Temperature injury. Health care

FUNDAMENTALS OF FIRST AID
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Temperature injury. Health care

Fundamentals of First Aid (OPMP)

Temperature injury It is subdivided into burns and frostbite when it comes to the direct effect of high (more than +45°C) and low (usually below 0°C) temperatures on the skin, as well as overheating (heat stroke) and hypothermia, when there is a violation of thermal body balance under the influence of adverse external temperature conditions.

Burns

The severity of burns is determined by the area, as well as the depth and nature of the lesion. With burns of the II degree and deeper with a lesion area of more than 50% of the body surface, there is a serious threat to the life of the victim.

The depth of the lesion has four degrees:

I degree - redness and swelling of the skin, acute pain.

II degree - redness and swelling of the skin, the formation of blisters due to delamination or exfoliation of the epidermis, filled with a yellowish liquid.

III degree - the appearance of blisters with jelly-like contents, some of the blisters are destroyed, necrosis of the epidermis and dermis with the formation of a dark red or dark brown scab. At the third degree "a" the dermal layer of the skin dies partially, at the third degree "b" - completely.

IV degree - the skin and deeper tissues (fiber, muscles, blood vessels, nerves, bones) are completely affected. There is often charring.

The area of burns is determined by the rule of the palm, the surface of which is 1% of the surface of the body.

Extensive burns are accompanied by a number of severe complications:

pain shock;
loss of blood plasma through the burn surface and with it proteins, salts, which leads to dehydration of the body and thickening of the blood;
intoxication of the body with products of thermal decomposition of tissues on the burned surface;
the addition of a pyogenic infection, which subsequently significantly complicates the healing of burns.

First aid for burns is based on the possibility of quickly eliminating the effects of the thermal factor itself and combating complications. To do this, the victim must be quickly removed from the affected area, then extinguish the burning clothing with a large piece of dense fabric, a jet of water, sand, earth, snow. The victim can put out the fire by rolling on the ground. After the burning stops, the clothes are removed or cut off from the affected areas of the patient's body, the adhering areas of the clothes are not cut off, but cut off along the edges of the burn and left. Immediately begin to cool the burn surface to prevent the destructive effect of heat.

Cooling is carried out using cold by any means available in a particular situation (running water, blisters with water, ice, snow, frost), burn blisters are not opened or pierced. An aseptic dressing is applied to the burn surface. In case of burns of the limbs, immobilization is carried out. The victim is prescribed painkillers (analgin, citramon, aspirin, if available - promedol), let's say alcohol in a dose of 50-75 ml. The burned person should be given plenty of liquid to drink - tea, mineral water, juice, plain water, a prepared solution - ²/z teaspoon of soda and a teaspoon of table salt per liter of water. The patient needs to ensure maximum peace, with chills - carefully wrap.

Heatstroke

Heat stroke is a consequence of a violation of thermoregulation in the body. The disease manifests itself after a long (several hours) stay in an atmosphere of warm and humid weather, after heavy physical exertion at high temperatures, after prolonged (4-8 hours) exposure to direct sunlight on the head or naked body. Symptoms: fever, chills, fatigue, headache, dizziness, redness of the skin, increased heart rate and respiration, nausea, profuse sweating. Further deterioration of the condition may manifest itself in an increase in body temperature up to 40 ° C, weakened shallow breathing, a sharp increase in the pulse of weak filling, convulsions, loss of consciousness.

First of all, first aid consists in stopping the effect of the thermal factor (it is necessary to move the patient to a shade, cool room), cooling the body (primarily the head) with cold compresses, ice, dousing with water, wet wrapping, blowing the body with a stream of air, cold drinking. Rest is shown, the position of the body is lying with a raised head or sitting. Chilled coffee and tea are given to stimulate cardiovascular activity with a weak pulse and a drop in blood pressure.

Frostbite

Frostbite occurs with prolonged exposure to cold at temperatures below 0°C. Frostbite is promoted by tight, damp shoes, prolonged immobility, forced decreed stay in the cold (ski trip, mountaineering, extreme situations), uncontrolled stay in the cold (deviant states - alcohol intoxication, drug addiction).

Frostbite has four degrees of severity. However, it is possible to establish the degree of frostbite only after the latent (pre-reactive) period has elapsed.

All degrees of frostbite in the latent period (12-14 hours) look the same - pallor of the skin (vasoconstriction) and decreased sensitivity. The picture of frostbite in the reactive period is outwardly similar to burns.

First aid is to stop exposure to cold and restore blood circulation. When staying in the air and inability to hide from the cold, the frostbitten place is protected with warm cloth, a scarf, a woolen sweater, warm gloves, socks or a bandage with cotton pads.

In a warm room, frostbitten parts of the body are warmed for 40-60 minutes in a container with water, the temperature of which rises from 20 to 40 ° C. At the same time massage in circular motions. After warming, the affected areas are smeared with an alcohol tincture of iodine, a dry or semi-alcohol compress is applied and bandaged. Give hot tea, coffee, milk, warm food, alcohol, warmly wrap. If frostbite is shallow and there are no conditions for a bath, you can limit yourself to a circular massage using soft wool until blood circulation is restored. In no case should you rub it with snow.

Body hypothermia

Hypothermia occurs as a result of a person's prolonged stay in cold conditions, when heat transfer to the external environment is greater than heat production in the body. Hypothermia is promoted by bad clothes, wet clothes, wind, cold, physical inactivity, alcohol intoxication. Hypothermia in water with a low temperature is especially dangerous, since water has a much higher thermal conductivity than air (Table 5.2). Progressive hypothermia leads to a decrease in body temperature, which, upon reaching 30-28 ° C, may become uncontrollable. At a body temperature of about 28°C, a person loses consciousness, at a temperature of 24-20°C, cardiac arrest occurs.

First aid is aimed at warming the human body, for which a variety of methods are used. If there are conditions, a person is placed in a bath with a water temperature of 36-37 ° C for 1-1,5 hours, or they are surrounded by heating pads with hot water, electric blankets, and placed next to a heat source. After warming up, hot tea, coffee, alcohol is recommended. It is important to remember that eating, tea, coffee before or during warming is not recommended. Alcohol can also be used after warming up, if the person remains warm and does not subsequently find himself in cold conditions. If there are no heat sources in the room, you should change wet clothes, or put on additional dry clothes, or use the warmth of another person by close contact with the victim’s body using a general heat-insulating cover (blankets, mattresses, warm dry clothes).

Table 5.2. Tolerance of cold water by the body (everyday clothes)

Author: Mikhailov L.A.

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