Advice(Councils) on the pre-medical help in a hike
Necessity of rendering of a medical care for a ski hike is bound to a frigorism of an organism and traumas as a result of falls more often.The cold and strong wind can become the reason of a freezing injury(frostbite) and freezing which serious consequences, down to destruction, are possible(probable) not only at low temperatures, but also at 0 and even a little bit above. Freezing injuries(Frostbites) often cause humidification of clothes and footwear, disturbance of a circulation because of close footwear, hard shnurovki, pullings of a foot by belts of the cats, hardly fastened tapes bahil, a garrot or a compressing bandage. The most widespread reason - the frozen footwear or deformation a boot as a result of negligent drying at a fire, and also transferred(carried) before a freezing injury(frostbite).
Depression of the general(common) body resistance can come(step) as a result of the weakened(easied) delivery, absence of hot nutrition and vitamins, diseases, mental depression. It also promotes freezing injuries(frostbites) and freezing of an organism.
Distinguish four degrees of freezing injuries(frostbites).
The first degree is shown normally in a blanching or an erubescence, an edema, a tumescence of the freezed site, sensation of a burning sensation and a pain. Recoolings of extremities, oznoblenija, are considered as a chronic freezing injury(frostbite) of the first degree. On oznoblennyh sites the skin reddens more strongly and bubbles are easily formed.
The second degree of a freezing injury(frostbite) is characterized by deeper, than at the first degree, a circulatory disturbance, blue discoloration and a cutaneous dropsy. In some hours after warming there are bubbles with transparent, sometimes krovjanistym the maintenance(contents),
At the third and fourth degree of a freezing injury(frostbite) there is a necrosis of a skin, a hypodermic fat, partially muscles, tendons and knuckles. The skin becomes cold, tolerant to touches and nyxes. The maintenance(contents) of bubbles is colored in krovjanistyj color. Process of delamination of the devitalized sites can be accompanied by a pyesis.
Prophylaxis of freezing injuries(frostbites) begins long before a hike and consists in correct selection of clothes and footwear and their preparation for a hike, and also in mastering by practical skills of the prevention(warning) and treatment of freezing injuries(frostbites) in marching conditions. It is not recommended to wrap a leg(foot) a paper: she frays, rolls down(frays, slides) in lumps that causes natiranie and promotes freezing injuries(frostbites). It is necessary to refuse also greasing legs(foots) by fatty contents as they interfere with vaporization of sweat and enlarge humidity of a skin.
Boots before to put on them, it is necessary to warm up at a fire or above a flame of a kerosene stove and carefully to knead, that they did not cool(refrigerate) and did not compress a foot. Toes(socks) also should be warm. Mittens should be thrust under a jacket (for a girdle of trousers), and before putting on - to warm respiration. In a strong frost and a wind it is necessary to cover the face fur of a hood, a mask or a scarf, more often to examine each other. If necessary rendering assistance on a wind it is necessary from skis and polyethylene (tent) to build a barrier for covering the victim and group.
Rendering assistance at freezing injuries(frostbites). pobelevshie cheeks, it is recommended to pound(triturate) a nose and ears a pure(clean) arm(hand) or warm down varezhkoj before occurrence of an erythema and sensitivity of a skin. To pound(triturate) the freezed places of a skin a snow it is impossible, as he cools(refrigerates) a tissue even more and puts(renders) the smallest scratchs in which germs can get. Sogretyj it is necessary to cover a site a dry bandage or a scarf.
The freezed extremities should be warmed and massed up to porozovenija and findings of sensitivity of a skin with simultaneous movement by fingers. If contusion does not bring the desirable result, the freezed extremities get warm under a sweater on a body of comrade. To this way normally resort during rises and draining offs on complex(difficult) slopes when it is impossible to establish(install) tent and to dissolve a fire. In a wood zone the freezed extremities is better to warm at a fire.
If all these measures do not help(assist), it is necessary to put quickly tent and to warm the freezed leg(foot) (arm(hand)) in warm water. As a tray(basin) it is possible to use some polyethylene saccules or one of cooking buckets. In the beginning the temperature of water should be no more 20o. The next 20-30 minutes it(her) lead up up to 37-38o. Warming in water needs to be combined with E light(mild) massage, contusion and movement by fingers, After restoration of a circulation the skin should be wiped dry, obteret alcohol and to impose a dry bandage. Fingers normally bandage together. It is not necessary to slush the freezed sites an iodine and other color solutions, and also Adeps.
The help rendered before display of attributes of a freezing injury(frostbite) (right after disappearances(eradications) of a pain and occurrence of a numbness), often in general prevents its(his) development. If the pounded(triturated) site of a skin gets cyanotic painting that testifies to incomplete restoration of the circulation which have suffered in order to prevent serious consequences it is necessary to deliver more quickly whenever possible in hospital.
If the freezing injury(frostbite) is found out with delay - during warming when there is a puffiness and bubbles, - it is impossible to do(make) massage and contusion. In this case it is necessary a gauze (cotton) moistened by alcohol, to wipe a skin and to impose a dry sterile bandage the Further treatment it is made only by the doctor.
Freezing comes at a long and intense cold as a result of which the body temperature falls up to hazardous limits. Most often the tourists who have appeared in private with snowstorm, a strong wind and a frost are exposed to freezing. The reasons of freezing also can become an immovability (a dream on a frost, a finding in an avalanche or a crack), a morbid state, traumatic damages.
Attributes of freezing (distinguish their three degrees) - a temperature loss of a body up to 32-30o and below, dropping of pulse till 65-38 impacts in minute, feeling of weariness, weakening of memory, a sleepiness, cyanotic painting of a skin. Disturbance of a rhythm of work of heart and respiration, loss of the consciousness, the freezed extremities not giving in to a violent extension testify to the most serious form of freezing.
At immediate rendering assistance it is possible to count on success of homing of the person by a life. The basis of it(this) is fast warming and intense contusion. In light(mild) events of cooling (the person is in consciousness, there are no freezing injuries(frostbites)) sometimes there is enough a general(common) warming and acceptance of hot tea or a broth.
For rendering assistance frozen it is necessary to put tent quickly. At absence of an oven to heat up tent it is possible burning in a bowl alcohol. With this purpose hot coals from a fire, nasypannye in cooking buckets or on duralumin sheets are used also. The victim is desirable for putting on an eminence from backpacks or on a couch from skis and other improvised agents, to impose with self-made heaters, the body follows obteret alcohol and to begin contusion. It is necessary to cover the sites of a body pounded up to red discoloration progretymi with sweaters and jackets. With the advent of mobility in knuckles of an arm(a hand) and a leg(foot) it is necessary cautiously, without special efforts to incurvate and unbend, continuing their contusion.
The victim brought round should be given a drink hot tea or a broth, to give cardiacs. If at sogretom a body the victim does not come to consciousness, he needs to allow to smell vatku, moistened by ammonia solution.
At absence of respiration the victim should do(make) artificial respiration, not stopping contusion and heating.
Rendering assistance taken of an avalanche normally consists in restoration of respiration, intimate(cardiac) activity and liquidation of consequences of freezing.
Fig. 110. Artificial respiration: and - by means of a S-shaped artificial airway; - « a mouth in a mouth »; in - an indirect cardiac massage.
Artificial respiration (fig. 110, and,) is spent in such sequence:
1) to lay victim on back with arms(hand) extended along a trunk, to clear respiratory ways of a snow and to release(exempt) a thorax from belts and bindings;
2) to throw back the head, one arm(hand) to delay a mandible, and another to clip a nose. In case of a retraction of tongue to extend it(him) and to keep fingers;
3) to make the maximal inspiration and, having nestled labiums to the open mouth of the victim to insufflate in it(him) air up to raspravlenija a thorax then to take away a mouth from labiums of the victim and to stop to squeeze to him a nose. In a minute it is necessary to do(make) from 15 up to 20 insufflations. At damage of a mandible the insufflation is made through a nose.
Absence of pulse and neproslushivanie heart beat testifies to its(his) stopping. The indirect cardiac massage which is made so is necessary: having risen sideways from the victim to put one palm on bottom (the part of a breast bone, and another - from above the first, is closer to the bottom part of a breast bone, with force (all gravity of a body) to compress approximately on 4-5 sm a breast bone in a direction of a vertebrae, on polsekundy to fix(record) this position and sharply to weaken(easy) pressing (fig. 110. Movements should be repeated with a rhythm about 70 pressings in a minute. The wave will testify to sufficient force of pressing on a carotid artificial pulsovaja. If after 2 hours of artificial respiration and a cardiac massage independent respiration and intimate(cardiac) activity are not restored, rendering assistance can be stopped.
The most frequent in a ski hike a trauma - a stretching of ligaments(cords) - is defined(determined) on a tumescence and morbidity of a knuckle saving mobility. It is necessary to slush the damaged(injured) knuckle an iodine and to impose a pressure bandage (for the night it(she) can be taken out).
Catarrhal diseases (tracheites, bronchites, anginas) are accompanied by the raised(increased) temperature, headaches, the general(common) delicacy. Besides at anginas are observed red discoloration of a throat and zatrudnennost swallowings, and at tracheites and bronchites - hoarse tussis, all over again - dry, then - with a sputum. For treatment of acute forms of illnesses(diseases) it is necessary to stop, sometimes even for some days. Treatment: warm(warmly), a gargle, hot milk with soda, reception of Norsulfazolum (Sulfadimezinum, Sulfadimethoxinum) in the first day on 2 tablets of 4-6 times, in the subsequent - on a tablet. From antibiotics - Tetracyclinum (Vitacyclinum, Oletetrinum), erythromycin in the same dosages.
The marching first-aid set on 6-8 person: bandage narrow, average and wide on 8 pieces, a gauze of 5 m, cotton 50 g, an adhesive plaster wide and narrow on one reel, alcohol 300 g, tincture of an iodine 25 g, fining agent Áô-6 a collapsible tube, sintomitsinovaja an emulsion 50 g, Novocainum of 5 ampoules (0,5-2 %-s' solution), Norsulfazolum, Sulfadimethoxinum, Sulfadimezinum of 10 packings on 10 tablets (on 0,5), Tetracyclinum (Vitacyclinum) of 50 tablets, Aspirinum, Analginum, Pyramidonum (Amidopyrinum), Besalolum, a synthomycin (levomitsitin, Ftalazolum), Enteroseptolum - on 20 tablets of each medicine, Purgenum of 10 tablets.
P.I.Lukojanov Winter sports hikes.