooden cages or bars under it during breaks in work; (10) install and adjust chocks, wedges and other devices and devices under the load as it is lowered. All additional work related to preparing the installation site must be carried out with the load at a safe distance from the work site. 3.5. Safety requirements for installation and dismantling of equipment 3.5.1. When repairing and assembling equipment, measures must be taken to prevent spontaneous rotation of mechanisms or their activation. It is prohibited to carry out any work on moving parts of ship equipment. Safety signs must be posted on starting devices: “DO NOT TURN ON! PEOPLE ARE OPERATING.” 3.5.2. When working near moving mechanisms, dangerous places must be fenced off with shields, railings, etc. 3.5.3. Disassembly and reassembly of machinery parts must be carried out from a stable platform or scaffold. Scaffolding (scaffolding) must have fences 1,1 m high and side boards at least 0,15 m high. Working on faulty scaffolding and scaffolding that does not meet safety standards, from portable ladders, stepladders and similar unstable devices is prohibited. 3.5.4. When working on scaffolding and scaffolding, it is not allowed:
3.5.5. To perform work at a height of 1,5 m and above, if it is impossible to install floorings with fencing of workplaces, workers must use helmets and safety belts, without which they are not allowed to work. 3.5.6. Safety belts and safety ropes must be inspected before starting work. Only belts and ropes that have a passport, have passed the next test and are in good condition are allowed for use. After climbing to a height, you need to secure yourself with a carabiner or a safety rope for solid structures. 3.5.7. When disassembling machine parts that may fall after being disconnected, they should be securely strapped or secured before disassembly is completed. During the repair of large-sized and complex equipment associated with the disassembly, dismantling and installation of components, all passages and passages in the work area must be closed, and warning signs must be posted prohibiting the presence of unauthorized persons in the work area. 3.5.8. The parts removed during repairs must be placed in pre-selected places, firmly and stably laid using pads. Round parts are laid using stops. 3.5.9. It is not permitted to install removed parts near operating equipment. Free passages and working areas necessary for carrying out repair work must be left near the equipment being repaired. 3.5.10. The opening of shields and hatches of the engine crankcase after stopping it should be carried out with a time delay specified by the manufacturer. It is possible to work in the crankcase after stopping the engine only after preliminary forced ventilation. 3.5.11. When performing work on the engine crankcase, safety signs must be posted in visible places: “DO NOT TURN ON! PEOPLE WORKING.” The same safety signs must be posted on the clutch engagement levers for two motors operating on the same shaft. 3.5.12. It is prohibited to be in the crankcase well when performing work related to processing and fitting bearings on the beds and journals of the crankshaft while turning it. 3.5.13. After removing the covers and removing the pistons and movement parts, all openings in the cylinder blocks must be covered with durable shields. 3.5.14. The crankshaft must be lifted by a team of riggers and mechanics under the guidance of a foreman according to a pre-developed scheme. It is prohibited to stand in the engine crankcase while the crankshaft is being raised. 3.5.15. When assembling crank, head bearings and yokes, the gaskets should not protrude. Bearings and other parts should not have sharp corners or cotter pins protruding beyond the nuts. 3.5.16. When performing work on pressing out shafts, gears, bushings and other parts, the drift must be supported with special devices or forging tongs. It is prohibited to support the drift with your hands. Do not press out or press in loose parts. 3.5.17. When working on crimping mechanisms and parts, the following safety requirements must be observed: (01) all equipment must be in good condition, control pressure gauges have been tested, pressure testing hoses and fittings on them must not have defects; (02) plugs used for crimping must be securely fastened with bolts or clamps, the plugs must have proper threads; (03) when crimping a mechanism or part with high pressure (100 kg/sq. cm), the object and the crimping hose must be covered with a tarpaulin at a pressure above 150 kg/sq. cm. cm the object should be located behind the partition; (04) After crimping a mechanism or part, you must first relieve pressure using the bypass valve, and then proceed to remove the plugs. 3.5.18. The opening of the turbine must be carried out in the presence of the ship's chief engineer and the plant foreman. 3.5.19. It is prohibited to use inappropriate or worn tools when disassembling and assembling individual turbine components. 3.5.20. After removal from the turbine, the rotor must be placed on special trestles or strong stands, which must be securely installed and secured to the flooring. If there is a danger of the vessel rocking or hitting the hull, the rotor should be left on the trestles supported by the hoists. 3.5.21. During the process of opening (assembling) the turbine, measures must be taken to prevent foreign objects from getting into the nozzle boxes, pipes (into the internal cavities of the units being closed). Storing unused parts and tools at the workplace is not allowed. Welding, cutting and cleaning of parts should not be carried out near the turbine. 3.5.22. Before starting installation work on the boiler fittings of steam boilers, it is necessary to check the disconnection of steam lines and other systems from the operating boiler. 3.5.23. When flaring boiler pipes, you must use safety glasses. 3.5.24. Upon completion of installation of the boiler, there should be no foreign objects left in the collectors and pipes, as well as in other places of the boiler. The hole covers should be closed in the presence of a specialist. 3.5.25. Only electricians are allowed to connect portable machines to the electrical network (on ships, ship electricians). If the electrical equipment is faulty, you must call an electrician. It is prohibited to fix the malfunction yourself. 3.5.26. Work near electrical wires, cables and live parts of machinery is carried out only after they have been de-energized or a fence has been installed. 3.5.27. Before dismantling a mechanism driven by an electric motor on a ship, it is necessary for the ship's electrician to turn off the power supply to the main panel, remove the fuses (fuses) and install a safety sign: "DO NOT TURN ON! PEOPLE WORKING." 3.5.28. The mechanic is prohibited from touching general lighting fittings, broken electrical wires, terminals and other live parts, opening the doors of electrical distribution cabinets (panelboards), removing fences and protective covers from live parts of equipment. 3.5.29. When near oxygen cylinders, you should not touch them with hands contaminated with oil or allow oil to get on them, since the combination of even a small amount of oil (fat) with oxygen causes an explosion. 3.5.30. When working together with an electric welder, you must wear safety glasses with special lenses. You cannot look at the electric arc. 3.6. Safety requirements for washing parts 3.6.1. You can turn the pumping unit of the washing machine on and off only with the chamber doors closed. 3.6.2. When the washing machine is operating, its ventilation unit must be turned on. 3.6.3. Opening and closing the steam bath should be done slowly, without jerking. 3.6.4. Parts installed on the loading platform of the washing machine should, if necessary, be supported by supports to prevent them from tipping over. 3.6.5. When washing parts, the use of leaded petroleum products, flammable liquids, carbon tetrachloride and other dangerous or harmful solvents is prohibited. 3.7. Safety requirements for testing mechanisms and pipelines 3.7.1. Only specially trained persons who know the rules of their operation are allowed to participate in testing engines and mechanisms. Persons who have a certificate for the right to carry out this work are allowed to service mechanisms when tested on a bench. 3.7.2. During the period of testing of mechanisms, access of unauthorized persons to the engine room of the vessel or to the stand premises must be stopped and safety signs must be posted: “ENTRY IS PROHIBITED.” 3.7.3. Before starting up the mechanisms after installation, their serviceability, the presence of guards for moving parts, as well as the presence of platforms and ladders must be checked. 3.7.4. Before turning shafts and main mechanisms, it is necessary to thoroughly inspect the crankcases, bearings, gears, foundation frames and structures, and also ensure that there are no foreign objects in the crankcase. 3.7.5. When performing a test run at idle, the mechanisms can only be turned on as directed by the foreman. Before starting the mechanisms, you must warn others about this. 3.7.6. In preparation for testing, the air valve must remain open while the boiler is being filled with water. Filling a cold boiler with warm water should be done slowly. 3.7.7. To test pipelines, the release of water, steam or air must be carried out as directed and under the supervision of the work manager and the ship's administration. 3.7.8. Elimination of defects discovered during testing of seacocks on ships docked can only be done after the pressure has been relieved. 3.7.9. When testing on the bench, it is prohibited:
3.7.10. When hydraulic testing pipelines (products), air or water must be released using a discharge tube and through a tap placed on the plug of the free end of the pipe (product). 3.7.11. During the test, it is prohibited:
Flange connection leaks can be repaired after the pressure in the system has been reduced to atmospheric pressure. When testing pipelines, the pressure should be increased gradually to avoid hydraulic shocks and ruptures. After completion of pipeline testing, the pressure must be reduced to atmospheric pressure, and the pipeline must be disconnected from the test medium main. 4. Labor protection requirements in emergency situations 4.1. When the carbon dioxide fire extinguishing system is activated in the ship's spaces (when sound and light signals are turned on), all persons must immediately leave these spaces. 4.2. In all cases of detection of a fire or its signs (smoke, burning smell), damage to technical equipment or other danger, the mechanic must immediately report to the work manager and leave the danger zone. 4.3. In case of ignition of flammable substances, it is necessary to use a fire extinguisher, sand, earth, or cover the fire with a tarpaulin or felt. It is prohibited to pour water on burning fuel or electrical equipment that has not been switched off. 4.4. If the lighting suddenly turns off, you must wait for it to turn on. It is dangerous to move around in unlit areas of the vessel. 4.5. If you detect the slightest signs of poisoning or irritation of the skin, mucous membranes of the eyes, or upper respiratory tract, you must stop working, inform the foreman and contact the first aid station. 5. Labor protection requirements at the end of work 5.1. Upon completion of the work, the locksmith must: (01) remove tools, equipment, work materials and personal protective equipment to their designated places; (02) close all hatches, openings, clean the workplace, where possible - remove temporary fences and safety signs, remove wires for portable lighting and power supply for power tools; (03) ensure that none of the workers are accidentally left in the ship's premises; (04) put overalls and safety shoes in a personal closet for overalls, in case of contamination of overalls, hand it over for washing (replace); (05) 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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